New method for local drug delivery using resorbable base material in periodontal therapy

Area of Science:

• Periodontology
• Drug Delivery Systems
• Microbiology

Background:

• Periodontal disease affects millions globally, necessitating effective local drug delivery methods.
• Hydroxypropylcellulose (HPC) offers a promising base for sustained drug release in periodontal pockets.
• Antimicrobial agents like chlorhexidine (CH) and tetracycline (TC) are crucial for managing subgingival plaque.

Purpose of the Study:

• To develop and evaluate a novel local drug delivery system for subgingival plaque using HPC strips.
• To assess the clinical and microbiological efficacy of CH-loaded HPC strips in human periodontal disease.
• To investigate the in vitro and in vivo drug release profiles of CH and TC from HPC strips.

Main Methods:

• HPC strips loaded with CH or TC were prepared for drug release studies.
• In vitro drug release rates for CH and TC from HPC strips were determined.
• Clinical parameters (Plaque Index, Gingival Index, probing depth, bleeding on probing) and microbiological samples were analyzed.
• CH-containing HPC strips and placebo strips were applied to periodontal pockets in a controlled clinical trial.

Main Results:

• Both CH and TC demonstrated rapid in vitro release from HPC strips (within 2 hours).
• Tetracycline (TC) showed sustained presence in gingival crevicular fluid for up to 24 hours post-delivery.
• Application of CH-loaded HPC strips led to a marked reduction in bleeding on probing.
• A significant decrease in the proportion of Bacteroides asaccharolyticus was observed in CH-treated pockets (p < 0.01).

Conclusions:

• HPC-based drug delivery strips are effective for local antimicrobial administration in periodontal pockets.
• Local delivery of CH using HPC strips shows significant clinical benefits, including reduced bleeding.
• This novel delivery system demonstrates potential for controlling key periodontal pathogens like Bacteroides asaccharolyticus.