Evaluating the Efficacy of Microbubble as Local Drug Delivery System in Endodontic Management: An In-vitro Study | Chapter 1 | Medical Science: Recent Advances and Applications Vol. 8

 

Background: Microbubbles (MBs) are gas or vapour-filled cavities inside liquids with sizes ranging from 2 to 3 µm. Endodontics is one area where microbubble technologies are gaining popularity in medicine and dentistry. Recently, MBs have shown great promise in nanomedicine owing to their high encapsulation efficiency, targeted drug release, improved biocompatibility, and longer blood circulation. Furthermore, they are more suitable for focusing on particular body regions and are safer and non-invasive. MBs generators are used to create bubbles in fluid dynamics, chemistry, medicine, agriculture, and the environment. Drug delivery using MBs increases penetration without causing systemic toxicity. The European Society of Endodontists and the American Association of Endodontists recommend the use of antibiotic pastes made of two or three different antibiotics, or calcium hydroxide (CH) paste, to eliminate intracanal microbial colonies. Triple antibiotic paste (TAP) is traditionally prepared by diluting minocycline, metronidazole, and ciprofloxacin using propylene glycol. Despite the excellent efficacy of clindamycin-modified TAP (mTAP) against endodontic infections, concerns remain regarding the penetrability of these antibiotic pastes.

 

Objectives: This study aimed to examine whether the use of microbubbles as a local drug-delivery mechanism increases tubular penetration of endodontic medications and irrigant.

 

Materials and Methods: This study was conducted at SRM Kattankulathur Dental College and Hospital. An Enterococcus faecalis culture was added to 38 dentin cylinders of single-rooted teeth. Samples were divided into the experimental and control groups that received a triple antibiotic paste with and without MB infusion (n = 19 in each group), respectively. Group 1 received TAP (metronidazole, ciprofloxacin, and minocycline; vehicle: propylene glycol at 1: 1: 1 ratio, while Group 2 was treated with Triple antibiotic-infused Microbubble. After 14 days, the number of live bacteria in the samples was determined using confocal laser scanning microscopy. GraphPad Prisma 8.3 Software (GraphPad Software Inc., La Jolla, CA) was used to perform the statistical analysis.

 

Results: After 14 days of contact with the medication, the percentages of live and dead bacteria were assessed. Results show that Group 2 (Triple antibiotic infused micro bubble) showed significantly (P < 0.05) higher antibacterial efficacy than Group 1 (TAP).

 

Conclusion: In this study, the antibacterial efficacy was significantly higher in the experimental group than in the control group. The possible explanation for the improved efficacy of triple antibiotic-infused MBs is due to the microbubble size, which facilitates the drug’s deeper delivery into the dentinal tubules.  Within the limitations of the study, it can be said that MB infusion is a viable technique to improve root canal disinfection. Hence, it can be considered a novel technique for local drug delivery systems in endodontic management.

 

Author(s) Details

V. Shyam Ganesh
Department of Conservative Dentistry and Endodontics, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu 603203, India.

 

K. Vijay Venkatesh
Department of Conservative Dentistry and Endodontics, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu 603203, India.

 

D. Sihivahanan
Department of Conservative Dentistry and Endodontics, SRM Kattankulathur Dental College and Hospital, SRM Institute of Science and Technology, Kattankulathur, Tamil Nadu 603203, India.

 

Pradeep Kumar Yadala
Department of Oral & Maxillofacial Surgery & Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, Saudi Arabia.

 

Deepti Shrivastava
Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka, Saudi Arabia.

 

Kumar Chandan Srivastava
Department of Oral & Maxillofacial Surgery & Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka, Saudi Arabia and Department of Oral Medicine and Radiology, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai 602105, India.

 

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v8/5414