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Local drug delivery in the management of periodontal diseases part 1: general principles

From Volume 41, Issue 8, October 2014 | Pages 732-736

Authors

Jane E Eastham

BDS(Hons)

Research Assistant, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle Upon Tyne, NE2 4BW, UK

Articles by Jane E Eastham

Robin A Seymour

BDS, FDS RCS, FDS RCS(Edin), PhD, FHKAMS

Dean of Dentistry and Professor of Restorative Dentistry, School of Dental Sciences, Newcastle University, Framlington Place, Newcastle upon Tyne, NE2 4BW, UK

Articles by Robin A Seymour

Abstract

Periodontal pockets provide an ideal environment for the application of local drug delivery for the management of periodontitis. In this first article, consideration is given to the principles that underlie local drug delivery and the pharmacological challenges. It is essential that such systems are compatible with the periodontal tissues. Potential unwanted effects that can arise from both drug and delivery vehicle are also appraised.

Clinical Relevance: Local drug delivery systems still have a place in the management of periodontal diseases. This first article considers the pharmacological principles and unwanted effects that can arise from the use of such systems.

Article

A local drug delivery device consists of a drug reservoir and a limiting element that has a control over the amount of active ingredient released. This can be divided into two classes:

The sustained release devices release a drug over a period of 24 hours, whereas the controlled delivery device has duration of drug release greater than 1 day.

Several areas are targeted by locally delivered pharmacological agents in the treatment of periodontal disease. These include the bacteria which reside in the periodontal pocket, the soft tissue walls of the pocket itself and exposed cementum or radicular dentine. The periodontal pocket provides a natural environment which is easily accessible for the positioning of a drug delivery device and offers theoretical benefits to local drug delivery technology, such as:

The delivery device should be able to expand into the volume of the periodontal pocket and remain dimensionally stable.

A local drug delivery device is designed to deliver a pre-determined amount of drug to a specific anatomical site for an extended period of time.1

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