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1. CRISPR GENE THERAPY OPENS UP A NEW ERA OF DENTISTRY

2. INTRODUCTION Gene therapy in simple words means to modify individual's genetic makeup to treat or cure a disease. Gene therapy was first used as a treatment modality in the year 1990. CRISPR gene therapy is one such which is at the brink of modern medicine. CRISPR C- Clustered R- Regular I- Interspaced P-Palindromic R- Repeats

3. The primary aim of this presentation is to review about the CRISPR GENE THERAPY and it's applications in dentistry. Search strategies Recent trends in dentistry Gene therapy Crispr gene therapy nobel prize- nytimes Research articles from pubmed,, sciencedirect, frontier. Google scholar search Images from various research articles.

4. BRIEF HISTORY ABOUT CRISPR CRISPR is simply a genome identified in bacteria and other archeal forms.

5. HOW DOES THIS WORK?

6. Crispr gene therapy is used in various fields of medicine for both diagnosis and treatment of diseases like Cancer Cardiovascular diseases Neurodegenerative diseases like alzheimers and parkinsons disease Metabolic diseases like obesity, diabetes and hyperlipidemia Hematological diseases like sickle cell anemia,beta thalassemia, leukemias and lymphomas Viral diseases like HIV and HPV Other hereditary disorders

7. APPLICATIONS IN DENTISTRY DENTAL CARIES DENTAL PLAQUE AND OTHER PERIODONTAL PROBLEMS TMJ AND ASSOCIATED PAIN ORAL CANCER HERPES VIRAL INFECTIONS SALIVARY DYSFUNCTION OROFACIAL GENETIC ABNORMALITIES

8. DENTAL CARIES Streptococcus mutans CRISPR system played a role in preventing the uptake and dissemination of the antibiotic resistance genes To harness the antibiotic resistance of S. Mutans by targeting its CRISPR system.

9. DENTAL PLAQUE AND OTHER PERIODONTAL PROBLEMS Cas3 can be used to target the periodontal biofilm and to develop new strategies to reduce or eliminate periodontal pathogens. Porphyromonas gingivalis is a foremost pathogen causing microbial dysbiosis, it has been found to bear CRISPR arrays

10. TEMPOROMANDIBULAR JOINT DISORDERS Seventh meeting of TMD association held in 2014 proposed genome modification for TMJ related disorders New technologies including CRISPR gene therapy with its cas 9 protein were discussed in this meeting

11. ORAL CANCER Gene therapy is one of the targeted treatments for oral cancer. Chai et al. used CRISPR to examine 21 cell lines from patients diagnosed with oral squamous cell carcinoma. On analysing he found some cell lines unique to that of oral cancer. It may be possible to repurpose them as a treatment for this widespread mouth cancer.

12. HERPES VIRAL INFECTION Dash et al gave clearance for usage of CRISPR technology HIV associated viral infections, it was proposed for use in Herpes viral infection HELP which is HSV 1 Erasing Lentiviral Particles which target the genome and prevents its replication and occurrence Studies have been conducted in vitro for preventing Herpetic stromal keratitis .

13. Orofacial genetic abnormalities CRISPR genome editing can bring about improved treatment options for genetic defects   Stem cells can be profoundly affected by the advancements in the CRISPR technique.. Embryonic Stem cells and induced pluripotent stem cells are ideal targets for CRISPR, as they repopulate easily after the genome editing

14. SALIVARY DYSFUNCTION Ionizing Radiation results in irreversible and severe salivary gland dysfunction or xerostomia. Salivary gland gene therapy utilizing the water-specific protein aquaporin 1 (AQP1) has been of great interest to potentially correct salivary dysfunction. Functional experiments confirmed that over-expressed AQP1 increased transmembrane fluid flux indicative of increased intracellular fluid flux . This demonstrated a high specificity for the Cas9 cleavage.

15. LIMITATIONS OF CRISPR GENE THERAPY Developing protocol can be challenging and time consuming. Patient to patient variability - serious immune storm in patients receiving CRISPR-Cas9 treatment Generalizability of CRISPR-Cas9 technology is not excellent Unexpected and unintended results Genetic drive is the biggest fear of CRISPR passed on generation to generation. Expensive

16. Conclusion Crispr gene therapy has paved a way to treat various diseases . Studies have been conducted in cell lines and is going on in mammalian animals. In around 10 years human trials may begin and life threatening diseases can be cured. Let 's believe in science to believe in future. Let's believe in science to believe in future!