Periodontal and peri-implant diseases are a group of inflammatory conditions affecting the gum tissues supporting the teeth and dental implants, respectively. Current primary treatment options include conventional scaling and root planing, in conjunction with plaque control. Antibiotics and antiseptics have also been used to treat moderate to severe periodontal disease and peri-implantitis. However, the high doses of systemic antibiotics required have resulted in increased risk of side-effects, and the local drug delivery methods currently available are unable to reach the intended site of action, achieve therapeutic concentration, or last for a sufficient amount of time.
In this study, Dr Livia Nastri and colleagues from the University of Campania “Luigi Vanvitelli'' and Istituto Italiano di Tecnologia formulated a new controlled-release mucoadhesive gel containing the antimicrobial agents metronidazole and doxycycline. The authors then carried out an in vitro evaluation of its antibacterial properties against four species of bacteria commonly involved in periodontal and peri-implant diseases.
The study showed that the formulation allowed a convenient release profile of the drugs whilst exhibiting viscosities suitable for injectability, thus representing an attractive antibiotic delivery system in the periodontal or peri-implant pocket. The amount of each antibiotic released by the gel was shown to be greater than the minimum inhibitory concentration required for antimicrobial effect, and showed in vitro efficacy over a period of 13 days.
The team report that this controlled-release antibacterial gel could be useful for the treatment of periodontal and peri-implant diseases, where conventional therapy is unsuccessful. However, due to the complexity and polymicrobial nature of periodontal and peri-implant infections, the authors note that it is difficult to foresee all the limitations of clinical use of the gel and therefore, they recommend that further in vitro and in vivo studies of the gel are carried out.
This blog post is distributed under the Creative Commons Attribution License (CC-BY). Illustration by David Jury.