A REVIEW : APPROACH IN DENTAL DRUG DELIVERY SYSTEM

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ABOUT AUTHORS:
Badola Ashutosh,* Nishu Sharma
Shri Guru Ram Rai Institute of Technology & Science ( SGRRITS ),
Dehradun 248001, Uttarakhand , India
*ashutosh.badolam.pharma@gmail.com

ABSTRACT:
Controlled release local drug delivery systems offer advantages compared to systemic dosage forms for periodontitis. The objective of this research was to design and evaluate sustained release dental films containing drug in a non-biodegradable polymer for targeted delivery of the drug. The polymer ethyl cellulose was used in the formulation of dental films. The dental film was then evaluated for various parameters like thickness, folding endurance, and weight variation, and content uniformity, in vitro and in vivo study. Drug release profile of the dental film showed that the film exerted an initial burst release followed by a sustained release of the drug and the drug release was well above the minimum inhibitory concentration throughout the time of study. The release data obtained were subjected for release kinetics study. The study suggested that the non-biodegradable based dental film is a potential local drug delivery device for the treatment of periodontitis.

REFERENCE ID: PHARMATUTOR-ART-1791

INTRODUCTION
Dental inserts are described by positioning between interproximal surfaces of teeth during a dental procedure. The tooth inserts have thin regions positioned in the interproximal contact of the teeth. In one form, a tooth inserts comprises an elongated band having spaced apart from the thin central regions positioned so that, when the band is wrapped around a teeth, a first of the central regions is positioned between a first tooth and adjacent tooth and the second of the central regions is positioned between the first and third tooth, which is adjacent to the first tooth and at the opposite side of the first tooth from the second tooth.1

Dental inserts used for stopping or filling a cavity of carious tooth treated by a preparation. Nowadays dental inserts used for the treatment of local disease like periodontitis in a form chip, strip, gels, and bio-dental inserts as a local drug delivery for the sustained and controlled effect.2

Advantages 3
1. Periodontal pockets are easily accessible and are therefore a convenient site for localized drug delivery system, which could be inserted into the pocket.
2. It is useful in controlling and monitoring the desired drug levels in the site.
3. It allows local modification of tissue permeability, inhibit protease activity or decrease immunogenic response.
4. It is a useful means of delivering a drug to oral cavity that is not absorbed into the gastrointestinal system.
5. It by passes hepatic first pass metabolism, thereby offering a greater bioavailability and reduction in dosage.
6. The drugs escape from the destructive acidic environment of the stomach.
7. Therapeutic serum concentration of the drug can be achieved more rapidly.
8. Sustained release drugs offer a onetime application and have an advantage over repeated application.

Disadvantages 4
1. There is difficulty in placing therapeutic concentration of antimicrobial agent into deeper parts of periodontal pockets.
2. Personal application of antimicrobial agents by patients, lack of adequate manual dexterity, limited understanding of periodontal anatomy and poor compliance and performance with recommended procedure.
3. The task of professionally applying local antimicrobial agents in periodontitis patients with numerous advanced lesions distributed throughout their mouth is time consuming and labour intensive.
4. Antimicrobial agents locally applied into periodontal pockets do not  affect pathogens residing within adjacent gingival connective tissues and on extra- pocket oral surfaces which increases the risk of re-infection.

The oral cavity provides a diverse environment for colonization of a wide range of microorganisms. Periodontal diseases are a general term encompassing several pathological conditions such as gingivitis and periodontitis. Periodontitis is a local infection with primary bacterial etiology in the gingival crevices, which affects the structural organs surrounding the teeth like periodontal ligament, connective tissue and bone. The warm and moist pocket environment fasters the growth of gram-negative, anaerobic bacteria that proliferate in the subgingival space. The aim of dental healthcare is to control the population of microorganisms. Slowing or arresting of the oro-dental infections can be achieved by controlling bacterial plaque.5

The systemic administration of antibiotics is a useful method for controlling subgingival flora but it has been found that discontinuation of systemic antibiotic therapy results in recolonization of pathogens. Therefore long term antimicrobial therapy is required for complete eradication of microorganisms. High oral doses are required to achieve effective concentrations in the pocket but high doses given for long periods of time eventually cause development of resistant strains of bacteria, super infection, gastrointestinal and central nervous system disturbances. To overcome the disadvantages of systemic chemotherapy with antibiotics, recent technical advancements have led to the development of new drug delivery systems that provide sustained therapeutic activity by targeting the delivery of a drug to a particular site. If a particular drug is targeted to a desired site, it minimizes the distribution of drug to other body organs.6

Controlled drug delivery systems offer numerous advantages compared with conventional dosage forms, which include improved efficacy, reduced toxicity, improved patient compliance and convenience. The primary objective of this research was to design and evaluate sustained release dental bio-dental inserts containing moxifloxacin HCl for placement into the periodontal pockets of chronic periodontitis patients for targeted delivery of drug in order to reduce periodontal pathogens. The effects of various formulation variables on the drug release profiles from the bio-dental inserts were studied to determine optimum formulations.7

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