Rational development of nanomedicines for molecular targeting in periodontal disease.

Recent advances in understanding the etiology and pathogenesis of periodontal disease and polymicrobial synergy in the dysbiotic oral microbial community endorsed novel therapeutic targets and assured further improvement in periodontal disease treatment. Moreover, understanding of the events at the molecular level inspired the researchers to alleviate the stress from the disease by applying the bottom-up approach and delivering the drugs at the site of action, using nanoscale medicines. This review is focused on promising strategies for rational design of nanopaharmaceuticals for periodontal disease treatment based on novel therapeutic targets and the potential of advanced concepts for inflammation cascade targeting. Due to their size, nanomedicines are capable to interact with the elements of the immune system through cell receptor binding and to subsequently influence specific intracellular signaling pathways activation. They might also interfere with different signaling molecules continuously involved in the disease progression, in order to abolish cell activation and block the production of proinflammatory substances. Different biomacromolecules can be trafficked to the site of action using nanomedicines for gene targeting: i) decoy oligodeoxynucleotide (ODN) for suppression of NF-κB transcription activity, ii) DNA therapeutics for modulation of cell inflammatory response and iii) siRNA for cytokine production silencing. However, despite the potential of the nanotechnology for improvement of periodontal disease treatment, the translation of nano-drug delivery systems to clinical therapy is hindered by the lack of standard procedures for proper safety and efficacy profile evaluation.