title: A novel polymeric chlorhexidine delivery device for the treatment of periodontal disease.
abstract: An implantable, anti-microbial delivery device for the treatment of periodontal disease has been developed. In this polymer-based delivery system, the encapsulation efficiency, release characteristics, and bioactivity of anti-microbial agent were controlled by the complexation of the drug with cyclodextrins of differing lipophilicity. Microparticles of poly(dl-lactic-co-glycolic acid) (PLGA) containing chlorhexidine (Chx) free base, chlorhexidine digluconate (Chx-Dg) and their association or inclusion complex with methylated-beta-cyclodextrin (MBCD) and hydroxypropyl-beta-cyclodextrin (HPBCD) were prepared by single emulsion, solvent evaporation technique. It was observed that encapsulation efficiency and release of the chlorhexidine derivatives from the microparticles was a function of the lipophilicity of the cyclodextrin. Complexation of the poorly water soluble Chx with the more hydrophilic HPBCD resulted in 62% higher encapsulation efficiency and longer duration of sustained release over a 2-week period than complexation with the more lipophilic MBCD. In contrast, the complexation of the more water-soluble derivative of chlorhexidine, Chx-Dg, with the more lipophilic MBCD improved encapsulation efficiency by 12% and prolonged its release in comparison to both the free Chx-Dg and its complex with HPBCD. Furthermore, it was observed that the initial burst effect could be diminished by complexation with CD. Preliminary studies have shown that the chlorhexidine released from PLGA chips is biologically active against bacterial population that is relevant in periodontitis (P. gingivalis and B. forsythus) and a healthy inhibition zone is maintained in agar plate assay over a period of at least a 1-week. The PLGA/CD delivery system described in this paper may prove useful for the localized delivery of chlorhexidine salts and other anti-microbial agents in the treatment of periodontal disease where prolonged-controlled delivery is desired.
authors.affiliation: Harvard School of Dental Medicine, Boston, MA, USA.
authors.forename: Isaac C
authors.initials: IC
authors.lastname: Yue
authors.forename: Jason
authors.initials: J
authors.lastname: Poff
authors.forename: María E
authors.initials: ME
authors.lastname: Cortés
authors.forename: Ruben D
authors.initials: RD
authors.lastname: Sinisterra
authors.forename: Caroline B
authors.initials: CB
authors.lastname: Faris
authors.forename: Patrice
authors.initials: P
authors.lastname: Hildgen
authors.forename: Robert
authors.initials: R
authors.lastname: Langer
authors.forename: V Prasad
authors.initials: VP
authors.lastname: Shastri
mesh_terms: D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000737:chemistry; D002710:Chlorhexidine / Q000008:administration & dosage* / Q000737:chemistry; D003505:Cyclodextrins; D003692:Delayed-Action Preparations / Q000008:administration & dosage / Q000737:chemistry; D016503:Drug Delivery Systems / Q000295:instrumentation* / Q000379:methods; D004343:Drug Implants / Q000008:administration & dosage / Q000737:chemistry; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006801:Humans; D019344:Lactic Acid / Q000737:chemistry*; D008863:Microspheres; D010510:Periodontal Diseases / Q000188:drug therapy*; D010518:Periodontitis / Q000188:drug therapy; D011100:Polyglycolic Acid / Q000737:chemistry*; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011108:Polymers / Q000737:chemistry*; D016966:Porphyromonas gingivalis / Q000166:cytology / Q000187:drug effects*; D012463:Saliva / Q000737:chemistry; D012995:Solubility
chemical_list: D000891:Anti-Infective Agents, Local; D003505:Cyclodextrins; D003692:Delayed-Action Preparations; D004343:Drug Implants; D011108:Polymers; D000077182:Polylactic Acid-Polyglycolic Acid Copolymer; D011100:Polyglycolic Acid; D019344:Lactic Acid; D002710:Chlorhexidine