Drug Delivery Systems for Periodontitis

do medicates Delivery Systems for Periodontitis2.0 LITERATURE SURVEY2.1 TECHNIQUEPeriodontitis, a sickness involving supportive structures of the teeth prevails in all groups, ethnicities, races and both genders. It is a situate inflammatory response caused by bacterial infection of a periodontic pocket associated with subgingival plaque. periodontal diseases include conditions such as chronic periodontitis, belligerent periodontitis and necrotizing periodontitis. Aggressive creates of periodontitis gutter be topical anaestheticized or generalized. Antibacterial agents contribute been used effectively in the management of periodontal infection. The effectiveness of mechanical debridement of plaque and repeated topical and constitutionic presidency of antibacterial agents are contain referable to the want of accessibility to periodontopathic organisms in the periodontal pocket. Systemic memorial tablet of doses leads to therapeutic concentrations at the come in of inf ection, just for slight periods of time, forcing repeated dosing for long-term periods. Local legal transfer of antimicrobics has been investigated for the possibility of overcoming the limitations of customary therapy. The use of sustained force out formulations to deliver antibacterials to the site of infection (periodontal pocket) is gaining interest. These products reserve a long-term, effective treatment at the site of infection at much smaller doses. (Kaplish et al. 2013)Formulation and development of a gel found topical dosage form for germicide medicate will be proved to be worthwhile like ability to deliver drug more selectively to a specific site, avoidance of gastro-intestinal incompatibility, providing utilization of drugs with short biological half-life, improving physiological and pharmacological response and provide suitableness for self medication. (Basavaraj et al. 2012)2.1.1 Periodontal Local Drug DeliveryGoodson et al in 1979 first proposed the concept of controlled voice communication in the treatment of periodontitis. The effectiveness of this form of therapy is that, it reaches the base of periodontal pocket and is maintained for an adequate time for the antimicrobial effect to occur. These delivery systems are also called sustained fire, controlled-release, prolonged release, measure release, slow release, sustained bring through, prolonged action or extended action. at that place are distinct phases in a periodontal treatment scheme where a dental practitioner can use this sustained release device.They are as followsAs an adjunct to Scaling and Root planning.Periodontal maintenance therapy Recurrent periodontitis usually involves only a a few(prenominal) teeth. These sites are ideal for the treatment with this device.For whom surgery is not an option or those who refuse operative treatmentSustained release device is a less invasive treatment option and it requires less time compared to surgical treatment. (Kaplish et al. 2013)2.1.1.1 Types of local drug delivery devicesSustained released devices These are delivery systems whose action lasts less than 24 hours therefore require multiple applications. It follows the first fiat kinetics.Controlled delivery devices These are the devices which follows zero order kinetics and whose actions last longer than 24 hours, thereby decreasing the number applications. (Greenstein et al. 2000)2.1.1.2 Advantages of local drug delivery systemProvides drug in an effective concentration that can be maintained there long enough for the desired effect to be accomplished without causing any side effect.It can attain upto one hundred fold higher concentration of an antimicrobial agent in subgingival site compared with a systemic therapy.Broad spectrum antibiotics which cannot be employed systemically because of many sideeffects can be safely employed locally with minimum side effects.Superinfection and drug resistance are rare. It also reduces the risk of developin g drug repellent microbial populations at non oral body sites.The potentials of daily drug fix into periodontal pockets as a dower of home self shell out procedure can be performed by a compliant patient.This street whitethorn employ antimicrobial agents not suitable for systemic administration such as various broad spectrum antiseptics solutions. e.g. chlorhexidineImprove the patient compliance. (Slots et al. 1996 and Chadha et al. 2012)2.1.1.3 Disadvantages of local delivery systemInaccessible and deeper pocket areas, furcations cannot be completely dealt with antimicrobial agents.Time consuming and laborious, if many sites are involved.Non-sustained local delivery is limited by an only brief exposure of targeted microorganisms to applied antimicrobial agent. connective tissue associated plaque and extra pocket oral surfaces dont get affected by local drug delivery which may be responsible for recurrence of disease in treated areas. bar in placing therapeutic concentration of antimicrobial agent into deeper parts of periodontal pockets and furcations lesions.Personal application of antimicrobial agents by patients as a part of their home self-care procedure is frequently compromised by the patients lack of adequate manual dexterity, limited understanding of periodontal anatomy and shortsighted compliance and performance with recommended procedures. (Axelsson 1999)2.1.1.4 Local drug delivery systems for treating periodontitis several(a) local drug delivery system for treating periodontitis-Fibers, Film, Injectable systems, Gels, Strips and compacts, Vesicular systems, Microparticle system, Nanoparticle system etc.Injectable drug delivery systemsInjectable systems are oddly attractive for the delivery of antibiotic agents into the periodontal pocket. The application can be easily and rapidly carried out, without pain, by using a syringe. Thus, the cost of the therapy is considerably reduced compared to devices that need time to be placed and secured. Mo reover, an injectable delivery system should be able to fill the pocket, thus reaching a large proportion of pathogens. Two types of injectable drug delivery systems bemuse been studied in periodontal diseases- biodegradable (1) microparticles and (2) gels. (Kaplish et al. 2013)1. Microparticles /MicrospheresThese are controlled release drug delivery system which comprises of drug-containing microparticles or microspheres, between 10 and 500 microns in size, suspended in a pharmaceutically acceptable carrier medium, and are equal ofmaintaining an effective level of drug in the periodontal pocket for a period of one to thirty days. They are spherical free silken particles consisting of proteins or unreal polymers. Non-biodegradable as well as biodegradable materials have been investigated for the preparation of microspheres.There are two types of microspheresa) Microcapsules.b) Micromatrices.In microcapsules entrapped centre of attention is distinctly surrounded by distinct cap sule wall and in micromatrices entrapped substance is dispersing throughout the microspheres matrix. Solid biodegradable microspheres incorporating a drug dispersed or dissolved through particle matrix have the potential for the controlled release of drug. They are made from polymeric, waxy, or other protective materials (i.e. biodegradable synthetic polymers and modified natural products). (Chaudhari et al. 2010)Advantages of microspheresConstant and prolonged therapeutic effect.Reduction in dosing frequency and thereby improve the patient compliance.They could be injected into the body due to the spherical shape and smaller size.Better drug utilization will improve the bioavailability and reduce the incidence or intensity of adverse effects.Microsphere sound structure allows a controllable variability in degradation and drug release.