Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India.
Department of Pharmaceutics, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi 110062, India.
Med Hypotheses. 2019 Dec;133:109392. doi: 10.1016/j.mehy.2019.109392. Epub 2019 Sep 6.
Global prevalence of the severe periodontitis is at the alarming stage and its association with the systemic complications is highly evident which cannot be neglected. An insight into the pathophysiology of the periodontitis reveals that the promising amelioration could only be envisaged with the 4-D/multi-pronged approach of combining antibiotic along with the host modulating agents. The complications of the disease itself suggest that the use of antibiotic alone is not able to cater the symptoms completely. There is a need of other host modulatory agents too, such as Cyclo-oxygenase -II (COX II) enzyme inhibitors, Matrix metalloproteinase's (MMPs) inhibitors and osteo-integrating agents. Also, there is an unmet need of singular treatment modality through which all these agents can be sequentially and directly delivered into the periodontal cavity. The current hypothesis takes it a step forward wherein an antibiotic is combined with other three host modulatory agents in a singular drug delivery system. The encapsulation of multiple therapeutic agents with controlled release would therefore allow for reduced drug dose thus minimizing side effects; contributing to enhanced patient compliance and treatment efficacy. Hence this approach can be presented as a 4-D/multi-pronged approach for circumvention of periodontitis.
全球严重牙周炎的患病率处于令人担忧的阶段,其与全身并发症的关联非常明显,不容忽视。深入了解牙周炎的病理生理学表明,只有通过联合使用抗生素和宿主调节因子的 4D/多管齐下的方法,才能有望改善。该疾病本身的并发症表明,仅使用抗生素不能完全缓解症状。还需要其他宿主调节因子,如环氧化酶- II (COX II) 酶抑制剂、基质金属蛋白酶 (MMPs) 抑制剂和骨整合剂。此外,还需要一种单一的治疗方式,通过这种方式可以将所有这些药物依次直接递送到牙周囊中。目前的假设更进一步,即将抗生素与其他三种宿主调节因子结合在单一的药物递送系统中。因此,通过控制释放来封装多种治疗药物将允许减少药物剂量,从而最大限度地减少副作用;有助于提高患者的依从性和治疗效果。因此,这种方法可以作为一种 4D/多管齐下的方法来预防牙周炎。