Local Drug Delivery in Periodontics (original) (raw)
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Review Article LOCAL DRUG DELIVERY SYSTEMS IN THE TREATMENT OF PERIODONTITIS: A REVIEW
2013
Periodontitis, a disease involving supportive structures of the teeth prevails in all groups, ethnicities, races and both genders. It is a localised inflammatory response caused by bacterial infection of a periodontal pocket associated with subgingival plaque. Periodontal diseases include conditions such as chronic periodontitis, aggressive periodontitis and necrotizing periodontitis. Aggressive forms of periodontitis can be localized or generalized. 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 investiga...
Dentistry Journal
This review sheds light on the recent published scientific evidence relating to the use of professionally delivered local antimicrobial agents (LA’s). The review also analyses drug delivery systems available to date and provides an update on the latest scientific evidence about the benefits, limitations, and clinical results obtained by use of local drugs in the treatment of periodontal disease. The search strategy revealed randomized controlled trials (RCTs) that compared the efficacy of adjunctive LA’s to mechanical therapy alone. Based on the available evidence gathered from this review, we can infer that the use of local antimicrobial agents in conjunction to scaling and root debridement (SRD) delivers significant benefits in periodontal therapy and it is a useful aid, avoiding many of the side effects that systemic antibiotic therapy may involve. Local drug delivery (LDD) is an efficient and effective means of delivering drugs based on the evidence presented in the review. The ...
LOCAL DRUG DELIVERY IN THE TREATMENT OF PERIODONTITIS: A REVIEW
Periodontitis is an inflammatory disease that causes destruction of tooth supporting tissues like periodontal ligament and alveolar bone. It is characterized by multifactorial etiology with specific bacteria. Local drug delivery system includes antimicrobial dosages that produce more constant and prolonged concentration profiles within the subgingival tissue. It provides better access into the periodontal pockets. It gives the critical distress of exposing the patient to adverse effects of systemic administration. This article reviews the literature and presents novel trends in the local drug delivery system.
Local Drug Delivery Modalities in Treatment of Periodontitis: A Review
Periodontitis is an inflammatory disease that causes destruction of tooth supporting tissues, characterized by multifactorial etiology with pathogenic bacteria being the primary etiologic agents that dwells the subgingival area. Local drug delivery system consists of antimicrobial dosages that produces more constant and prolonged concentration profiles within the subgingival tissue and provides better access into the periodontal pockets. It addresses the critical distress of exposing the patient to adverse effects of systemic administration. This article reviews the literature and presents novel trends such as osteoblast activators, growth factors, and herbal products in the local drug delivery system.
The Journal of Contemporary Dental Practice
Aim: The aim of this study was to evaluate the efficacy of three different local drug delivery medications in the treatment of chronic periodontitis. Materials and methods: Sixty participants, aged 30-55 years, were involved in the current research. Participants who fulfilled the inclusion criteria entered the study and were allocated at random to one of the three groups, each comprising 20 patients as: group A: Scaling and root planing (SRP) with local application of doxycycline gel, group B: SRP with local application of tetracycline fibers, and group C: SRP with local application of chlorhexidine gel. The plaque index (PI), the gingival index (GI), and periodontal pocket depth (PPD) were documented at baseline visit (prior to local drug delivery), and these indices were again documented 30 and 90 days post-local drug delivery. Results: At baseline, GI score for doxycycline gel use decreased from 1.38 ± 0.05 to 0.94 ± 0.02, 1.36 ± 0.11 to 0.76 ± 0.19 for tetracycline fibers use, as well as from 1.38 ± 0.10 to 0.84 ± 0.21 for chlorhexidine gel use post 90 days. The PI value at baseline for doxycycline gel use lessened from 1.26 ± 0.01 to 1.02 ± 0.06, 1.30 ± 0.14 to 0.82 ± 0.16 for tetracycline fibers use, as well as 1.30 ± 0.22 to 0.98 ± 0.11 for chlorhexidine gel use post 90 days. At baseline, PPD values for doxycycline gel use decreased from 5.88 ± 0.24 to 3.72 ± 0.11, tetracycline fibers use lessened from 5.90 ± 0.09 to 3.02 ± 0.06, as well as for chlorhexidine gel group from 5.82 ± 0.18 to 3.44 ± 0.16 post 90 days. Conclusion: Within the limitations of the current research, it may be inferred that tetracycline fibers exhibited somewhat superior enhancement to chlorhexidine as well as doxycycline gel. Clinical significance: Local administration of antibacterial agents in continued or regulated delivery arrangement is employed to augment the actions of nonsurgical periodontal management, and it may be likely to attain gingival well-being by eliminating the requirement for invasive methods with the aid of local drug delivery arrangements. Chosen elimination or prohibition of microbial pathogens with locally administered antibacterial agents coupled with SRP is an efficient move toward treatment of chronic periodontitis.
2021
Aim: Aim of the present study was to assess the efficacy of two local drug delivery systems in the treatment of chronic periodontitis. Materials and Methods: A total of 40 patients aged around 30–55 years were included in the present study.The enrolled patients underwent initial phase therapy which comprised scaling and root planning done by a single operator. Patients who fulfilled the selection criteria for the study were randomly allocated to two groups. Group 1: Tetracycline Fibers, Group 2: Chlorhexidine Gel. The plaque index (PI), the gingival index (GI), and periodontal pocket depth (PPD) were noted during baseline visit (before the local drug delivery), and these indices were rerecorded after 30 days after the local drug delivery. Results: The reduction of mean plaque index score was seen more in group 1 compared to group 2. There was no statistically significant difference found between the groups. The reduction of mean gingival index score and periodontal pocket depth was ...
Journal of Clinical and Experimental Dentistry, 2011
Background: The selective removal or inhibition of pathogenic microbes with locally delivered antimicrobials when combined with scaling and root planing is often an effective approach for the managment of chronic periodontitis. Aim: To compare the clinical efficacy of tetracycline fibers and a xanthan based chlorhexidine gel in the treatment of chronic periodontitis. Methods and materials: Thirty systemically healthy patients in the age group of 30-50 years suffering from generalized chronic moderate periodontitis were selected. For each subject, two experimental sites were chosen that had probing depth >5mm and were located in symmetric quadrants and the sites were randomized at split mouth level with one receiving tetracycline fibers and the other chlorhexidine gel. Plaque score, bleeding score, probing pocket depth and relative attachment level gain was recorded on day 0 and at the end of 3 months. Results and conclusion: In both groups, there was statistically highly significant reduction in all the clinical parameters i.e. plaque score, bleeding score and probing pocket depth and relative attachment level gain was seen at different time intervals. Local delivery of tetracycline and chlorhexidine is a safe, easy and efficacious method along with scaling and root planing in the treatment of chronic periodontitis. Inter-comparison of both local drug delivery agents with respect to clinical changes shows that tetracycline fibers are better than chlorhexidine gel for treatment of chronic periodontitis. Nevertheless, long term studies with more samples are suggested to further evaluate and compare the efficacy of both materials.
Antibiotics, 2020
Periodontal infections tend to be site-specific, mostly confined to the periodontal pocket. With the surge of antibiotic-resistant bacteria, the trend is shifting towards other therapeutic modalities, especially locally delivered approaches that include other pharmacotherapeutic drugs and medical devices. This narrative review aimed to provide insights into the clinical efficacy of local drug delivery and adjunctive agents used in nonsurgical management of periodontitis. Electronic (PubMed/MEDLINE, CENTRAL, and EMBASE) and bibliographic searches of past systematic reviews were carried out to identify previous publications on the topic. Only relevant literature and randomized controlled trials published in English were selected. In addition, a literature review was developed based on the selected articles. Experimental drugs or agents were excluded. This review highlights the clinically proven and commercially available therapeutic agents related to the management of periodontal disease with comparisons of their clinical efficacies and challenges. A vast array of commercial local pharmacotherapeutic agents had been clinically tested, but the methodologies and clinical results varied within and between each agent used, causing difficulty in drawing conclusions and providing support to the superiority of one agent over another. Considering the benefit–cost ratio with the modest clinical results, the long-term usefulness of these agents remains debatable. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.