Study on pathogenesis and treatment of periodontal disease which is focused in bone metabolism

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Fibroblasts derived from gingiva and periodontal ligaments showed osteoinductive properties ; regulation of osteoclast differentiation and life period (Kobayashi) and expression of osteoclastgenesis inhibitory factor (OCIF) in human periodontal ligament cells (Kurihara). It was also found that mouse clonal periodontal ligament cells expressed bone-related extracellular matrix proteins such as type-1 collagen, osteocalcin (OCN) and osteopontin (OPN) (Murakami)Lipopolysaccharide (LPS) is a potent pathogenic factor in periodontal diseases. LPS decreased bone nodule formation in rat calvaria cells and substance P, which is associated with mental stress, augumented the inhibitory action of LPS, suggesting that LPS and substance P influence in periodontal bone differentiation (Nagata). LPS-induced TNF-α factor (LITAF) was identified as a novel transcription factor in human monocytic cells and characterization of LITAF promoter revealed that a 34-bp sequence domain located from nucleotides -7 … More 6 to -43 in the promoter and this new sequence domain contributed the up-regulation of LITAF gene transcription (Myoukai). The receptors of calcitonin gene-related peptide (CGRP) expressed in immature osteoblastic human MG63 cells (Okuda). LPS promoted the survival of osteoclasts via Toll-like receptor 4, but cytokine production of osteoclasts in response to LPS is different from that of macrophages (Nishihara). Also, capsular polysaccharide from A.actinomycetemcomitans inhibited IL-6 and IL-8 production in human gingival fibroblasts (Nishihara)Macrophages are involved in both progression and resolution of apical periodontitis, and macrophages expressing TGF-β1 may play an important role in reducing the destructive mediators in periapical lesions and in the activation of new bone formation (Maeda). The combination of rhBMP-2 and barrier membrane had advantagees in producing and maintaining bone in the intended shape by inducing osteoblasts directly on the inner surface of the membrane (Irie). BMP-4, -5, -6 affected on DNA synthesis and expression of bone-related proteins in cultured periodontal ligament cells (Kurihara). Attachment of human periodontal ligament cells to enamel matrix-derived protein was mediated via interaction between bone sialoprotein (BSP)-like molecules and integrin αvβ3 (Maeno). Propeptide of type-1 procollagen (P1CP) in gingival crevicular fluid was a useful marker for bone turnover in periodontitis (Nagata). Stimulatory effect of low-level laser irradiation (LLLI) on bone formation was evaluated and the increased expression of osteoglycin gene by LLLI was associated with bone formation in concert with matrix proteins and growth factors (Abiko). Radiographic observation revealed that alveolar bone treated with flap operation was recovered after 10 years in severe destructive periodontitis (Yaegashi)Cycloxygenase-2 (COX-2) inhibitor not only inhibited the production of inflammatory bone-resorptive factors but also increased the production of OCIF (Kurihara). Matrix metaloprotease (MMP) administration inhibited alveolar bone resorption in hamster's experimental periodontitis (Nagata). Local administration of bisphosphonate also inhibited alveolar bone resorption in rats and dogs (Shibutani). Although statin did not increase alkaline phosphatase activity in human periodontal ligament cells, amount of IL-6 in culture medium of human gingival fibroblasts was decreased by statin, suggesting that statin has anti-inflammatory action as well as bone-forming action (Yamamoto) Less