Local Drug Delivery as an Adjunct to Surgical Intervention in the Management of Periapical Cyst

2017 ◽  
Vol 2 (1) ◽  
pp. 28-31 ◽  
Author(s):  
Anulekh Babu ◽  
P Sajith Chandran ◽  
CU Vivekchand ◽  
Lija I Parackal ◽  
Susan Jacob ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Root Canal ◽  
Antimicrobial Agents ◽  
Surgical Intervention ◽  
Treatment Options ◽  
Local Drug Delivery ◽  
Prolonged Release ◽  
Present Case Report ◽  
Periapical Lesions ◽  
Periapical Cyst

ABSTRACT Radicular cysts are the most common cystic lesions affecting the jaws. They arise from the epithelial remnants in the periodontal ligament as a result of the stimulus from periapical infection following pulpal necrosis. Treatment options to manage large periapical lesions range from nonsurgical root canal treatment or apical surgery to extraction. New approaches involve the use of local drug delivery systems based on microparticles/nanoparticles made from biocompatible polymers along with surgical intervention. Such devices enable the introduction of antimicrobial agents or other drugs directly in the periradicular area or inside the root canal, and the prolonged release of constant concentrations of these agents for fast and better healing. The present case report illustrates the combined endodontic and surgical management of a large periapical cyst with local drug delivery as an adjunct. How to cite this article Chandran PS, Babu A, Vivekchand CU, Parackal LI, Jacob S, Simon D. Local Drug Delivery as an Adjunct to Surgical Intervention in the Management of Periapical Cyst. Cons Dent Endod J 2017;2(1):28-31.

scholarly journals Non-surgical management of periapical lesions with triple antibiotic paste: A case reports

2020 ◽  
Vol 2 ◽  
pp. 120-123
Author(s):  
Munish Singla ◽  
Iyana Garg ◽  
Vandana Goyal ◽  
Harleen Kaur ◽  
Litik Mittal
Keyword(s):  
Case Report ◽  
Surgical Management ◽  
Root Canal ◽  
Case Reports ◽  
Endodontic Treatment ◽  
Root Canal Treatment ◽  
Periapical Lesion ◽  
Present Case Report ◽  
Periapical Lesions ◽  
Triple Antibiotic Paste

Sterilization of root canal space is foremost for the success of the endodontic treatment which is usually carried out with intracanal irrigants and medicaments. Triple antibiotic paste (metronidazole, ciprofloxacin, and minocycline) is used to achieve sterilization and healing of periradicular area. In the present case report, the triple antibiotic paste was used for non-surgical management of periapical lesion for 3 weeks. After 3 weeks, the tooth became asymptomatic that was then obturated. Hence, it is confirmed that conventional root canal treatment, along with intracanal medicaments (triple antibiotic paste), can non-surgically manage the periapical lesions and further promotes healing.

Development of Drug Targeting and Delivery in Cervical Cancer

2018 ◽  
Vol 18 (8) ◽  
pp. 792-806 ◽  
Author(s):  
Urvashi Aggarwal ◽  
Amit Kumar Goyal ◽  
Goutam Rath
Keyword(s):  
Drug Delivery ◽  
Cervical Cancer ◽  
Side Effects ◽  
Targeted Delivery ◽  
Drug Targeting ◽  
Drug Delivery Systems ◽  
Treatment Options ◽  
Delivery Systems ◽  
Local Drug Delivery ◽  
Delivery Strategies

Cervical cancer is the second most common cancer in women. Standard treatment options available for cervical cancer include chemotherapy, surgery and radiation therapy associated with their own side effects and toxicities. Tumor-targeted delivery of anticancer drugs is perhaps one of the most appropriate strategies to achieve optimal outcomes from the treatment and improve the quality of life. Recently nanocarriers based drug delivery systems owing to their unique properties have been extensively investigated for anticancer drug delivery. In addition to that addressing the anatomical significance of cervical cancer, various local drug delivery strategies for the cancer treatment are introduced like: gels, nanoparticles, polymeric films, rods and wafers, lipid based nanocarrier. Localized drug delivery systems allow passive drug targeting results in high drug concentration at the target site. Further they can be tailor made to achieve both sustained and controlled release behavior, substantially improving therapeutic outcomes and minimizing side effects. This review summarizes the meaningful advances in drug delivery strategies to treat cervical cancer.

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

2021 ◽  
Author(s):  
Sevda Şenel ◽  
Ayben Işılay Özdoğan ◽  
Gülçin Akca
Keyword(s):  
Drug Delivery ◽  
Oral Cavity ◽  
Drug Delivery Systems ◽  
Well Being ◽  
Delivery Systems ◽  
Local Drug Delivery ◽  
Current Status ◽  
Aqueous Environment ◽  
Prolonged Release ◽  
Prevention And Treatment

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.

Local Drug Delivery Based Treatment Approaches for Effective Management of Periodontitis

2019 ◽  
Vol 14 (2) ◽  
pp. 135-152 ◽  
Author(s):  
Geeta Aggarwal ◽  
Sonia Verma ◽  
Madhu Gupta ◽  
Manju Nagpal
Keyword(s):  
Drug Delivery ◽  
Periodontal Disease ◽  
Antimicrobial Agents ◽  
Delivery Systems ◽  
Local Delivery ◽  
Local Drug Delivery ◽  
Prolonged Treatment ◽  
Effective Management ◽  
Pocket Depth ◽  
Mechanical Removal

Background: Periodontal disease is an immuno-inflammatory condition of tissues that surround and hold the teeth. It is the disease which succeeds in all races, groups and both genders. Almost 10 to15% of the global population gets suffered from severe periodontitis as per WHO reports. Periodontal disease may likely cause other systemic diseases such as cardiovascular disease and pre-term low birth weight infants. Mechanical removal of plaques and calculus deposits from supra and subgingival environment is the backbone of periodontal treatment till date whereas complete elimination of these deleterious agents is quite unrealistic as the pocket depth increases. Recent Approaches: Recently controlled local drug delivery application is more encouraging in comparison to systemic approach as it mainly targets to enhance the therapeutic efficacy by maintaining site-specificity, avoiding first pass metabolism, reduction in gastrointestinal (GI) side effects and decreasing the dose. Several drugs such as antiseptics and antibiotics alongwith various carriers are being formulated as local drug delivery systems for effective management of the disease. Various local delivery systems reported are fibers, films, strips, compacts, injectables, microparticles, vesicular carriers, gels and nanoparticles. These local carriers provide effective prolonged treatment at the site of infection at reduced doses. This review enlightens detailed pathophysiology and various phases of periodontitis, challenges in treatment of disease and various antimicrobial agents (along with their marketed formulations) used. The main emphasis of the review is to cover all carrier systems developed so far for local delivery application in the effective management of periodontitis, as a patient compliant drug therapy.

scholarly journals Resolution of a large periapical lesion in an immature maxillary lateral incisor with the aid of triple antibiotic paste

2021 ◽  
Vol 76 (09) ◽  
pp. 560-564
Author(s):  
Nicoline Potgieter ◽  
Glynn Buchanan
Keyword(s):  
Root Canal ◽  
Root Formation ◽  
Surgical Intervention ◽  
Lateral Incisor ◽  
Permanent Teeth ◽  
Periapical Lesion ◽  
Periapical Lesions ◽  
Triple Antibiotic Paste ◽  
Maxillary Lateral Incisor ◽  
And Control

Apexification procedures are frequently performed on immature permanent teeth with incomplete root formation, open apices and necrotic pulp status with or without  periapical lesions in order to induce a calcific barrier prior to root canal therapy. The elimination and control of infection in the root canal space is critical to the success of these procedures. A healthy 21-year old male presented with pulpal necrosis, a large periapical lesion, incomplete root formation and an open apex on a maxillary right lateral incisor. Triple antibiotic paste was used to achieve antimicrobial control after traditional calcium hydroxide paste medicament failed to resolve the symptoms. Obturation was achieved using MTA and the conventional apexification technique. Excellent healing of the large periapical lesion was achieved without surgical intervention and the 4-year follow-up CBCT demonstrated complete bone fill of the lesion. Clinicians should be aware that alternative antimicrobial medicaments, such as triple antibiotic paste, may be beneficial in situations where conventional medicaments prove unsuccessful. The use of triple antibiotic paste may result in sufficient healing of the periapical lesion to justify placement of an MTA apical barrier without the need for surgical intervention

scholarly journals Professionally Delivered Local Antimicrobials in the Treatment of Patients with Periodontitis—A Narrative Review

2020 ◽  
Vol 9 (1) ◽  
pp. 2
Author(s):  
Amar Sholapurkar ◽  
Dileep Sharma ◽  
Beverley Glass ◽  
Catherine Miller ◽  
Alan Nimmo ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Search Strategy ◽  
Antimicrobial Agents ◽  
Scientific Evidence ◽  
Effective Means ◽  
Clinical Results ◽  
Local Drug Delivery ◽  
Randomized Controlled ◽  
Systemic Antibiotic Therapy ◽  
Mechanical Therapy

This review sheds light on the recent published scientific evidence relating to the use of professionally delivered local antimicrobial agents (LA’s). The review also analyses drug delivery systems available to date and provides an update on the latest scientific evidence about the benefits, limitations, and clinical results obtained by use of local drugs in the treatment of periodontal disease. The search strategy revealed randomized controlled trials (RCTs) that compared the efficacy of adjunctive LA’s to mechanical therapy alone. Based on the available evidence gathered from this review, we can infer that the use of local antimicrobial agents in conjunction to scaling and root debridement (SRD) delivers significant benefits in periodontal therapy and it is a useful aid, avoiding many of the side effects that systemic antibiotic therapy may involve. Local drug delivery (LDD) is an efficient and effective means of delivering drugs based on the evidence presented in the review. The authors of this review would suggest the use of local antimicrobials in cases of localized periodontitis or individual areas that do not respond to the usual mechanical therapy alone. This review summarizes the current use of local drug delivery in periodontal management ensuring that the general practitioners are able to choose an appropriate local antimicrobial.

scholarly journals Perawatan endodontik konvensional pada gigi molar pertama kanan rahang bawah dengan kista radikuler Conventional endodontic treatment in lower right first molar with radicular cyst

2012 ◽  
Vol 11 (1) ◽  
pp. 18
Author(s):  
Badi Soerachman ◽  
Moch. Richata Fadil ◽  
Endang Sukartini ◽  
Milly Armilia
Keyword(s):  
Calcium Hydroxide ◽  
Root Canal ◽  
Healing Process ◽  
Poor Quality ◽  
Endodontic Treatment ◽  
Hard Tissue ◽  
Periapical Lesions ◽  
Gutta Percha ◽  
Periapical Cyst

Abnormalities of the teeth that have had periapical endodontic treatment generally due to recurrent infections of root canal. Infection of the root canal is caused by leakage due to poor quality of coronal restoration and iatrogenicfactors. Root canal treatment of the tooth with periapical cyst generally do conventionally. Medication materialsused for healing of periapical lesions is calcium hydroxide, since it has properties not irritating, alkaline pH andantibacterial capabilities, so it is a biological stimulator for the formation of hard tissue in the area of damage andis expected to accelerate the healing process. It was reported the case of a 23-year-old student came to the Dentalclinic of Conservation Specialist RSGM Sekeloa with complaints lower right back teeth has restored with amalgam,no pain, but less comfortable when chewing. The results obtained after treatment with calcium hydroxide andmedikamen gutta percha filling with resin-based root canal cement. Approximately 4 months later, the periapicalradiolucent area had thinned. So it was concluded that conventional endodontic treatment proved to heal periapicallesions including cysts, as long as the treatment is taken adequately.

scholarly journals The use of long-acting drugs for the treatment of periodontitis

2021 ◽  
Vol 105 (1) ◽  
pp. 48-54
Author(s):  
Yu. Sulim ◽  
◽  
O. Petrishin ◽  
Keyword(s):  
Drug Delivery ◽  
Drug Delivery Systems ◽  
Antimicrobial Agents ◽  
Root Surface ◽  
Delivery Systems ◽  
Local Drug Delivery ◽  
Periodontal Pocket ◽  
Universal Method ◽  
Antimicrobial Drugs ◽  
Advantages And Disadvantages

Resume. The most common and universal method of treating periodontitis is periodontal pocket curettage and root surface smoothing (SRP), after which it is important to prevent re-infection of the pocket. For this purpose, antibiotics and other antimicrobial drugs are prescribed. For many years, periodontists have used the systemic administration of high doses of antibiotics during and after the completion of SRP in order to achieve the desired concentration of the drug in the gingival fluid. Such tactics often led to organic complications. In recent years, the method of introducing antimicrobial agents immobilized on natural or synthetic polymers directly into the periodontal pocket has become widespread. Such compositions slowly dissolve on the spot and eventually release the desired drug component. The study analyzes the publications of recent years on the use of controlled release systems of drugs injected into the periodontal pocket. The most common problems that may arise during the application of this method of treatment are analyzed. The advantages and disadvantages of using such systems are indicated. The indications and contraindications for the use of controlled drug delivery systems are considered, data on their comparative clinical efficacy are given. The main dosage forms used for introduction into the periodontal pocket are described, the drugs registered and sold in Ukraine are listed and the data on their therapeutic efficacy. The future prospects of application of this method in periodontology are also considered in the work. Key words: periodontitis treatment, controlled local drug delivery systems, dental gels and films.

scholarly journals Abordagem endodôntica não cirúrgica em extensa lesão periapical: relato de caso

2020 ◽  
Vol 9 (6) ◽  
pp. 513-516
Author(s):  
Mailon Cury Carneiro ◽  
Fernanda Angelio Da Costa ◽  
Paula Gabriela Vieira Chicora ◽  
Marcos Sergio Endo ◽  
Vanessa Cristina Veltrini
Keyword(s):  
Case Report ◽  
Calcium Hydroxide ◽  
Surgical Management ◽  
Root Canal ◽  
Endodontic Treatment ◽  
Root Canal Treatment ◽  
Periapical Lesion ◽  
Periapical Lesions ◽  
Periapical Cyst

O objetivo deste trabalho é relatar um caso clínico de uma extensa lesão periapical em maxila, tratada somente por uma abordagem endodôntica não cirúrgica, com expressivo reparo periapical. Paciente do sexo feminino, 52 anos, compareceu à clínica odontológica, com a queixa principal de “cisto crescendo na boca”. Os dentes 13, 14 e 15 apresentavam-se sem vitalidade pulpar. Os exames radiográficos mostraram duas áreas radiolúcidas, uniloculares, envolvendo os ápices dos dentes 13 e 15, ambos sem sinais de intervenção endodôntica. As áreas eram sugestivas de granuloma periapical e cisto periapical inflamatório, respectivamente. Realizou-se tratamento endodôntico dos dentes 13, 14 e 15. Após 11 meses, notou-se regressão significativa da rarefação óssea periapical, não sendo necessária qualquer intervenção cirúrgica. A paciente continuará em proservação até a remissão completa da lesão. O preparo químico-mecânico, associado ao emprego de medicação intracanal, pode ser suficiente para o reparo de lesões periapicais extensas. Sugere-se que o tratamento conservador seja sempre a primeira opção em casos semelhantes, de forma a se evitar cirurgias parendodônticas invasivas desnecessárias. Descritores: Endodontia; Cisto Radicular; Tratamento Conservador. Referências Hammouti J, Chhoul H, Ramdi H. Non-surgical management of large periapical cyst like lesion: case report and litterature review. J Oral Heal Dent Sci. 2019;3(1):1–7. Mitra A, Adhikari C. Management of large periapical lesions by non surgical endodontic approach - two case reports. 2017;2(5):97–104. Al Khasawnah Q, Hassan F, Malhan D, Engelhardt M, Daghma DES, Obidat D, et al. Nonsurgical clinical management of periapical lesions using calcium hydroxide-iodoform-silicon-oil paste. Biomed Res Int. 2018;2018:1-8. Schulz M, von Arx T, Altermatt HJ, Bosshardt D. Histology of periapical lesions obtained during apical surgery. 2009;35(5):634-42. Ramachandran Nair PN, Pajarola G, Schroeder HE. Types and incidence of human periapical lesions obtained with extracted teeth. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1996;81(1):93-102. Gutmann JL, Baumgartner JC, Gluskin AH, Hartwell GR, Walton RE. Identify and define all diagnostic terms for periapical/periradicular health and disease states. JOE. 2009;35(12):1658-74. Antoh M, Hasegawa H, Kawakami T, Kage T, Chino T, Eda S. Hyperkeratosis and atypical proliferation appearing in the lining epithelium of a radicular cyst. Report of a case. J Cranio-Maxillo-Facial Surg. 1983;21(5):210-13. Natkin E, Oswald RJ, Carries LI. The relationship of lesion size to diagnosis, incidence, and treatment of periapical cysts and granulomas. Oral Surg. 1984;57(1):82-94. Rathod DM, Mulay SA. Non-surgical treatment of large periapical lesion using various formulations of calcium hydroxide & nd: yag laser. Int J Curr Res. 2017;9(8):56668-72. Rosenberg PA, Frisbie J, Lee J, Lee K, Frommer H, Kottal S, et al. Evaluation of pathologists (histopathology) and radiologists (cone beam computed tomography) differentiating radicular cysts from granulomas. J Endod. 2010;36(3):423-28. Sant’ana Filho M, Rados PV. Lesões apicais. In: Silveira JOL, Beltrão GC. Exodontia. 1Porto Alegre: Missau; 1998. cap. 22, p. 275-85. Sood N, Maheshwari N, Gothi R, Sood N. Treatment of large periapical cyst like lesion: a noninvasive approach: a report of two cases. Int J Clin Pediatr Dent. 2015;8(2):133-37. Singh U, Nagpal R, Sinha D, Tuhin, Tyagi N. Iodoform based calcium hydroxide paste (metapex):an aid for the healing of chronic periapical lesion. J Adv Res Biol Sci. 2013;6(1):63-7. Dandotikar D, Peddi R, Lakhani B, Lata K, Mathur A, Chowdary UK. Nonsurgical management of a periapical cyst: a case report. J Int Oral Health. 2013;5(3):79-84. Calişkan MK. Prognosis of large cyst-like periapical lesions following nonsurgical root canal treatment: a clinical review. Int Endod J. 2004;37(6):408-16.  Kanmaz F, Altunbaş D, Zan R, Akpınar KE. Nonsurgical endodontic treatment of a large periradicular lesion. Turk Endod J. 2017;2(1):21–4. Öztan MD. Endodontic treatment of teeth associated with a large periapical lesion. Int Endod J. 2002;35(1):73–8. Barroso JAY, Uchimura JYT, Endo MS, Pavan NNO, Queiroz AF. Avaliação in vitro da influência da lima patência na manutenção do comprimento de trabalho. Rev Odontol UNESP. 2017;46(2):72-6. Madhusudhana K, Surada R, Kumar CS, Lavanya A. Non-surgical management of a large periapical lesion: a case report. Ann Essences Dent. 2017;9(2):22-5. Soares J, Santos S, Silveira F, Nunes E. Nonsurgical treatment of extensive cyst-like periapical lesion of endodontic origin. Int Endod J. 2006;39(7):566-75. Mohammadi Z, Shalavi S, Yazdizadeh M. Antimicrobial activity of calcium hydroxide in endodontics: a review. Chonnam Med J. 2013;48(3):133-40. Estrela C, Bammann LL, Pimenta FC, Pécora JD. Control of microorganisms in vitro by calcium hydroxide pastes. Int Endod J. 2001;34(5):341-45. Soares JA, Brito-Júnior M, Silveira FF, Nunes E, Santos SMC. Favorable response of an extensive periapical lesion to root canal treatment. J Oral Sci. 2008;50(1):107-11.

scholarly journals Recent Advances in Nanosystems and Strategies for Vaginal Delivery of Antimicrobials

Nanomaterials ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 311
Author(s):  
Giulia Chindamo ◽  
Simona Sapino ◽  
Elena Peira ◽  
Daniela Chirio ◽  
Marina Gallarate
Keyword(s):  
Drug Delivery ◽  
Vaginal Delivery ◽  
Antimicrobial Agents ◽  
Local Drug Delivery ◽  
Innovative Drug ◽  
Vaginal Infections ◽  
Sexually Transmitted ◽  
Rapid Removal ◽  
Vaginal Canal ◽  
Topical Dosage

Vaginal infections such as bacterial vaginosis (BV), chlamydia, gonorrhea, genital herpes, candidiasis, and trichomoniasis affect millions of women each year. They are caused by an overgrowth of microorganisms, generally sexually transmitted, which in turn can be favored by alterations in the vaginal flora. Conventional treatments of these infections consist in systemic or local antimicrobial therapies. However, in the attempt to reduce adverse effects and to contrast microbial resistance and infection recurrences, many efforts have been devoted to the development of vaginal systems for the local delivery of antimicrobials. Several topical dosage forms such as aerosols, lotions, suppositories, tablets, gels, and creams have been proposed, although they are sometimes ineffective due to their poor penetration and rapid removal from the vaginal canal. For these reasons, the development of innovative drug delivery systems, able to remain in situ and release active agents for a prolonged period, is becoming more and more important. Among all, nanosystems such as liposomes, nanoparticles (NPs), and micelles with tunable surface properties, but also thermogelling nanocomposites, could be exploited to improve local drug delivery, biodistribution, retention, and uptake in vulvovaginal tissues. The aim of this review is to provide a survey of the variety of nanoplatforms developed for the vaginal delivery of antimicrobial agents. A concise summary of the most common vaginal infections and of the conventional therapies is also provided.

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