The effects of topical erythropoietin on non-surgical treatment of periodontitis: a preliminary study

Abstract

Background The purpose of periodontal treatments is to reduce inflammation, restore gingival health and clinical attachment level gain by controlling microbial plaque formation and other etiological factors. One of the drugs that has been tested in many areas and shown good anti-inflammatory properties is erythropoietin (EPO). We evaluated the effect of this drug on the improvement of periodontitis after the phase I treatment. Methods This study was conducted on 30 patients with stage III periodontitis who had at least two bilateral teeth with CAL of ≥ 5 mm and PPD ≥ 6 mm at ≥ 2 non‐adjacent teeth and bleeding on probing. After oral hygiene instruction and scaling and root planning (SRP), EPO gel containing a solution of 4000 units was applied deeply in the test group and placebo gel was deeply administered in the control pockets (5 times, every other day). The clinical parameters of the plaque index (PI), gingival index (GI), clinical attachment level (CAL), probing depth (PD) and bleeding index (BI) were measured at baseline and after three months of follow up. The P-value was set at 0.05. Results All clinical variables improved after treatment in both groups. The BI and GI scores (which reflects the degree of gingival inflammation) showed statistically more reduction in test group. The CAL decreased from 5.1 ± 4.1 to 3.40 ± 2.71 mm; and 5.67 ± 4.32 to 4.33 ± 3.19 mm in test and control group, respectively (P < 0.00). After the treatment, there was a significant greater reduction in CAL and also PD values in test group (P < 0.01). Conclusion Local application of EPO gel in adjunct to SRP can improve clinical inflammation and CAL gain in periodontitis. Trial registration: This study was registered at 2017-11-06 in IRCT. All procedures performed in this study were approved with ID number of IR.TUMS.DENTISTRY.REC.1396.3139 in Tehran University of medical science.

Syringeable atorvastatin loaded eugenol enriched PEGylated cubosomes in-situ gel for the intra-pocket treatment of periodontitis: statistical optimization and clinical assessment

“…As presented in Figure 8I , the statistical intra-group comparison at the end of the study showed a significant reduction in the mean PD values ( p < 0.001) and this was in accordance with a previously published study (Aslroosta et al., 2021 ). This might be attributed to the decrease in bacterial bioburden as a result of the mechanical removal of plaque and calculus and the meticulous oral hygiene restricted by the patients (Aslroosta et al., 2021 ).…”

“…As presented in Figure 8I , the statistical intra-group comparison at the end of the study showed a significant reduction in the mean PD values ( p < 0.001) and this was in accordance with a previously published study (Aslroosta et al., 2021 ). This might be attributed to the decrease in bacterial bioburden as a result of the mechanical removal of plaque and calculus and the meticulous oral hygiene restricted by the patients (Aslroosta et al., 2021 ). While the statistical inter-group comparison revealed that group 2 showed the highest statistical reduction in PD values with a mean value of 4.50 ± 0.53 at baseline reduced to 1.87 ± 0.64 at the end of the study ( p < 0.05).…”

Erythropoietin Activates Autophagy to Regulate Apoptosis and Angiogenesis of Periodontal Ligament Stem Cells via the Akt/ERK1/2/BAD Signaling Pathway under Inflammatory Microenvironment

“…EPO has been learned as a multifunctional cytokine/drug for wound healing and bone regeneration, particularly in the realm of periodontology [ 54 – 56 ]. An avalanche of researches argued that EPO attenuated inflammation, contributed to antiapoptosis, enhanced autophagy, and promoted angiogenesis [ 13 , 18 , 57 – 59 ].…”

Drug-Loaded Chitosan Scaffolds for Periodontal Tissue Regeneration

“…Furthermore, between the third and fourth weeks following free gingival transplant procedures, topical EPO treatment accelerates palate wound healing [ 189 ]. Aslroosta et al published preliminary studies in 2021 demonstrating that EPO showed potential in the treatment of people with moderate to severe chronic periodontitis [ 190 ]. In a study, Wang et al discovered that Erythropoietin enhances the osteogenesis of periodontal mesenchymal stem cells from healthy and periodontitis sources [ 191 ].…”