Drug Delivery Systems for Periodontitis

Drug Delivery Systems for Periodontitis 2.0 LITERATURE SURVEY 2.1 TECHNIQUE Periodontitis, a disease involving supportive structures of the teeth prevails in all groups, ethnicities, races and both genders. It is a localised inflammatory response caused by bacterial infection of a periodontal pocket associated with subgingival plaque. Periodontal diseases include conditions such as chronic periodontitis, aggressive periodontitis and necrotizing periodontitis. Aggressive forms of periodontitis can be localized or generalized. Antibacterial agents have been used effectively in the management of periodontal infection. The effectiveness of mechanical debridement of plaque and repeated topical and systemic administration of antibacterial agents are limited due to the lack of accessibility to periodontopathic organisms in the periodontal pocket. Systemic administration of drugs leads to therapeutic concentrations at the site of infection, but for short periods of time, forcing repeated dosing for longer periods. Local delivery of antimicrobials has been investigat ed for the possibility of overcoming the limitations of conventional therapy. The use of sustained release formulations to deliver antibacterials to the site of infection (periodontal pocket) is gaining interest. These products provide a long-term, effective treatment at the site of infection at much smaller doses. (Kaplish et al. 2013) Formulation and development of a gel based topical dosage form for antimicrobial drug will be proved to be worthwhile like ability to deliver drug more selectively to a specific site, avoidance of gastro-intestinal incompatibility, providing utilization of drugs with short biological half-life, improving physiological and pharmacological response and provide suitability for self medication. (Basavaraj et al. 2012) 2.1.1 Periodontal Local Drug Delivery Goodson et al in 1979 first proposed the concept of controlled delivery in the treatment of periodontitis. The effectiveness of this form of therapy is that, it reaches the base of periodontal pocket and is maintained for an adequate time for the antimicrobial effect to occur. These delivery systems are also called sustained release, controlled-release, prolonged release, timed release, slow release, sustained action, prolonged action or extended action. There are distinct phases in a periodontal treatment plan where a dental practitioner can use this sustained release device. They are as follows: As an adjunct to Scaling and Root planning. Periodontal maintenance therapy: Recurrent periodontitis usually involves only a few teeth. These sites are ideal for the treatment with this device. For whom surgery is not an option or those who refuse surgical treatment Sustained release device is a less invasive treatment option and it requires less time compared to surgical treatment. (Kaplish et al. 2013) 2.1.1.1 Types of local drug delivery devices Sustained released devices These are delivery systems whose action lasts less than 24 hours therefore require multiple applications. It follows the first order kinetics. Controlled delivery devices – These are the devices which follows zero order kinetics and whose actions last longer than 24 hours, thereby decreasing the number applications. (Greenstein et al. 2000) 2.1.1.2 Advantages of local drug delivery system Provides drug in an effective concentration that can be maintained there long enough for the desired effect to be accomplished without causing any side effect. It can attain upto 100 fold higher concentration of an antimicrobial agent in subgingival site compared with a systemic therapy. Broad spectrum antibiotics which cannot be employed systemically because of many sideeffects can be safely employed locally with minimum side effects. Superinfection and drug resistance are rare. It also reduces the risk of developing drug resistant microbial populations at non oral body sites. The potentials of daily drug placement into periodontal pockets as a part of home self care procedure can be performed by a compliant patient. This route may employ antimicrobial agents not suitable for systemic administration such as various broad spectrum antiseptics solutions. e.g.– chlorhexidine Improve the patient compliance. (Slots et al. 1996 and Chadha et al. 2012) 2.1.1.3 Disadvantages of local delivery system Inaccessible and deeper pocket areas, furcations cannot be completely dealt with antimicrobial agents. Time consuming and laborious, if many sites are involved. Non-sustained local delivery is limited by an only brief exposure of targeted microorganisms to applied antimicrobial agent. Connective tissue associated plaque and extra pocket oral surfaces don‘t get affected by local drug delivery which may be responsible for recurrence of disease in treated areas. Difficulty in placing therapeutic concentration of antimicrobial agent into deeper parts of periodontal pockets and furcations lesions. Personal application of antimicrobial agents by patients as a part of their home self-care procedure is frequently compromised by the patient‘s lack of adequate manual dexterity, limited understanding of periodontal anatomy and poor compliance and performance with recommended procedures. (Axelsson 1999) 2.1.1.4 Local drug delivery systems for treating periodontitis Various local drug delivery system for treating periodontitis-Fibers, Film, Injectable systems, Gels, Strips and compacts, Vesicular systems, Microparticle system, Nanoparticle system etc. Injectable drug delivery systems Injectable systems are particularly attractive for the delivery of antibiotic agents into the periodontal pocket. The application can be easily and rapidly carried out, without pain, by using a syringe. Thus, the cost of the therapy is considerably reduced compared to devices that need time to be placed and secured. Moreover, an injectable delivery system should be able to fill the pocket, thus reaching a large proportion of pathogens. Two types of injectable drug delivery systems have been studied in periodontal diseases- biodegradable (1) microparticles and (2) gels. (Kaplish et al. 2013) 1. Microparticles /Microspheres These are controlled release drug delivery system which comprises of drug-containing microparticles or microspheres, between 10 and 500 microns in size, suspended in a pharmaceutically acceptable carrier medium, and are capable of maintaining an effective level of drug in the periodontal pocket for a period of one to thirty days. They are spherical free flowing particles consisting of proteins or synthetic polymers. Non-biodegradable as well as biodegradable materials have been investigated for the preparation of microspheres. There are two types of microspheres; a) Microcapsules. b) Micromatrices. In microcapsules entrapped substance is distinctly surrounded by distinct capsule wall and in micromatrices entrapped substance is dispersing throughout the microspheres matrix. Solid biodegradable microspheres incorporating a drug dispersed or dissolved through particle matrix have the potential for the controlled release of drug. They are made from polymeric, waxy, or other protective materials (i.e. biodegradable synthetic polymers and modified natural products). (Chaudhari et al. 2010) Advantages of microspheres Constant and prolonged therapeutic effect. Reduction in dosing frequency and thereby improve the patient compliance. They could be injected into the body due to the spherical shape and smaller size. Better drug utilization will improve the bioavailability and reduce the incidence or intensity of adverse effects. Microsphere morphology allows a controllable variability in degradation and drug release.

History of Alicia Bohol Philippines Essay

Those men do not learn very much from the lessons of history is the most important of all the lessons of history. Aldous Huxley In the early part of the 19th century the town of Alicia, formerly known as Batuanan, was one of the three (3) biggest and oldest towns of Bohol along with Catigbian and Balilihan. It was a thriving trading center shortly after the Dagohoy Rebellion (1744 – 1829). The town of Batuanan, however, was formally established in June 1860 by virtue of a decree signed by the Spanish Governor General Livarez. There are two versions as to how the place came to be called Batuanan. One version stated that the place was a â€Å" Batuganan† meaning perch or lookout of the warriors of Dagohoy guarding against invading Spanish and pirates. From then on, the place was called Batuanan derived the word â€Å" Batuganan†. The second version is that Batuan trees bearing tomato-shaped fruits were abundant in the locality. This prompted the Spanish soldiers who were then conducting mopping-out operations against Dagohoy’s men to call the place Batuanan. Close to the end of Spanish regime in the country, two (2) high ranking officers were ambushed in the outskirts of the town. This incident prompted the Spanish officers to burn the whole Poblacion in retaliation. Again, in the early American regime, an American soldier was killed in another ambuscade, which brought about another scourge upon the town. This time the American soldiers burned all the structures to the ground, thus, resulting to the transfer of the seat of government to barrio Libas which is now the Poblacion of the Municipality of Mabini. This continued until 1903 when the Philippines Commission passed Commonwealth Act. No. 968 formally creating the Municipality of Mabini, wherein Batuanan became only a barrio thereof. However, after the span of few years, the people of Batuanan started agitating for the restoration of its status into a municipality. Towards  that end, they succeeded in having elected two (2) Mayors, namely: Dulcisimo Ayuban and Cipriano G. Aton. Also elected were two (2) Vice-Mayors, namely: Buenaventura Asas and Segunda Duetes and several councilors, among them were Victor Doydora, Dionisio Muring, Anastacio Curit, Pedro Huiso and Gaudencio Gumop-as. These officials paved the way for a concerted effort to secede from the town of mabini. It was not until 1949 when the real break came. Pedro Huiso and Cipriano Aton, together with some prominent leaders of Batuanan, through the help Governor Jacinto Borja sought an audience with President Elpidio Quirino, then seeking reelection, lobbying to create Batuanan into a municipality with a pledge that the people thereat will deliver a solid vote for the liberal Party candidates in the 1949 national elections. Thus, President Elpidio Quirino, during his stopover in Dumaguete from Tagbilaran, Bohol on September 16, 1949 issued Executive Order No. 265 creating Batuanan into an independent municipality to be known as Alicia, in honor of his wife, Doà ±a Alicia Syquia Quirino. On January 18, 1950 the municipality of Alicia, Bohol was formally inaugurated with its first appointed officials, namely: Mayor Pedro Huiso, Vice – Mayor Anastacio Curit, and Councilors Perpetua Talili, Gaudencio Gumop-as, Eladio Iyoy, Buenaventura Asas, Benito Licayan and Arsenio Ayuban. From then on, the town elected 9 mayors who succeded Pedro Huiso (1950-55), namely: Exequiel Madrià ±an Sr., Leoncio Garcia (1956- 59), Jesus Madrià ±an (1960-80), Dominador Molina (1980 – 1987), Exequiel Madrià ±an Jr.( 1988 – 1995), Basilio H. Balahay Jr. (1995 – 2001), Bienvenido C. Molina Jr., MD ( 2001 – 2007), Pedro B. Miasco ( 2007 – 2010), Marnilou S. Ayuban (2010 – present).

The Advent of the Renaissance

To what extent is the term â€Å"Renaissance† a valid concept for a distinct period in early modern European history? Prior to the 14th century, the Middle Ages revolved around the basic understanding of the Bible. Middle to lower class citizens relied heavily on the teachings of the priest's and blindly followed their ways of living. The church discouraged any new concepts and believed that life on Earth was simply a preparation for the after life.The Renaissance, ranging from the 14th to 16th entries, became a distinct period in European history due to the increase in trade, influence of art and the artist, and the growing phenomenon of individual thinking, as this will lead to future exploration and economic advances. Italy, the epicenter of Renaissance culture, was able to advance their society through a growth in economic stability. As ships and trade routes began to advance technologically, the Italian merchant class also grew.Italian merchants and sailors would import g oods from all over Europe, such as wool from England, and ship them o other countries. The risks of such endeavors were high, but the end profit was even higher. This new industry not only stabilized the Italian economy, but it eventually led to the development of the Urban Nobility class, who strongly contributed to the Renaissance efforts. During the Renaissance, the influence of art and the artist grew extensively. Artists in the Middle Ages worked strictly on religious pieces for the church and many struggled to make a reasonable living.Art during the Renaissance was in high demand. Every rich and powerful family used works of art as a way to flaunt their wealth and demonstrate their lavish lifestyle. The technique of dark and light was added to show depth and dimension. Artists also began to use realism, painting more realistic faces and bodies, as this was a newly accepted style. Some of the highly influential Renaissance artists include Michelangelo, Leonardo dad Vinci, Rapha el, and Ghetto. Their works were not only revolutionary for their time, but they continue to be inspirations for the modern day artist.Through the invention of the printing press, revolutionary thinkers were able to communicate their theories to the mass population, an opportunity that was never accessible prior to the Renaissance. Three main proprietary concepts were developed in this time. The ideas of humanism, individualism, and secularism dominated the Renaissance culture like never before. Humanists emerged with a newfound interest in the classics. They studied these works in order to discover more about human nature.Individualists prioritize the potential of the human being. They believed that everyone should have to opportunity to be the best they can possibly be. Secularism was the basic concern with the material world, as opposed to the spiritual world. These ideas strongly opposed the teachings of the church, yet they continued to spread rapidly and strongly. Coming out o f a banal period in western culture, the Renaissance brought on countless revolutionary thinkers that worked to open the eyes of their peers and make an impact on society.The Renaissance was an explosion of revolutionary ideas that spread all across Europe. For the first time in centuries, artists, merchants, writers, and philosophers alike were able to express themselves in an amazing way. Many of the greatest minds that we often look back to for inspiration originated from the Renaissance era. Their ideas made a lasting impact on culture, then and now. The Renaissance would not have been such a distinct period if not for the combined efforts of every possible industry and art form.

Considerations in Casino Design Essay - 695 Words

Considerations in Casino Design â€Å" Architecture organizes and structures space for us, and its interiors and the objects enclosing and inhabiting its rooms can facilitate or inhibit our activities by the way they use this language†(Lawson pg.6). nbsp;nbsp;nbsp;nbsp;nbsp;Casinos are tough and competitive markets that strive to out do one another in promotions, amenities and overall design. A critical analysis of the considerations taken when designing a casino can be broken down into the theoretical forces of psychology, that include motivational, cognitive, perceptual and social influences. In this examination I will determine the aspects of design that should be taken into account to create a successful operation. â€Å" Casinos are†¦show more content†¦By providing them with twenty-four hour services and amenities, casino operators create a sensation for the patrons that the days spent in the casino feel as if you stepped out of normal time. â€Å"The geographic location of a casino is a huge consideration† (Lewis pg. 1). Demographics, travel patterns and nearby competition play a significant part in casino design. â€Å" Most people in North America live within a day’s drive of one or more gaming areas† (Lewis pg. 1), so in order to attract people to the casino there must be something other than the gaming floor to draw them in. Many amenity and non-gaming attractions must be considered in order to really stand out. The casino must design strong support facilities, a hotel that can accommodate as many players as it can afford, a parking system for the traveling patrons, non-gambling facilities for families and it must be an inviting space. In order for a casino to be successful they must establish their target audience. Based on the proximity of neighboring casinos and the owner’s intentions for their ideal gaming facility, the criteria can be ascertained and implemented for a certain theme. Many casinos have found that themed areas and designs are very successful and draw in target markets. 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