‣ cellular proliferation , migration and secretion of matrix molecules , and the organisation of these matrix components into functionally active fibres that finally restore the periodontium . A real-time wound-healing assay with NIH-3T3 fibroblasts which followed the wound-healing process by life imaging over 48 hours showed that AHE significantly accelerated wound healing process ( Figure 3 ). This demonstrates its pro-healing properties and regenerative capacity .
Controlling inflammation
Chronic inflammation of the gingiva , supporting connective tissues and the alveolar bone causes periodontal diseases . 14 Thus , preventing inflammation is critical in preventing periodontal diseases . P . gingivalis is a key pathogen of the disease provoking periodontal microbiota . 15 It contributes to the pathogenesis of aggressive periodontitis by inducing high levels of proinflammatory cytokines , such as IL-1β and IL-6 by peripheral CD4 + T helper cells . 16 P . gingivalis LPS plays a key role in this process . AHE at 1 % and 2 % reduced by 13 %, and 65 %, respectively , the release of prostaglandin E2 , a proinflammatory lipid mediator induced by LPS treatment in raw cells . Its anti-inflammatory activity was also confirmed by IL-1β- and LPS-induced inflammatory responses in monocytes . 2 % AHE reduced the release of several pro-inflammatory mediators , including IL-6 , IL-8 and isoprostan ( Figure 4 ).
Oxidative stress protection
Oxidative stress occurs as a state of disturbance between free radical production and the ability of antioxidant system to counteract this . It is characterised by an accumulation of reactive oxygen species ( ROS ) and plays a key role in the progression of inflammatory diseases , including periodontal diseases . 17 LPS from P . gingivalis , as well as hypoxia , induces a NOX4-dependent increase in H 2
O 2 release in periodontal ligament fibroblasts which may contribute to the development and progression of periodontal diseases in the absence of antioxidative systems . 18 P . gingivalis also induces ROS that activate Forkhead Box sub-family O transcription factors through cJun N-terminal kinase signalling , which subsequently controls oxidative stress responses , inflammatory cytokine production and cell survival relevant to dysbiotic host responses in periodontal diseases . 19 Maillard AGEs are responsible for inducing low intensity chronic inflammation and thereby , for initiating and / or aggravating chronic diseases . Research has demonstrated a significant association between AGEs and dental or periodontal pathology . Therefore , we evaluated the effect of
Figure 5 - Toothshade reduction of AHE with VITA Bleachedguide 3D-Master scale
AHE on various oxidative stress and glycation markers . We demonstrated that AHE 1 % neutralises H 2
O 2
-induced ROS by 43 % and was more effective than Trolox , a potent antioxidant molecule , at 50 µ g / ml . AHE also inhibited IL-1b-induced RCAN1 expression , LPS-induced NO and 8-Iso-PGF2α production , which is a key biomarker of oxidative stress . Importantly , AHE increases the expression of AGE-R1 , an oxidative stress suppressor and a negative regulator of the inflammatory response to AGE . This makes AHE a potent antioxidant , a property that prolongs cell survival for healthy gums . Finally , we showed that AHE 1 % strongly inhibited IL-1β-induced RAGE expression . This data suggests that AHE can inhibit the proinflammatory and pro-oxidative effects of AGEs and can be considered as an anti-glycation active ingredient .
Toothshade reduction
AHE was investigated for its ability to reduce tooth shade . The most prominent shade of the frontal teeth was determined on every subject before and after the period of product application , using 15 grades of the Vita Bleachedguide 3DMaster scale . In addition to demonstrating perfect tolerance , the volunteers saw an average 15 % reduction in the tooth shade , demonstrating the whitening effect of AHE ( Figure 5 ). 14 of the 20 subjects who did not apply the placebo displayed a decrease of tooth shade to more bright teeth with a mean reduction of 21 %. The other six subjects , plus those who applied a placebo , did not exhibit a change in tooth shade . In all , 20 subjects who did not apply placebo , the tooth shade was reduced by a mean of 15 %. AHE can therefore be used to brighten teeth .
Plaque & gingivitis reduction
Oral hygiene can be assessed by determining various indices which record , for example , the incidence of plaque and signs of inflammation of the gingiva . Plaque
38 SPECIALITY CHEMICALS MAGAZINE ESTABLISHED 1981