Local Drug Delivery Systems as an Adjunct to Cure Periodontitis- The Novel Dental Applicant

Abstract

Periodontitis is a complex disease that involves the loss of attachment around teeth resulting from action of microorganisms and the response of the host to these organisms. The basic treatment of chronic periodontitis is a mechanical debridement of periodontal pockets by Scaling and root planing (SRP) in combination with efficient plaque control. 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. The introduction of a slow release and subgingival delivery of tetracycline has changed the rationale from a mechanical treatment towards a combined therapy for full mouth/sites disinfection. Various antibiotics, antiseptics and resorbable carriers are now proposed as Local drug delivery systems with similar targets to arrest disease progression. The dosage forms include fibers, film, injectable systems, liposomal system, micro or nanoparticle based systems, some of which are degradable while others are not and need to be removed at the termination of the treatment. These products provide a long-term, effective treatment at the site of infection at much smaller doses. This article reviews the current status of controlled local delivery their usefulness, as well as the advancement of these systems in the treatment of periodontitis. Key wors: Chlorhexidine, Doxycycline, Local drug delivery systems, Minocycline, Metronidazole, Tetracyclines.