⭐ PHYTOTHERAPEUTIC AGENTS
📌 POINTS TO PONDER
- Phytotherapy is the use of medicinal plants and herbs for the prevention and cure of diseases and for improvement of health conditions.
- Recommended Miswak stick length for adult is 20 cm and for children is 15 cm.
- Vitamin C is present mainly in amla, cranberry, barberry, miswak and propolis.
- Triphala is a tridoshic formula of fruits of Emblica officinalis, Terminalia belerica and Terminalia chebula.
📌 VIVA VOCE
Q1. Name the various chemical substances found in miswak.
Ans. Trimethylamine—an alkaloid, high amounts of fluoride, chlorides, sulfur, silica (SiO2), vitamin C, and small amounts of saponins, tannins, sterols, flavonoids, resin and large amounts of salts with fluoride and chlorine.
Q2. Which MMPs are inhibited by craneberries?
Ans. MMP-3 and MMP-9.
Q3. Name various catechins found in green tea.
Ans. Four catechins are found in green tea, namely:
epicatechin gallate (ECG), epicatechin (EC), epigallocatechin (EGC) and epigallocatechin gallate (EGCG).
Q4. What are the periodontal applications of Aloe vera?
Ans. Anti-inflammatory action; enhances immune system and accelerates periodontal healing.
Q5. Name various minerals and vitamins present in Propolis.
Ans. Minerals like Mg, Ca, I, K, Na, Cu, Zn, Mn and Fe and Vitamins like B1, B2, B6, C and E.
Q6. What is phytotherapy?
Ans. The use of medicinal plants and herbs for the prevention and cure of diseases and for improvement of health conditions is called phytotherapy.
Q7. What are the beneficial roles of active substances in barberry?
Ans. The active substances in barberry play beneficial role as vasodilator, diuretic, anti-inflammatory and antibacterial effects.
Q8. What are the periodontal applications of cuminumcyminum?
Ans. Antimicrobial; antibiofilm; antifungal.
Q9. What are the active substances in barberry?
Ans. Alkaloids (berberine, berbamine, oxyacantha), tanines, glucose, malic acid, fructose, pectin and vitamin C.
Q10. What is Triphala?
Ans. Triphala is a tridoshic formula of fruits of Emblica officinalis, Terminalia bellirica and Terminalia chebula.
⭐ HOST MODULATORY THERAPY
📌 POINTS TO PONDER
🔹Host modulation concept was introduced by Williams and Golub et al.
🔹 Generations of Bisphosphonates are:
– First Generation: short chain molecules which inhibit the Krebs cycle; Etidronate.
– Second Generation: long chain molecules which inhibit fatty chain pathways; Alendronate.
– Third Generation: Risedronate.
🔹Future Host modulation agents are Resolvins, Lipoxins and Probiotics.
📣 HOST MODULATORY AGENTS
🔺Various HMT have been developed or proposed to block pathways responsible for periodontal tissue breakdown.
1️⃣ Inhibition of Matrix metalloproteinases (MMPs):
Through Chemically Modified Tetracyclines (CMTs)
2️⃣ Inhibition of Arachidonic acid metabolites:
Through NSAIDs
🔸COX – 1 inhibitors: Indomethacin, Naproxen,Flurbiprofen
🔸COX – 2 inhibitors: Rofecoxib
🔸COX and LOX inhibitors: Triclosan, Topical Ketoprofen
🔸LOX inhibitors: Lipoxins
3️⃣ Modulation of bone metabolism:
🔸Bisphosphonates
🔸Hormone replacement therapy (HRT)
🔸Calcium supplementation
4️⃣ Regulation of immune and inflammatory responses:
🔸Suppressing proinflammatory cytokines (IL – 1 and TNF – α receptor antagonists)
🔸Nitric Oxide inhibition
📌 VIVA VOCE
Q1. What are basic three categories of host modulating agents?
Ans. Basic three categories of host modulating agents are:
🔸Antiproteinases: Tetracyclines, CMTs.
🔸Anti-inflammatory drugs: NSAIDs.
🔸Bone-sparing drugs: Bisphosphonates.
Q2. What are chemically-modified tetracyclines (CMT)?
Ans. Chemically-modified tetracyclines are those which lack dimethylamino group on the 4th carbon atom.
Q3. Name the novel host modulatory therapies.
Ans. The novel host modulatory therapies are prore-solving lipid mediators of inflammation lipoxins,protectins and resolvins.
Q4. Which is a natural inhibitor of RANKL?
Ans. Osteoprotegerin.
Q5. Name local host modulation agent approved by FDA.
Ans. Emdogain.
Q6. What is periostat?
Ans. Periostat is sub antimicrobial dose of doxycycline hyclate capsule of 20 mg prescribed to patients with chronic periodontitis twice daily.
Q7. What are the contraindications to the use of bisphosphonates?
Ans. Sensitivity to phosphonates and gastrointestinal upset.
Q8. Which molecules are involved in regulation of osteoclast formation and process of bone resorption?
Ans. Receptor activator of nuclear factor-kappa B ligand (RANKL); and Osteoprotegerin (OPG).
Q9. Who introduced the Host modulation concept?
Ans. Williams and Golub et al.
Q10. What is the long-term side effect of bisphosphonates?
Ans. Osteonecrosis of the jaw.