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Table of Contents
Year : 2022  |  Volume : 10  |  Issue : 1  |  Page : 17-19

Effectiveness of resolvins in treating periodontitis: A review

1 Department of Periodontics, Government College of Dentistry, Indore, Madhya Pradesh, India
2 Department of Conservative Dentistry, Government College of Dentistry, Indore, Madhya Pradesh, India
3 Department of Pedodontics and Preventive Dentistry, Hitkarini Dental College, Jabalpur, Madhya Pradesh, India
4 Department of Periodontics, Pacific Dental College and Hospital, Udaipur, Rajasthan, India

Date of Submission22-Feb-2022
Date of Acceptance03-Mar-2022
Date of Web Publication25-Mar-2022

Correspondence Address:
Dr. Manish Varma
Department of Periodontics, Government College of Dentistry, Indore, Madhya Pradesh.
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/INJO.INJO_5_22

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Periodontitis is a prevalent condition that affects more than 10% of individuals worldwide. Periodontitis may lead to tooth loss besides a worse quality of life in severe instances. Periodontitis has a complex etiology. In a vulnerable host, a subgingival dental biofilm provokes an inflammatory as well as immunological response, eventually leading to irreparable loss of the periodontium (alveolar bone as well as periodontal ligament). Dental practitioners must grasp the pathogenesis, main etiology, risk factors, contributing variables, together with therapy regimens in order to effectively manage periodontitis. Resolvins enhance inflammation resolution via a variety of ways, including limiting neutrophil penetration and phagocytosing apoptotic neutrophils to remove the lesion, in addition to improving inflammation clearance inside the lesion to endorse tissue regeneration.

Keywords: Inflammation, periodontitis, resolvins

How to cite this article:
Varma M, Vijaywargiya N, Ratre M, Khetrapal S, Rao A, Pal PC. Effectiveness of resolvins in treating periodontitis: A review. Int J Oral Care Res 2022;10:17-9

How to cite this URL:
Varma M, Vijaywargiya N, Ratre M, Khetrapal S, Rao A, Pal PC. Effectiveness of resolvins in treating periodontitis: A review. Int J Oral Care Res [serial online] 2022 [cited 2022 May 25];10:17-9. Available from: https://www.ijocr.org/text.asp?2022/10/1/17/340919

  Introduction Top

Periodontal disorders are regarded as infectious processes that need the presence of bacteria and a host response, as well as other local, environmental, and genetic variables that influence and modify them. Periodontal infection is a complicated multiphase illness due to its association with organ systems such as the cardiovascular, endocrine, reproductive, and respiratory systems. Inflamed periodontal tissues release large levels of proinflammatory cytokines, comprising inflammatory cytokines such as interleukin (IL)-1, IL-6, as well as IL-8, which are prevalent in diseased periodontal tissues and seem to have a role in chronic leukocyte recruitment and tissue death.[1],[2],[3],[4],[5] A local innate immune response to the microorganisms of the dental biofilm is the prime source of acute periodontal disease. Toll-like receptors on gingival epithelial cells identify bacterial cell components and produce IL-1 and tumor necrosis factor-α. Bacteria and bacterial metabolites may also infiltrate the tissues under the skin. They interact with fibroblasts and dendritic cells in this area. Proinflammatory cytokines are also produced by these cells. Resolvins (Rv) enhance inflammation resolution via a variety of ways, including limiting neutrophil penetration, phagocytosing apoptotic neutrophils to remove the lesion, in addition to improving inflammation clearance inside the lesion to endorse tissue regeneration.[6],[7],[8]

  Resolvins in Inflammation Top

Docosatrienes which are new lipid mediators generated from docosahexaenoic acid (DHA), a prevalent omega-3 fatty acid in brain tissues, in addition to 17S series resolvins (Rv), have been proven to be anti-inflammatory in addition to tissue protecting. Phagocytes, even though designed to protect the host, may exacerbate damage by releasing proinflammatory mediators. This helps to understand the pathogenesis of a variation of clinical as well as chronic inflammatory disorders. Acute inflammation, in addition to its prompt resolution, is important in the body’s reaction to trauma, tissue damage, ischemia–reperfusion therapy, together with surgical procedures, plus in microbial host defense. Eicosanoids, notably classic prostaglandins (PGs), and leukotrienes (LT) are lipid-derived mediators that play a key role in orchestrating inflammation.[9],[10] Within the innate acute inflammatory response, they are autacoids or local-acting mediators. To suppress PG production, non-steroidal anti-inflammatory medications such as aspirin as well as cyclooxygenase inhibitors (both COX-1 and COX-2) are utilized. LX, aspirin-triggered 15-epi-lipoxins, Rv, docosatrienes, together with neuroprotectins, offer therapeutic promise in controlling inflammation along with illnesses due to their primary pathways and biological activities. The local response to acute inflammation is an active, not passive, process that sets in motion certain biochemicals in addition to cellular resolution mechanisms.[11],[12],[13] The first “pro-resolution” route contains Rv, which are endogenous lipid mediators with anti-inflammatory as well as pro-resolution effects. In addition, docosatrienes, which are lipid mediators derived from DHA, an ample omega-3 fatty acid in cerebral tissues, have been demonstrated to be anti-inflammatory together with tissue protecting.[14],[15],[16],[17],[18]

  Systemic Effects Top

Lymph nodes have recently been shown to create 17-HDHA, which boosts antibody production, in addition to the D-series Rv along with metabolome, these are also found in other lymphoid tissues of the animal, including the spleen. As a result, it is probable that, in addition to their involvement in returning acute inflammation to equilibrium and avoiding chronicity, specific pro-resolving mediators actively participate in acquired immunity. Despite the fact that the levels of n-3 essential fatty acids (e.g., eicosapentaenoic acid [EPA], DHA) along with n-6 (e.g., arachidonic acid) in mouse tissues differ from those in human tissues, there is even now a widespread belief that n-3 fatty acids, for example, DHA, play an imperative role in human health as well as disease prevention, together with cardiovascular disease.[19]

  Periodontal Disease and Resolvins Top

The bioactive local mediators or autacoids need enzymatic synthesis from the omega-3 essential fatty acids EPA to resolve inflammatory exudates in vivo, besides having significant stereoselective biological activities. They were given the name RvE series, which was derived from EPA.[20] RvD series refers to those produced from DHA. Periodontal disease (PD) refers to the other family of bioactive chemical signals derived from DHA (i.e., docosanoids, oxygenated DHA derivatives), which have a conjugated triene double-bond system in their structures. In vivo, the PD have anti-inflammatory as well as neuroprotective properties.[21]

Oxygenated molecules generated from omega-3 polyunsaturated fatty acids such PGs along with LT (LT B5) were discovered to be significantly less effective or altogether devoid of bioactivity than their AA-derived equivalents. Rv and PD are natural exudate products that elicit biological responses in the nanogram range in vivo. Rv (resolution-phase interaction products) was initially used to describe these novel compounds as endogenous mediators that were biosynthesized during the resolution phase of inflammatory exudates and had extremely powerful anti-inflammatory as well as immunoregulatory properties. Minimizing neutrophil traffic, controlling cytokines as well as reactive oxygen species, and lessening the size of the reaction are all examples of these activities. RvE1 was topically given to Porphyromonas gingivalis ligatured teeth (4 g/tooth) three times a week in the rabbit model of periodontitis throughout a 6-week research tenure. The similar regularity of topical administration of vehicle (ethanol) combined with P. gingivalis application to ligatured teeth or ligature insertion unaided was used in the control groups.[22],[23]

The buccal and lingual mandibular regions of rabbits getting non-RvE1 vehicle control showed inflammation, in addition to tissue along with bone loss, at the end of the 6-week period, indicating severe periodontal disease development. Histological examination revealed a significant rise in bone-resorbing osteoclasts, in addition to osteoclast proliferation rising with increasing closeness to the ligature and substantial leukocyte infiltrates besides collagen degradation.[24] In contrast, when RvE1 was applied, the genesis along with the advancement of periodontal disease appeared to be avoided, with almost no neutrophils or tissue damage identified. The lack of inflammatory alterations and osteoclast growth was striking, and the bone remained essentially intact. In comparison to vehicle controls, mean alveolar bone loss was dramatically decreased by the RvE1 therapy or ligature unaided. Radiographic data also showed that RvE1 therapy resulted in a considerably lower proportion of bone loss (5%) over the 6-week period as equated to vehicle controls (35%) or ligature unaided (12%) (P = 0.05).[25],[26]

  Conclusions Top

Resolvins, which are connected with inflammation, are thought to be the molecules responsible for inflammation resolution, according to a vast body of current research. These compounds have been shown to have a role in a number of disease processes, along with their therapeutic potential, and have been discovered in a number of model systems. Resolution of inflammation in periodontitis via resolving mediated pathways has been shown to have promise for the inhibition as well as therapy of periodontal lesions. The usefulness of resolvin therapy in humans for the inhibition and therapy of periodontal diseases should be the focus of future research. To firmly confirm the use of resolvins/lipoxins in the resolution of inflammation in periodontitis patients, many multi-centric longitudinal interventional studies in diverse demographic groups would be necessary.

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Conflicts of interest

There are no conflicts of interest.

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