Local antimicrobial delivery in periodontal therapy.

Treatment strategies towards periodontal diseases have evolved to eliminate specific pathogens or suppress destructive host response. The inherent activity of the antibiotic against the target microorganism and various Pharmacokinetic parameters such as potency, permeability, intrinsic efficacy, and substantivity of the drug dictate the success of the therapeutic outcome. However selection of an appropriate delivery system is an important factor. Rapid advances in molecular biology have helped to overcome the disadvantages of systemic and topical applications, by direct placement of antimicrobial agent (s) into subgingival sites, thus minimizing antimicrobial impact on non-oral body sites. As periodontitis is a 'localized' disease condition it is amenable to localized drug treatments. By means of controlled local delivery from within the periodontal pocket, a single administration of a few milligram of an antibacterial agent can maintain therapeutic concentrations within the crevicular fluid for a longer period of time than any other mode of delivery. This paper shall review the different local delivery systems along with the commonly employed drugs through these delivery systems.