Biomedical Engineering Reference
In-Depth Information
The review [5] provides an insight into various potential areas of dentistry that are being
invaded by nanotechnology-based drugs and drug delivery systems. Current treatments for oral/
dental diseases rely on the use of classical therapeutic agents which are applied or delivered, but in
many cases their application and efficacy is limited by low level of absorption locally and lack of
selectivity to target cells. The different treatments in dental areas of importance include caries
control, restorations, tooth remineralization, management of dentinal hypersensitivity, dental caries
vaccine, management of oral biofilm, root canal disinfection, local anesthesia, and periodontal
infection [6
8] . Some areas are identified in dental applications demanding extensive research to
emerge as a promising therapeutic strategy. The authors of the review have concluded by claiming
that dentistry should follow the
trend of probing matter
at nanoscale
to achieve
a
predictable treatment outcome.
24.2 Dental applications of nano drug delivery
24.2.1 Nanoparticulate drug delivery systems local anesthesia
Pain control is one of the top priorities in therapeutics in dental treatments and in spite of the recent
advances in clinical investigation of new therapeutic agents, pain relief is still a significant chal-
lenge for dental physicians. The reasons include difficulties of correctly evaluating pain, underesti-
mation of patient's pain, misconceptions about analgesic use and side effects, gaps in pain
management process, and lack of acute pain service. Local anesthetics (LAs) are among the most
widely used classes of pharmacological compounds, used to eliminate pain.
LAs are small molecules that could be easily eluted from the site of administration, thus lim-
iting the analgesic property. Tan et al. [9] reported the nanogel systems for LAs such as bupiva-
caine
poly(DL-lactide-co-glycolide) nanospheres, procaine hydrochloride (PrHy) hydrogel
delivery systems and showed that the drug release can be delayed over 7
15 h depending on
the type of hydrogel combination used and also reported various factors affecting the drug
release of LAs, which can be used in the dental scenario. The use of LA could be limited by the
relatively short therapeutic action and systemic toxicity related to high drug plasma concentra-
tion as a result of fast systemic uptake. Improvement of regional administration of LAs could
be achieved by incorporating them into drug delivery systems. Nanogels are probably one of
the best candidates due to the lesser pain during injection and longer blood circulation time.
However, designing a perfect candidate would require one to have a thorough knowledge of the
interaction between the drug and the carrier and the effect of size and drug loading on drug
release [9] .
There are several reports relating the applications of nano drug delivery for LAs, Tan et al. [10]
reported about PrHy from pH-responsive nanogels. Date and Nagarsenker [11] have reported the use
of micro emulsions for LA delivery. Some of the drugs with LAs properties used in nanodelivery
are clonixic acid [12] , benzocaine-
β
-cyclodextrin inclusion complexes [13] , bupivacaine-loaded poly
ε
(
-caprolactone) microspheres [14] , spray-dried bupivacaine-loaded microspheres [15] , carrageenan
microspheres containing allopurinol and LA agents [16] , bupivacaine included in poly(acrylamide-
co-monomethyl itaconate) hydrogels [17] and LA bupivacaine in biodegradable poly(DL-lactide-co-
glycolide) nanospheres [18] .
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