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View of Titanium Zirconium (Tizr) Alloys for Use in Endosseous Dental Implants

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View of Titanium Zirconium (Tizr) Alloys for Use in Endosseous Dental Implants Anuradha Tiwari et al, Int. Journal of Pharmaceutical Sciences and Medicine (IJPSM), Vol.4 Issue. 7, July- 2019, pg. 1-21 ISSN: 2519-9889 Impact Factor: 3.426 GEL LOADED DENTAL IMPLANT: A DEMIURGIC DRUG DELIVERY SYSTEM FOR TREATMENT OF GINGIVITIS Anuradha Tiwari*; Deepak Kumar Gupta@; Raju Choukse; Sourabh Jain; Rakesh Patel; Karunakar Shukla DR. APJ ABDUL KALAM UNIVERSITY, BYPASS ROAD, ARANDIA VILLAGE, POST JHALARIA, INDORE (M.P) – 452016 @ [email protected], Tel- +918827666607 ABSTRACT- The main objective of the project was to develop a dental implant for the patients suffering from oral gingivitis caused by bacterial infection, trauma etc. Person suffering from Gingivitis has chance to miss the medication during travel. For optimization of formula for the gel six batches were taken in which different amount of drug and polymer were added and observation were recorded. Six batches of gel were prepared by changing the polymer ratio. Six batches of gel were prepared by changing the polymer ratio. Three batches consist of carbopol whereas three batches consist of chitosan. Triclosan was added in all gel was subjected to in-vitro characterization it was observed that the in case batches containing chitosan, the gel formed by hazy and it contain come particulate matter also whereas the gel formed in case of carbopol were clear. Formulation f1 and f2 were less viscous and gel did not formed completely whereas formulation f4, f5, and f6, the gel formed was also less viscous as well as hazy. This could be due to the incorporation of chitosan in f4, f5, and f6 formulation which derived from chitin and it may not imbibe large amount of water to result in formulation of efficient gel. Obtained formula (f3) was characterized and it was found that viscosity of gel (f3) was highly viscous whereas drug content was 91.48 %. The gel was subjected to in-vitro drug release it was found that 59% drug was released in the end of 72 hr. This may be due to the efficient gel forming capacity of carbopol which was further enhanced by incorporation of triclosan. Formulation F3 was selected as optimum formulation with desired properties and was subjected to further studies. KEYWORDS- Dental Implant, Gingivitis, Dental diseases, Demiurgic drug delivery system © 2019, IJPSM All Rights Reserved, www.ijpsm.com 1 Anuradha Tiwari et al, Int. Journal of Pharmaceutical Sciences and Medicine (IJPSM), Vol.4 Issue. 7, July- 2019, pg. 1-21 ISSN: 2519-9889 Impact Factor: 3.426 I. INTRODUCTION Dental disease is one of the major causes of tooth loss in India. These include pathological conditions of the supporting structures of the teeth, i.e. gingival, alveolar bone, periodontal ligament and cementum. Gingival disease progresses to periodontal disease, if not checked in time (Shah et al). Gingivitis is the most common and mild form of oral/dental disease. Gingivitis is characterized by inflammation and bleeding of the gums. Because gingivitis is rarely painful in its early stages, it often goes unnoticed until severe irritation or receding gums occur. Gingivitis may lead to a more serious condition called periodontitis, in which the inner gum and bone pull away from teeth and form pocket. These pockets can collect bacteria and debris, and become infected or abscessed. The ultimate outcome is tooth loss. 1.1 Classification of Dental Disease: Various types of DD can be broadly classified as Fig.1 © 2019, IJPSM All Rights Reserved, www.ijpsm.com 2 Anuradha Tiwari et al, Int. Journal of Pharmaceutical Sciences and Medicine (IJPSM), Vol.4 Issue. 7, July- 2019, pg. 1-21 ISSN: 2519-9889 Impact Factor: 3.426 Gingivitis and Periodontitis: Gingivitis and periodontitis are the two major forms of inflammatory diseases affecting the periodontium. General progression steps of gum diseases are shown in Fig.1.2. Gingivitis is inflammation of the gingiva that does not result in clinical attachment loss. Periodontitis is inflammation of the gingival and the adjacent attachment apparatus and is characterized by loss of connective tissue attachment and alveolar bone. Appropriate supportive periodontal maintenance that includes personal and periodontal maintenance that includes personal and professional care is important in preventing reinitiation of inflammation. Therapeutic approaches for periodontitis fall into two major categories: 1) Anti-infective treatment -: It is designed to halt the progression of periodontal attachment loss by removing etiologic factors. 2) Regenerative therapy -: It includes anti-infective treatment and is intended to restore structures destroyed by disease (S.Pragati et al). © 2019, IJPSM All Rights Reserved, www.ijpsm.com 3 Anuradha Tiwari et al, Int. Journal of Pharmaceutical Sciences and Medicine (IJPSM), Vol.4 Issue. 7, July- 2019, pg. 1-21 ISSN: 2519-9889 Impact Factor: 3.426 A chronic inflammatory disease of the gingiva and periodontium results in destruction of gingival connective tissue, periodontal ligament, and alveolar bone. Clinically, inflammation is seen as redness, swelling, and bleeding upon probing. The main provoking factor that induces inflammation of gingival tissue is the presence of bacterial biofilm (dental plaque) on the teeth/gingival interfaces. Inflammation is the localized, protective response of the body to injury or infection. The classic clinical signs that characterize inflammation are heat, redness, swelling, pain and loss of function. During inflammation, cells and their secreted chemicals attempt to destroy, dilute, or wall off the injurious agent. A series of biochemical events cause the blood vessels to dilate and become more permeable, resulting in the activation of the complement, clotting, and kinin systems. The end result of inflammation is the return of function by the regeneration or repair of the affected tissue. Fig. 1.2 Progression of Gum Disease 1.2 Gingivitis: Gingivitis is an infection of the gums. If left untreated, it can become a more severe infection known as periodontitis. The gingivitis and periodontitis are the major causes of tooth loss in adults. Gingivitis is a form of periodontal disease. Periodontal disease is inflammation and infection that destroys the tissues that support the teeth. This can include the gums, the periodontal ligaments, and the tooth sockets (alveolar bone) (Lights et al). © 2019, IJPSM All Rights Reserved, www.ijpsm.com 4 Anuradha Tiwari et al, Int. Journal of Pharmaceutical Sciences and Medicine (IJPSM), Vol.4 Issue. 7, July- 2019, pg. 1-21 ISSN: 2519-9889 Impact Factor: 3.426 1.2.1 Classification of Gingivitis: There are two primary categories of gingival diseases, each with numerous subgroups: 1) Dental plaque-induced gingival diseases. a) Gingivitis associated with plaque only b) Gingival diseases modified by systemic factors c) Gingival diseases modified by medication d) Gingival diseases modified by malnutrition 2) Non-plaque induced gingival lesions a) Gingival diseases of specific bacterial origin b) Gingival diseases of viral origin c) Gingival diseases of fungal origin d) Gingival diseases of genetic origin e) Gingival manifestations of systemic conditions f) Traumatic lesions g) Foreign body reactions (Gary et al) 1.2.2 Etiology of Gingivitis Gingivitis is due to the long-term effects of plaque deposits on the teeth. Plaque is a thin film of bacteria. It constantly forms on the surface of the teeth. As plaque advances, it hardens and becomes tartar. When plaque extends below the gum line, infection can occur. Plaque is a sticky material made of bacteria, mucus and food debris that builds up on the exposed parts of the teeth. It is also a major cause of tooth decay. If plaque is not removed, it turns into a hard deposit called tartar that becomes trapped at the base of the tooth. Plaque and tartar irritate and inflame the gums. Bacteria and toxins produced cause the gums to become infected, swollen, and tender (James et al). The following raises risk for gingivitis: Certain infections and body-wide (systemic) diseases Poor dental hygiene Pregnancy (hormonal changes increase the sensitivity of the gums) Uncontrolled diabetes Misaligned teeth, rough edges of filling and unclean mouth appliances (such as braces, dentures, bridges and crowns) © 2019, IJPSM All Rights Reserved, www.ijpsm.com 5 Anuradha Tiwari et al, Int. Journal of Pharmaceutical Sciences and Medicine (IJPSM), Vol.4 Issue. 7, July- 2019, pg. 1-21 ISSN: 2519-9889 Impact Factor: 3.426 Use of certain medications, including phenytoin, bismuth and some birth control pills Smoking or chewing tobacco 1.3 Dental Implant (D.I): Tooth loss is very common and it can happen as a result of disease and trauma; therefore the use of D.I to provide support for replacement of missing teeth has a long and multifaceted history. D.I has created a revolution in the routine approach to dental care for patients missing one or more teeth. (Clark et al). Research on dental implant designs, material and techniques has increased in the past few years and is expected to expand in the future. Structure of Dental implant is shown in Fig. 1.4. Fig. 1.4 Dental Implant II. RESEARCH ENVIZAGED The main objective of the project was to develop a dental implant for the patients suffering from oral gingivitis caused by bacterial infection, trauma etc. Person suffering from Gingivitis has chance to miss the medication during travel. For such patients dental implant is can be effectively utilized. The implant releases the drug in sustained manner near infected part. Drug released provides localized action for long duration and hence drug medication will not have to be administered frequently. III. MATERIAL AND METHODS Following Drugs & materials are used in this method- Diclofenac Sodium, Triclosan, Carbopol p934, Chitosan, Propylene Glycol etc. © 2019, IJPSM All Rights Reserved, www.ijpsm.com 6 Anuradha Tiwari et al, Int. Journal of Pharmaceutical Sciences and Medicine (IJPSM), Vol.4 Issue. 7, July- 2019, pg. 1-21 ISSN: 2519-9889 Impact Factor: 3.426 IV.
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