Recent advances in periodontal drug delivery systems.

Pragati S, Ashok S, Kuldeep S

Abstract


Periodontitis, a disease involving supportive structures of the teeth prevails in all groups, ethnicities, races and both genders. The relationship between bacterial plaque and the development of periodontal disease and caries is well established. Antibacterial agents have been used effectively in the management of periodontal infection. The effectiveness of mechanical debridement of plaque and repeated topical and systemic administration of antibacterial agents are limited due to the lack of accessibility to periodontopathic organisms in the periodontal pocket. Systemic administration of drugs leads to therapeutic concentrations at the site of infection, but for short periods of time, forcing repeated dosing for longer periods. Local delivery of antimicrobials has been investigated for the possibility of overcoming the limitations of conventional therapy. The use of sustained release formulations to deliver antibacterials to the site of infection (periodontal pocket) has recently gained interest. These products provide a long-term, effective treatment at the site of infection at much smaller doses. Biodegradable polymers are extensively employed in periodontal drug delivery devices because of their abundant source, lack of toxicity, and high tissue compatibility. A major advantage of natural polymers is that they do not affect periodontal tissue regeneration. Amongst various natural polymers, chitosan, a deacetylated product of chitin is widely used in drug delivery devices. Since it exhibits favourable biological properties such as non-toxicity, biocompatibility, biodegradability and wound healing traits, it has attracted great attention in the pharmaceutical and biomedical fields. The conventional treatment consists of tooth surface mechanical cleaning and root planning, associated or not to the systemic use of high concentrations of antibiotics, but with reduced effectiveness, and adverse effects. The patient compliance to the therapeutic is committed too. In the last decades, the treatment has been optimized for the use of drug delivery systems to the periodontal pocket, with the advantage of delivering the drug in the specific site, sustaining and/or controlling the drug concentration. Recently, the use of new drug delivery systems has been receiving great interest. This review approaches the main delivery systems for the administration of drugs to the periodontal pocket, their usefulness, as well as the advancement of these systems effectiveness in the periodontal therapy.

Keywords : Periodontal diseases; Periodontal pocket; Delivery systems; Periodontal pocket delivery


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