title: Host modulation therapeutics in periodontics: role as an adjunctive periodontal therapy.
abstract: Host Modulation Therapy (HMT) is a treatment concept that reduces tissue destruction and stabilizes or even regenerates inflammatory tissue by modifying host response factors. It has been used for treating osteoporosis and arthritis for several decades. However, its use in dentistry has only been recently reported. The objective of this article is to present a review of the various literatures available on HMT and also its role as adjunct therapy in periodontics. For identifying studies for this review, a PUBMED search was carried out in 2013 for all articles published till December 2012. The search was restricted to English language publications only. Longitudinal prospective and retrospective studies were included in the search. The key words used were: Host Modulation Therapy; Sub antimicrobial dose doxycycline and Non-Surgical Periodontal Therapy. The main outcomes sought were host modulation therapeutics in periodontics. Exclusion criteria included cross sectional studies, short case series as well as studies with short follow-up periods. There is a paucity of literature on HMT in periodontics although the only drug approved by United States Food and Drug Administration (FDA) is a subantimicrobial dose of doxycycline (SDD) with highly predictable results as a host modulating agent in periodontal diseases and also an effective adjunctive therapy in various diseases of periodontium. However, more randomized controlled trials are needed to obtain clinical guidelines on the usage of other host modulating agents as adjunct as well as definite therapy for periodontal diseases. SDD is an effective adjunct therapy when used in dosage of 20mg twice daily for minimum 3 months duration in various periodontal diseases with predictable clinical outcomes. It is also recommended that future clinical research on anti cytokine drugs, chemically modified tetracycline and other HMT agents should be conducted so that new drugs are available with highly predictable results.
authors.affiliation: Department of Periodontology, Pakistan Air Force Hospital, Islamabad.
authors.forename: Muhammad Saad
authors.initials: MS
authors.lastname: Shinwari
authors.affiliation: Department of Periodontology, Ziauddin University, Karachi.
authors.forename: Farzeen
authors.initials: F
authors.lastname: Tanwir
authors.affiliation: Department of Dentistry, Federal Government Polyclinic Postgraduate Medical Institute, Islamabad.
authors.forename: Pakiza Raza
authors.initials: PR
authors.lastname: Hyder
authors.affiliation: Department of Community Dentistry, Islamic International Dental College, Islamabad.
authors.forename: Muhammad Humza
authors.initials: MH
authors.lastname: Bin Saeed
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016723:Bone Remodeling / Q000187:drug effects; D003131:Combined Modality Therapy; D012534:Dental Scaling; D004318:Doxycycline / Q000008:administration & dosage*; D006801:Humans; D007155:Immunologic Factors; D008297:Male; D061965:Matrix Metalloproteinase Inhibitors; D020782:Matrix Metalloproteinases / Q000378:metabolism; D010510:Periodontal Diseases / Q000188:drug therapy* / Q000378:metabolism; D010517:Periodontics / Q000379:methods*
chemical_list: D000900:Anti-Bacterial Agents; D007155:Immunologic Factors; D061965:Matrix Metalloproteinase Inhibitors; D020782:Matrix Metalloproteinases; D004318:Doxycycline