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Biomaterials

Biomaterials - Poster Session E

Poster C7 - Using Antimicrobial Peptide Hydrogel Therapeutic for Apical Periodontitis Treatment

Saturday, October 26, 2024
10:00 AM – 11:00 AM EST
Location: Exhibit Hall E, F & G

Introduction:  Apical periodontitis (AP) is a common inflammatory response caused by pulp infection, with about 50% of the global population having at least one tooth with AP. [1] This can be caused by numerous factors ranging from lifestyle to physical trauma. The current treatments such as the nonsurgical endodontic treatment have been tested but are inconsistent in generating results. To fill this gap there have been many different approaches being tried such as stem cell therapy, antioxidants, biological medications, and more. However, most of these methods are expensive or require multiple invasive procedures. Using a self-assembling peptide (SAP) would mitigate inflammation and infection from the dental pulp space, further enhancing the improvements in inflammation modulation and alveolar bone healing in the apical region through a single injection. This study uses the antimicrobial and angiogenic efficacy of our SAPs in an infected rodent apical periodontitis model, followed by periapical resolution tracking with CT images.

Materials and

Methods:  To evaluate the efficacy of the combination of angiogenic and antimicrobial scaffolds an infected pulpectomy model will be employed using equal male and female Wistar rats (225-250 g). 2 molars on each side of the maxilla will be cleaned and exposed with a dental round burr (n=4 implant sites for each animal). Hemorrhage from the dental pulp space will be controlled with sterile paper points and cotton pellets. The dental pulp was left uncapped, exposing the rat's oral microbiome for three weeks. Apical periodontitis will be assessed as a function of periapical radiolucency quantified using MILABs Vector6/CT imaging. After confirmation of apical periodontitis by CT imaging, the dental pulp regeneration procedure will commence. Day 0 preoperative and postoperative periapical CT images will be taken to assess the variability of the clinical procedure. 4 groups including, Angiogenic SAP, Antimicrobial SAP, 1:1 Angiogenic / Antimicrobial SAP combination, and PBS (negative control). At 0, 7, and 14 days periapical radiographs will be assessed for all subjects in the study. Each periapical radiograph will be blinded to two examiners for evaluation of periapical bone resorption, quantified as a function of the traced volume of the periapical space.

Results, Conclusions, and Discussions: In this study, animals underwent treatment with hydrogels using CT scans to observe the decline in infection in the molars on the buccal and lingual side. In an apical periodontitis rat model, SAP treatment groups showed significant differences compared to the control group (PBS) after 14 days. These preliminary data suggest that SAP treatment may enhance healing (Figure 1). The results showed an improvement in the periapical bone resorption, up to 35% after 14 days of treatment on both molars on the lingual and buccal side. It is hypothesized the antimicrobial hydrogel will mitigate inflammation and infection from the dental pulp space, further enhancing the improvements in inflammation modulation and alveolar bone healing in the apical region. The combination of antimicrobial and angiogenic SAP systems could be used in the treatment of apical periodontitis to decrease bacterial resolution in the periapical region and facilitate bone regeneration. The scope of the work described herein serves as a proof of concept for combining different bioactive peptides to form a multi-faceted hydrogel system that addresses complex pathologies. Future directions include refinement of the bioactive domains and translational work involving higher-order animal models.

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