Shahri Fereshteh, Parhizkar Ardavan
Dental Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Iranian Center for Endodontic Research, Research Institute of Dental Sciences, Dental School, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Iran Endod J. 2020 Spring;15(2):65-78. doi: 10.22037/iej.v15i2.30374.
Endodontic pathosis is preliminary caused by bacteria and their by-products that interact with pulpal and periradicular host tissues. The purge of the root canal system (RCS) from bacteria is a necessity for successful endodontic treatment. Different approaches have been considered to reduce the number of microorganisms and confront microbiota in the radicular area; namely chemomechanical preparation and intracanal medication. However, various studies have shown that, due to the intricate anatomy of RCS, bacteria can persist in distant areas and significantly decrease the degree of success in endodontic ministrations. Thereby, elimination of bacteria remains a challenge, specifically from the infectious root canals. In recent years, local drug delivery systems (LDDS), loaded with drugs and/or antibacterial agents, have been deliberated for the removal of microorganisms or as a medicinal adjunct to mechanical instrumentation. Owing to the resistant species and complexities in the structure of root canals, it seems that LDDS may be able to closely affect microorganisms and improve the success rate of endodontic treatment. Furthermore, they are capable of limiting drugs to RCS, and can achieve a more effective therapeutic dose/concentration in the target site. Furthermore, and due to successful outcomes, administration of LDDS has also been given great attention for regenerative purposes. Micro/nanoparticles, liposomes, nanofibers, sealers and so forth represent typical delivery systems used for endodontic treatments. This study addresses pivotal LDDS used in endodontics and their applications
牙髓病最初是由细菌及其与牙髓和根尖周宿主组织相互作用的副产物引起的。清除根管系统(RCS)中的细菌是牙髓治疗成功的必要条件。人们已经考虑了不同的方法来减少根区微生物的数量并对抗微生物群;即化学机械预备和根管内用药。然而,各种研究表明,由于根管系统复杂的解剖结构,细菌可以在远处区域持续存在,并显著降低牙髓治疗的成功率。因此,消除细菌仍然是一项挑战,特别是从感染的根管中清除细菌。近年来,装载药物和/或抗菌剂的局部给药系统(LDDS)已被考虑用于清除微生物或作为机械预备的药物辅助手段。由于耐药菌的存在和根管结构的复杂性,LDDS似乎能够更紧密地影响微生物并提高牙髓治疗的成功率。此外,它们能够将药物局限于根管系统,并能在靶部位达到更有效的治疗剂量/浓度。此外,由于取得了成功的结果,LDDS的应用在牙髓再生方面也受到了极大的关注。微/纳米颗粒、脂质体、纳米纤维、封闭剂等是用于牙髓治疗的典型给药系统。本研究阐述了牙髓病治疗中使用的关键局部给药系统及其应用
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