Today's Veterinary Practice

JAN-FEB 2016

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

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tvpjournal.com | January/February 2016 | Today's VeTerinary PracTice PracTical denTisTry Peer reviewed 89 osteoclastic bone resorption in cases of chronic periodontitis. in addition, several drug therapies have good effcacy in slowing the progression of periodontal disease. 38-52 Many of these preparations have substantial adverse effects, which make their use questionable. 53 However, an increasing number of products are natural products or nutraceuticals with minimal to no adverse effects. Infammatory Mediators as stated earlier, resolution of infammation (and return to homeostasis) prevents osteoclastic bone resorption. Nonsteroidal Anti-infammatory Drugs. control through classic anti-infammatory pathways is effective but typically associated with signifcant adverse effects. numerous nonsteroidal anti-infammatory drugs (eg, cyclooxygenase-1 and -2 inhibitors) have been helpful in decreasing periodontal disease and alveolar bone loss. 54-61 However, these products appear most effective in the short term. 38,39 Antimicrobials. antimicrobials are another group of medications with signifcant promise both locally and systemically; in particular, the tetracycline class and especially doxycycline (2 mg/ kg Po Q 24 H life long 62 ). These are typically used below the antimicrobial dose needed for their anti-infammatory properties. numerous human studies now support long-term administration of low-dose doxycycline after periodontal therapy has been performed. 40-42 Bioactive Products. lipoxins, resolvins, and protectins are a new family of bioactive products of fatty acids, such as eicosapentaenoic acid, that may decrease periodontal infammation. 43–51 Topical application of resolvin e1 (rve1) in rabbit periodontitis protected against infammation- induced tissue and bone loss associated with periodontitis. 44 an additional study showed that topical application of rve1 in rabbits had dramatic effects on the regeneration of periodontal tissues destroyed by periodontal disease. 52 These products may represent a future option for the control of periodontal infammation and secondary alveolar bone loss. Antioxidants several recent studies have linked chronic oxidative stress with periodontal disease (Table 4). 63-67 Furthermore, antioxidant capacity is decreased in patients with established periodontal disease (particularly those with diabetes mellitus). 68,69 Finally, proper equilibrium between free radicals and antioxidants is now thought to be the main prerequisite for healthy periodontal tissue. 70 Therefore, antioxidants appear to be an important aspect of periodontal health, and supplementation may have protective qualities. 71 numerous methods and products are available for increasing antioxidant capacity. These can range from simple vitamin supplementation (vitamins c and e) 72,73 to specifc products that more effectively increase total antioxidant capacity. • Topical application of antioxidants improves periodontal health. 74,75 in addition, a veterinary- specific formulation (antioxidant oral Gel and Breath renewal system, toothtotail.com) decreases halitosis in dogs. 76 • on the systemic side, nrf2 (see What Is Nrf2?) triggers production of superoxide dismutase, gluthathione, and catalase, which helps protect against free radicals, and may have benefits for treating periodontal disease. 77,78 a natural product with a veterinary-specific formulation (lifeVantage canine Health, lifevantage.com/ iVs) stimulates antioxidant production in the body and in humans increases the levels of natural antioxidants far more than vitamin supplementation alone. 79,80 Nutraceuticals Fatty Acids. recent studies on the use of fatty acid supplements have shown benefcial results in periodontal infammation. 81-86 However, because of the high epithelial penetration of fatty acids, TAB le 4. d iseases a ssociated With Chronic Oxidative s tress Autoimmune diseases Cancer Cardiovascular disease Chronic lung diseases (eg, emphysema, asthma, pulmonary fbrosis) Diabetes Epilepsy Infammatory bowel disease Kidney disease Lung disease Neurodegenerative diseases Periodontal disease Toxic liver damage

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