| Abstract | Parodontološke su bolesti kronične upalne bolesti multifaktorijalne etiologije čiji se razvitak i napredak povezuje s gram-negativnim anaerobnim bakterijama poput Porphyromonas gingivalis i fakultativnim anaerobima, postojanjem biofilma, odgovorom domaćina te genetskom podlogom i navikama pojedinca. Bitnu ulogu u odgovoru domaćina na kolonizaciju bakterija u subgingivalnom biofilmu imaju polimorfonuklearni neutrofili koji otpuštaju slobodne kisikove radikale kao jedan od obrambenih mehanizama. Slobodni kisikovi radikali, odnosno reaktivne vrste kisika, u malim količinama stimuliraju rast fibroblasta i epitelnih stanica, ali u prekomjernoj količini mogu potaknuti stanice makrofaga na sintezu i lučenje proupalnih citokina i hidrolitičkih enzima što dovodi do destrukcije mekih i tvrdih tkiva. Liječenje parodontoloških i periimplantatnih bolesti provodi se nekirurškom parodontološkom terapijom, ali se istražuju i dodatne metode za poboljšavanje ishoda terapije. Resveratrol je polifenol koji se nalazi u pojedinim biljkama i voću, a istražuje se zbog svojih antioksidativnih, imunomodulatornih i antimikrobnih učinaka te zbog učinka na modulaciju kosti. In vitro istraživanja na stanicama parodontnog ligamenta ukazuju na pozitivan učinak resveratrola na oksidativan stres te pozitivan učinak na diferencijaciju stanica parodontnog ligamenta povećanjem ekspresije enzima SIRT-1. Uočeni su i pozitivni učinci na diferencijaciju osteoblasta u stanicama koštane srži te je ustanovljena inhibicija proteina RANKL. Na životinjskom modelu parodontitisa uzrokovanog ligaturama uočen je pozitivan učinak resveratrola na gubitak kosti i na ekspresiju upalnih citokina. Klinička istraživanja na ljudima su malobrojna, provedena na malom uzorku pacijenata, a trajanje je istraživanja relativno kratko. U provedenim istraživanjima gubitak pričvrstka pokazuje značajnu razliku kod pacijenta u terapiji s resveratrolom ili da nema razlike u usporedbi s kontrolnom grupom. Ekspresija upalnih citokina je nešto manja od kontrolne skupine, ali ne i statistički značajna, no ima naznaka da resveratrol može biti djelotvoran u kontroli akumulacije dentalnog biofilma bakterija. |
| Abstract (english) | Periodontal diseases are chronic inflammatory diseases of multifactorial etiology, the development and progression of which are associated with gram-negative anaerobic bacteria such as Porphyromonas gingivalis and facultative anaerobes, the existence of biofilm, the host's response, and the genetic background and habits of the individual. An essential role in the host's response to bacterial colonization in the subgingival biofilm is played by polymorphonuclear neutrophils, which release free oxygen radicals as one of their defense mechanisms. Free oxygen radicals, i.e., reactive oxygen species, in small quantities stimulate the growth of fibroblasts and epithelial cells, while in excessive quantities they can stimulate macrophage cells to synthesize and secrete pro-inflammatory cytokines and hydrolytic enzymes, which lead to the destruction of soft and hard tissues. Treatment of periodontal and peri-implant diseases is carried out with the initial periodontal therapy, although, additional methods are being investigated to improve the outcome of the therapy. Resveratrol is a polyphenol found in particular plants and fruits, and is being investigated for its antioxidant, immunomodulatory and antimicrobial effects, as well as for its effect on bone modulation. In vitro studies on periodontal ligament cells indicate a positive effect of resveratrol on oxidative stress and a positive effect on the differentiation of periodontal ligament cells by increasing the expression of the SIRT-1 enzyme. Moreover, positive effects were observed on the differentiation of osteoblasts in bone marrow cells, and inhibition of the RANKL protein was established. In an animal model of periodontitis caused by ligatures, a positive effect of resveratrol on bone loss and on the expression of inflammatory cytokines was observed. Clinical human trials are scarce, conducted on a small sample of patients, and the duration of the research is relatively short. The conducted research has shown that the clinical attachment loss presents significant difference in patients on resveratrol therapy or no difference compared to the control group. The expression of inflammatory cytokines was slightly lower than the one in the control group, although not statistically significant, whereas there are indications that resveratrol can be effective in controlling the accumulation of the dental biofilm bacteria. |
