Innovations in Periodontal Treatments

Periodontic research holds promise for tangible developments that can change the face of clinical care. Active projects at Pitt Dental Medicine include studies on using magnesium devices for ridge augmentation and treatment of periodontal inflammation.

Insight into Ridge Augmentation

Ridge augmentation reshapes the jaw and gums to restore their natural contour. This procedure often is needed when bone loss in the jaw happens after normal tooth extraction. Magnesium device-based ridge augmentation being developed at the Pitt Dental Medicine has a number of advantages that set it apart from current clinical options. According to Dr. Pratiksha Amin, second-year periodontics resident at the Pitt Dental Medicine, these include fewer complications after surgery; increased stability for larger augmentations; and elimination of the need for a second surgery, 

“This would provide a safer, more predictable option for ridge augmentations,” Dr. Amin said. The mechanical properties of magnesium, she added, closely match those of bone and safely breakdown in the human body.

During in vitro studies, Dr. Amin continued, exposing cells to magnesium promotes rapid reproduction and expression of bone-producing markers. When magnesium devices are surgically placed over the grafted area, they hold the graft in place until it turns over to bone. Once their job is complete, the devices degrade through a process called biocorrosion, eliminating the need for an additional surgery to remove the devices.

“Hopefully, many commercially available products will come out of this: magnesium resorbable members, fixation screws, digitally-designed and 3-D printed membranes, to name a few.”

Alternative Therapy to Decrease Inflammation Response

Another periodontal intervention Pitt Dental Medicine researchers are investigating offers an alternative to scaling and root planing—the conventional treatment for periodontal inflammation. This method uses small, anti-inflammatory protein molecules encapsulated in polymer microspheres to attract specific immune cells to the troublesome sites. 

When locally injected in periodontal tissues, these polymer microspheres start degrading and slowly release the encapsulated proteins, which in turn, send a message to the immune system to modulate inflammation. 

Pitt researchers are revealing that this approach could stop much of the tissue destruction occurring during the course of periodontal disease.
Periodontal disease is provoked initially by oral bacteria. But the damage arising from it is usually the result of an overreaction of the body’s own immune response. Using these anti-inflammatory polymer microspheres can promote a healing response in a manner that current therapies do not offer.

“The major challenge about periodontal disease is that it is triggered by periodontal bacteria, but the actual damage that happens is caused by an overactive and uncontrolled immune response,” said Mostafa Shehabeldin, a student in the Pitt Dental Medicine Oral & Craniofacial Sciences PhD program.

"The local delivery of anti-inflammatory polymer microspheres offers a beneficial alternative to scaling and root planing, especially in cases where scaling and root planning alone fail to stop periodontal disease progression", he added. By halting the inflammation, these microspheres hold promise for preventing most of the tissue destruction caused by periodontal disease, which causes some individual’s inflammatory responses to go into overdrive.

“These are small peptide molecules that, when delivered in the periodontal environment, recruit and induce immune cells responsible for the resolution of inflammation and induction of reparative processes, thereby restoring normal tissue homeostasis.”

“Our approach aims at addressing the inflammatory component of the disease,” Shehabeldin said. “The long-term goal of this project is to translate this strategy into an FDA-approved therapy that will improve patient outcomes.”