ABSTRACT
The idea of the local drug delivery system is getting popular nowadays to treat gingivitis and periodontitis. The method of delivering the drug locally is quite easy and requires minimal intervention. This delivery system not only treats the periodontal diseases effectively but also prevents the side effects linked with the use of the drugs which are used orally for longer periods to cure these diseases. Chlorhexidine (CHX) is being widely used to treat these conditions because of its broad spectrum anti-bacterial effect and is found to be more effective in lowering plaque formation. The aim of this study was to appraise the effect of the local drug delivery system by using 1% CHX gel in patients with periodontal diseases. 1% CHX gel was prepared and its physicochemical characteristics were then assessed. Clinical parameters and inflammatory salivary biomarkers were evaluated in two groups of patients. Group I: standard treatment group. Group II: gel treatment group. These parameters were evaluated before treatment and after 4 weeks of treatment. 1% CHX gel was highly effective in reducing gingivitis and periodontitis by using the local drug delivery system which allowed the drug to retain into the periodontal pocket for prolong period of time.
Subject(s)
Anti-Infective Agents, Local/administration & dosage , Chlorhexidine/administration & dosage , Drug Delivery Systems/methods , Mouthwashes/administration & dosage , Periodontal Diseases/drug therapy , Dinoprostone/analysis , Gels , Gingivitis/drug therapy , Gingivitis/metabolism , Humans , Periodontal Diseases/metabolism , Periodontitis/drug therapy , Periodontitis/metabolism , Saliva/chemistry , Saliva/drug effects , Saliva/metabolism , Treatment Outcome , Tumor Necrosis Factor-alpha/analysisABSTRACT
The gold standard therapy for treating the periodontal infections is the removal of bacterial plaque and deposits of calculus from tooth surfaces by scaling and root planning. In order to eliminate these bacterial reservoirs, beside conventional treatment, chemo therapeutic agents are commonly prescribed by periodontologists. To avoid the systemic side effects and development of antibiotics resistance, local drug delivery methods has gained the attention of dentists to treat periodontal infections, along with scaling and root planning. The aim of this study was to evaluate the effectiveness of local drug delivery system in combination with scaling and root planning, by using 1% metronidazole gel and mouthwash. The patients were divided into 3 groups. Group I: conventional treatment group. Group II: patients received treatment with gel. Group III: patients received treatment with mouthwash. All groups received treatment for 30 days. Clinical parameters and salivary concentration of TNF-α, PGE2 and nitric oxide were measured before and after treatment in both groups. All clinical parameters and inflammatory biomarkers significantly reduced in gel and mouthwash group patients (p≤0.001) as compared to patients received conventional treatment. The gel is found to be more efficacious than mouthwash especially in reducing clinical attachment loss (p< 0.05) and in reducing inflammatory biomarkers (p≤0.001). We strongly suggest the use of metronidazole via local drug delivery system combined with scaling and root planning to treat periodontal diseases.
Subject(s)
Anti-Bacterial Agents/administration & dosage , Drug Delivery Systems , Metronidazole/administration & dosage , Mouthwashes/administration & dosage , Periodontal Diseases/therapy , Administration, Oral , Anti-Bacterial Agents/chemistry , Combined Modality Therapy , Dental Scaling , Dinoprostone/metabolism , Drug Compounding , Female , Gels , Humans , Inflammation Mediators/metabolism , Male , Metronidazole/chemistry , Mouthwashes/chemistry , Nitric Oxide/metabolism , Pakistan , Periodontal Diseases/diagnosis , Periodontal Diseases/metabolism , Periodontal Diseases/microbiology , Root Planing , Saliva/metabolism , Time Factors , Treatment Outcome , Tumor Necrosis Factor-alpha/metabolismABSTRACT
Inflammation and its mediators have an important role in gingivitis and periodontitis. Prostaglandin is one of the eicosanoid involved in many chronic inflammatory diseases, including periodontal diseases. Aspirin irreversibly acetylates cyclooxygenase and inactivate this enzyme responsible for the production of PGE2 that mediates pain and inflammation. The aim of the study was to prepare aspirin gel and mouthwash in 1% concentration and use it in patients with periodontal diseases during the non-surgical periodontal treatment and to assess its anti-inflammatory effects on salivary biomarkers PGE2, TNF-α, and nitric oxide. Thirty patients were divided into three treatment groups, standard treatment group, second received scaling and root planning with gel application of 1% aspirin, third received scaling and root planning followed by rinsing with 1% aspirin mouthwash. Results indicated that the levels of PGE2, TNF-α and nitric oxide in the groups of patients received gel treatment and mouthwash treatment was decreased to significant levels (p<0.001) as compared to the group of standard treatment. Aspirin gel was found to be more effective in reducing inflammatory biomarkers in contrast to aspirin mouthwash (p<0.001). We concluded from our study, that low concentration of aspirin oral preparations are highly active in reducing the inflammatory biomarkers associated with periodontal diseases.
Subject(s)
Aspirin/pharmacology , Biomarkers/metabolism , Mouthwashes/pharmacology , Periodontal Diseases/drug therapy , Periodontal Diseases/metabolism , Saliva/metabolism , Adult , Anti-Inflammatory Agents/pharmacology , Dinoprostone/metabolism , Female , Gels/pharmacology , Gingivitis/drug therapy , Gingivitis/metabolism , Humans , Inflammation Mediators/metabolism , Male , Nitric Oxide/metabolism , Periodontitis/drug therapy , Periodontitis/metabolism , Saliva/drug effects , Tumor Necrosis Factor-alpha/metabolism , Young AdultABSTRACT
Amitriptyline, an agent universally used to treat depression, has an anti-inflammatory activity and a potential for lowering inflammatory mediators. Periodontal diseases like gingivitis and periodontitis if untreated contributes to gingival tissue destruction and bone resorption. These diseases are commonly treated with conventional non-steroidal anti-inflammatory agents and antibiotics along with standard periodontal treatment. The aim of this experimental, observational and randomized clinical control trial was to evaluate the anti-inflammatory effects of amitriptyline on clinical parameters and on inflammatory biomarkers in patients of periodontal diseases by developing 1% oral gel and mouthwash formulations. 30 patients participated in the study were grouped in three categories, patients received standard conventional treatment, patients received gel treatment for four weeks after standard treatment, patients received mouthwash for four weeks after standard periodontal treatment. Results showed that amitriptyline gel and mouthwash in 1% formulation showed promising results by significantly reducing periodontal parameters and inflammatory biomarkers (p<0.001) as compared to standard treatment. Thus, we suggest that gel and mouthwash formulation of amitriptyline is highly efficacious in treating the periodontal diseases.
Subject(s)
Amitriptyline/administration & dosage , Mouthwashes/administration & dosage , Periodontal Diseases/drug therapy , Periodontitis/drug therapy , Anti-Inflammatory Agents/administration & dosage , Biomarkers/metabolism , Drug Delivery Systems/methods , Female , Gingiva/drug effects , Gingiva/metabolism , Gingivitis/drug therapy , Gingivitis/metabolism , Humans , Male , Periodontal Diseases/metabolism , Periodontitis/metabolismABSTRACT
Simvastatin is an anti-hyperlipidemic drug which reduces the cholesterol synthesis and also has anti-inflammatory, immunomodulatory and anti-microbial action against the bacteria. This develops the interest of periodontologist to use it in combination with conventional treatment to treat periodontal diseases. The objective of the study was to develop the gel and mouthwash of simvastatin and use it locally to treat gingivitis and periodontitis as an adjunct to scaling and root planning. The patients were randomly allocated into three groups that were standard treatment group, gel treatment group and mouthwash treatment group. Results indicated that simvastatin gel and mouthwash in 1% preparation showed favorable results by significantly reducing periodontal parameters and inflammatory biomarkers (p<0.001) as compared to standard treatment. Thus, we strongly suggest the use of simvastatin by local drug delivery system as an adjunct treatment of scaling and root planning.
