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Understanding the Role of Metalloproteinases and Their Inhibitors in Periodontology

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Abstract

Periodontitis is a complex and inflammatory disorder characterized by elevated level of tissue-degrading enzymes leading to the destruction of periodontal tissue and ultimately causes loss of the tooth. Apart from standard therapeutic measures used to control periodontal infection and inflammation, matrix metalloproteinase (MMP) control plays an important role in improving outcomes of periodontal therapy. In chronic periodontitis, levels of endogenous tissue inhibitor are not sufficient to inhibit the elevated MMPs, leading to increased pathogenesis of the periodontal disease. Literature evidence revealed adjunctive tissue inhibitors of metalloproteinases (TIMPs) play a pivotal role in managing chronic periodontitis. Recently, a large number of products including collagen, peptidomimetics, non-peptidomimetics, tetracycline, chemically modified tetracycline, and bisphosphonates are being investigated as MMP inhibitors to improve outcomes in periodontal therapy. This review aims to analyze the role of MMPs in periodontitis and summarizes the therapeutic application of TIMPs that could help in selecting an appropriate adjunct to periodontal therapy for better outcomes.

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  1. Institute of Dental Sciences, Siksha ‘O’ Anusandhan (Deemed To Be University), Bhubaneswar, Odisha, India

    Akankshya Sahu, Sanat Kumar Bhuyan & Ruchi Bhuyan

  2. Department of Pharmacognosy, School of Pharmaceutical Sciences, Siksha ‘O’ Anusandhan (Deemed To Be University), Bhubaneswar, Odisha, India

    Biswakanth Kar, Goutam Ghosh & Goutam Rath

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  1. Akankshya Sahu
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  2. Sanat Kumar Bhuyan
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Correspondence to Goutam Rath.

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Highlights

• MMPs are the key mediators of tissue destruction in periodontitis

• MMPs can be inhibited by TIMPs but they have short half-lives and non-selective

• Doxycycline can inhibit the activity of MMPs in periodontitis with beneficial clinical outcome

• MMPs and TIMPs levels in saliva could be diagnostically utilized as a biomarker for the early detection of periodontitis

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Sahu, A., Bhuyan, S.K., Bhuyan, R. et al. Understanding the Role of Metalloproteinases and Their Inhibitors in Periodontology. Clinic Rev Bone Miner Metab 19, 36–49 (2021). https://doi.org/10.1007/s12018-021-09281-y

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