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Periodontal disease is a complex inflammatory process that leads to the destruction of tooth-supporting structures including the gingiva, the periodontal ligament, the cementum, and the alveolar bone. For periodontal bone loss to develop, the breakage of the gingival barrier and bacterial invasion need to occur, in addition to the recruitment of inflammatory cells, and the transition from an innate-dominated to an acquired-dominated immune response1. The final imbalance between osteoblasts and osteoclasts will result in alveolar bone loss via its destruction2. The hallmark phenotypic finding that differentiates the diagnosis of periodontal disease from reversible gingival inflammation (gingivitis) is the loss of alveolar bone. Therefore, the amount of tooth-supporting alveolar bone is a key therapeutic outcome in the preclinical setting.
No single animal model can replicate all biological aspects required for the development of different therapeutics3,4,5. The ligature-induced periodontitis mouse model develops quantifiable bone destruction in a reasonably short amount of time (3-9 days)5, making this a cost-effective model to test novel therapeutic interventions for periodontitis prevention and modulation. Despite its success in supporting the development of phase II-III human clinical trials6,7,8,9,10, ligature-induced periodontitis in mice is not commonly utilized as a preclinical model. To overcome technical challenges of the classic model in which the ligature surrounds the tooth, the simplified ligature-induced periodontitis mouse model11,12 was established. The simple modification of the classic model is centered on a focused bone destruction site, between rather than around teeth. The benefits of this modification are multifold, including a shorter length of time required for 1) personnel training, 2) technical ease of the experimental procedure, and 3) reproducibility of bone quantification. Additionally, it was discovered that several microbiological and immunological events that develop and manifest under this simplified model are aligned with the current understanding of common human periodontal disease2,11,12,13. Last, the effective drug-induced bone loss prevention previously reported by us2,14 further supports the usage of the simplified ligature-induced periodontitis model as an in vivo tool to evaluate key aspects of novel periodontal therapies.
An innovative aspect of the simplified ligature-induced periodontitis model has been the development of 3D-printed tools to more easily facilitate the disease induction process11,12. While intuitive for some, investigators have reported an inability to assemble the 3D-printed tools15, which may further impede or delay animal study initiation. The present study expands upon the information presented in our previous protocol study11and provides detailed information to allow the successful implementation of the simplified ligature-induced periodontitis model in a laboratory setting. Details included in this current protocol are part of a complex array of factors that may contribute to the lack of result reproducibility of scientific findings15,16,17. The consistent model usage and reliable bone resorption identified in the multiple studies2,11,12,14,18 and by collaborative research groups13,19,20,21 over the past 10 years support the importance of disseminating detailed information to promote reproducibility in the scientific community.