LOCAL DRUG DELIVERY
IN THE TREATMENT OF
PERIODONTAL DISEASES
LOCAL DRUG DELIVERY SYSTEM
INTRODUCTION

Periodontal disease is associated with bacteria and treatment by
chemotherapeutic agents appears to be appropriate
 Chemotherapeutic agents may be administered
 Delivered locally -Controlled release local delivery systems or
 Systemically
Advantage
 Route is safe and convenient route
 Can produce longer duration of action
 Offers noninvasive, painless, and simple application
 Offers avoidance of GI tract problems
 Bypasses the first pass metabolism by the liver
Disadvantages
 More chair side time
 Development of bacterial resistance
 No effect on bacterial reservoirs
 Hypersensitivity,
 More expensive
Local drug delivery systems
Tetracycline fibers (Actisite)
 Doxycycline gel (Atridox)
 Minocycline microspheres (Arestin)
 Metronidazole gel (Elyzol)
 Chlorhexidine chip (Periochip)

AGENTS USED IN LOCAL DRUG DELIVERY
Antimicrobial Agent
Product
Tetracycline fibres
Actisite
MINOCYCLINE GEL
dentomycin
Minocycline microspheres,
ointment
Arestin
periocline
Doxycycline polymer
atridox
Metronidazole gel
elyzol
Chlorhexidine chip
periochip
Tetracycline Fibre (Actisite)
 The first local delivery product available in the
U.S.

ethylene/vinyl acetate copolymer fiber,
diameter 0.5 mm, containing tetracycline, 12.7;
 When packed into a periodontal pocket, it is
well tolerated by oral tissues, and for 10 days it
sustains tetracycline concentrations
 Disadvantages

length of time required for placement (10
minutes or more per tooth)
 need for a second appointment for removal
 Development of resistant bacteria
 Pregnant and nursing mothers
Subgingival Delivery of Doxycycline (Atridox)
 It is a gel system containing 10% doxycycline hyclate is
contained within a syringe .
 The tip of the cannula is introduced to the depth of the
pocket and is expressed into the pocket until it just
overfills the pocket.
 It begins to harden on contact with the moisture in the
pocket.
MINOCYLINE GEL AND OINTMENT(periocline)
 2% MINOCYCLINE hydrochloride
 Once in a week for 4 consecutive weeks
 Minocycline Microspheres (ARESTIN)
 Antibiotic minocycline hydrochloride micro encapsulated in
bio absorbable polymer of polyglycolide.
 Maintain therapeutic drug conc 14 days
METRONIDAZOLE GEL(ELYZOL dental gel)
 containing an oil-based metronidazole 25% dental gel
 It is applied in viscous consistency to the pocket, where it is liquidized
by the body heat and then hardens again forming crystals in contact
with water.
 Two 25% gel applications at a 1-week interval have been used
CHLORHEXIDINE CHIP (PERIOCHIP)
 The chlorhexidine chip is a small bio – degradable film of
hydrolysed gelatin into which had been incorporated 2.5mg
of Chlorhexidine gluconate.
 The chip is bio-degradable and indicated for use in
periodontal pockets that are 5mm or more.
 This delivery system releases chlorhexidine and maintains
drug concentrations in the gingival crevicular fluid greater
than 100 hg/ml for at least 7 days,