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针对牙周炎的先进药物递送方法。

Advanced drug delivery approaches against periodontitis.

作者信息

Joshi Deeksha, Garg Tarun, Goyal Amit K, Rath Goutam

机构信息

a Department of Pharmaceutics , ISF College of Pharmacy , Moga , Punjab , India.

出版信息

Drug Deliv. 2016;23(2):363-77. doi: 10.3109/10717544.2014.935531. Epub 2014 Jul 9.

Abstract

Periodontitis is an inflammatory disease of gums involving the degeneration of periodontal ligaments, creation of periodontal pocket and resorption of alveolar bone, resulting in the disruption of the support structure of teeth. According to WHO, 10-15% of the global population suffers from severe periodontitis. The disease results from the growth of a diverse microflora (especially anaerobes) in the pockets and release of toxins, enzymes and stimulation of body's immune response. Various local or systemic approaches were used for an effective treatment of periodontitis. Currently, controlled local drug delivery approach is more favorable as compared to systemic approach because it mainly focuses on improving the therapeutic outcomes by achieving factors like site-specific delivery, low dose requirement, bypass of first-pass metabolism, reduction in gastrointestinal side effects and decrease in dosing frequency. Overall it provides a safe and effective mode of treatment, which enhances patient compliance. Complete eradication of the organisms from the sites was not achieved by using various surgical and mechanical treatments. So a number of polymer-based delivery systems like fibers, films, chips, strips, microparticles, nanoparticles and nanofibers made from a variety of natural and synthetic materials have been successfully tested to deliver a variety of drugs. These systems are biocompatible and biodegradable, completely fill the pockets, and have strong retention on the target site due to excellent mucoadhesion properties. The review summarizes various available and recently developing targeted delivery devices for the treatment of periodontitis.

摘要

牙周炎是一种牙龈的炎症性疾病,涉及牙周韧带的退化、牙周袋的形成和牙槽骨的吸收,导致牙齿支持结构的破坏。据世界卫生组织统计,全球10%-15%的人口患有严重牙周炎。该疾病是由牙周袋中多种微生物群落(尤其是厌氧菌)的生长以及毒素、酶的释放和机体免疫反应的刺激所导致的。为有效治疗牙周炎,人们采用了各种局部或全身治疗方法。目前,与全身治疗方法相比,局部药物控释方法更受青睐,因为它主要致力于通过实现诸如靶向给药、低剂量需求、避免首过代谢、减少胃肠道副作用以及降低给药频率等因素来提高治疗效果。总体而言,它提供了一种安全有效的治疗方式,可提高患者的依从性。通过各种手术和机械治疗方法无法完全清除感染部位的微生物。因此,许多基于聚合物的给药系统,如由各种天然和合成材料制成的纤维、薄膜、芯片、条带、微粒、纳米颗粒和纳米纤维,已成功用于递送多种药物。这些系统具有生物相容性和可生物降解性,能完全填充牙周袋,并且由于出色的粘膜粘附特性而在靶部位具有很强的滞留性。本文综述了用于治疗牙周炎的各种现有及最新研发的靶向给药装置。

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