Development of sustained-release devices for modulation of dental plaque biofilm and treatment of oral infectious diseases

Dental diseases are among the most prevalent human illnesses. Dental biofilm plaque harboring cariogenic bacteria (caries-associated bacteria) is the major pathogenic factor leading to dental caries. Subgingival plaque harboring periopathogenic bacteria is an additional etiological factor associated with periodontal diseases. Many pharmaceutical dosage forms are used in the prevention and treatment of these oral diseases. Toothpastes and mouthwashes are among the most popular dental medicaments. The main disadvantage of these delivery systems is their low substantivity in the target site, resulting in a low penetration coefficiency into the biofilm. A local delivery application that prolongs the release of the active agent in the mouth offers great advantages in the prevention and treatment of caries and periodontal diseases. Sustained-release varnishes, containing fluorides or antibacterial agents, have been applied to hard surfaces in the oral cavity for prevention and treatment of dental caries. Sustained-release dosage forms such as films/chips, gels, or fibers containing antibacterial agents or antiinflammatory agents have been inserted into the periodontal pocket to treat periodontal diseases. These dosage forms have been shown to reduce periopathogenic bacteria along with clinical improvements in the periodontium. An additional advantage of sustained-release devices is high patient compliance, which is an important factor in dental treatment. Sustained-release devices are a relatively new concept in the dental field. It is predicted that the use of these devices at home and in the dental clinic will increase sharply in the next decade. (C) 2000 Wiley-Liss, Inc.