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Open Access 20-11-2023 | Active Ingredients | Review

Intraoral medical devices for sustained drug delivery

Authors: Suhail Alghanem, Ewelina Dziurkowska, Iwona Ordyniec-Kwaśnica, Małgorzata Sznitowska

Published in: Clinical Oral Investigations

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.

Abudiak H, Robinson C, Duggal MS, Strafford S, Toumba KJ (2011) The effect of fluoride slow-releasing devices on fluoride in plaque biofilms and saliva: a randomised controlled trial. Eur Arch Paediatr Dent 12:163–166. https://doi.org/10.1007/BF03262799 CrossRefPubMed

Abudiak H, Robinson C, Duggal MS, Strafford S, Toumba KJ (2012) Effect of fluoride sustained slow-releasing device on fluoride, phosphate and calcium levels in plaque biofilms over time measured using ion chromatography. J Dent 40:632–638. https://doi.org/10.1016/j.jdent.2012.04.008 CrossRefPubMed

Achong RA, Briskie DM, Hildebrandt GH, Feigal RJ, Loesche WJ (1999) Effect of chlorhexidine varnish mouthguards on the levels of selected oral microorganisms in pediatric patients. Pediatr Dent 21:169–175 PubMed

Ahanthem N, Gazge N (2015) Orodental local drug delivery. J Heal Sci Res 6:41–46. https://doi.org/10.5005/jp-journals-10042-1019 CrossRef

Akhtar N (2014) Microneedles: an innovative approach to transdermal delivery- a review. Int J Pharm Pharm Sci 6:18–25

Alawdi S, Solanki AB (2021) Mucoadhesive drug delivery systems: a review of recent developments. J Sci Res Med Biol Sci 2:50–64. https://bcsdjournals.com/index.php/jsrmbs/article/view/213. Accessed 8 Nov 2023

Arnold RR, Wei HH, Simmons E, Tallury P, Barrow DA, Kalachandra S (2008) Antimicrobial activity and local release characteristics of chlorhexidine diacetate loaded within the dental copolymer matrix, ethylene vinyl acetate. J Biomed Mater Res Part B Appl Biomater 86B:506–513. https://doi.org/10.1002/jbm.b.31049 CrossRef

Attaie AB, Ahmed MK (2015) In: Taub PJ, Patel PK, Buchman SR, Cohen MN (eds) Oral anatomy BT - Ferraro’s fundamentals of maxillofacial surgery. Springer New York, New York, NY, pp 49–63. https://doi.org/10.1007/978-1-4614-8341-0_3 CrossRef

Bagade OM, Mali AR, Survase SS, Chaudhari AK, Doke PE (2021) An updated overview on mucoadhesive buccal drug delivery system. Res J Pharm Technol 4495–4500. https://rjptonline.org/AbstractView.aspx?PID=2021-14-8-87. Accessed 8 Nov 2023

10.

Basilicata M, Grillo P, Tancredi A, Di Fiore A, Bollero P, Stefani A et al (2023) Oral health and use of novel transbuccal drug delivery systems in patients with Alzheimer’s and Parkinson’s disease: a review. Appl Sci 13:4974. https://doi.org/10.3390/app13084974 CrossRef

11.

Benn AM, Thomson WM (2014) Saliva: an overview Report Saliva: an overview. N Z Dent J 110:92–96 PubMed

12.

Berger V, Luo Z, Leroux JC (2022) 3D printing of a controlled fluoride delivery device for the prevention and treatment of tooth decay. J Control Release 348:870–880 CrossRefPubMed

13.

Bhutani U, Basu T, Majumdar S (2021) Oral drug delivery: conventional to long acting new-age designs. Eur J Pharm Biopharm 162:23–42 CrossRefPubMed

14.

Caffarel-Salvador E, Kim S, Soares V, Tian RY, Stern SR, Minahan D et al (2023) A microneedle platform for buccal macromolecule delivery. Sci Adv 7:eabe2620. https://doi.org/10.1126/sciadv.abe2620

15.

Campisi G, Paderni C, Saccone R, Fede DO, Wolff A, Giannola IL (2010) Human buccal mucosa as an innovative site of drug delivery [Internet]. Curr Pharm Des 641–652 Available from: http://www.eurekaselect.com/article/15947. Accessed 8 Nov 2023

16.

Campisi G, Giannola LI, Florena AM, De Caro V, Schumacher A, Göttsche T et al (2010) Bioavailability in vivo of naltrexone following transbuccal administration by an electronically-controlled intraoral device: a trial on pigs. J Control Release 145:214–220. https://www.sciencedirect.com/science/article/pii/S0168365910003020. Accessed 8 Nov 2023

17.

Chambers MS, Mellberg JR, Keene HJ, Bouwsma OJ, Garden AS, Sipos T et al (2006) Clinical evaluation of the intraoral fluoride releasing system in radiation-induced xerostomic subjects. Part 1: fluorides. Oral Oncol 42:934–945 CrossRefPubMed

18.

Chambers MS, Mellberg JR, Keene HJ, Bouwsma OJ, Garden AS, Sipos T et al (2006) Clinical evaluation of the intraoral fluoride releasing system in radiation-induced xerostomic subjects. Part 2: phase I study. Oral Oncol 42:946–953 Available from: https://www.sciencedirect.com/science/article/pii/S1368837506000078 CrossRefPubMed

19.

Choi JJE, Zwirner J, Ramani RS, Ma S, Hussaini HM, Waddell JN et al (2020) Mechanical properties of human oral mucosa tissues are site dependent: a combined biomechanical, histological and ultrastructural approach. Clin Exp Dent Res 6:602–611 CrossRefPubMedPubMedCentral

20.

Curzon MEJ, Toumba KJ (2004) In vitro and in vivo assessment of a glass slow fluoride releasing device: a pilot study. Br Dent J 196:543–546 Available from: http://www.nature.com/articles/4811225 CrossRefPubMed

21.

Davoodi P, Lee LY, Xu Q, Sunil V, Sun Y, Soh S et al (2018) Drug delivery systems for programmed and on-demand release. Adv Drug Deliv Rev 132:104–138 CrossRefPubMed

22.

Delgado-Dolset MI, Rodriguez-Coira J, Sánchez-Solares J (2022) Word of mouth: oral mucosa composition in health and immune disease. Allergy 77:1641–1643. https://doi.org/10.1111/all.15219 CrossRefPubMed

23.

Di Carla SS, Fávaro-Moreira NC, Abdalla HB, Augusto GGX, Costa YM, Volpato MC et al (2021) A crossover clinical study to evaluate pain intensity from microneedle insertion in different parts of the oral cavity. Int J Pharm 592:120050 CrossRef

24.

do Couto RO, Cubayachi C, MPF D, RFV L, Pedrazzi V, De Gaitani CM et al (2021) Towards the advance of a novel iontophoretic patch for needle-free buccal anesthesia. Mater Sci Eng C 122:111778 Available from: https://www.sciencedirect.com/science/article/pii/S0928493120336973 CrossRef

25.

Eduok U, Szpunar J (2020) In vitro corrosion studies of stainless-steel dental substrates during Porphyromonas gingivalis biofilm growth in artificial saliva solutions: providing insights into the role of resident oral bacterium. RSC Adv 10:31280–31294 Available from: http://xlink.rsc.org/?DOI=D0RA05500J CrossRefPubMedPubMedCentral

26.

Fedele S, Wolff A, Strietzel F, López RMG, Porter SR, Konttinen YT (2008) Neuroelectrostimulation in treatment of hyposalivation and xerostomia in Sjögren’s syndrome: a salivary pacemaker. J Rheumatol 35:1489–1494 PubMed

27.

Fiorillo L (2020) We do not eat alone: formation and maturation of the oral microbiota. Biology (Basel) 9:17. https://www.mdpi.com/2079-7737/9/1/17. Accessed 8 Nov 2023

28.

Giannola IL, Paderni C, De Caro V, Florena MA, Wolff A, Campisi G (2010) New prospectives in the delivery of galantamine for elderly patients using the IntelliDrug intraoral device: in vivo animal studies [Internet]. Curr Pharm Des 653–659. http://www.eurekaselect.com/article/15948. Accessed 8 Nov 2023

29.

Giannola LI, Sutera FM, De Caro V (2013) Physical methods to promote drug delivery on mucosal tissues of the oral cavity. Expert Opin Drug Deliv 10:1449–1462. https://doi.org/10.1517/17425247.2013.809061 CrossRefPubMed

30.

Girenes G, Ulusu T (2014) An in vitro evaluation of the efficacy of a novel iontophoresis fluoride tray on remineralization. J Clin Exp Dent 6:e327–e334 CrossRefPubMedPubMedCentral

31.

Haeberle S, Hradetzky D, Schumacher A, Vosseler M, Messner S, Zengerle R (2009) Microfluidics for drug delivery:359–362. https://doi.org/10.1007/978-3-642-03887-7_103

32.

Hakim LK, Yazdanian M, Alam M, Abbasi K, Tebyaniyan H, Tahmasebi E et al (2021) Biocompatible and biomaterials application in drug delivery system in oral cavity. In: LAR V (ed) Evidence-based complement altern med, vol 2021, p 9011226. https://doi.org/10.1155/2021/9011226 CrossRef

33.

Herrlich S, Haffa U, Wolff A, Spieth S, Zengerle R (2013) Mikrosystemintegration im Herausnehmbaren Zahnersatz. Biomed Eng-Biomedizinische Technik 58. https://doi.org/10.1515/bmt-2013-4372

34.

Herrlich S, Wolff A, Nouna R, Spieth S, Zengerle R (2013) Clinical evaluation of a telemedically linked intraoral drug delivery system. Ger Congr Microsystems Technol 40–41

35.

Herrlich S, Lorenz T, Marker M, Spieth S, Messner S, Zengerle R (2011) Miniaturized osmotic pump for oromucosal drug delivery with external readout station. Proc Annu Int Conf IEEE Eng Med Biol Soc EMBS 8380–8383. https://doi.org/10.1109/IEMBS.2011.6092067

36.

Herrlich S, Spieth S, Messner S, Zengerle R (2012) Osmotic micropumps for drug delivery. Adv Drug Deliv Rev 64:1617–1627 CrossRefPubMed

37.

Hildebrandt GH, Pape HR Jr, Syed SA, Gregory WA, Friedman M (1992) Effect of slow-release chlorhexidine mouthguards on the levels of selected salivary bacteria. Caries Res 26:268–274 Available from: https://www.karger.com/Article/FullText/261450 CrossRefPubMed

38.

Giannola LI, De Caro V, Giandalia G, Siragusa MG, Campisi G, Wolff A (2008) Current status in buccal drug delivery. Pharm Technol Eur 20:32–39

39.

Iona T, Masala D, Tornello F, Mascaro V, Iona A, Ammendolia A (2019) Relationship between mouth guards use, dental injuries and infection in young combat sport athletes. J Phys Educ Sport 19:1878–1884

40.

Karpiński TM (2018) Selected medicines used in iontophoresis. Pharmaceutics 10:204. https://doi.org/10.3390/pharmaceutics10040204 CrossRefPubMed

41.

Khorsandi D, Fahimipour A, Abasian P, Saber SS, Seyedi M, Ghanavati S et al (2021) 3D and 4D printing in dentistry and maxillofacial surgery: printing techniques, materials, and applications. Acta Biomater 122:26–49 CrossRefPubMed

42.

Kijsamanmith K, Monthonjulaket N, Kuanpradit N, Thongwong K, Kijprasert N (2022) The effect of iontophoresis delivery of fluoride in stannous fluoride desensitizing toothpaste on dentin permeability in human extracted teeth. Sci Rep 12:1–8. https://doi.org/10.1038/s41598-022-18043-9 CrossRef

43.

Kijsamanmith K, Wallanon P, Pitchayasatit C, Kittiratanaviwat P (2022) The effect of fluoride iontophoresis on seal ability of self-etch adhesive in human dentin in vitro. BMC Oral Health 22:1–8. https://doi.org/10.1186/s12903-022-02146-w CrossRef

44.

Kurosaki Y, Takatori T, Nishimura H, Nakayama T, Kimura T (1991) Regional variation in oral mucosal drug absorption: permeability and degree of keratinization in hamster oral cavity. Pharm Res 8:1297–1301. https://doi.org/10.1023/A:1015812114843 CrossRefPubMed

45.

Lam JKW, Cheung CCK, Chow MYT, Harrop E, Lapwood S, Barclay SIG et al (2020) Transmucosal drug administration as an alternative route in palliative and end-of-life care during the COVID-19 pandemic. Adv Drug Deliv Rev 160:234–243. https://linkinghub.elsevier.com/retrieve/pii/S0169409X20301654. Accessed 8 Nov 2023

46.

Lau ETL, Steadman KJ, Cichero JAY, Nissen LM (2018) Dosage form modification and oral drug delivery in older people. Adv Drug Deliv Rev 135:75–84 CrossRefPubMed

47.

Lee K, Jung H (2012) Drawing lithography for microneedles: a review of fundamentals and biomedical applications. Biomaterials 33:7309–7326 CrossRefPubMed

48.

Lee KJ, Goudie MJ, Tebon P, Sun W, Luo Z, Lee J et al (2020) Non-transdermal microneedles for advanced drug delivery. Adv Drug Deliv Rev 165–166:41–59 CrossRefPubMed

49.

Liang K, Carmone S, Brambilla D, Leroux J-C (2018) 3D printing of a wearable personalized oral delivery device: a first-in-human study. Sci Adv 4:eaat2544. https://doi.org/10.1126/sciadv.aat2544

50.

Liang J, Peng X, Zhou X, Zou J, Cheng L (2020) Emerging applications of drug delivery systems in oral infectious diseases prevention and treatment. In: Molecules, MDPI AG

51.

Li X, Xie X, Wu Y, Zhang Z, Liao J (2023) Microneedles: structure, classification, and application in oral cancer theranostics. Drug Deliv Transl Res 13:2195–2212. https://doi.org/10.1007/s13346-023-01311-0 CrossRefPubMed

52.

Liu Y, Guo H, Xu R, Chen W (2022) Smart intraoral systems for advanced drug delivery. MedComm – Biomater Appl 1:e19. https://doi.org/10.1002/mba2.19 CrossRef

53.

Ma Y, Tao W, Krebs SJ, Sutton WF, Haigwood NL, Gill HS (2014) Vaccine delivery to the oral cavity using coated microneedles induces systemic and mucosal immunity. Pharm Res 31:2393–2403 CrossRefPubMedPubMedCentral

54.

Ma Y, Boese SE, Luo Z, Nitin N, Gill HS (2015) Drug coated microneedles for minimally-invasive treatment of oral carcinomas: development and in vitro evaluation. Biomed Microdevices 17:44. https://doi.org/10.1007/s10544-015-9944-y CrossRefPubMed

55.

Mańka-Malara K, Panasiewicz P, Kacprzyk M, Gawryszewska M, Mierzwińska-Nastalska E, Gawlak D (2019) The effect of decontamination procedures on elastic polymeric materials used in dental mouthguards fabrication. Acta Bioeng Biomech 21. http://www.actabio.pwr.wroc.pl/Vol21No4/67.pdf. Accessed 8 Nov 2023

56.

Martins Andrade JF, da Cunha MT, Cunha-Filho M, Taveira SF, Gelfuso GM, Gratieri T (2023) Iontophoresis application for drug delivery in high resistivity membranes: nails and teeth. Drug Deliv Transl Res 13:1272–1287. https://doi.org/10.1007/s13346-022-01244-0 CrossRefPubMed

57.

Marya A, Venugopal A (2021) The use of technology in the management of orthodontic treatment-related pain. Jamayet N, editor. Pain Res Manag 2021:5512031. https://doi.org/10.1155/2021/5512031 CrossRefPubMedPubMedCentral

58.

Meyerowitz C, Watson GE (1998) The efficacy of an intraoral fluoride-releasing system in irradiated head and neck cancer patients: a preliminary study. J Am Dent Assoc 129:1252–1259 Available from: https://www.sciencedirect.com/science/article/pii/S0002817714662668 CrossRefPubMed

59.

Moscicka AE, Czarnecka K, Ciach T (2007) IntelliDrug implant for medicine delivery in Alzheimer’s disease treatment. Macromol Symp 253:134–138. https://doi.org/10.1002/masy.200750720 CrossRef

60.

Neligan PC, Gullane PJ, Gilbert RW (2003) Functional reconstruction of the oral cavity. World J Surg 27:856–862. https://doi.org/10.1007/s00268-003-7108-3 CrossRefPubMed

61.

Oh YJ, Cha HR, Hwang SJ, Kim DS, Choi YJ, Kim YS et al (2021) Ovalbumin and cholera toxin delivery to buccal mucus for immunization using microneedles and comparison of immunological response to transmucosal delivery. Drug Deliv Transl Res 11:1390–1400. https://doi.org/10.1007/s13346-021-00964-z CrossRefPubMed

62.

Paderni C, Compilato D, Giannola LI, Campisi G (2012) Oral local drug delivery and new perspectives in oral drug formulation. Oral Surg Oral Med Oral Pathol Oral Radiol 114:e25–e34 CrossRefPubMed

63.

Paderni C, Campisi G, Schumacher A, Göttsche T, Giannola LI, De Caro V et al (2013) Controlled delivery of naltrexone by an intraoral device: in vivo study on human subjects. Int J Pharm 452:128–134 Available from: https://www.sciencedirect.com/science/article/pii/S0378517313003712 CrossRefPubMed

64.

Parhi R (2022) Recent advances in microneedle designs and their applications in drug and cosmeceutical delivery. J Drug Deliv Sci Technol 75:103639 CrossRef

65.

Pessan JP, Al-Ibrahim NS, Buzalaf MAR, Toumba KJ (2008) Slow-release fluoride devices: a literature review. J Appl Oral Sci 16:238–244 Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1678-77572008000400003&lng=en&tlng=en [cited 2023 Jul 20] CrossRefPubMedPubMedCentral

66.

Pitts NB, Wright JP (2018) Reminova and EAER: keeping enamel whole through caries remineralization. Adv Dent Res 29:48–54. https://doi.org/10.1177/0022034517737026 CrossRefPubMed

67.

Ragit R, Fulzele P, Rathi NV, Thosar NR, Khubchandani M, Malviya NS et al (2022) Iontophoresis as an effective drug delivery system in dentistry: a review. Cureus Available from: https://www.cureus.com/articles/118824-iontophoresis-as-an-effective-drug-delivery-system-in-dentistry-a-review

68.

Rathbone MJ, Drummond BK, Tucker IG (1994) The oral cavity as a site for systemic drug delivery. Adv Drug Deliv Rev 13:1–22 CrossRef

69.

Rathbone MJ, Pather I, Şenel S (2015) Overview of oral mucosal delivery. In: Rathbone MJ, Senel S, Pather I (eds) Overv oral mucosal deliv [Internet]. Springer US, Boston, MA, pp 17–29. https://doi.org/10.1007/978-1-4899-7558-4 CrossRef

70.

Reddy MS, Varalakshmi K, Prasad CS, Swetha S, Shruthi B (2013) Drug delivery through osmotic micropump–a review. Res J Pharm Technol 6:12–16

71.

Rzhevskiy AS, Singh TRR, Donnelly RF, Anissimov YG (2018) Microneedles as the technique of drug delivery enhancement in diverse organs and tissues. J Control Release 270:184–202 CrossRefPubMed

72.

SaliPen® [Internet]. Available from: https://saliwell.com/

73.

Scholz OA, Wolff A, Schumacher A, Giannola LI, Campisi G, Ciach T et al (2008) Drug delivery from the oral cavity: focus on a novel mechatronic delivery device. Drug Discov Today 13:247–253. https://doi.org/10.1016/j.drudis.2007.10.018 CrossRefPubMed

74.

Saxena A, Tewari G, Saraf SA (2011) Formulation and evaluation of mucoadhesive buccal patch of acyclovir utilizing inclusion phenomenon. Brazilian J Pharm Sci 47:887–897. http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1984-82502011000400026&lng=en&tlng=en. Accessed 8 Nov 2023

75.

Scaturro AL, De Caro V, Campisi G, Giannola LI (2016) Potential transbuccal delivery of l-DOPA methylester prodrug: stability in the environment of the oral cavity and ability to cross the mucosal tissue. Drug Deliv 23:2355–2362. https://doi.org/10.3109/10717544.2014.987332 CrossRefPubMed

76.

Seeni RZ, Zheng M, Lio DCS, Wiraja C, Mohd Yusoff MF, Bin KWTY et al (2021) Targeted delivery of anesthetic agents to bone tissues using conductive microneedles enhanced iontophoresis for painless dental anesthesia. Adv Funct Mater 31:2105686. https://doi.org/10.1002/adfm.202105686 CrossRef

77.

Serpe L, Jain A, de Macedo CG, Volpato MC, Groppo FC, Gill HS et al (2016) Influence of salivary washout on drug delivery to the oral cavity using coated microneedles: an in vitro evaluation. Eur J Pharm Sci 93:215–223. https://www.sciencedirect.com/science/article/pii/S0928098716303128. Accessed 8 Nov 2023

78.

Squier CA, Kremer MJ (2001) Biology of oral mucosa and esophagus. JNCI Monogr 2001:7–15. https://doi.org/10.1093/oxfordjournals.jncimonographs.a003443 CrossRef

79.

Steffen A, Walke T, Donadel S (2012) User-friendly design of a drug delivery system for Parkinson patients. Biomed Eng/Biomedizinische Technik 57:956–958. https://doi.org/10.1515/bmt-2012-4190 CrossRef

80.

Suharyani I, Fouad Abdelwahab Mohammed A, Muchtaridi M, Wathoni N, Abdassah M (2021) Evolution of drug delivery systems for recurrent aphthous stomatitis. Drug Des Devel Ther 15:4071–4089. https://www.dovepress.com/evolution-of-drug-delivery-systems-for-recurrent-aphthous-stomatitis-peer-reviewed-fulltext-article-DDDT. Accessed 8 Nov 2023

81.

Tangri P, Madhav NV (2010) Recent advances in oral mucoadhesive drug delivery systems: a review. Int J Biopharm 2:36–46

82.

Tasti C, Toumba KJ. Effect of fluoride slow-release glass devices on salivary and gingival crevicular fluid levels of fluoride : a pilot study. 2019;620–626

83.

Toumba KJ (2001) Slow-release devices for fluoride delivery to high-risk individuals. Caries Res 35:10–13. https://doi.org/10.1159/000049102 CrossRefPubMed

84.

Toumba KJ, Al-Ibrahim NS, Curzon MEJ (2009) A review of slow-release fluoride devices. Eur Arch Paediatr Dent 10:175–182. https://doi.org/10.1007/BF03262680 CrossRefPubMed

85.

Vila T, Rizk AM, Sultan AS, Jabra-Rizk MA (2019) The power of saliva: antimicrobial and beyond. PLOS Pathog 15:e1008058. https://doi.org/10.1371/journal.ppat.1008058 CrossRefPubMedPubMedCentral

86.

Wanasathop A, Li SK (2018) Iontophoretic drug delivery in the oral cavity. Pharmaceutics

87.

Wei R, Simon L, Hu L, Michniak-Kohn B (2012) Effects of iontophoresis and chemical enhancers on the transport of lidocaine and nicotine across the oral mucosa. Pharm Res 29:961–971 CrossRefPubMed

Title: Intraoral medical devices for sustained drug delivery
Authors: Suhail Alghanem
Ewelina Dziurkowska
Iwona Ordyniec-Kwaśnica
Małgorzata Sznitowska
Publication date: 20-11-2023
Publisher: Springer Berlin Heidelberg
Keyword: Active Ingredients
Published in: Clinical Oral Investigations
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-023-05377-5

Keynote Webinar | Spotlight on Diet and Diabetes

Springer Medicine

Intraoral medical devices for sustained drug delivery

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

Keynote Webinar | Spotlight on Diet and Diabetes

Springer Medicine

Abstract

Objectives

Materials and methods

Results

Conclusion

Clinical relevance

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