Could drug-loaded dental implants offer pain-free chronic med delivery?
Chronic diseases are on the rise and the associated painful procedures -- such as blood sugar detection or regular intravenous injections -- can lead to low patient compliance, Yu-Jung Li et al of National Taipei University of Technology note.
A device based on titanium dental implants used as part of routine procedures for natural tooth loss could offer long-term continuous drug delivery through the maxilla bone marrow, the team note in their Elsevier paper (1).
The struggle to develop non-invasive delivery methods is ongoing, for instance the well-documented battle to get an oral insulin is approved.
Li et al suggest drug release over the maxilla bone marrow which offers a rich blood supply would mean drug delivery into the blood pool hence avoiding the need for injections -- for instance with insulin.
Insulin release has thus far been tested with the device in a canine model, which showed blood sugar circulation reduction as rapid as subcutaneous or intravenous injection.
Blood sugar did reach levels low enough for potential fainting in the model, however, the team attribute this to possibly excessive rapid onset insulin loading.
How it works
With dental implants, the surrounding bone tissue can grow into the titanium surface, which corresponds to osseointegration, the researchers note.
Removal of the periodontal ligament and pulp nerve structure as part of the procedure -- the two components of tooth sensation -- creates a new pathway for continuous drug release while reducing discomfort, they suggest.
Looser bone structure after procedure further accommodates drug release, according to a 2008 paper by J. Weng et al (2) cited in the intra-oral device study.
The device could be conducted under local anaestesia and drug containers within it can be replaced periodically making it a "semi-implanted" device.
Due to early manufacturing considerations, drug release systems were based on mechanical and piezoelectric modes for early testing.
However, the scientists write that it is likely electrical or wireless control devices to release drug would be most practical in clinical application, the team wrote.
Sources:
1. Li, Y. J. et al., "An intra-oral drug delivery system design for painless, long-term and continuous drug release". Sensors and Actuators B: Chemical, Published online ahead of print.
2. Weng, J et al., "Effect of intensive insulin therapy on B-cell function and glycaemic control in patients with newly diagnosed type 2 diabetes: a multicentre randomised parallel-group trial". Lancet, 371(2008), pg 1753- 1760.
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