QbD-Assisted Development and Optimization of Doxycycline Hyclate- and Hydroxyapatite-Loaded Nanoparticles for Periodontal Delivery.

The current research aims to develop a carrier system for the delivery of a matrix metalloproteinase (MMP) inhibitor along with a bioceramic agent to the periodontal pocket. It is proposed that the present system, if given along with a systemic antibiotic, would be a fruitful approach for periodontitis amelioration. To fulfill the aforementioned objective, a doxycycline hyclate- and hydroxyapatite-adsorbed composite was prepared by a physical adsorption method and successfully loaded inside sodium alginate-chitosan nanoparticles and optimized based on particle size and drug content. Optimized formulation was then subjected to different evaluation parameters like encapsulation efficiency, hydroxyapatite content, ζ potential, surface morphology, in vitro drug release, cell line studies, and stability studies. For the optimized formulation, particle size, polydispersity index (PDI), entrapment efficiency, ζ potential, and drug content were found to be 336.50 nm, 0.23, 41.77%, -13.85 mV, and 14.00%, respectively. The surface morphology of the placebo and adsorbed composite-loaded nanoparticles as observed by scanning electron microscopy (SEM) and transmission electron microscopy (TEM) revealed the spherical shape and rough surface of the particles. In gingival crevicular fluid (GCF) 7.6, a sustained drug release profile was obtained up to 36 h. In vitro % viability studies performed on murine fibroblast cells (NIH3T3) and human periodontal ligament (hPDL) cell lines confirmed the proliferative nature of the formulation. Also, when subjected to stability studies for 4 weeks, particle size, PDI, and drug content did not vary considerably, thereby ensuring the stable nature of nanoparticles. Henceforth, sodium alginate-chitosan nanoparticles appeared to be a good carrier system for doxycycline hyclate and hydroxyapatite for periodontal therapy. If given along with a system antibiotic, the system will serve as a fruitful tool for infection-mediated periodontal regeneration and healing.

Comparison between Platelet-rich Fibrin and Saline Filling after Sinus Elevation without Adjunctive Bone Graft in Dental Implants Insertion Using CBCT.

AIM: The goal of this research was to compare radiographically the outcomes of hydraulic transcrestal sinus lifting with platelet-rich fibrin (PRF) or normal saline filling on implant survival rates, negative outcomes, and variations in the height of residual alveolar ridge (HARB). MATERIALS AND METHODS: There were 80 study participants included and 90 dental implants were placed. The study participants were divided into two categories: Category A and Category B. Each category consists of 40 study participants. Category A: Normal saline was placed in the maxillary sinus. Category B: PRF was placed in the maxillary sinus. Implant survival, complications, and HARB alterations were the outcome metrics. Radiographic images through Cone-beam computed tomography (CBCT) were retrieved and compared prior to surgery (T0), immediately following surgery (T1), three months later (T2), 6 months later (T3), and 12 months later (T4). RESULTS: There are 90 implants having an average length of 10.5 ± 0.7 mm were inserted into the posterior portion of the maxilla of 80 patients with an average HARB of 6.9 ± 1.2 mm. At T1, elevation in HARB peaked, and the sinus membrane continued to droop but steadied while observed at T3. The steady increment of areas of radiopacities was noticed below the elevated membrane of the maxillary antrum. A radiographic intrasinus bone increase of 2.9 ± 1.4 mm was caused by the PRF filling, compared to 1.8 ± 1.1 mm by the saline filling at T4 (p < 0.05). Over the course of the one-year follow-up period, all of the implants were operating normally with no major issues. CONCLUSION: Platelet-rich fibrin when used as a filling medium alone without bone graft can cause significant ascend in height of the residual alveolar bone (HRAB). CLINICAL SIGNIFICANCE: The degradation of the alveolar bone under the maxillary sinus following tooth loss frequently restricts the placement of the implant in the edentulous region of posterior maxilla. Numerous sinus-lifting surgery procedures and tools have been developed to address these problems. It has been a topic of debate regarding the benefits of bone grafts placed at the apical region of the implant. The sharp protrusions of the granules of bone graft may also provide a danger of membrane puncture. Recently, it was shown that regular bone gain might occur inside the maxillary antrum without the use of any bone transplant material. Additionally, if there were substances that filled the gap between the floor of the sinus and the raised sinus membrane, then the membrane of the maxillary sinus could be raised greater and for a longer period of time during the phase of formation of new bone formation.

Comparative Evaluation of Bioactive Glass Putty and Platelet Rich Fibrin in the Treatment of Human Periodontal Intrabony Defects: A Randomized Control Trial.

INTRODUCTION: Platelet-Rich Fibrin (PRF) and bioactive glass putty have been shown to be effective in promoting reduction in probing depth, gain in clinical attachment, and defect fill in intrabony periodontal defects. The individual role played by bioactive glass putty in combination with PRF is yet to be elucidated. AIM: To compare the clinical effectiveness of the combination of PRF and bioactive glass putty and bioactive glass putty alone as regenerative techniques for intrabony defects in humans. MATERIALS AND METHODS: Ten pairs of intrabony defects were surgically treated with PRF and bioactive glass putty (Test group) on one side or bioactive glass putty alone (Control group) on other side. The primary outcomes of the study included changes in probing depth; attachment level and bone fill of osseous defect. The clinical parameters were recorded at baseline, 3, 6, and 9 months. Radiographic assessment was done using standardized intraoral periapical radiographs. Differences between baseline and postoperative measurementsbetween the control and test groups were calculated using independent t-test. Comparisons were made within each group between baseline, 3 months, 6 months and 9 months using the ANOVA test followed by Bonferroni test. RESULTS: The mean probing depth reduction was greater in the test group (bioactive glass putty and PRF) i.e., (3.2±2.3 mm) than in the control group (bioactive glass putty alone) i.e., (3.15±1.06 mm). The mean CAL gain was also greater in the test group (4.1±1.73 mm) as compared to the control group (3.15±1.06 mm), (p-value<0.95). Furthermore significantly greater mean bone fill was found in the test group (7.1±1.37 mm) as compared to the control group (5.7 ± 1.64 mm), (p-value<0.043). CONCLUSION: The results of this study showed both the groups bioactive glass putty alone (Control Group) and the combination of PRF and bioactive glass putty (Test Group) are effective in the treatment of intrabony defects. The bioactive glass putty appears to be a suitable vehicle to administer biologic substances like PRF and growth factors to induce the new bone regeneration.