Department of Biomedical Engineering, University of Kentucky, Lexington, KY 40506-0070, USA.
Biomaterials. 2013 Nov;34(34):8835-42. doi: 10.1016/j.biomaterials.2013.07.093. Epub 2013 Aug 12.
Periodontal disease is highly prevalent, with 90% of the world population affected by either periodontitis or its preceding condition, gingivitis. These conditions are caused by bacterial biofilms on teeth, which stimulate a chronic inflammatory response that leads to loss of alveolar bone and, ultimately, the tooth. Current treatment methods for periodontitis address specific parts of the disease, with no individual treatment serving as a complete therapy. The present research sought to demonstrate development of a multiple drug delivery system for stepwise treatment of different stages of periodontal disease. More specifically, multilayered films were fabricated from an association polymer comprising cellulose acetate phthalate and Pluronic F-127 to achieve sequential release of drugs. The four types of drugs used were metronidazole, ketoprofen, doxycycline, and simvastatin to eliminate infection, inhibit inflammation, prevent tissue destruction, and aid bone regeneration, respectively. Different erosion times and adjustable sequential release profiles were achieved by modifying the number of layers or by inclusion of a slower-eroding polymer layer. Analysis of antibiotic and anti-inflammatory bioactivity showed that drugs released from the devices retained 100% bioactivity. The multilayered CAPP delivery system offers a versatile approach for releasing different drugs based on the pathogenesis of periodontitis and other conditions.
牙周病的发病率很高，全球 90%的人口患有牙周炎或其前期病症牙龈炎。这些病症是由牙齿上的细菌生物膜引起的，它会引发慢性炎症反应，导致牙槽骨丧失，最终导致牙齿脱落。目前牙周炎的治疗方法针对疾病的特定部位，没有一种单一的治疗方法可以作为完整的治疗方法。本研究旨在展示一种用于牙周病不同阶段分步治疗的多药物递送系统的开发。更具体地说，通过将包含邻苯二甲酸醋酸纤维素和 Pluronic F-127 的缔合聚合物制成多层膜，以实现药物的顺序释放。使用的四种药物分别为甲硝唑、酮洛芬、强力霉素和辛伐他汀，以分别消除感染、抑制炎症、防止组织破坏和促进骨再生。通过改变层数或包含释放更慢的聚合物层，可以实现不同的侵蚀时间和可调节的顺序释放曲线。对抗生素和抗炎生物活性的分析表明，从这些装置中释放的药物保留了 100%的生物活性。CAPP 递药系统为基于牙周炎和其他病症的发病机制释放不同药物提供了一种通用的方法。
