口腔局部药物递送系统在牙周炎治疗中的研究进展

doi:10.13701/j.cnki.kqyxyj.2025.06.002

摘要/Abstract

摘要： 牙周炎作为口腔多发、常见的慢性感染性疾病,是成年人缺牙的主要原因。目前牙周炎的临床治疗以系列非手术方式的基础治疗——刮治和根面平整(scaling and root planning,SRP)为主,并取得了良好的临床疗效。但口腔局部解剖的特殊性增加了机械治疗的难度,使得药物治疗成为了重要的辅助治疗手段。近年来,局部药物递送系统(local drug delivery systems,LDDS)因使用便捷、不良反应小、缓释控释、靶向作用等优点逐渐成为主流。尤其在各种口腔疾病的治疗中,口腔病变部位的局部给药更有着巨大的优势,因此口腔LDDS也成为了当前的研究热点。本文将对牙周炎治疗研究领域涌现的LDDS进行综述,包括纤维、条带、薄膜、凝胶、微球、纳米粒子,以及基因工程化药物等。

关键词: 牙周炎, 药物递送系统, 微球, 纳米粒子, 基因工程

Abstract: As a commonly and frequently occurred chronic infectious disease, periodontitis has become the main cause of teeth loss in adults. Nowadays, the clinical treatment of periodontitis is mainly based on non-surgical mechanical treatment: scaling and root planting (SRP). But the particular oral anatomy has increased the difficulty of mechanical treatment, which makes drug application an important adjunctive treatment. In recent years, local drug delivery system (LDDS) has gradually become the mainstream for its convenient use, sustain-release, control-release, targeted effect, and low side effects. Especially for various oral diseases, oral LDDS has become a hotspot in the treatment. This paper reviews these emerged oral LDDS: fibers, strips, films, gel, microspheres, nanoparticles, and gene engineering materials.

Key words: periodontitis, drug delivery system, microspheres, nanoparticles, gene engineering

杜岚, 陈亮. 口腔局部药物递送系统在牙周炎治疗中的研究进展[J]. 口腔医学研究, 2025, 41(6): 457-462.

DU Lan, CHEN Liang. Research Progress of Oral Local Drug Delivery System in Treatment of Periodontitis:A Literature Review[J]. Journal of Oral Science Research, 2025, 41(6): 457-462.

参考文献

[1] Mehrotra N, Singh S. Periodontitis [M]. StatPearls Publishing. 2023.
[2] Zúñiga-Loor D, Parise-Vasco JM, Montesinos-Guevara C. Mechanical debridement combined with amoxicillin and metronidazole compared with mechanical debridement alone for the treatment of chronic periodontitis: An overview of systematic reviews [J]. Dent Med Probl, 2024, 61(3): 439-446.
[3] Zhang Y, Jiang R, Lei L, et al. Drug delivery systems for oral disease applications [J]. J Appl Oral Sci, 2022, 30: e20210349.
[4] Viglianisi G, Santonocito S, Lupi SM, et al. Impact of local drug delivery and natural agents as new target strategies against periodontitis: new challenges for personalized therapeutic approach [J]. Ther Adv Chronic Dis, 2023, 14: 20406223231191043.
[5] Barhate A, Bajaj P, Shirbhate U, et al. Implications of gene therapy in dentistry and periodontics: a narrative review [J]. Cureus, 2023, 15(11): e49437.
[6] Shetty K, Bhandari A, Yadav KS. Nanoparticles incorporated in nanofibers using electrospinning: A novel nano-in-nano delivery system [J]. J Control Release, 2022, 350: 421-434.
[7] Tan OL, Safii SH, Razali M. Commercial local pharmacotherapeutics and adjunctive agents for nonsurgical treatment of periodontitis: a contemporary review of clinical efficacies and challenges [J]. Antibiotics (Basel), 2019, 9(1): 11.
[8] Amato M, Santonocito S, Polizzi A, et al. Local delivery and controlled release drugs systems: a new approach for the clinical treatment of periodontitis therapy [J]. Pharmaceutics, 2023, 15(4): 1312.
[9] Reise M, Kranz S, Guellmar A, et al. Coaxial electrospun nanofibers as drug delivery system for local treatment of periodontitis [J]. Dent Mater, 2023, 39(1): 132-139.
[10] Lucaciu PO, Repciuc CC, Matei IA, et al. In vivo validation of a nanostructured electrospun polycaprolactone membrane loaded with gentamicin and nano-hydroxyapatite for the treatment of periodontitis [J]. Membranes, 2024, 14(3): 18.
[11] Tang L, Liu WL, Wang XY, et al. Electrospinning of MNZ/PLGA/SF nanofibers for periodontitis [J]. Nanotechnol Rev, 2024, 13(1): 12.
[12] Lim SY, Dafydd M, Ong J, et al. Mucoadhesive thin films for the simultaneous delivery of microbicide and anti-inflammatory drugs in the treatment of periodontal diseases [J]. Int J Pharm, 2020, 573: 118860.
[13] Petrescu N, Crisan B, Aghiorghiesei O, et al. Gradual drug release membranes and films used for the treatment of periodontal disease [J]. Membranes (Basel), 2022, 12(9): 895.
[14] Rosa C, Gomes JML, Moraes SLD, et al. Use of chlorhexidine chip after scaling and root planning on periodontal disease: A systematic review and meta-analysis [J]. Saudi Dent J, 2021, 33(1): 1-10.
[15] Constantin M, Lupei M, Bucatariu SM, et al. PVA/chitosan thin films containing silver nanoparticles and ibuprofen for the treatment of periodontal disease [J]. Polymers, 2023, 15(1): 30.
[16] Arisoy S, Bux K, Herwig R, et al. Development, evaluation, and molecular dynamics study of ampicillin-loaded chitosan-hyaluronic acid films as a drug delivery system [J]. Acs Omega, 2024, 9(18): 19805-19815.
[17] Alavi SE, Raza A, Gholami M, et al. Advanced drug delivery platforms for the treatment of oral pathogens [J]. Pharmaceutics, 2022, 14(11): 2293.
[18] Li QQ, Wang D, Xiao CS, et al. Advances in hydrogels for periodontitis treatment [J]. ACS Biomater Sci Eng, 2024, 10(5): 2742-2761.
[19] Karmakar S, Shanmugasundaram S, Modak B. Oleogel-based drug delivery for the treatment of periodontitis: current strategies and future perspectives [J]. F1000Res, 2023, 12: 1228.
[20] Zheng H, Zhou Y, Zheng Y, et al. Advances in hydrogels for the treatment of periodontitis [J]. J Mater Chem B, 2023, 11(31): 7321-7333.
[21] Hu Z, Zhou Y, Wu H, et al. An injectable photopolymerizable chitosan hydrogel doped anti-inflammatory peptide for long-lasting periodontal pocket delivery and periodontitis therapy [J]. Int J Biol Macromol, 2023, 252: 126060.
[22] Wang Y, Li J, Tang M, et al. Smart stimuli-responsive hydrogels for drug delivery in periodontitis treatment [J]. Biomed Pharmacother, 2023, 162: 114688.
[23] 周岳,申玉芹.透明质酸凝胶联合Nd:YAG激光对老年牙周炎患者牙根敏感的实验研究及临床疗效观察[J].口腔医学研究, 2021, 37(1): 39-42.
[24] Tahmasebi E, Ardestani AK, Hassani Z, et al. The current novel drug delivery system (natural and chemical composites) in dental infections for antibiotics resistance: a narrative review [J]. Cell Mol Biol (Noisy-le-grand), 2022, 68(10): 141-160.
[25] Zhao JS, Wei Y, Xiong J, et al. Antibacterial-anti-inflammatory-bone restoration procedure achieved by MIN-Loaded PLGA microsphere for efficient treatment of periodontitis [J]. AAPS PharmSciTech, 2023, 24(3): 74.
[26] Ren B, Lu J, Li M, et al. Anti-inflammatory effect of IL-1ra-loaded dextran/PLGA microspheres on Porphyromonas gingivalis lipopolysaccharide-stimulated macrophages in vitro and in vivo in a rat model of periodontitis [J]. Biomed Pharmacother, 2021, 134: 111171.
[27] Arnett MC, Chanthavisouk P, Costalonga M, et al. Effect of scaling and root planing with and without minocycline HCl microspheres on periodontal pathogens and clinical outcomes: A randomized clinical trial [J]. J Periodontol, 2023, 94(9): 1133-1145.
[28] Tan X, Liu S, Hu X, et al. Near-infrared-enhanced dual enzyme-mimicking Ag-TiO(2-x)@Alginate microspheres with antibactericidal and oxygeneration abilities to treat periodontitis [J]. ACS Appl Mater Interfaces, 2023, 15(1): 391-406.
[29] Song CH, Huang DQ, Zhao C, et al. Abalone-inspired adhesive and photo-responsive microparticle delivery systems for periodontal drug therapy [J]. Adv Sci, 2022, 9(30): 9.
[30] 张新坚,张斌.纳米粒子递药系统在牙周炎局部药物治疗中应用的研究进展[J].口腔疾病防治,2022,30(1): 73-76.
[31] Kumaar NR, Nair SC. Nanomaterials: an intra-periodontal pocketdrug-delivery system for periodontitis [J]. Ther Deliv, 2023, 14(3): 227-249.
[32] Nasiri K, Masoumi SM, Amini S, et al. Recent advances in metal nanoparticles to treat periodontitis [J]. J Nanobiotechnology, 2023, 21(1): 283.
[33] Kiarashi M, Mahamed P, Ghotbi N, et al. Spotlight on therapeutic efficiency of green synthesis metals and their oxide nanoparticles in periodontitis [J]. J Nanobiotechnology, 2024, 22(1): 21.
[34] Thangavelu A, Stelin KS, Vannala V, et al. An overview of chitosan and its role in periodontics [J]. J Pharm Bioallied Sci, 2021, 13(Suppl 1): S15-S18.
[35] Cocos DI, Buzia OD, Tatu AL, et al. Challenges in optimizing nanoplatforms used for local and systemic delivery in the oral cavity [J]. Pharmaceutics, 2024, 16(5): 22.
[36] Yan M, Liang W, Du L, et al. Metronidazole-loaded polydopamine nanomedicine with antioxidant and antibacterial bioactivity for periodontitis [J]. Nanomedicine (Lond), 2023, 18(29): 2143-2157.
[37] Luan J, Li R, Xu W, et al. Functional biomaterials for comprehensive periodontitis therapy [J]. Acta Pharm Sin B, 2023, 13(6): 2310-2333.
[38] Krasilnikova O, Yakimova A, Ivanov S, et al. Gene-activated materials in regenerative dentistry: Narrative review of technology and study results [J]. Int J Mol Sci, 2023, 24(22): 16250.
[39] Deng Y, Ren M, He P, et al. Genetically engineered cell membrane-coated nanoparticles for antibacterial and immunoregulatory dual-function treatment of ligature-induced periodontitis [J]. Front Bioeng Biotechnol, 2023, 11: 1113367.
[40] Huang X, Deng Y, Xiao J, et al. Genetically engineered M2-like macrophage-derived exosomes for P. gingivalis-suppressed cementum regeneration: From mechanism to therapy [J]. Bioact Mater, 2024, 32: 473-487.
[41] Jung YH, Park JY, Kim HJ, et al. Regenerative potential of bone morphogenetic protein 7-engineered mesenchymal stem cells in ligature-induced periodontitis [J]. Tissue Eng Part A, 2023, 29(7-8): 200-210.
[42] Pan J, Tian H, Xu S, et al. Sustained delivery of chemically modified mRNA encoding amelogenin from self-assembling hydrogels for periodontal regeneration [J]. Composites Part B: Engineering, 2024, 271: 111162.