Drug-loaded PLA filler for ridge preservation post-tooth extraction

| Posted in: Science

Journal name: Journal of Indian Society of Periodontology
Original article title: Fabrication and anti-microbial evaluation of drug loaded polylactide space filler intended for ridge preservation following tooth extraction
The Journal of Indian Society of Periodontology (JISP) publishes original scientific articles on periodontology (the study of supporting structures of teeth) and oral implantology. It is a bimonthly open-access journal with special issues for specific occasions.
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Original source:

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Author:

Nebu George Thomas, George P. Sanil, Gopimohan Rajmohan, Jayachandran V. Prabhakaran, Amulya K. Panda


Journal of Indian Society of Periodontology:

(A bimonthly open-access journal)

Full text available for: Fabrication and anti-microbial evaluation of drug loaded polylactide space filler intended for ridge preservation following tooth extraction

Year: 2011 | Doi: 10.4103/0972-124X.85671

Copyright (license): CC BY-NC-SA


Summary of article contents:

Introduction

Alveolar ridge resorption following tooth extraction poses significant challenges for subsequent dental implant placement. This study explores the use of biodegradable polylactide space fillers as a method for ridge preservation, aiming to prevent alveolar bone loss and promote regeneration. The incorporation of medications, such as chlorhexidine, into these space fillers could offer additional advantages by addressing potential postoperative infections, thereby promoting a conducive healing environment.

The Role of Chlorhexidine in Preventing Alveolar Osteitis

One of the critical findings of this study is the effective antimicrobial property of chlorhexidine-loaded polylactide sponges against multi-drug resistant Pseudomonas aeruginosa isolated from a chronic periodontitis patient. The study demonstrates that these biodegradable sponges not only serve as a physical space filler but also act as a drug delivery system, significantly inhibiting bacterial growth. Chlorhexidine is noted for its rare development of resistance among microbes, making it a valuable addition to ridge preservation strategies. Its use could mitigate risks associated with alveolar osteitis—a complication that can hamper adequate healing and lead to further bone loss.

Conclusion

The research confirms that porous polylactide sponges are promising biomaterials for ridge preservation after tooth extraction. These sponges exhibit a controlled degradation over four to six months, ideal for supporting bone regeneration in extraction sites. Furthermore, the successful loading of antimicrobial agents like chlorhexidine and piperacillin + tazobactam into these sponges provides an innovative solution to prevent infections, ensuring a higher likelihood of positive outcomes in dental implant treatments. The findings advocate for further studies to evaluate the clinical application of these materials in dental practice.

FAQ section (important questions/answers):

What is the purpose of polylactide space fillers in dentistry?

Polylactide space fillers are used to prevent alveolar ridge resorption after tooth extraction, aiding in ridge preservation and facilitating future dental implant placement.

How do chlorhexidine-loaded sponges help after tooth extraction?

Chlorhexidine-loaded sponges release the drug in the socket, preventing infections like alveolar osteitis, which can interfere with the healing process after tooth extraction.

What are the advantages of synthetic biodegradable polymers over graft materials?

Synthetic biodegradable polymers, like polylactide, reduce risk of infection, offer controlled degradation, and do not host any potential for transmissible infection like some xenografts.

How were the polylactide space fillers tested for antibacterial activity?

Antibacterial activity was evaluated by loading the sponges with drugs and performing disc diffusion tests against a multidrug-resistant Pseudomonas aeruginosa isolated from chronic periodontitis.

What are the safety benefits of using polylactide in ridge preservation?

Polylactide is biocompatible and biodegradable, ensuring safety during the healing process without the risk of contamination associated with animal-derived graft materials.

Glossary definitions and references:

Scientific and Ayurvedic Glossary list for “Drug-loaded PLA filler for ridge preservation post-tooth extraction”. This list explains important keywords that occur in this article and links it to the glossary for a better understanding of that concept in the context of Ayurveda and other topics.

1) Drug:
A drug is a substance used for medical treatment, including prevention, diagnosis, or alleviation of disease symptoms. In the context of this study, drugs such as chlorhexidine and piperacillin+tazobactam were loaded into polylactide sponges to provide antimicrobial activity against Pseudomonas aeruginosa, helping manage post-extraction complications.

2) Study (Studying):
The study conducted focuses on the development and evaluation of biodegradable polylactide sponges designed for ridge preservation after tooth extraction. It aims to assess their cytocompatibility, drug loading capabilities, and antimicrobial effectiveness against specific bacteria, thus contributing valuable findings to dental and regenerative medicine fields.

3) Antibiotic (Antibacterial):
Anti-bacterial relates specifically to any substance that can destroy or inhibit bacterial growth. In this study, the focus was on formulating polylactide sponges that not only serve as space fillers for bone healing but also actively prevent bacterial infections utilizing antibiotics like chlorhexidine.

4) Activity:
Activity in this context pertains to the effectiveness of the drug, particularly its action against bacteria. The study measured the antibacterial activity of drug-loaded polylactide sponges, particularly focusing on their ability to inhibit the growth of infectious bacteria such as Pseudomonas aeruginosa, which is crucial for successful healing.

5) Biodegradable:
Biodegradable materials are designed to break down into harmless products over time through natural processes. The polylactide sponges studied are biodegradable, enabling them to safely dissolve in the body after serving their purpose in ridge preservation, minimizing long-term complications and promoting bone regeneration.

6) Surface:
Surface refers to the outer layer or boundary of the polylactide sponges. The surface properties were evaluated to determine their suitability for cell adhesion and growth, being critical for the interaction with surrounding biological tissues and effective integration into the extraction site during healing.

7) Medium:
Medium refers to the substance used to cultivate microbial or cellular growth. In the study, various culture media were utilized during the evaluation of polylactide sponges' compatibility with B-16 melanoma cells and for culturing the isolated bacterial strain, providing a controlled environment for experimentation.

8) Table:
Table signifies the structured format used to present data systematically in the study. Tables were used to summarize findings about antibiotic sensitivity and the antibacterial efficacy of drug-loaded sponges against Pseudomonas aeruginosa, allowing easier comparison and interpretation of results for the readers.

9) Post:
Post indicates a temporal phase in the healing process that follows a significant event, such as tooth extraction. The study particularly focuses on aspects related to post-extraction conditions, including the prevention of alveolar osteitis, a complication that can affect healing outcomes.

10) Suffering:
Suffering refers to the distress or discomfort experienced by patients, particularly in relation to dental conditions like chronic periodontitis. The study addresses treatment developments to alleviate the suffering of patients by employing strategies like drug-loaded sponges for effective infection management post-extraction.

11) Water:
Water is an essential solvent and biological medium. In the study, it is used for washing polylactide sponges to remove residual solvents and in the preparation process. Its role underscores the importance of maintaining sterility and cleanliness in biomedical applications of the sponges developed.

12) Blood:
Blood is a vital fluid in the body, often involved in healing processes and infections. The study's context acknowledges the role of dental infections that may arise from blood-borne bacteria, emphasizing the significance of antibacterial strategies, like drug-loaded sponges, to manage such complications effectively.

13) Line:
Line in this context may refer to cell lines, which are cells cultured in a lab for research purposes. The B-16 melanoma cell line was used to evaluate the cytocompatibility of polylactide sponges, crucial for assessing their biological safety prior to clinical application in dental therapies.

14) Pushpagiri (Pushpa-giri, Puṣpagiri):
Pushpagiri refers to the Pushpagiri Research Center, where the study was conducted. The center plays an important role in facilitating the research, providing necessary resources, and insights that contribute to the development of innovative preventative and therapeutic strategies in dental and periodontal medicine.

15) Cleansing:
Cleansing refers to purification processes aimed at removing impurities or pathogens. In the context of this study, the term may relate to daily oral cleansing routines that patients undergo to prevent infections, highlighting the relevance of hygiene in dental health and recovery from procedures.

16) Grafting:
Grafting refers to the surgical procedure of transplanting tissue to promote healing in dental contexts. Although the study investigates synthetic biodegradable sponges as alternatives, understanding traditional grafting techniques and materials helps inform the benecits of using polylactide sponges in ridge preservation.

17) Disease:
Disease encompasses pathological conditions that affect the body. In the study's context, the focus is on periodontal disease and chronic conditions that result in infection, complicating dental extractions. The study aims to develop strategies to manage such diseases effectively through innovative applications.

18) Species:
Species refers to specific groups of organisms, in this case, Pseudomonas aeruginosa, a gram-negative bacterium responsible for various infections. The study assesses the antimicrobial activity of drug-delivering sponges specifically against this multi-drug-resistant species, emphasizing the challenge in treating infections in dental patients.

19) Mineral:
Mineral typically refers to inorganic substances occurring naturally in the environment. In dental applications, minerals are significant in bone health and regeneration. Understanding mineralization processes is important as it associates with the healing dynamics post-extraction and the development of ridge-preserving materials.

20) Thomas:
Thomas refers to Dr. Thomas George, the Professor and Head of the Department of Periodontics acknowledged for his guidance throughout the study. His insights were vital in shaping the research objectives, methodologies, and analytical frameworks that contributed to the success of the work presented.

21) Nature:
Nature relates to the inherent qualities or characteristics of organisms and materials. In the context of this study, it encompasses the biocompatibility and biodegradability of polylactide sponges, crucial for their acceptance in biological systems and the efficacy of ridge preservation strategies explored.

22) Animal:
Animal refers to living organisms that can be a source of biological materials, such as xenografts. The study underlines the advantages of using synthetic alternatives over animal-derived materials to minimize risk of disease transmission while achieving effective biological functions in dental applications.

23) Cotton:
Cotton commonly refers to a soft, fluffy fiber used in various applications. Although not directly mentioned in the methods or results, it could relate to standard laboratory practices regarding maintaining cleanliness, or as an absorbent material during surgical or experimental procedures conducted in the study.

24) Filling (Filled):
Filled pertains to the encapsulation or insertion of materials into a defined space. In this study, polylactide sponges are filled with drugs like chlorhexidine to treat infections. Proper filling ensures adequate distribution of antimicrobial agents, enhancing the therapeutic effectiveness of the ridge preservation technique.

25) India:
India denotes the geographical context where this research was conducted, influencing the study's clinical relevance, addressing local health needs, and contributing to the expanding body of knowledge regarding dental health and innovation in biomedical materials in the Asian context.

26) Glass:
Glass, in biomedical contexts, particularly refers to bioactive glass that can interact beneficially with living tissues, promoting bone regeneration. Its inclusion suggests alternative material considerations for dental applications, contrasting with the focus on biodegradable polylactide sponges used in the study to prevent bone resorption.

27) Jacob:
Jacob refers to Dr. Oommen Aju Jacob, the Principal of the Dental College who provided support for the study. His involvement attests to the oversight and institutional backing crucial for successful research development and eventual application in clinical dental practice.

28) Hita:
Hita refers to Hita-Iglesias, a researcher whose findings on chlorhexidine application in surgical wounds are referenced, highlighting previous work related to antimicrobial interventions in dentistry. This connection underlines the significance of established research in informing and guiding the study's objectives and methodologies.

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