The use of hyaluronic acid injection for treatment of black triangle and reconstruction of lost interdental papilla in anterior teeth: a systematic review.

OBJECTIVE: Non-surgical therapeutics to reconstruct lost interdental papilla are evolving; these include hyaluronic acid injection. The aim of this systematic review is to evaluate the efficacy, safety, and long-term outcomes of hyaluronic acid injection in the treatment of black triangles and reconstruction of lost interdental papilla in anterior teeth. MATERIALS AND METHODS: The protocol was registered in PROSPERO (CRD42023446875) and in accordance with the Cochrane Handbook of Systematic Reviews of Interventions and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 'PRISMA'. The search involved four databases, PubMed/MEDLINE, The Cochrane Library, Google Scholar, and ProQuest for ''grey literature' with additional manual search for studies published up to May 2024. Human clinical studies of a prospective nature (randomised clinical trials and prospective cohort studies) were included. Exclusion criteria were case reports, case series, review articles, letter to editor, personal opinion, and animal studies. Furthermore, studies which utilised hyaluronic acid injection in conjunction with other therapeutic material, tissue graft, or any surgical procedure were also excluded. The data were extracted independently by the two authors and incorporated after consensus. The risk of bias was assessed using the RoB2: the revised Cochrane risk of bias tool for randomised clinical trials and the Newcastle Ottawa scale for prospective cohort studies. RESULTS: 24 studies, 15 prospective clinical studies and nine randomised clinical trials, were included with a total of 898 interdental papillae injected with hyaluronic acid. The studies showed promising outcomes in the reconstruction of lost interdental papilla with minimal adverse reactions. Risk of bias assessment among prospective clinical studies revealed 13 good quality studies with only two poor studies while the randomised clinical trials consisted of three with low, one with some concern, and five studies with high risk of bias. However, due to the high heterogeneity, a meta-analysis was not feasible.  Conclusion: Hyaluronic acid injection is an effective minimally invasive approach in treating black triangles and reconstructing lost interdental papilla in the anterior teeth. Further long-term well-designed randomised clinical trials employing standardised procedures are essential to validate this treatment and provide better quality of evidence.

The involvement of Kav001 in inhibition of LPS/P. gingivalis-induced.

TNF-a is an important cytokine mediator of inflammation which suggests that inhibition of TNF activity may provide potential for clinical application. Recent data indicated that treatment of both human and mouse cells with Kavain significantly modulates P. gingivalis- and LPS-induced TNF-α expression. In order to obtain a selective analog with optimized biological activity and structural physico-chemical properties of Kavain, Kavain analogs were designed and synthesized and found one Kavain analogue (named Kav001) that is similar to Kavain but soluble and does not induce a significant toxicity. Both studies in vitro and in vivo treatment by Kav001 showed stronger biological function as compared to Kavain. Furthermore, most mouse bone marrow macrophages up-regulated Bcl-6 while down-regulating LITAF expression after treatment with Kav001 for 36 h. Consequently, this led to an extension of macrophage pseudopods due to its immune response to P.g. infection/LPS stimulation.

Health Effects of Oral Contraceptives on Periodontal Disease and Gingivitis: A Cross-Sectional Questionnaire-Based Study Among Saudi Women in Jeddah.

Background: Sex hormones strongly influence the health and ailment of the oral cavity. For instance, a woman's oral health is influenced by her menstrual cycle, menopause, pregnancy, and usage of oral contraceptives. The use of various therapeutic medication results in intraoral alterations. Oral contraceptive pills (OCPs) are among the drugs that produce intraoral alterations. The study's objective was to evaluate attitudes and oral health conditions of Saudi women's utilizing OCPs in Jeddah, Saudi Arabia. Methods: A cross-sectional questionnaire-based study was conducted among Saudi women in Jeddah, Saudi Arabia. The self-administered questionnaire was made and sent to women to evaluate the attitude and oral health condition of women utilizing OCPs. The women using OCPs were asked to self-administer 17 questions to evaluate attitudes and oral health conditions. The questionnaire had multiple-choice questions and was consisted of four sections. Results: The number of participants who used contraceptives was 125 (35.9%) women; of them, only 94 (75.2%) used oral contraceptives. The duration of using oral contraceptives mainly was 1-5 years (39.4%), then > 5 years (34.0%), and <1 year (26.6%). Of the 94 women, 34 (36.2%) had gingival diseases, 23 (24.5%) treated their gums; and 13 (13.8%) cleaned their gums at a dental clinic regularly. Times of teeth brushing per day were one time in 32 women (34%), twice in 47 women (50.0%), and three times in 15 (16.0%). Of the 94 women, 4 (4.3%) were smoking, 24 (25.5%) took medication other than OCPs, and 16 (17.02%) had chronic diseases. Common oral complications noticed by participants were gum bleeding after brushing (51.6%), dental caries (25.5%), and oral ulcers (10.6%). Conclusion: Females on OCPs had a high rate of gingival bleeding, dental caries, and oral ulcers. OCPs users had poor periodontal and gingival health. Establishing an oral hygiene program was necessary to treat gingival and periodontal inflammation that exacerbated by OCPs.

The role of TNF-α induced protein 1 in the activation of pro-apoptotic proteins.

It is known that Porphyromonas gingivalis/lipopolysaccharide (P. gingivalis/LPS) induces inflammatory diseases via TNF-α-mediated transcription factors. Our recent data shows that TNFAIP1 (TNF-α induced protein 1) is related to TNF-α. However, little is known regarding how TNFAIP1 is involved in the TNF-α-dependent pathway. We therefore focused on the biological function of TNFAIP1 and examined how TNFAIP1 mediates TNF-α and other genes. We found that TNF-α was upregulated and peaks before the upregulation of apoptotic genes such as Bad, Bcl-x, Caspase 3, Catalase, Claspin, Cytochromic, Ho-1/HMOX1/HSP32, or MCI-1 in our time course with TNFAIP1-treated cells. Our findings here may serve as the foundation for future studies linking regulation of TNFAIP1 and intervention of inflammatory disease.