Abstract:

Microorganisms are closely related to the occurrence and development of common oral diseases. Due to the unique physiological and anatomical characteristics of the oral cavity, locally introduced antibacterial drugs cannot be maintained in the effective concentration range under the effect of saliva erosion. Therefore, to enhance the retention and bioavailability of antibacterial drugs in biofilms, some scholars designed pH sensitive drug delivery systems with the fact that the pH value of oral biofilm is lower than the physiological pH value. This article reviews the research reports of a pH-sensitive drug delivery system in the oral cavity and elaborates its application in oral diseases such as dental caries, endodontic disease, periapical disease, peri-implant diseases, and oral candidiasis. Literature review Results show that the pH-sensitive drug delivery system loaded with antibacterial drugs could be used for the control of oral microorganisms with excellent pH sensitivity and antibacterial properties, especially in the application of acid-producing bacteria such as Streptococcus mutans for the prevention and treatment of dental caries. However, the research of pH-sensitive drug delivery systems in the oral cavity is still limited to basic research,and in clinical applications, it still faces many challenges, such as a complex design and synthesis, difficulties with lasting effects and eliminating drug-resistance and persistent bacteria. Further optimization of pH sensitive systems, as well as animal experiments and in vivo studies will be the focus of future research.

Key words: pH sensitive drug delivery, drug delivery system, nanoparticles, oral microorganisms, acid-producing bacteria, Streptococcus mutans, drug-resistance bacteria, biofilms

摘要：

微生物与口腔常见疾病的发生发展过程密切相关。口腔由于其独特的生理、解剖等特点,局部引入的抗菌药物在唾液的冲刷作用下不能长期维持在有效浓度范围内,因此,为了增强生物膜内抗菌药物的保留和生物利用度,有学者利用口腔生物膜pH值低于生理pH值这一特点,设计了pH敏感载药系统用于清除口腔致病生物膜。本文综述了pH敏感载药系统在口腔的研究报道,并阐述了其在龋病、牙髓病、根尖周病、种植体周围疾病和口腔念珠菌病等口腔疾病中的应用,文献复习结果表明,pH敏感载药系统负载抗菌药物可以以优良的pH敏感性和抗菌性用于口腔微生物的控制,尤其在作用于产酸菌如变异链球菌用于龋病防治方面有很好的应用前景。但是,pH敏感载药系统在口腔的研究仍局限于基础研究阶段,在临床应用中还面临着设计合成复杂、作用难以持久、耐药菌和持留菌难以消除等挑战,对pH敏感系统进行进一步的优化,以及进行动物实验和体内研究将是未来研究的焦点。

关键词: pH敏感载药, 药物递送系统, 纳米粒子, 口腔微生物, 产酸菌, 变异链球菌, 耐药菌, 生物膜