Review Article LOCAL DRUG DELIVERY SYSTEMS IN THE TREATMENT OF PERIODONTITIS: A REVIEW (original) (raw)
Related papers
Local Drug Delivery in Periodontics
Aim: To investigate the local drug delivery of antimicrobials for overcoming the limitations of conventional therapy. Background: Periodontitis is an inflammatory disease involving supportive structures of the teeth which is seen universally in all groups, ethnicities, races and both genders. Various 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. Clinical Significance: These products provide a long-term, effective treatment at the site of infection at much smaller doses. Prospective multicentre studies considering risk factors for disease progression have to be designed to identify patients who may benefit the most from Local drug delivery. Conclusion: In co- occurrence with scaling and root planing, the adjunctive use of local drug delivery may improve the results in sites that don’t respond to conventional therapy
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.
Current Status of Local Drug Delivery Systems in the Treatment of Periodontal Diseases
Journal of Dental and Maxillofacial Research
Periodontal disease includes many pathological conditions affecting the periodontium, but gingivitis and periodontitis are the more common types. Gingivitis is a progressive condition, although it is reversible, when left untreated it can lead to periodontitis. Microbial species have a major role in the aetiology of periodontitis. Method: Information was derived from research papers using PubMed, Science Direct, and Google Scholar using the keywords local drug delivery system, treatment, and periodontal disease. The search included articles up to 2018 with majorly in vivo studies in patients with periodontitis. The usage of local drug delivery systems with controlled or sustained release mechanisms may provide slightly better therapeutic effect in comparison with patients who undergo scaling and root planning only. Conclusion: The present review of the literature of the currently available local drug delivery systems in the treatment of periodontal diseases.
Intrapocket Local Drug Delivery System for Periodontitis
Annals of Tropical Medicine and Public Health
Periodontitis is sort of inflammation disorder related to the tooth supportive tissue majorly occurring due to microbial infestations. In this disease, dental plaque is considered as the main cause and it is found as bio film. Plaque consists of microorganisms which initiate inflammatory activities that ultimately leads to destruction of connective tissue, pocket formation and teeth bone loss. Varieties of drug administration or delivery systems are employed to eradicate this condition. As periodontitis is caused by the microorganisms so antibacterial agents have been found effective in the management of periodontal infection. Mechanical removal of deposited plaque and repeated administration of antibacterial agents topically and systemically are limited due to limited or nonaccessibility to causing microbes present in the periodontal pocket. Local delivery of antimicrobial has been studied for the likelihood to overcome these limitations of therapies used conventionally. The use of sustained/ controlled release formulations to deliver antibacterial drugs to the site of infection is gaining interest and found to be promising delivery system. The dental inserts provide effective treatment at the infection site for prolonged duration of time at much lesser doses. This review focuses on the dental inserts for the delivery of drugs to infection site (intrapocket system), focusing on their applications, advantages and efficiency.
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 ...
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.
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.
Recent trends in treatment of periodontitis
Periodontal diseases are one of the common microbial infections which affect 35% of adult population in the world. Periodontal diseases are of two types-gingivitis and periodontitis. Periodontal disease has been considered as a possible risk factor for other systemic diseases such as cardiovascular. Gingivitis involves general inflammation of the periodontal tissue that starts from the accumulation of sub gingival plaque and results in major damage to the soft tissue and bone. Periodontitis is an inflammatory disorder which is characterized by microbial colonization of periodontal pockets, which ultimately leads to the bacterial plaques and tooth loosening. Aggressive forms of periodontitis can be localized or generalized. Local delivery of antimicrobial agents using controlled release systems should be considered as adjunctive to mechanical debridement for the treatment of localized forms of periodontal destruction. 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. Biodegradable polymers are extensively employed in periodontal drug delivery devices because of their abundant source, lack of toxicity, and high tissue compatibility. 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.