Background::
Periodontitis is one of the most widespread oral diseases. Curcumin, a hydrophobic polyphenolic compound derived from the rhizomes of Curcuma longa has a great potential for biological and pharmacological activities. The introduction of local controlled delivery of curcumin directly into the periodontal pocket is a promising approach for the treatment of periodontitis.
Objective::
The study has been designed to formulate intrapocket dental film loaded with curcumin to be used for insertion into the periodontal pockets and evaluate its clinical efficacy.
Methods::
Curcumin dental films were prepared by the solvent casting technique using polymers such as Ethylcellulose, HPMC K4M, Eudragit RL 100, Chitosan with Dibutyl Phthalate and Poly Ethylene Glycol 400 as the plasticizer. The prepared films (CDF1-CDF16) were evaluated for various physicochemical parameters regarding established pharmaceutical procedures such as surface pH, folding endurance, tensile strength, swelling index, drug content, in-vitro drug release, antibacterial efficacy, stability studies, and clinical efficacy.
Results::
Experimental parameters of the obtained film exhibited results within the desired limit. Fourier Transform Infrared Spectroscopy and Differential Scanning Calorimetry studies revealed the formulated film is stable during drug stability and are compatible between drugs and excipients. The surface morphology of the formulation using Scanning Electron Microscope images showed the presence of free drug particles on the surface causing a burst effect at the desired site. In-Vitro dissolution studies showed an initial burst release to achieve an immediate therapeutic level of drug in the periodontal pocket followed by a progressive fall and extended-release of the drug for 10 days. The therapeutics effects such as antibacterial activity of films on P. gingivalis are also observed. Furthermore, the clinical trials of formulation CDF16 on affected patients proved the therapeutic efficacy of the dental films showing a statistically significant (p < 0.05) decrease in the clinical markers of periodontitis, i.e. periodontal probing depth, plaque index, and sulcular bleeding index.
Conclusion::
The experimental results suggest that Curcumin dental film is experimentally identified as a potential drug delivery device. Hence the use of curcumin dental film can be used for topical treatment of periodontal diseases and to achieve optimum therapeutic efficacy.
Periodontitis describes a group of related inflammatory diseases resulting in the destruction of the tissues that support the tooth. This disease results from the growth of diverse microflora (especially anaerobes) in the periodontal pockets and releases various bacterial enzymes, toxins, and stimulation of the body’s immune response. Scaling and Root planning is the basic treatment modality for periodontitis. Mechanical treatment is limited by physical impediments and biochemical considerations. Antimicrobial agents may be used as an adjunct to overcome the limitations of mechanical therapy. Nonsurgical controlled intrapocket delivery of antimicrobials in the treatment of periodontitis has been investigated for the possibility of overcoming the limitations of conventional therapy. Nonsurgical controlled release formulations to deliver antibacterial to the site of periodontal pocket are designed to be of low cost, nontoxic, biocompatible, biodegradable, greater stability, non-immunogenicity, and effective long-term treatment at the site of infection with reduced systemic dosing. A number of polymer based delivery systems like fibers, strips, films, chips, microparticles, nanoparticles, and nanofiber made from a variety of natural and synthetic materials have been successfully tested to deliver a variety of drugs. Periodontal pockets as a drug delivery platform for designing a suitable dental localized dosage form along with its potential advantage and limitations is reviewed here.
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