Palabras clave
Cannabis
Enfermedades periodontales
Enfermedades periodontales
Cómo citar
Influencia del consumo de cannabis en la enfermedad periodontal:: una Scoping Review. (2018). Odontoestomatología, 20(31). https://odon.edu.uy/ojs/index.php/ode/article/view/245
Resumen
Recientes publicaciones plantean la posible asociación del cannabis (Cannabis sativa) con el desarrollo de la periodontitis. Objetivo: Analizar la influencia del consumo de cannabis en la enfermedad periodontal, relevando la evidencia disponible e identificando las variables asociadas en los estudios. Material y método: se realizó una Scoping Review a partir de una búsqueda estructurada en PubMed/ MEDLINE, Science Direct, LILACS, SciELO hasta mayo de 2017 . Resultados: Estudios “In vivo” mostraron una mayor pérdida ósea en animales expuestos a Cannabis. Los casos clínicos muestran que el uso crónico de cannabis puede resultar en agrandamientos gingivales y periodontitis crónica severa localizada. Los estudios epidemiológicos demuestran una asociación estadística entre Cannabis y periodontitis. Conclusiones: El consumo del Cannabis parece estar asociado con una mayor presencia de periodontitis. Sin embargo, se desconoce el mecanismo específico por el cual actúa en los tejidos gingivales.
Referencias
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2. Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJL, Marcenes W. Global Burden of Severe Periodontitis in 1990-2010. J Dent Res. 2014; 93 (11): 1045-53.
3. Botero JE, Rösing CK, Duque A, Jaramillo A, Contreras A. Periodontal disease in children and adolescents of Latin America. Periodontol 2000. 2015; 67 (1): 34-57.
4. Oppermann R V., Haas AN, Rösing CK, Susin C. Epidemiology of periodontal diseases in adults from Latin America. Periodontol 2000. 2015; 67 (1): 13-33.
5. Lorenzo S, Piccardo V, Alvarez F, Massa F, Alvarez R. Enfermedad Periodontal en la población joven y adulta uruguaya del Interior del país. Relevamiento Nacional 2010-2011. Odontoestomatologia. 2013; 15 (Noespecial): 35-46.
6. Lorenzo SM, Alvarez R, Andrade E, Piccardo V, Francia A, Massa F, Correa MB, Peres MB. Periodontal conditions and associated factors among adults and the elderly?: findings from the first National Oral Health Survey in Uruguay. Cad Saúde Pública. 2015; 31 (11): 2425-36.
7. Albandar JM, Goldstein H. Multi-Level Statistica Models in Studies of Periodontal Diseases. Am Acad Periodontol. 1992; 63 (8): 690-5.
8. Kim J, Amar S. Periodontal disease and systemic conditions: a bidirectional relationship. Odontology. 2006; 94 (1): 10-21.
9. Rioboo Crespo M, Bascones a. Factores de riesgo de la enfermedad periodontal: factores genéticos. Av en Periodoncia e Implantol Oral. 2005; 17 (2): 69-77.
10. Johannsen A, Susin C, Gustafsson A. Smoking and inflammation: Evidence for a synergistic role in chronic disease. Periodontol 2000. 2014; 64 (1): 111-26.
11. Pihlstrom BL. Periodontal risk assessment, diagnosis and treatment planning. Periodontology 2000. 2001; 25: 37-58.
12. Mealey BL, Oates TW. Diabetes Mellitus and Periodontal Diseases. J Periodontol. 2006; 77 (8): 1289-303.
13. Khader YS, Dauod AS, El-Qaderi SS, Alkafajei A, Batayha WQ. Periodontal status of diabetics compared with nondiabetics: A meta-analysis. J Diabetes Complications. 2006; 20 (1): 59-68.
14. Nelson RG, Shlossman M, Budding LM, Pettitt DJ, Saad MF, Genco RJ, Knowler WC. Periodontal disease and NIDDM in Pima Indians. Diabetes Care. 1990;13 (8): 836-40.
15. Keller A, Rohde JF, Raymond K, Heitmann BL. Association between periodontal disease and overweight and obesity: a systematic review. J Periodontol. 2015;86 (6): 766-76.
16. Chaffee BW, Weston SJ. Association Between Chronic Periodontal Disease and Obesity: A Systematic Review and Meta-Analysis. J Periodontol. 2011; 81 (12): 1708-24.
17. Negrato CA, Tarzia O, Jovanovic L, Chinellato LEM. Periodontal disease and diabetes mellitus. J Appl Oral Sci. 2013; 21 (1): 1-12.
18. Preshaw PM, Alba AL, Herrera D, Jepsen S, Konstantinidis A, Makrilakis K, Taylor R. Periodontitis and diabetes: a two-way relationship. Diabetologia. 2012; 6; 55 (1):21-31
19. Shariff JA, Ahluwalia KP, Papapanou PN. Relationship Between Frequent Recreational Cannabis (Marijuana and Hashish) Use and Periodontitis in Adults in the United States: National Health and Nutrition Examination Survey 2011 to 2012. J Periodontol. 2016; 88 (3) :273-80.
20. López R, Baelum V. Cannabis use and destructive periodontal diseases among adolescents. J Clin Periodontol. 2009; 36 (3): 185-9.
21. Thomson WM, Poulton R, Broadbent JM, Terrie E, Caspi A, Beck JD, et al. Cannabis Smoking and Periodontal Disease Among Young Adults. Jama. 2008; 299 (5): 525-31.
22. Ashton CH. Pharmacology and effects of cannabis?: a brief review. Br J psychiatry. 2001; 178:101-6.
23. Naftali T, Mechulam R, Lev LB, Konikoff FM. Cannabis for inflammatory bowel disease. Dig Dis. 2014; 32 (4): 468-74.
24. Biehl JR, Burnham EL. Cannabis smoking in 2015: A concern for lung health? Chest. 2015;148 (3): 596-606.
25. Arksey H, O'Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005; 8 (1): 19-32.
26. Conde MCM, Chisini LA, Sarkis-Onofre R, Schuch HS, Nör JE, Demarco FF. A scoping review of root canal revascularization: relevant aspects for clinical success and tissue formation. Int Endod J. 2017; 50 (9): 860-74.
27. Meier MH, Caspi A, Cerdá M, Hancox RJ, Harrington H, Houts R, et al. Associations Between Cannabis Use and Physical Health Problems in Early Midlife. JAMA Psychiatry. 2016; 73 (7): 731.
28. Zeng J, Williams SM, Fletcher DJ, Cameron CM, Broadbent JM, Shearer DM, et al. Reexamining the Association Between Smoking and Periodontitis in the Dunedin Study With an Enhanced Analytical Approach. J Periodontol. 2014; 85 (10): 1390-7.
29. Momen-Heravi F, Kang P. Management of cannabis-induced periodontitis via resective surgical therapy: A clinical report. J Am Dent Assoc. 2016; 148 (3): 179-84.
30. Rawal SY, Dabbous MK, Tipton DA. Effect of cannabidiol on human gingival fibroblast extracellular matrix metabolism: MMP production and activity, and production of fibronectin and transforming growth factor ß. J Periodontal Res. 2012; 47 (3): 320-9.
31. Jamieson LM, Gunthorpe W, Cairney SJ, Sayers SM, Roberts-Thomson KF, Slade GD. Substance use and periodontal disease among Australian Aboriginal young adults. Addiction. 2010;105 (4): 719-26.
32. Versteeg PA, Slot DE, van der Velden U, van der Weijden GA. Effect of cannabis usage on the oral environment: a review. Int J Dent Hyg. 2008;6 (4): 315-20.
33. Taylor DR, Hall W. Respiratory health effects of cannabis: position statement of the Thoracic Society of Australia and New Zealand. Intern Med J. 2003; 33: 310-3.
34. Berdyshev E V. Cannabinoid receptors and the regulation of immune response. Chem Phys Lipids. 2000;108 (1-2): 169-90.
35. Kalant H. Medical use of cannabis: history and current status. Pain Res Manag. 2001; 6 (2) :80-91.
36. Lehmann T, Sager F, Brenneisen R. Excretion of cannabinoids in urine after ingestion of cannabis seed oil. J Anal Toxicol. 1997; 21 (5): 373-5.
37. Maloney W. Significance of cannabis use to dental practice. New York State Dent Assoc. 2011;77 (3): 36-9.
38. Ali EMM, Almagboul AZI, Khogali SME, Gergeir UMA. Antimicrobial Activity of Cannabis sativa L . Chin Med. 2012; 3: 61-4.
39. Murnion B. Medicinal cannabis. Aust Prescr. 2015; 38 (6): 212-5.
40. Welty TE, Luebke A, Gidal BE. Cannabidiol: Promise and Pitfalls. Epilepsy Curr. 2014;14 (5): 250-2.
41. Greydanus DE, Hawver EK, Greydanus MM, Merrick J. Marijuana: Current Concepts. Front Public Heal. 2013;1: 1-17.
42. UNODC. Informe Mundial sobre las Drogas. publicación las Nac Unidas. Viena: UNODC 2016.
43. UNODC. Informe Mundial sobre las Drogas. Publicación las Nac Unidas, núm Vent S11XI10. 2011
44. Uruguay. Junta Nacional de Drogas. VI Encuesta Nacional en Hogares sobre Consumo de Drogas, 2016: Informe de Investigacion. Montevideo: Junta Nacional de Drogas, 2016
45. Fairman BJ. Cannabis Problem Experiences Among Users of the Tobacco- Cannabis Combination Known As Blunts. Drug Alcohol Depend. 2015; 150:77-84.
46. Kayal RA, Elias WY, Alharthi KJ, Demyati AK, Mandurah JM. Illicit drug abuse affects periodontal health status. Saudi Med J. 2014; 35 (7): 724-8.
47. Shekarchizadeh H, Khami M, Mohebbi S, Ekhtiari H, Virtanen J. Oral Health of Drug Abusers?: A Review of Health Effects and. Iran J Publ Heal. 2013; 42 (9): 929-40.
48. Madnier I. Illicit drugs for toothache: Letter to editor of Brit Dent J. Br Dent J. 2002; 192( 3): 120-1.
49. Benson MK, Bentley AM. Editorials Lung disease induced by drug addiction. Thorax. 1995; 50: 1125-7.
50. WU T-C, Tashkin DP, Djahed B, Rose JE. Pulmonary Hazards of Smoking Marijuana as Compared with Tobacco. N Engl J Med. 1988; 318 (6): 347-51.
51. Phillipson JD. 50 Years of Medicinal Plant Research - Every Progress in Methodology is a Progress in Science. Planta Med. 2003; 69 (6): 491-5.
52. Melamede R. Cannabis and tobacco smoke are not equally carcinogenic. Harm Reduct J. 2005; 2: 21.
53. Galve Roperh I, Sanchez C, Cortes ML, Gomez del Pulgar T, Izquierdo M, Guzman M. Anti-tumoral action of cannabinoids: involvement of sustained ceramide accumulation and extracellular signal-regulated kinase activation. Nat Med. 2000; 6: 313-9.
54. Heeschen C, Jang JJ, Weis M, Pathak A, Kaji S, Hu RS, et al. Nicotine stimulates angiogenesis and promotes tumor growth and atherosclerosis. Nat Med. 2001;7 (7): 833-9.
55. Watzl B, Scuderi P, Watson RR. Influence of marijuana components (THC and CBD) on human mononuclear cell cytokine secretion in vitro. AdvExpMedBiol. 1991;288: 63-70.
56. Sacerdote P, Martucci C, Vaccani A, Bariselli F, Panerai AE, Colombo A, Parolaro D, Massi P. The nonpsychoactive component of marijuana cannabidiol modulates chemotaxis and IL-10 and IL-12 production of murine macrophages both in vivo and in vitro. J Neuroimmunol. 2005;159(1-2):97-105.
57. Napimoga MH, Benatti BB, Lima FO, Alves PM, Campos AC, Pena-dos-Santos DR, Severino FP, Cunha FQ, Guimarães FS. Cannabidiol decreases bone resorption by inhibiting RANK/RANKL expression and pro-inflammatory cytokines during experimental periodontitis in rats. Int Immunopharmacol. 2009; 9 (2): 216-22.
58. Nogueira-Filho GR, Todescan S, Shah A, Rosa BT, Tunes U da R, Cesar Neto JB. Impact of Cannabis Sativa (Marijuana) Smoke on Alveolar Bone Loss: A Histometric Study in Rats. J Periodontol. 2011;82 (11): 1602-7.
59. Idris AI, Sophocleous A, Landao-Bassonga E, Van't Hof RJ, Ralston SH. Regulation of bone mass, osteoclast function, and ovariectomy-induced bone loss by the type 2 cannabinoid receptor. Endocrinology. 2008; 149 (11): 5619-26.
60. Idris AI, Van't Hof RJ, Greig IR, A RS, Al. E. Regulation of bone mass, bone loss and osteoclast activity by cannabinoid receptors. 2005; 11 (7): 774-9.
61. Nakajima Y, Furuichi Y, Biswas KK, Hashiguchi T, Kawahara KI, Yamaji K, et al. Endocannabinoid, anandamide in gingival tissue regulates the periodontal inflammation through NF-?B pathway inhibition. FEBS Lett. 2006; 580 (2): 613-9.
62. Kozono S, Matsuyama T, Biwasa KK, Kawahara K ichi, Nakajima Y, Yoshimoto T, Yonamine Y, Kadomatsu H, Tancharoen S, Hashiguchi T, Noguchi K, Maruyama I. Involvement of the endocannabinoid system in periodontal healing. Biochem Biophys Res Commun. 2010; 394 (4): 928-33.
63. Rawal SY, Tatakis DN, Tipton DA. Periodontal and Oral Manifestations of Mariiuana Use. J Tenn Dent Assoc. 2012; 92 (2): 26-31.
64. Libro R, Scionti D, Diomede F, Marchisio M, Grassi G, Pollastro F, et al. Cannabidiol Modulates the Immunophenotype and Inhibits the Activation of the Inflammasome in Human Gingival Mesenchymal Stem Cells. Front Physiol. 2016; 7: 1-17.
2. Kassebaum NJ, Bernabé E, Dahiya M, Bhandari B, Murray CJL, Marcenes W. Global Burden of Severe Periodontitis in 1990-2010. J Dent Res. 2014; 93 (11): 1045-53.
3. Botero JE, Rösing CK, Duque A, Jaramillo A, Contreras A. Periodontal disease in children and adolescents of Latin America. Periodontol 2000. 2015; 67 (1): 34-57.
4. Oppermann R V., Haas AN, Rösing CK, Susin C. Epidemiology of periodontal diseases in adults from Latin America. Periodontol 2000. 2015; 67 (1): 13-33.
5. Lorenzo S, Piccardo V, Alvarez F, Massa F, Alvarez R. Enfermedad Periodontal en la población joven y adulta uruguaya del Interior del país. Relevamiento Nacional 2010-2011. Odontoestomatologia. 2013; 15 (Noespecial): 35-46.
6. Lorenzo SM, Alvarez R, Andrade E, Piccardo V, Francia A, Massa F, Correa MB, Peres MB. Periodontal conditions and associated factors among adults and the elderly?: findings from the first National Oral Health Survey in Uruguay. Cad Saúde Pública. 2015; 31 (11): 2425-36.
7. Albandar JM, Goldstein H. Multi-Level Statistica Models in Studies of Periodontal Diseases. Am Acad Periodontol. 1992; 63 (8): 690-5.
8. Kim J, Amar S. Periodontal disease and systemic conditions: a bidirectional relationship. Odontology. 2006; 94 (1): 10-21.
9. Rioboo Crespo M, Bascones a. Factores de riesgo de la enfermedad periodontal: factores genéticos. Av en Periodoncia e Implantol Oral. 2005; 17 (2): 69-77.
10. Johannsen A, Susin C, Gustafsson A. Smoking and inflammation: Evidence for a synergistic role in chronic disease. Periodontol 2000. 2014; 64 (1): 111-26.
11. Pihlstrom BL. Periodontal risk assessment, diagnosis and treatment planning. Periodontology 2000. 2001; 25: 37-58.
12. Mealey BL, Oates TW. Diabetes Mellitus and Periodontal Diseases. J Periodontol. 2006; 77 (8): 1289-303.
13. Khader YS, Dauod AS, El-Qaderi SS, Alkafajei A, Batayha WQ. Periodontal status of diabetics compared with nondiabetics: A meta-analysis. J Diabetes Complications. 2006; 20 (1): 59-68.
14. Nelson RG, Shlossman M, Budding LM, Pettitt DJ, Saad MF, Genco RJ, Knowler WC. Periodontal disease and NIDDM in Pima Indians. Diabetes Care. 1990;13 (8): 836-40.
15. Keller A, Rohde JF, Raymond K, Heitmann BL. Association between periodontal disease and overweight and obesity: a systematic review. J Periodontol. 2015;86 (6): 766-76.
16. Chaffee BW, Weston SJ. Association Between Chronic Periodontal Disease and Obesity: A Systematic Review and Meta-Analysis. J Periodontol. 2011; 81 (12): 1708-24.
17. Negrato CA, Tarzia O, Jovanovic L, Chinellato LEM. Periodontal disease and diabetes mellitus. J Appl Oral Sci. 2013; 21 (1): 1-12.
18. Preshaw PM, Alba AL, Herrera D, Jepsen S, Konstantinidis A, Makrilakis K, Taylor R. Periodontitis and diabetes: a two-way relationship. Diabetologia. 2012; 6; 55 (1):21-31
19. Shariff JA, Ahluwalia KP, Papapanou PN. Relationship Between Frequent Recreational Cannabis (Marijuana and Hashish) Use and Periodontitis in Adults in the United States: National Health and Nutrition Examination Survey 2011 to 2012. J Periodontol. 2016; 88 (3) :273-80.
20. López R, Baelum V. Cannabis use and destructive periodontal diseases among adolescents. J Clin Periodontol. 2009; 36 (3): 185-9.
21. Thomson WM, Poulton R, Broadbent JM, Terrie E, Caspi A, Beck JD, et al. Cannabis Smoking and Periodontal Disease Among Young Adults. Jama. 2008; 299 (5): 525-31.
22. Ashton CH. Pharmacology and effects of cannabis?: a brief review. Br J psychiatry. 2001; 178:101-6.
23. Naftali T, Mechulam R, Lev LB, Konikoff FM. Cannabis for inflammatory bowel disease. Dig Dis. 2014; 32 (4): 468-74.
24. Biehl JR, Burnham EL. Cannabis smoking in 2015: A concern for lung health? Chest. 2015;148 (3): 596-606.
25. Arksey H, O'Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005; 8 (1): 19-32.
26. Conde MCM, Chisini LA, Sarkis-Onofre R, Schuch HS, Nör JE, Demarco FF. A scoping review of root canal revascularization: relevant aspects for clinical success and tissue formation. Int Endod J. 2017; 50 (9): 860-74.
27. Meier MH, Caspi A, Cerdá M, Hancox RJ, Harrington H, Houts R, et al. Associations Between Cannabis Use and Physical Health Problems in Early Midlife. JAMA Psychiatry. 2016; 73 (7): 731.
28. Zeng J, Williams SM, Fletcher DJ, Cameron CM, Broadbent JM, Shearer DM, et al. Reexamining the Association Between Smoking and Periodontitis in the Dunedin Study With an Enhanced Analytical Approach. J Periodontol. 2014; 85 (10): 1390-7.
29. Momen-Heravi F, Kang P. Management of cannabis-induced periodontitis via resective surgical therapy: A clinical report. J Am Dent Assoc. 2016; 148 (3): 179-84.
30. Rawal SY, Dabbous MK, Tipton DA. Effect of cannabidiol on human gingival fibroblast extracellular matrix metabolism: MMP production and activity, and production of fibronectin and transforming growth factor ß. J Periodontal Res. 2012; 47 (3): 320-9.
31. Jamieson LM, Gunthorpe W, Cairney SJ, Sayers SM, Roberts-Thomson KF, Slade GD. Substance use and periodontal disease among Australian Aboriginal young adults. Addiction. 2010;105 (4): 719-26.
32. Versteeg PA, Slot DE, van der Velden U, van der Weijden GA. Effect of cannabis usage on the oral environment: a review. Int J Dent Hyg. 2008;6 (4): 315-20.
33. Taylor DR, Hall W. Respiratory health effects of cannabis: position statement of the Thoracic Society of Australia and New Zealand. Intern Med J. 2003; 33: 310-3.
34. Berdyshev E V. Cannabinoid receptors and the regulation of immune response. Chem Phys Lipids. 2000;108 (1-2): 169-90.
35. Kalant H. Medical use of cannabis: history and current status. Pain Res Manag. 2001; 6 (2) :80-91.
36. Lehmann T, Sager F, Brenneisen R. Excretion of cannabinoids in urine after ingestion of cannabis seed oil. J Anal Toxicol. 1997; 21 (5): 373-5.
37. Maloney W. Significance of cannabis use to dental practice. New York State Dent Assoc. 2011;77 (3): 36-9.
38. Ali EMM, Almagboul AZI, Khogali SME, Gergeir UMA. Antimicrobial Activity of Cannabis sativa L . Chin Med. 2012; 3: 61-4.
39. Murnion B. Medicinal cannabis. Aust Prescr. 2015; 38 (6): 212-5.
40. Welty TE, Luebke A, Gidal BE. Cannabidiol: Promise and Pitfalls. Epilepsy Curr. 2014;14 (5): 250-2.
41. Greydanus DE, Hawver EK, Greydanus MM, Merrick J. Marijuana: Current Concepts. Front Public Heal. 2013;1: 1-17.
42. UNODC. Informe Mundial sobre las Drogas. publicación las Nac Unidas. Viena: UNODC 2016.
43. UNODC. Informe Mundial sobre las Drogas. Publicación las Nac Unidas, núm Vent S11XI10. 2011
44. Uruguay. Junta Nacional de Drogas. VI Encuesta Nacional en Hogares sobre Consumo de Drogas, 2016: Informe de Investigacion. Montevideo: Junta Nacional de Drogas, 2016
45. Fairman BJ. Cannabis Problem Experiences Among Users of the Tobacco- Cannabis Combination Known As Blunts. Drug Alcohol Depend. 2015; 150:77-84.
46. Kayal RA, Elias WY, Alharthi KJ, Demyati AK, Mandurah JM. Illicit drug abuse affects periodontal health status. Saudi Med J. 2014; 35 (7): 724-8.
47. Shekarchizadeh H, Khami M, Mohebbi S, Ekhtiari H, Virtanen J. Oral Health of Drug Abusers?: A Review of Health Effects and. Iran J Publ Heal. 2013; 42 (9): 929-40.
48. Madnier I. Illicit drugs for toothache: Letter to editor of Brit Dent J. Br Dent J. 2002; 192( 3): 120-1.
49. Benson MK, Bentley AM. Editorials Lung disease induced by drug addiction. Thorax. 1995; 50: 1125-7.
50. WU T-C, Tashkin DP, Djahed B, Rose JE. Pulmonary Hazards of Smoking Marijuana as Compared with Tobacco. N Engl J Med. 1988; 318 (6): 347-51.
51. Phillipson JD. 50 Years of Medicinal Plant Research - Every Progress in Methodology is a Progress in Science. Planta Med. 2003; 69 (6): 491-5.
52. Melamede R. Cannabis and tobacco smoke are not equally carcinogenic. Harm Reduct J. 2005; 2: 21.
53. Galve Roperh I, Sanchez C, Cortes ML, Gomez del Pulgar T, Izquierdo M, Guzman M. Anti-tumoral action of cannabinoids: involvement of sustained ceramide accumulation and extracellular signal-regulated kinase activation. Nat Med. 2000; 6: 313-9.
54. Heeschen C, Jang JJ, Weis M, Pathak A, Kaji S, Hu RS, et al. Nicotine stimulates angiogenesis and promotes tumor growth and atherosclerosis. Nat Med. 2001;7 (7): 833-9.
55. Watzl B, Scuderi P, Watson RR. Influence of marijuana components (THC and CBD) on human mononuclear cell cytokine secretion in vitro. AdvExpMedBiol. 1991;288: 63-70.
56. Sacerdote P, Martucci C, Vaccani A, Bariselli F, Panerai AE, Colombo A, Parolaro D, Massi P. The nonpsychoactive component of marijuana cannabidiol modulates chemotaxis and IL-10 and IL-12 production of murine macrophages both in vivo and in vitro. J Neuroimmunol. 2005;159(1-2):97-105.
57. Napimoga MH, Benatti BB, Lima FO, Alves PM, Campos AC, Pena-dos-Santos DR, Severino FP, Cunha FQ, Guimarães FS. Cannabidiol decreases bone resorption by inhibiting RANK/RANKL expression and pro-inflammatory cytokines during experimental periodontitis in rats. Int Immunopharmacol. 2009; 9 (2): 216-22.
58. Nogueira-Filho GR, Todescan S, Shah A, Rosa BT, Tunes U da R, Cesar Neto JB. Impact of Cannabis Sativa (Marijuana) Smoke on Alveolar Bone Loss: A Histometric Study in Rats. J Periodontol. 2011;82 (11): 1602-7.
59. Idris AI, Sophocleous A, Landao-Bassonga E, Van't Hof RJ, Ralston SH. Regulation of bone mass, osteoclast function, and ovariectomy-induced bone loss by the type 2 cannabinoid receptor. Endocrinology. 2008; 149 (11): 5619-26.
60. Idris AI, Van't Hof RJ, Greig IR, A RS, Al. E. Regulation of bone mass, bone loss and osteoclast activity by cannabinoid receptors. 2005; 11 (7): 774-9.
61. Nakajima Y, Furuichi Y, Biswas KK, Hashiguchi T, Kawahara KI, Yamaji K, et al. Endocannabinoid, anandamide in gingival tissue regulates the periodontal inflammation through NF-?B pathway inhibition. FEBS Lett. 2006; 580 (2): 613-9.
62. Kozono S, Matsuyama T, Biwasa KK, Kawahara K ichi, Nakajima Y, Yoshimoto T, Yonamine Y, Kadomatsu H, Tancharoen S, Hashiguchi T, Noguchi K, Maruyama I. Involvement of the endocannabinoid system in periodontal healing. Biochem Biophys Res Commun. 2010; 394 (4): 928-33.
63. Rawal SY, Tatakis DN, Tipton DA. Periodontal and Oral Manifestations of Mariiuana Use. J Tenn Dent Assoc. 2012; 92 (2): 26-31.
64. Libro R, Scionti D, Diomede F, Marchisio M, Grassi G, Pollastro F, et al. Cannabidiol Modulates the Immunophenotype and Inhibits the Activation of the Inflammasome in Human Gingival Mesenchymal Stem Cells. Front Physiol. 2016; 7: 1-17.