Phytocannabinoids and gingival inflammation: Preclinical findings and a placebo-controlled double-blind randomized clinical trial with cannabidiol

JIRASEK, Petr, Alexandr JUSKU, Jana FRANKOVA, Marketa URBANKOVA, Daniel DIABELKO, Filip RŮŽIČKA, Barbora PAPOUSKOVA, Karin CHYTILOVA, Jiri VRBA, Jakub HAVLASEK, Katerina LANGOVA, Jan STORCH, Iva VOBORNA, Vilim SIMANEK and Jan VACEK. Phytocannabinoids and gingival inflammation: Preclinical findings and a placebo-controlled double-blind randomized clinical trial with cannabidiol. JOURNAL OF PERIODONTAL RESEARCH. HOBOKEN: WILEY, 2024, vol. 59, No 3, p. 468-479. ISSN 0022-3484. Available from: https://dx.doi.org/10.1111/jre.13234.

Basic information

• Original name: Phytocannabinoids and gingival inflammation: Preclinical findings and a placebo-controlled double-blind randomized clinical trial with cannabidiol
• Authors: JIRASEK, Petr, Alexandr JUSKU, Jana FRANKOVA, Marketa URBANKOVA, Daniel DIABELKO, Filip RŮŽIČKA, Barbora PAPOUSKOVA, Karin CHYTILOVA, Jiri VRBA, Jakub HAVLASEK, Katerina LANGOVA, Jan STORCH, Iva VOBORNA, Vilim SIMANEK and Jan VACEK.
• Edition: JOURNAL OF PERIODONTAL RESEARCH, HOBOKEN, WILEY, 2024, 0022-3484.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Country of publisher: United States of America
• Confidentiality degree: is not subject to a state or trade secret
• WWW: URL
• Impact factor: Impact factor: 3.500 in 2022
• Organization unit: Faculty of Medicine
• Doi: http://dx.doi.org/10.1111/jre.13234
• UT WoS: 001157410200001
• Keywords in English: cannabidiol; inflammation; microbiota; oral hygiene; periodontium; phytocannabinoid
• Tags: 14110113, rivok
• Tags: International impact, Reviewed

Abstract

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 mu g/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.