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Annaji M, Mita N, Heard J, Kang X, Poudel I, Boddu SHS, Tiwari AK, Babu RJ. Long-Acting Drug Delivery Technologies for Meloxicam as a Pain Medicine. Crit Rev Ther Drug Carrier Syst 2024; 41:111-150. [PMID: 38608134 DOI: 10.1615/critrevtherdrugcarriersyst.2024048988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
Meloxicam, a selective COX-2 inhibitor, has demonstrated clinical effectiveness in managing inflammation and acute pain. Although available in oral and parenteral formulations such as capsule, tablet, suspension, and solution, frequent administration is necessary to maintain therapeutic efficacy, which can increase adverse effects and patient non-compliance. To address these issues, several sustained drug delivery strategies such as oral, transdermal, transmucosal, injectable, and implantable drug delivery systems have been developed for meloxicam. These sustained drug delivery strategies have the potential to improve the therapeutic efficacy and safety profile of meloxicam, thereby reducing the frequency of dosing and associated gastrointestinal side effects. The choice of drug delivery system will depend on the desired release profile, the target site of inflammation, and the mode of administration. Overall, meloxicam sustained delivery systems offer better patient compliance, and reduce the side effects, thereby improving the clinical applications of this drug. Herein, we discuss in detail different strategies for sustained delivery of meloxicam.
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Affiliation(s)
- Manjusha Annaji
- Department of Drug Discovery and Development, Harrison College of Pharmacy, Auburn University, Auburn, AL 36849, USA
| | | | - Jessica Heard
- Department of Drug Discovery and Development, Harrison College of Pharmacy, Auburn University, Auburn, AL 36849, USA
| | - Xuejia Kang
- Department of Drug Discovery and Development, Harrison College of Pharmacy, Auburn University, Auburn, AL 36849, USA
| | - Ishwor Poudel
- Department of Drug Discovery and Development, Harrison College of Pharmacy, Auburn University, Auburn, AL 36849, USA
| | - Sai H S Boddu
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, UAE; Center of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, UAE
| | - Amit K Tiwari
- Department of Pharmacology and Experimental Therapeutics, College of Pharmacy & Pharmaceutical Sciences, University of Toledo, Toledo, OH 43614, USA
| | - R Jayachandra Babu
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL 36849, USA
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Aggarwal G, Verma S, Gupta M, Nagpal M. Local Drug Delivery Based Treatment Approaches for Effective Management of Periodontitis. CURRENT DRUG THERAPY 2019. [DOI: 10.2174/1574885514666190103112855] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Periodontal disease is an immuno-inflammatory condition of
tissues that surround and hold the teeth. It is the disease which succeeds in all races,
groups and both genders. Almost 10 to15% of the global population gets suffered from
severe periodontitis as per WHO reports. Periodontal disease may likely cause other systemic
diseases such as cardiovascular disease and pre-term low birth weight infants. Mechanical
removal of plaques and calculus deposits from supra and subgingival environment
is the backbone of periodontal treatment till date whereas complete elimination of
these deleterious agents is quite unrealistic as the pocket depth increases.
Recent Approaches:
Recently controlled local drug delivery application is more encouraging
in comparison to systemic approach as it mainly targets to enhance the therapeutic
efficacy by maintaining site-specificity, avoiding first pass metabolism, reduction in gastrointestinal
(GI) side effects and decreasing the dose. Several drugs such as antiseptics
and antibiotics alongwith various carriers are being formulated as local drug delivery systems
for effective management of the disease. Various local delivery systems reported are
fibers, films, strips, compacts, injectables, microparticles, vesicular carriers, gels and
nanoparticles. These local carriers provide effective prolonged treatment at the site of
infection at reduced doses. This review enlightens detailed pathophysiology and various
phases of periodontitis, challenges in treatment of disease and various antimicrobial
agents (along with their marketed formulations) used. The main emphasis of the review is
to cover all carrier systems developed so far for local delivery application in the effective
management of periodontitis, as a patient compliant drug therapy.
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Affiliation(s)
- Geeta Aggarwal
- Delhi Pharmaceutical Sciences and Research University, Pushp Vihar, Sector-3 MB Road, New Delhi-110017, India
| | - Sonia Verma
- Delhi Pharmaceutical Sciences and Research University, Pushp Vihar, Sector-3 MB Road, New Delhi-110017, India
| | - Madhu Gupta
- Delhi Pharmaceutical Sciences and Research University, Pushp Vihar, Sector-3 MB Road, New Delhi-110017, India
| | - Manju Nagpal
- Chitkara College of Pharmacy, Chitkara University, Chandigarh-Patiala National Highway, Rajpura, Patiala-140401, India
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Novel meloxicam releasing electrospun polymer/ceramic reinforced biodegradable membranes for periodontal regeneration applications. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 64:148-156. [PMID: 27127039 DOI: 10.1016/j.msec.2016.03.072] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 02/27/2016] [Accepted: 03/21/2016] [Indexed: 11/23/2022]
Abstract
Periodontal disease is associated with the destruction of periodontal tissues, along with other disorders/problems including inflammation of tissues and severe pain. This paper reports the synthesis of meloxicam (MX) immobilized biodegradable chitosan (CS)/poly(vinyl alcohol) (PVA)/hydroxyapatite (HA) based electrospun (e-spun) fibers and films. Electrospinning was employed to produce drug loaded fibrous mats, whereas films were generated by solvent casting method. In-vitro drug release from materials containing varying concentrations of MX revealed that the scaffolds containing higher amount of drug showed comparatively faster release. During initial first few hours fast release was noted from membranes and films; however after around 5h sustained release was achieved. The hydrogels showed good swelling property, which is highly desired for soft tissue engineered implants. To investigate the biocompatibility of our synthesized materials, VERO cells (epithelial cells) were selected and cell culture results showed that these all materials were non-cytotoxic and also these cells were very well proliferated on these synthesized scaffolds. These properties along with the anti-inflammatory potential of our fabricated materials suggest their effective utilization in periodontital treatments.
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Rajeswari SR, Gowda TM, Kumar TAB, Thimmasetty J, Mehta DS. An appraisal of innovative meloxicam mucoadhesive films for periodontal postsurgical pain control: A double-blinded, randomized clinical trial of effectiveness. Contemp Clin Dent 2015; 6:299-304. [PMID: 26321824 PMCID: PMC4549976 DOI: 10.4103/0976-237x.161857] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background and Objective: Transmucosal analgesic delivery is a promising approach to periodontal postoperative pain management. The purpose of this clinical trial is to appraise the effectiveness of transmucosal drug delivery system with meloxicam films and to identify its minimum effective dosage via this route after periodontal flap surgery. Materials and Methods: The analgesic mucoadhesive films were formulated using meloxicam and hydroxypropyl methyl cellulose polymer by solvent casting method. The sample size consisted of 60 chronic periodontitis patients who require periodontal flap surgery. The subjects were randomized using lottery method into four groups (Group A - 45 mg; B - 30 mg; C - 20 mg; D - 10 mg meloxicam per film). After periodontal flap surgery, the respective meloxicam mucoadhesive films were placed over the surgical site and were removed on 4th day of postsurgery. The primary outcome measure was postsurgical pain level and recorded at 1st, 2nd, 3rd, 4th, 5th, 24th, and 48th h using a 0–10 mm visual analog scale with markings from 0 = no pain to 10 = extreme pain. Results: The postoperative pain control observed in Groups A and B was found to be effective, and the patient comfort level was very satisfactory. Whereas in Group C, it was found to be high in the first 3 h postsurgically, after which adequate pain relief was seen. Group D exhibited inadequate pain relief. No adverse reactions were noted after applying the film in any of the groups. Conclusion: Transmucosal delivery of meloxicam was found to be effective and safe in postsurgical pain control of periodontal flap surgery. The minimum effective dosage via this route for meloxicam was found to be with 30 mg mucoadhesive films.
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Affiliation(s)
- S Raja Rajeswari
- Department of Periodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Triveni M Gowda
- Department of Periodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - Tarun A B Kumar
- Department of Periodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
| | - J Thimmasetty
- Department of Pharmaceutics, Bapuji Pharmacy College, Davangere, Karnataka, India
| | - Dhoom Singh Mehta
- Department of Periodontics, Bapuji Dental College and Hospital, Davangere, Karnataka, India
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Farooq A, Yar M, Khan AS, Shahzadi L, Siddiqi SA, Mahmood N, Rauf A, Qureshi ZUA, Manzoor F, Chaudhry AA, ur Rehman I. Synthesis of piroxicam loaded novel electrospun biodegradable nanocomposite scaffolds for periodontal regeneration. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2015; 56:104-13. [PMID: 26249571 DOI: 10.1016/j.msec.2015.06.006] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2015] [Revised: 05/12/2015] [Accepted: 06/09/2015] [Indexed: 11/17/2022]
Abstract
Development of biodegradable composites having the ability to suppress or eliminate the pathogenic micro-biota or modulate the inflammatory response has attracted great interest in order to limit/repair periodontal tissue destruction. The present report includes the development of non-steroidal anti-inflammatory drug encapsulated novel biodegradable chitosan (CS)/poly(vinyl alcohol) (PVA)/hydroxyapatite (HA) electro-spun (e-spun) composite nanofibrous mats and films and study of the effect of heat treatment on fibers and films morphology. It also describes comparative in-vitro drug release profiles from heat treated and control (non-heat treated) nanofibrous mats and films containing varying concentrations of piroxicam (PX). Electrospinning was used to obtain drug loaded ultrafine fibrous mats. The physical/chemical interactions were evaluated by Fourier Transform Infrared (FT-IR) spectroscopy. The morphology, structure and pore size of the materials were investigated by scanning electron microscopy (SEM). The thermal behavior of the materials was investigated by thermal gravimetric analysis (TGA) and differential scanning calorimetry (DSC). Control (not heat treated) and heat treated e-spun fibers mats and films were tested for in vitro drug release studies at physiological pH7.4 and initially, as per requirement burst release patterns were observed from both fibers and films and later sustained release profiles were noted. In vitro cytocompatibility was performed using VERO cell line of epithelial cells and all the synthesized materials were found to be non-cytotoxic. The current observations suggested that these materials are potential candidates for periodontal regeneration.
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Affiliation(s)
- Ariba Farooq
- Department of Chemistry, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan; Interdisciplinary Research Center in Biomedical Materials, COMSATS Institute of Information Technology, Lahore,54000, Pakistan
| | - Muhammad Yar
- Interdisciplinary Research Center in Biomedical Materials, COMSATS Institute of Information Technology, Lahore,54000, Pakistan.
| | - Abdul Samad Khan
- Interdisciplinary Research Center in Biomedical Materials, COMSATS Institute of Information Technology, Lahore,54000, Pakistan
| | - Lubna Shahzadi
- Interdisciplinary Research Center in Biomedical Materials, COMSATS Institute of Information Technology, Lahore,54000, Pakistan
| | - Saadat Anwar Siddiqi
- Interdisciplinary Research Center in Biomedical Materials, COMSATS Institute of Information Technology, Lahore,54000, Pakistan
| | - Nasir Mahmood
- Department of Allied Health Sciences and Chemical Pathology, University of Health Sciences, Lahore, Pakistan; Department of Human Genetics and Molecular Biology, University of Health Sciences, Lahore, Pakistan
| | - Abdul Rauf
- Department of Chemistry, The Islamia University of Bahawalpur, Bahawalpur 63100, Pakistan
| | | | - Faisal Manzoor
- Interdisciplinary Research Center in Biomedical Materials, COMSATS Institute of Information Technology, Lahore,54000, Pakistan
| | - Aqif Anwar Chaudhry
- Interdisciplinary Research Center in Biomedical Materials, COMSATS Institute of Information Technology, Lahore,54000, Pakistan
| | - Ihtesham ur Rehman
- Interdisciplinary Research Center in Biomedical Materials, COMSATS Institute of Information Technology, Lahore,54000, Pakistan; Department of Materials Science and Engineering, The Kroto Research Institute, The University of Sheffield, North Campus, Broad Lane, Sheffield S3 7HQ, United Kingdom
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Kassem AA, Ismail FA, Naggar VF, Aboulmagd E. Comparative study to investigate the effect of meloxicam or minocycline HCl in situ gel system on local treatment of periodontal pockets. AAPS PharmSciTech 2014; 15:1021-8. [PMID: 24831089 PMCID: PMC4113610 DOI: 10.1208/s12249-014-0118-7] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 03/31/2014] [Indexed: 11/30/2022] Open
Abstract
In situ gelling formulations allow easy application to the target area. Gelation is induced by physiological stimuli at the site of application where the formula attains semisolid properties and exerts sustained drug release. In situ gelling formulations containing either 3% meloxicam (Mx) or 2% minocycline HCl (MH) were prepared for local application into the periodontal pockets. Gel formulations were based on the thermosensitive Pluronic(®) (Pl) and the pH-sensitive Carbopol(®) (C) polymers. C gels were prepared in combination with HPMC (H) to decrease its acidity. The total percent drug released from Pl formulae was 21.72% after 1 week for Mx and 85% after 3 days for MH. Their release kinetics data indicated anomalous non-Fickian behavior that could be controlled by both diffusion and chain relaxation. Addition of MH to C/H gels (1:2.5) resulted in liquefaction, followed by drug precipitation. Regarding C/H gel containing Mx, it showed a prolonged release rate up to 7 days with an initial burst effect; the kinetics data revealed Fickian-diffusion mechanism. The in vitro antibacterial activity studies for MH gel in Pl revealed that the drug released exceeded the minimum inhibitory concentration (MIC) of MH against Staphylococcus aureus ATCC 6538; placebo gel showed no effect on the microorganism. Clinical evaluation of Pl gels containing either Mx or MH showed significant improvement in chronic periodontitis patients, manifested by decrease in pocket depth and gingival index and increase in bone density.
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Affiliation(s)
- Abeer Ahmed Kassem
- Department of Pharmaceutics, Faculty of Pharmacy, Alexandria University, Alexandria, Egypt,
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Joshi D, Garg T, Goyal AK, Rath G. Advanced drug delivery approaches against periodontitis. Drug Deliv 2014; 23:363-77. [DOI: 10.3109/10717544.2014.935531] [Citation(s) in RCA: 116] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Tariq M, Iqbal Z, Ali J, Baboota S, Talegaonkar S, Ahmad Z, Sahni JK. Treatment modalities and evaluation models for periodontitis. Int J Pharm Investig 2012; 2:106-22. [PMID: 23373002 PMCID: PMC3555006 DOI: 10.4103/2230-973x.104394] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Periodontitis is the most common localized dental inflammatory disease related with several pathological conditions like inflammation of gums (gingivitis), degeneration of periodontal ligament, dental cementum and alveolar bone loss. In this perspective, the various preventive and treatment modalities, including oral hygiene, gingival irrigations, mechanical instrumentation, full mouth disinfection, host modulation and antimicrobial therapy, which are used either as adjunctive treatments or as stand-alone therapies in the non-surgical management of periodontal infections, have been discussed. Intra-pocket, sustained release systems have emerged as a novel paradigm for the future research. In this article, special consideration is given to different locally delivered anti-microbial and anti inflammatory medications which are either commercially available or are currently under consideration for Food and Drug Administration (FDA) approval. The various in vitro dissolution models and microbiological strain investigated to impersonate the infected and inflamed periodontal cavity and to predict the in vivo performance of treatment modalities have also been thrashed out. Animal models that have been employed to explore the pathology at the different stages of periodontitis and to evaluate its treatment modalities are enlightened in this proposed review.
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Affiliation(s)
- Mohammad Tariq
- Department of Pharmaceutics, Faculty of Pharmacy, Jamia Hamdard, Hamdard Nagar, New Delhi-110062, India
| | - Zeenat Iqbal
- Department of Pharmaceutics, Faculty of Pharmacy, Jamia Hamdard, Hamdard Nagar, New Delhi-110062, India
| | - Javed Ali
- Department of Pharmaceutics, Faculty of Pharmacy, Jamia Hamdard, Hamdard Nagar, New Delhi-110062, India
| | - Sanjula Baboota
- Department of Pharmaceutics, Faculty of Pharmacy, Jamia Hamdard, Hamdard Nagar, New Delhi-110062, India
| | - Sushama Talegaonkar
- Department of Pharmaceutics, Faculty of Pharmacy, Jamia Hamdard, Hamdard Nagar, New Delhi-110062, India
| | - Zulfiqar Ahmad
- Department of Pharmaceutics, Faculty of Pharmacy, Jamia Hamdard, Hamdard Nagar, New Delhi-110062, India
| | - Jasjeet K Sahni
- Department of Pharmaceutics, Faculty of Pharmacy, Jamia Hamdard, Hamdard Nagar, New Delhi-110062, India
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Machtei EE, Hirsh I, Falah M, Shoshani E, Avramoff A, Penhasi A. Multiple applications of flurbiprofen and chlorhexidine chips in patients with chronic periodontitis: a randomized, double blind, parallel, 2-arms clinical trial. J Clin Periodontol 2011; 38:1037-43. [PMID: 22092475 PMCID: PMC3586660 DOI: 10.1111/j.1600-051x.2011.01779.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2011] [Indexed: 11/29/2022]
Abstract
AIM The aim of the present randomized, double blind, parallel, 2-arm clinical study was to examine the safety and efficacy of frequent applications of chlorhexidine chip (CHX) and flurbiprofen chip (FBP) in patients with chronic periodontitis. METHODS Sixty patients were randomized into CHX and FBP groups. Following OHI and scaling and root planing (SRP), baseline pocket depth (PD) measurements, gingival recession and bleeding on probing (BOP) were performed and repeated at week 4 and 8. The assigned chip was placed at weeks 0, 1, 2, 3, 5, 7. RESULTS Mean PD reduction in the CHX group was 2.08 mm (7.17 to 5.09, p < 0.0001). Mean PD reduction in the FBP group was 2.27 mm (6.72 to 4.45, p < 0.0001). Ninety-seven percentage and 95% of these sites exhibited PD reduction ≥1 mm, while 38% and 34% of the sites exhibited PD ≥3 mm (FBP and CHX, respectively). Clinical attachment level gain (1.66 and 1.95 mm, respectively) was statistically significant (p < 0.0001). Baseline BOP dropped from 98% and 100% to 24% and 30% for the CHX and FBP groups, respectively (p < 0.0001). CONCLUSION Frequent applications of CHX and FBP chips resulted in a significant improvement in the periodontal condition in these sites. Furthermore studies will be required to compare this new treatment regimen to SRP or SRP with single chip application.
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Affiliation(s)
- Eli E Machtei
- Department of Periodontology, School of Graduate Dentistry, Rambam Health Care Campus and the Faculty of Medicine - Technion (I.I.T.), Haifa, Israel.
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Trindade PAK, Giglio FPM, Colombini-Ishikiriama BL, Calvo AM, Modena KCS, Ribeiro DA, Dionísio TJ, Brozoski DT, Lauris JRP, Faria FAC, Santos CF. Sublingual ketorolac and sublingual piroxicam are equally effective for postoperative pain, trismus, and swelling management in lower third molar removal. Oral Surg Oral Med Oral Pathol Oral Radiol 2011; 114:27-34. [PMID: 22732846 DOI: 10.1016/j.tripleo.2011.05.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Revised: 05/20/2011] [Accepted: 05/29/2011] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Lower third molar removal provides a clinical model for studying analgesic drugs. The present study's aim was to compare the clinical efficacy of sublingual ketorolac and sublingual piroxicam in managing pain, trismus and swelling after lower third molar extraction in adult volunteers. STUDY DESIGN In this double-blinded, randomized, crossover investigation, 47 volunteers received for 4 days ketorolac sublingually (10 mg 4 times daily) and piroxicam sublingually (20 mg once daily) during 2 separate appointments after lower third molar extraction of symmetrically positioned lower third molars. A surgeon evaluated objective parameters (surgery duration, mouth opening, rescue analgesic medication, and facial swelling) and volunteers documented subjective parameters (postoperative pain and global evaluation), comparing postoperative results for a total of 7 days after surgery. The means of the objective and subjective parameters were compared for statistical significance (P < .05). RESULTS Volunteers reported low pain scores during the postoperative period when treated with either sublingual ketorolac or piroxicam. Also, volunteers ingested similar amounts of analgesic rescue medication (paracetamol) when they received either drug sublingually (P > .05). Additionally, values for mouth openings measured just before surgery and immediately after suture removal 7 days later were similar among volunteers (P > .05), and the type of nonsteroidal antiinflammatory drug (NSAID) used in this study showed no significant differences between swellings on the second or seventh days after surgery (P > .05). CONCLUSIONS Pain, trismus, and swelling after lower third molar extraction, independent of surgical difficulty, were successfully controlled by sublingual ketorolac (10 mg 4 times daily) or sublingual piroxicam (20 mg once daily), and no significant differences were observed between the NSAIDs evaluated.
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Isiordia-Espinoza MA, Sánchez-Prieto M, Tobías-Azúa F, Reyes-García JG. Pre-emptive analgesic effectiveness of meloxicam versus tramadol after mandibular third molar surgery: a pilot study. J Oral Maxillofac Surg 2011; 70:31-6. [PMID: 21783298 DOI: 10.1016/j.joms.2011.03.039] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2010] [Revised: 03/05/2011] [Accepted: 03/30/2011] [Indexed: 11/17/2022]
Abstract
PURPOSE To compare the pre-emptive analgesic effectiveness of 15 mg of meloxicam and 50 mg of tramadol after mandibular third molar surgery. PATIENTS AND METHODS This pilot study was a double-blind, randomized, parallel-group clinical trial. The patients were randomized into 2 treatment groups, each with 15 patients, by use of a series of random numbers: group A was administered 15 mg of meloxicam intramuscularly (IM) 50 minutes before the surgery and group B was given 50 mg of tramadol IM 50 minutes before the surgery. We evaluated pain intensity, analgesic consumption, swelling, and trismus. RESULTS The group receiving 15 mg of meloxicam IM showed differences in pain intensity evaluated by the area under the curve of the visual analog scale and total analgesic consumption when compared with the group receiving 50 mg of tramadol IM. CONCLUSION The patients receiving 15 mg of preoperative meloxicam had less pain intensity and total analgesic consumption than those receiving 50 mg of preoperative tramadol.
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Affiliation(s)
- Mario A Isiordia-Espinoza
- Departamento de Postgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City, Mexico.
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12
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Trindade PAK, Giglio FPM, Colombini-Ishikiriama BL, Calvo AM, Modena KCS, Ribeiro DA, Dionísio TJ, Brozoski DT, Lauris JRP, Faria FAC, Santos CF. Comparison of oral versus sublingual piroxicam during postoperative pain management after lower third molar extraction. Int J Oral Maxillofac Surg 2010; 40:292-7. [PMID: 21144709 DOI: 10.1016/j.ijom.2010.10.026] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Revised: 09/29/2010] [Accepted: 10/29/2010] [Indexed: 11/30/2022]
Abstract
In this study, 53 patients received piroxicam, administered orally or sublingually, after undergoing removal of symmetrically positioned lower third molars, during two separate appointments. This study used a randomized, blind, cross-over protocol. Objective and subjective parameters were recorded for comparison of postoperative results for 7 days after surgery. Patients treated with oral or sublingual piroxicam reported low postoperative pain scores. The patients who received piroxicam orally took a similar average amount of analgesic rescue medication compared with patients who received piroxicam sublingually (p>0.05). Patients exhibited similar values for mouth opening measured just before surgery and immediately following suture removal 7 days later (p>0.05), and showed no significant differences between routes of piroxicam administration for swelling control during the second or seventh postoperative days (p>0.05). In summary, pain, trismus and swelling after lower third molar extraction, independent of surgical difficulty, could be controlled by piroxicam 20mg administered orally or sublingually and no significant differences were observed between the route of delivery used in this study.
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Affiliation(s)
- P A K Trindade
- Bauru School of Dentistry, University of São Paulo, Bauru, SP, Brazil
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Buduneli N, Buduneli E, Çetin EÖ, Kırılmaz L, Kütükçüler N. Clinical findings and gingival crevicular fluid prostaglandin E2 and interleukin-1-beta levels following initial periodontal treatment and short-term meloxicam administration. Expert Opin Pharmacother 2010; 11:1805-12. [DOI: 10.1517/14656566.2010.490555] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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14
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Stavinskaya ON, Laguta IV. The properties of silica-gelatin composites. RUSSIAN JOURNAL OF PHYSICAL CHEMISTRY A 2010. [DOI: 10.1134/s0036024410060270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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15
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Zilberman M, Malka A. Drug controlled release from structured bioresorbable films used in medical devices--a mathematical model. J Biomed Mater Res B Appl Biomater 2008; 89:155-64. [PMID: 18777579 DOI: 10.1002/jbm.b.31200] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
A mathematical model for predicting drug release profiles from structured bioresorbable films was developed and studied. These films, which combine good mechanical properties with desired drug release profiles, are designed for use in various biomedical applications. Our structured polymer/drug films are prepared using a promising technique for controlling the drug location/dispersion in the film. The present model was used for predicting drug release profiles from two film types that is films in which the drug is located on the surface (A-type) and films in which the drug is located in the bulk (B-type). The model is based on Fick's 2nd law of diffusion and assumes that the drug release profile from the films is affected by the host polymer's characteristics, the drug location/dispersion in the film and the drug's characteristics. This semiempirical model uses the weight loss profile of the host polymers as well as the change in their degree of crystallinity with degradation. Our study indicates that the model correlates well with in vitro release results, exhibiting a mean error of less than 7% for most studied cases. It also shows that the host polymer's degradation has a greater effect on the drug release profile than the degree of crystallinity. This new model exhibits a potential for simulating the release profile of bioactive agents from structured films for a wide variety of biomedical applications.
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Affiliation(s)
- Meital Zilberman
- Department of Biomedical Engineering, Faculty of Engineering, Tel-Aviv University, Tel-Aviv, Israel.
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Zilberman M, Shifrovitch Y, Aviv M, Hershkovitz M. Structured Drug-eluting Bioresorbable Films: Microstructure and Release Profile. J Biomater Appl 2008; 23:385-406. [DOI: 10.1177/0885328207088261] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Bioresorbable drug-eluting films can be used in many biomedical applications. Examples for such applications include biodegradable medical support devices which combine mechanical support with drug release and antibiotic-eluting film coatings for prevention of bacterial infections associated with orthopedic implants or during gingival healing. In the current study, bioresorbable drug-loaded polymer films are prepared by solution processing. Two film structures are studied: A polymer film with large drug crystals located on its surface (A-type) and a polymer film with small drug particles and crystals distributed within the bulk (B-type). The basic mode of drug dispersion/location in the film (A or B-type) is found to be determined mainly by the process of film formation and depends mainly on the solvent evaporation rate, whereas the drug's hydrophilicity has a minor effect on this structuring process. Most release profiles from A-type films exhibit a burst effect of ~30% and a second release stage that occurs at an approximately constant rate and is determined mainly by the polymer weight loss rate. An extremely high burst release is exhibited only by a very hydrophilic drug. The matrix (monolithic) nature of the B-type film enables release profiles that are determined mainly by the host polymer's degradation profile, with a very low burst effect in most of the studied systems. In addition to the drug location/ dispersion in the film, the host polymer and drug type also strongly affect the drug's release profile from the film. It has been demonstrated that appropriate selection of the process parameters and film components (polymer and drug) can yield film structures with desirable drug release behaviors. This can lead to the engineering of new bioresorbable drug-eluting film-based implants for various applications.
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Affiliation(s)
- M. Zilberman
- Department of Biomedical Engineering, Faculty of Engineering Tel Aviv University, Tel Aviv 69978, Israel,
| | - Y. Shifrovitch
- Department of Biomedical Engineering, Faculty of Engineering Tel Aviv University, Tel Aviv 69978, Israel
| | - M. Aviv
- Department of Biomedical Engineering, Faculty of Engineering Tel Aviv University, Tel Aviv 69978, Israel
| | - M. Hershkovitz
- Department of Biomedical Engineering, Faculty of Engineering Tel Aviv University, Tel Aviv 69978, Israel
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17
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Chitosan inserts for periodontitis: influence of drug loading, plasticizer and crosslinking on in vitro metronidazole release. ACTA PHARMACEUTICA 2007; 57:469-77. [PMID: 18165190 DOI: 10.2478/v10007-007-0037-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Chitosan based metronidazole (MZ) inserts were fabricated by the casting method and characterized with respect to mass and thickness uniformity, metronidazole loading and in vitro metronidazole release kinetics. The fabricated inserts exhibited satisfactory physical characteristics. The mass of inserts was in the range of 5.63 +/- 0.42 to 6.04 +/- 0.89 mg. The thickness ranged from 0.46 +/- 0.06 to 0.49 +/- 0.08 mm. Metronidazole loading was in the range of 0.98 +/- 0.09 to 1.07 +/- 0.07 mg except for batch CM3 with MZ loading of 2.01 +/- 0.08 mg. The inserts exhibited an initial burst release at the end of 24 h, irrespective of the drug to polymer ratio, plasticizer content or cross-linking. However, further drug release was sustained over the next 6 days. Cross-linking with 10% (m/m) of glutaraldehyde inhibited the burst release by approximately 30% and increased the mean dissolution time (MDT) from 0.67 to 8.59 days. The decrease in drug release was a result of reduced permeability of chitosan due to cross-linking.
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18
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Calvo AM, Sakai VT, Giglio FPM, Modena KCS, Colombini BL, Benetello V, Sakamoto FC, Freire TMS, Dionísio TJ, Lauris JRP, Trindade AS, Faria FAC, Santos CF. Analgesic and anti-inflammatory dose–response relationship of 7.5 and 15mg meloxicam after lower third molar removal: a double-blind, randomized, crossover study. Int J Oral Maxillofac Surg 2007; 36:26-31. [PMID: 17112703 DOI: 10.1016/j.ijom.2006.09.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2006] [Revised: 08/29/2006] [Accepted: 09/14/2006] [Indexed: 11/30/2022]
Abstract
Fifty patients were scheduled to undergo removal of symmetrically positioned lower third molars in two separate appointments. Meloxicam 7.5 or 15 mg was once daily administered in a double-blind, randomized and crossover manner after the surgery for 4 days. Objective and subjective parameters were recorded for comparison of postoperative courses. Patients treated with 7.5mg meloxicam who underwent osteotomy reported higher pain scores at 1.5, 3, 4, 10, 12 and 16 h (P<0.05) and ingested a greater amount of rescue analgesic medication (P<0.05) than those who did not require osteotomy. A higher percentage of patients who underwent osteotomy medicated with 7.5mg meloxicam needed rescue medication as compared to those who did not require osteotomy (P<0.05). There was a similar mouth opening at suture removal compared with preoperative values for both doses (P>0.05). There were no significant differences concerning swelling observed on the 2nd or 7th postoperative days in comparison with baseline (P>0.05) between the two doses. Pain, trismus and swelling after lower third molar removal not requiring osteotomy can be successfully controlled by a dose regimen of 7.5mg meloxicam once daily. For more aggressive extractions 15 mg meloxicam is advisable.
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Affiliation(s)
- A M Calvo
- Bauru School of Dentistry, University of São Paulo, Bauru/SP, Brazil
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Chen FM, Zhao YM, Wu H, Deng ZH, Wang QT, Zhou W, Liu Q, Dong GY, Li K, Wu ZF, Jin Y. Enhancement of periodontal tissue regeneration by locally controlled delivery of insulin-like growth factor-I from dextran–co-gelatin microspheres. J Control Release 2006; 114:209-22. [PMID: 16859799 DOI: 10.1016/j.jconrel.2006.05.014] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2006] [Revised: 05/15/2006] [Accepted: 05/17/2006] [Indexed: 12/31/2022]
Abstract
The present work focused on the design of novel hydrogel microspheres based on both dextran- and gelatin-derived biomaterials, and discussed whether locally controlled delivery of IGF-I from dextran-co-gelatin hydrogel microspheres (DG-MP) was useful for periodontal regeneration enhancement. Microspheres were synthesized when gelatin was cooperating with glycidyl methacrylate (GMA) derivatized dextrans (Dex-GMA) and the resultant DG-MP with a hydrogel character of which the cross-linking density could be controlled by the degree of substitution (DS, the number of methacrylates per 100 glucopyranose residues) of Dex-GMA. In this study, three types of DG-MP (DG-MP4.7, DG-MP6.3 and DG-MP7.8) obtained from gelatin and Dex-GMA (differing in DS: 4.7, 6.3 and 7.8 respectively) were prepared and characterized by swelling and degradation properties, drug release kinetics and biological capability in promoting tissue regeneration. By swelling in aqueous positively charged IGF-I solutions, the protein could be encapsulated in DG-MP by polyionic complexation with negatively charged acidic gelatin. No obvious influence of Dex-GMA's DS on DG-MP's configuration and size was observed, and the release and degraded properties showed no significant difference between three types of DG-MP in PBS buffer either. However, high DS of Dex-GMA could lower microsphere's swelling, prolong its degraded time and minimize IGF-I burst release markedly in dextranase-containing PBS, where IGF-I release from a slow release type of microspheres (DG-MP7.8) could be maintained more than 28 days, and an effective protein release kinetics without a significant burst but a relevantly constant release after the initial burst was achieved. IGF-I in DG-MP resulted in more new bone formation in the periodontal defects within 4 or 8 weeks than IGF-I in blood clot directly did (P < 0.01). The observed newly formation of periodontal tissues including the height and percentage of new bone and new cementum on the denuded root surfaces of the furcation area in DG-MP7.8 group were more than that in other groups (P < 0.05). The adequate width of regenerative periodontal ligament (PDL), regular Sharpey's fibers and alveolar bone reconstruction could be observed only in DG-MP7.8 group. These combined results demonstrate that effective release kinetics can be realized by adjusting the DS of Dex-GMA and followed cross-linking density of DG-MP, and that locally controlled delivery of IGF-I from slow release type of DG-MP may serve as a novel therapeutic strategy for periodontal tissue regeneration.
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Affiliation(s)
- Fa-ming Chen
- Department of Periodontology and Oral Medicine, College of Stomatology, Fourth Military Medical University, 145th Chang-le Road, Xi'an 710032, Shaanxi, China.
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