Periodontitis is an inflammatory condition affecting teeth resulting in progressive destruction of periodontal ligaments, resorption of alveolar bone and loss of teeth. Treatment of
periodontitis includes surgical and non surgical management. Systemic
antibiotics are also used for the treatment of
periodontitis. The aim of this research was to formulate smart gel system of
azithromycin (AZT) and to evaluate in vitro and in vivo for non-surgical treatment of
chronic periodontitis.
Azithromycin dihydrate, used systemically in the treatment of
periodontitis, was formulated into smart
gels using biodegradable, thermosensitive
polymer Pluronic® F-127 (PF-127) and Hydroxy
Ethyl Cellulose (HEC) as copolymer. The prepared smart
gels were evaluated for
sterility, content uniformity, gelation temperature and time, syringeability, rheological behavior, in vitro diffusion and in vivo efficacy in human patients. The prepared smart
gels were clear and transparent, sterile, thermoresponsive and
injectable. Viscosity of
gels increased with increase in concentration of
polymer/co-
polymer and also with temperature. They gelled in short response time below the body temperature. In vitro release studies showed controlled drug release which was influenced significantly by the properties and concentration of PF-127 and HEC. In vivo efficacy studies showed a significant improvement (p <0.001) in clinical parameters such as gingival index, probing pocket depth, clinical attachment level,
bleeding index and plaque index. The developed
azithromycin smart gel system is a novel approach for the treatment of
chronic periodontitis since it reduces the dose and side effects, bypasses the usual
surgical procedures and improves patient compliance.