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

Abstract

Vital pulp therapy (VPT) is deliberated as an ultraconservative/minimally invasive approach for the conservation of vital pulpal tissues, preservation of dental structure, and maintenance of tooth function in the oral cavity. In VPT, following the exposure of the dental pulp, the environment is prepared for the possible healing and probable refunctionalisation of pulpal connective tissue. However, to succeed in VPT, specific biomaterials are used to cover and/or dress the exposed pulp, lower the inflammation, heal the dental pulp, provoke the remaining odontoblastic cells, and induce the formation of a hard tissue, i.e., the dentinal bridge. It can be assumed that if the employed biomaterial is transferred to the target site using a specially designed micro-/nanosized local drug delivery system (LDDS), the biomaterial would be placed in closer proximity to the connective tissue, may be released in a controlled and sustained pattern, could properly conserve the remaining dental pulp and might appropriately enhance hard-tissue formation. Furthermore, the loaded LDDS could help VPT modalities to be more ultraconservative and may minimise the manipulation of the tooth structure as well as pulpal tissue, which could, in turn, result in better VPT outcomes.

Anti-Inflammatory and Mineralization Effects of an ASP/PLGA-ASP/ACP/PLLA-PLGA Composite Membrane as a Dental Pulp Capping Agent

“…These monomers are metabolized in the body through the tricarboxylic acid cycle, and the final metabolites, carbon dioxide and water, have no toxic effect on cells [ 62 , 63 , 64 , 65 ]. PLGA and PLLA can be used as suitable microcarriers to achieve sustained drug release [ 66 , 67 ]. As a scaffold material, PLGA is conducive to the colonization of cells (such as SHED, DPSCs, and dental pulp fibroblasts), and on PLGA scaffolds, stem cells can differentiate into odontoblast-like cells and endothelial cells, producing tissues similar to dental pulp and dentin [ 68 ].…”

Healing of large endodontic lesions using a new combination of triple antibiotics: A case report

“… 6 , 7 However, it has been recently shown that CH is not as effective as speculated against intracanal microorganisms and cannot be addressed as a strong antibacterial agent despite having an alkaline pH. 8 Therefore, different studies have investigated new drugs or combination of drugs with more efficient antimicrobial activity as appropriate replacements for CH, for example, antibiotics, to be employed in endodontic treatments. Triple antibiotics paste (TAP), a combination of ciprofloxacin, metronidazole, and minocycline, has been discussed in various investigations for use in regenerative endodontic protocols and disinfection of RCS.…”

“…In numerous studies, calcium hydroxide (CH) has been widely used as an intracanal medicament to combat regional microbiota 6,7 . However, it has been recently shown that CH is not as effective as speculated against intracanal microorganisms and cannot be addressed as a strong antibacterial agent despite having an alkaline pH 8 . Therefore, different studies have investigated new drugs or combination of drugs with more efficient antimicrobial activity as appropriate replacements for CH, for example, antibiotics, to be employed in endodontic treatments.…”

Evaluation of Alkaline-Treated Polycaprolactone and Zr-Hydroxyapatite as a Drug Delivery System in Dentistry

“…Dental and periodontal care in restorative dentistry is superior when using biocompatible and biodegradable drug delivery systems to eradicate bacterial infection, restore wound, and guide bone regeneration because re-operation will not be carried out (1) and drug bioavailability will be boosted by the limited diffusion and degradation of the loaded drugs (2) . Osseous tissues including teeth are mainly constituted by ions of calcium (Ca 2+ ) and phosphate (PO 4…”