Periodontal drug delivery: advances and challenges

BENEDINI LUCIANO

Advanced and Modern Approaches for Drug Delivery

ACADEMIC PRESS Elsevier

Año: 2023; p. 751 - 782

Teeth are supported in their place by the periodontium. This tissue structure is formed bygingiva, cementum, periodontal ligament, and alveolar bone. The inflammation of thistissue is known as periodontitis and shows different stages. Advanced stages of thispathology lead to degradation of periodontal tissues, where the final stage the tooth loss.Periodontal disease is a chronic infectious disease of tooth-supporting tissues with highprevalence in adults. This pathology has a higher prevalence in males than females anddepends on the phenotypic variations [1,2].The approach of periodontitis could be divided into two types of treatment. The first isfocused on treating the inflammation of the tissue by removing the plaque through theapplication of antiseptics, antibiotics, and anti-inflammatory drugs, in addition to scalingand root planing and surgical treatments. When patients show severe chronic periodontitis,these procedures help to decrease the symptomatology and avoid the process progress.However, tissues are not restored and remain impaired after the treatments. Due to that, asecond stage, for restoring the function of the tissue, must be carried out. This procedureis based on bone grafts and devices application [1e5].The first section of this work addresses a brief description of periodontal disease. Second,the main features of most used drugs such as antibiotics, analgesics, anti-inflammatories,disinfectants, and host modulators applied for this treatment are reviewed. The majorexcipients used for the development of formulations and devices such as polymers,ceramic materials, and other molecules are summarized in the third section. Finally, themost relevant formulations and devices (formed by the mentioned excipients and drugs) totreat periodontal disease and those for restoring the function of the tissue have been described. Among them, we can mention fibers, films, gels, wafers, microparticulate andnanoparticulate systems, membranes, and scaffolds.