Intraoral medical devices for sustained drug delivery

Abstract

Objectives: The oral cavity constitutes an attractive organ for the local and systemic application of drug substances. Oromucosal tablets, gels, or sprays are examples of the formulations applied. Due to the elution through the saliva, the residence time of the formulation at the application site is relatively short. Medical devices placed in the oral cavity, with a reservoir for an active substance, play an important role in solving this problem.

Materials and methods: In this review, we discuss the devices described in the literature that are designed to be used in the oral cavity, highlighting the advantages, disadvantages, and clinical applications of each of them.

Results: Among the intraoral medical devices, special types are personalized 3D-printed devices, iontophoretic devices, and microneedle patches.

Conclusion: We anticipate that with the development of 3D printing and new polymers, the technology of flexible and comfortable devices for prolonged drug delivery in the oral cavity will develop intensively.

Clinical relevance: The presented review is therefore a useful summary of the current technological state, when in fact none of the existing devices has been widely accepted clinically.

Keywords: 3D printing; Iontophoresis; Medical device; Microneedle patch; Oral cavity.

Fig. 1

Graphic presentation of the issues discussed in the manuscript

Fig. 2

Workflow for the manufacture of wearable personalized oral delivery mouthguards by 3D printing [49]

Fig. 3

Fluoride slow-release glass device attached to the buccal surface of an upper first permanent molar tooth (left) [83]. The latest version of the fluoride glass slow-release device and plastic retention bracket (right) [82]

Fig. 4

Intraoral fluoride-releasing system and fluoride pellets (right) and their appearance when placed on a maxillary molar (lift) [58]

Fig. 5

BuccalDose®—intraoral drug delivery system integrated in a model cast partial denture (A); the cartridges (B) [33]

Fig. 6

Drug-coated MN array for treating oral cavity cancers [54]

Fig. 7

Schematic drawing of a principle of iontophoretic delivery of an active substance in the oral cavity [86]

Fig. 8

Graphical representation of buccal tri-layered iontophoretic patch [24]

Fig. 9

Schematic diagram demonstrating microneedles in combination with iontophoresis for directed delivery of anesthetic drugs to deep tissues in density [76]

Fig. 10

A non-miniaturized “IntelliDrug” prototype embedded in a partial lower jaw denture [73]