Periodontitis

A novel periodontal film for the treatment of periodontitis was developed by using herbal drug Quercetin, it is a plant flavanol from the flavonoid group of polyphenols. It is found in many fruits, vegetables, leaves, seeds and grains; capers and red onions. It has a bitter flavour and is used as an antimicrobial agent and effective against infecting microorganisms in the periodontal pocket. Calibration curves for Quercetin was developed in phosphate buffer PH 6.6, FT-IR studies was performed, which revealed that no interaction between the selected drug and polymers. Differential scanning calorimetry was performed to the identification of various physical properties and thermal transitions of drug and the polymeric materials. Periodontal films were prepared by solvent casting technique using Eutragit  and HPMC as polymers Dibutyl phthalate as plasticizers and PEG as surface active agent. The formulated periodontal films were evaluated for their folding endurance, percent moisture loss, surface pH, viscosity, thickness, uniformity of weight, content uniformity, and in-vitro release. Scanning electron microscopy was done to study the surface characteristics of the patch on placebo and optimized formulation F3 before dissolution and after dissolution. SEM analysis revealed that the drug was uniformly distributed in patch and drug was released by diffusion. Data of In-vitro release from the formulated periodontal films were fit to different equations and kinetic models to explain release kinetics. Kinetic models used were zero first-order equations and Higuchi models. The release mechanism was understood by fitting the data to Korsemeyer-Peppas model.

The purpose of the present study was to evaluate the efficacy of the Photodynamic therapy in addition to the classical treatment with scaling root planing compare to subgingival chlorhexidine irrigation. A 20 patient of chronic generalized periodontitis with probing depth more than 5mm, were included in the study. According to split mouth design, for one quadrant scaling and root planning with Photodynamic therapy was performed and other side scaling and root planning with chlorhexidine irrigation was done as a control group. A statistically significant difference in median Gingival Index score over a period of 20 days from baseline was observed  in  the site of the test group as compared to control site. The present study supports the treatment approach of Photodynamic therapy an adjunct to routine scaling and root planning. Photodynamic therapy is as efficient and safe to be used in addition to root planing when compared to sub gingival irrigation with scaling and root planning.

  Periodontitis is an inflammatory disease of the supporting tissues of the teeth caused by groups of specific microorganisms. The concept that localized problem sites may be treated by local drug delivery appears attractive as the antimicrobial agent is delivered within periodontal pockets and the therapy is targeted on specific pathogenic microorganisms. Local delivery of antimicrobial agents using controlled release systems should be considered as adjunctive to mechanical debridement for the treatment of localized forms of periodontal destruction. Local delivery of in situ gelling system to periodontal pockets has the benefit of putting more drugs at target site while minimizing exposure of the total body to the drug. In situ gelling system helps in maintaining effective levels of drug in gingival cervicular fluid to produce desirable clinical effects. In situ gel for controlled drug delivery system of periodontal pocket has received greater interest and appears to hold some promise in periodontal therapy. They are designed to release drug slowly with more prolonged drug availability and sustained drug action. Controlled release systems offer an advantage of decrease in frequency of administration, improving patient compliance. The dose of the drug can also be decreased and hence, the toxicity when compared to conventional therapy. In controlled drug delivery, the drug is released over an extended period of time by zero order kinetics and hence constant plasma drug concentration can be achieved. Key words: Periodontitis, Periodontal pocket, In situ gel, Controlled drug delivery