Current status and future of delivery systems for prevention and treatment of infections in the oral cavity

Abstract

Oral health reflects the general health, and it is fundamental to well-being and quality of life. An infection in the oral cavity can be associated with serious complications in human health. Local therapy of these infections offers many advantages over systemic drug administration, targeting directly to the diseased area while minimizing systemic side effects. Specialized drug delivery systems into the oral cavity have to be designed in such a fashion that they resist to the aqueous environment that is constantly bathed in saliva and subject to mechanical forces. Additionally, a prolonged release of drug should also be provided, which would enhance the efficacy and also decrease the repeated dosing. This review is aimed to summarize the current most relevant findings related to local drug delivery of various drug groups for prevention and treatment of infections (viral, bacterial, fungal) and infection-related manifestations in the oral cavity. Current therapeutic challenges in regard to effective local drug delivery systems will be discussed, and the recent approaches to overcome these obstacles will be reviewed. Finally, future prospects will be overviewed to promote novel strategies that can be implemented in clinical management for prevention and treatment of oral infections.

PEG–PLGA nanoparticles for encapsulating ciprofloxacin

“…In regenerative endodontic treatment, complete removal of the microbial infection in the dental pulp is required for successful root canal therapy 1 . Topical antibiotic delivery into the root canals provides several advantages, such as higher drug concentration, specificity, and preventing systemic adverse effects 2 . Ciprofloxacin, a component of the triple antibiotic pastes applied as a root canal medicament 3 , is a broad-spectrum antibiotic targeting E. faecalis , which commonly leads to endodontic failure.…”

“…The acidity of the hydrophilic ciprofloxacin inhibited stem cell proliferation and differentiation when it was loaded at high concentration 4 . In addition, the antibiotic paste medicament rapidly degrades in the root canal, which can result in lowering the antibiotic concentration below its effective dose 2 . Therefore, developing a novel topical antibiotic delivery system is essential for prolonging the drug’s activity and being compatible with stem cells.…”

Local Drug Delivery Systems for Vital Pulp Therapy: A New Hope

“…In addition to films, biodegradable or nonbiodegradable polymer strips have been reported to be an efficient method of administering antibacterials for periodontal treatments [ 49 ]. Drug-loaded strips, specifically with tetracycline hydrochloride and metronidazole, have been successfully used in patients with advanced periodontal pathosis, with tetracycline being more successful than metronidazole in the conducted investigations [ 50 ]. Moreover, strips have been used as mucoadhesive local delivery systems for fluoride-incorporated layered double hydroxides in periodontal treatments with reasonable safety and efficient release of fluoride ions to prevent caries through an ion-exchange mechanism with the surrounding environment [ 51 ].…”

Cytotoxicity Assessment of Liposomes Loaded With Biologically Active Substances on Oral Tumour Cells

“…In dentistry, liposomes have been used to prevent caries and gingivitis and in the treatment of oral injuries and periodontitis. Moreover, the potential of liposomal systems as drug carriers in the treatment of ulcerated oral mucosa was investigated in vivo, noting that liposomes decrease systemic drug concentration and increase local concentration [22]. The therapeutic effect of betulin and its derivatives has been tested in vitro on a large number of cell lines [23] and also, in vivo, on animal models [24,25].…”