Oral Health and Use of Novel Transbuccal Drug Delivery Systems in Patients with Alzheimer's and Parkinson's Disease: A Review.

Neurodegenerative disorders, such as Alzheimer's disease (AD) and Parkinson's disease (PD), are common age-related diseases responsible for high disability. Disease-modifying treatments for AD and PD are still lacking, but symptomatic therapies are available, although limited by difficult administration and patients' scarce compliance at later disease stages. Transbuccal Drug Delivery Systems (TDDSs) include chemical-physics biotechnologies and mechatronic approaches, allowing drug delivery via the transbuccal route, a strategy that may theoretically overcome the limitations imposed by conventional oral administration. In this review, we provided a snapshot of TDDSs, their mechanism of action, the existing subtypes, and their potential application in PD and AD patients. We found a variety of TDDSs, including tablets, solutions, sprays, patches, and the more sophisticated "mechatronic" IntelliDrug and OraFuse devices using a system of pumps and valves for continuous drug release. Several trials have been conducted either on models or patients to test the safety and efficacy of the antidementia and antiparkinsonian agents delivered by TDDSs, which produced encouraging results that suggest future application on a larger scale. Moreover, oral health has emerged as a fundamental prerequisite for the successful use of TDDSs. Accordingly, greater attention to oral hygiene is now due in patients with neurodegenerative disease. [ABSTRACT FROM AUTHOR]