Phytocannabinoids and gingival inflammation: Preclinical findings and a placebo-controlled double-blind randomized clinical trial with cannabidiol
Language English Country United States Media print-electronic
Document type Journal Article, Randomized Controlled Trial
Grant support
RVO 61989592
UPOL
IGA_LF_2020_038
UPOL
IGA_LF_2022_025
UPOL
CZ.02.1.01/0.0/0.0/16_019/0000868
ENOCH
PubMed
38311974
DOI
10.1111/jre.13234
Knihovny.cz E-resources
- Keywords
- cannabidiol, inflammation, microbiota, oral hygiene, periodontium, phytocannabinoid,
- MeSH
- Anti-Inflammatory Agents therapeutic use pharmacology MeSH
- Chlorhexidine therapeutic use pharmacology analogs & derivatives MeSH
- Adult MeSH
- Double-Blind Method MeSH
- NF-E2-Related Factor 2 MeSH
- Fibroblasts * drug effects MeSH
- Gingiva * drug effects MeSH
- Gingivitis * drug therapy MeSH
- Heme Oxygenase-1 MeSH
- Interleukin-6 analysis MeSH
- Interleukin-8 drug effects MeSH
- Cannabidiol * pharmacology therapeutic use MeSH
- Cells, Cultured MeSH
- Middle Aged MeSH
- Humans MeSH
- Periodontitis drug therapy MeSH
- Check Tag
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Male MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Randomized Controlled Trial MeSH
- Names of Substances
- Anti-Inflammatory Agents MeSH
- Chlorhexidine MeSH
- chlorhexidine gluconate MeSH Browser
- NF-E2-Related Factor 2 MeSH
- Heme Oxygenase-1 MeSH
- Interleukin-6 MeSH
- Interleukin-8 MeSH
- Cannabidiol * MeSH
- NFE2L2 protein, human MeSH Browser
OBJECTIVE: The aim of this study was to: (1) evaluate the anti-inflammatory effects of cannabidiol (CBD) on primary cultures of human gingival fibroblasts (HGFs) and (2) to clinically monitor the effect of CBD in subjects with periodontitis. BACKGROUND: The use of phytocannabinoids is a new approach in the treatment of widely prevalent periodontal disease. MATERIALS AND METHODS: Cannabinoid receptors were analyzed by western blot and interleukin production detected using enzyme immunoassay. Activation of the Nrf2 pathway was studied via monitoring the mRNA level of heme oxygenase-1. Antimicrobial effects were determined by standard microdilution and 16S rRNA screening. In the clinical part, a placebo-control double-blind randomized study was conducted (56 days) in three groups (n = 90) using dental gel without CBD (group A) and with 1% (w/w) CBD (group B) and corresponding toothpaste (group A - no CBD, group B - with CBD) for home use to maintain oral health. Group C used dental gel containing 1% chlorhexidine digluconate (active comparator) and toothpaste without CBD. RESULTS: Human gingival fibroblasts were confirmed to express the cannabinoid receptor CB2. Lipopolysaccharide-induced cells exhibited increased production of pro-inflammatory IL-6 and IL-8, with deceasing levels upon exposure to CBD. CBD also exhibited antimicrobial activities against Porphyromonas gingivalis, with an MIC of 1.5 μg/mL. Activation of the Nrf2 pathway was also demonstrated. In the clinical part, statistically significant improvement was found for the gingival, gingival bleeding, and modified gingival indices between placebo group A and CBD group B after 56 days. CONCLUSIONS: Cannabidiol reduced inflammation and the growth of selected periodontal pathogenic bacteria. The clinical trial demonstrated a statistically significant improvement after CBD application. No adverse effects of CBD were reported by patients or observed upon clinical examination during the study. The results are a promising basis for a more comprehensive investigation of the application of non-psychotropic cannabinoids in dentistry.
Department of Analytical Chemistry Faculty of Science Palacky University Olomouc Czech Republic
Institute of Dentistry and Oral Sciences University Hospital Olomouc Olomouc Czech Republic
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