[The role of Matrix Metaloproteinases in the progression of periodontitis, and the use of specific inhibitors to these enzymes in the treatment of the periodontal disease].
Matrix Metaloproteinases (MMPs) play a crucial role in the pathogenesis of the periodontal disease. This group of enzymes can degrade most of the proteins that compose the extracellular matrix. Recently a new concept of treatment, the "host modulating therapy" (HMT) was developed. The rationale behind this concept is to inhibit the production of the inflammatory mediators and/or to block the production of the host MMPs and thus inhibiting disease production. In the recent years it was found that Tetracyclines (TC) decrease the levels of TNF-alpha, IL-1, Nitric Oxide, and prostaglandins, and via intra and extra cellular mechanisms inhibit the production and activation of the MMPs. A capsule of 20 mg Doxycycline, called later Low Dose Doxycycline (LDD), was the first HMT in the periodontal disease. In a 9 month study it was found that LDD bid after supragingival scaling statistically increased pocket reduction and attachment gain compared to supragingival scaling alone. However, this improvement was found only in pockets of 7 mm or more, and was not compared yet to periodontal supportive therapy every three month. There is a need for more basic and clinical research in the field of HMT in the treatment of periodontal disease, to expand our knowledge and clinical experience that will enable us to decide when and how to use medications to modulate host response.
Nasatzky
E
E
Dept. of Periodontics, Hebrew University-Hadassah School of Dental Medicine, Jerusalem.
Rubinstein
Y
Y
Goultschin
J
J
Schwartz
Z
Z
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D012534:Dental Scaling; D018450:Disease Progression; D006801:Humans; D018836:Inflammation Mediators / Q000502:physiology; D061965:Matrix Metalloproteinase Inhibitors; D020782:Matrix Metalloproteinases / Q000502:physiology*; D008911:Minocycline / Q000008:administration & dosage / Q000627:therapeutic use; D009569:Nitric Oxide / Q000502:physiology; D010518:Periodontitis / Q000188:drug therapy / Q000201:enzymology* / Q000503:physiopathology; D011453:Prostaglandins / Q000502:physiology; D019714:Tissue Inhibitor of Metalloproteinases / Q000627:therapeutic use*; D014409:Tumor Necrosis Factor-alpha / Q000502:physiology
D000900:Anti-Bacterial Agents; D018836:Inflammation Mediators; D061965:Matrix Metalloproteinase Inhibitors; D011453:Prostaglandins; D019714:Tissue Inhibitor of Metalloproteinases; D014409:Tumor Necrosis Factor-alpha; D009569:Nitric Oxide; D020782:Matrix Metalloproteinases; D008911:Minocycline