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载纳米纤维支架在慢性牙周炎治疗中的评估——一项随机对照分袋研究

Evaluation of nanofiber scaffolds laden in the management of chronic periodontitis-a randomized, controlled split pocket study.

作者信息

Dubey Pragati, Mittal Neelam, Mishra Brahmeshwar, Gautam Anju, Kumar Naveen, Rashika M

机构信息

Faculty of Dental Sciences, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, India.

Department of Pharmaceutical and Technology, IIT- BHU, Varanasi, 221005, India.

出版信息

J Oral Biol Craniofac Res. 2025 Nov-Dec;15(6):1336-1346. doi: 10.1016/j.jobcr.2025.07.027. Epub 2025 Aug 19.

Abstract

BACKGROUND

The main objective of periodontal treatment is to stop the progression of periodontal disease. Controlled-release drugs yield promising outcomes when conventional treatment is proven to be insufficient in establishing periodontal health in chronic periodontitis. A low-dose controlled-release delivery method for the treatment of periodontal infection was attempted to be developed in this study. With effective electrospinning, a novel sustained-release medication system including polycaprolactone (PCL) nanofibers containing (A2) and Tetracycline (TET) was accessed clinically for periodontitis.

METHOD & MATERIALS: The electrospinning technique prepared nanofibers with A2 and TET in PCL and gelatin. The A2-loaded nanofiber followed the Higuchi model release and had a sustained impact of 9 days (220 h). 75 periodontal sites from 31 patients with chronic periodontitis (≥5 mm probing depth) followed by 3 groups: Group I received Scaling and root planning (SRP) and blank polymer mat whereas Group II treated with SRP and PCL-GE-A2 nanofiber scaffold/mat, and Group III received SRP + PCL-GE-TET (tetracycline) nanofiber scaffolds. Clinical evaluations of GI, PI, PPD, and CAL were performed on each patient group.

CONCLUSION

Compared to the placebo and standard group, the test group was remarkably associated with improved GI, PI, PPD, and CAL at the end of the study. Therefore, drug-loaded nanofiber was found to be efficacious in treating periodontal diseases and may be appropriate as an alternative treatment.

CLINICAL SIGNIFICANCE

The fabricated PCL-GE-A2 nanofiber mat was more cost-efficient, minimized the dosage amount, and dosage frequency, and showed no adverse effects or discomforts with increased patient compliance.

摘要

背景

牙周治疗的主要目标是阻止牙周疾病的进展。当传统治疗被证明在建立慢性牙周炎的牙周健康方面不足时,控释药物产生了有前景的结果。本研究试图开发一种低剂量控释给药方法来治疗牙周感染。通过有效的静电纺丝技术,一种新型的包括含有(A2)和四环素(TET)的聚己内酯(PCL)纳米纤维的缓释药物系统在临床上用于治疗牙周炎。

方法与材料

静电纺丝技术制备了含有A2和TET的PCL和明胶纳米纤维。负载A2的纳米纤维遵循Higuchi模型释放,具有9天(220小时)的持续作用。来自31例慢性牙周炎患者(探诊深度≥5mm)的75个牙周部位分为3组:第一组接受龈上洁治和根面平整(SRP)及空白聚合物垫,而第二组用SRP和PCL-GE-A2纳米纤维支架/垫治疗,第三组接受SRP + PCL-GE-TET(四环素)纳米纤维支架。对每个患者组进行牙龈指数(GI)、菌斑指数(PI)、探诊深度(PPD)和临床附着丧失(CAL)的临床评估。

结论

与安慰剂组和标准组相比,试验组在研究结束时GI、PI、PPD和CAL有显著改善。因此,发现载药纳米纤维在治疗牙周疾病方面有效,可能适合作为替代治疗。

临床意义

制备的PCL-GE-A2纳米纤维垫成本效益更高,减少了用药量和用药频率,且未显示出不良反应或不适,提高了患者的依从性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6a0a/12395175/686aeb1eb89e/ga1.jpg

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