Development and Evaluation of a Novel Nanofibrous Chitosan Dressing with Eugenol and Iodoform for Treating Alveolar Osteitis
Authors: Arabi Bita , Kamali Hossein , Abbaspour Mohammadreza , Salarbashi Davoud 
Published: February 2024

Abstract
Objective: Dry socket or alveolar osteitis is the most common complication following bone exposure. Alveolus, after the dissolution of the blood clot in the tooth socket, is accompanied by severe and persistent pain, bad breath, foul taste in the mouth, or localized lymphadenitis. The treatment of dry socket is based on pain relief to facilitate its healing process. One of the commonly used treatments for dry socket is Alvogyl, which is produced by combining indigenous red fibers from South Asia with active ingredients such as eugenol and iodoform. Since access to these fibers is challenging, finding a suitable alternative for this material is essential. Chitosan is a polymeric substance with remarkable antimicrobial properties and is considered safe for human consumption. On the other hand, the production of nanofibers offers desirable characteristics such as an increased surface-to-volume ratio, which, along with other advantages of chitosan use, such as availability and antimicrobial properties, justifies the necessity of this research.
Methods and Materials: Based on the properties of chitosan, iodoform, and eugenol, formulations were prepared, including a drug-free formulation, a formulation containing 0.24% iodoform, 0.02% eugenol, and a formulation containing 0.24% iodoform with 0.02% eugenol, using an electrospinning apparatus to produce nanofibers. The characteristics of the polymeric solution, such as viscosity, pH, and electrical conductivity, were examined. The diameter, morphology, and diameter distribution of the nanofibers were investigated using SEM. XRD, DSC, and FT-IR tests were conducted to assess the crystalline properties and interaction of the materials. Drug delivery features, including tensile strength, drug loading, drug release profile, as well as cellular toxicity and minimum inhibitory concentration (MIC) of the nanofiber membrane, were evaluated.
Results: Nanofibers were successfully prepared using the electrospinning method, with average fiber diameters of 64 ± 335 nm, 80 ± 360 nm, 97 ± 355 nm, and 59 ± 214 nm for drug-free fibers, fibers containing 0.24% iodoform, 0.02% eugenol, and fibers containing 0.24% iodoform with 0.02% eugenol, respectively. The addition of iodoform and eugenol to the polymer increased the electrical conductivity of the solution and the fibers but decreased the pH and tensile strength. The desired drug loading percentage was achieved for drug-free fibers and fibers containing 0.24% iodoform, 0.02% eugenol, and fibers containing 0.24% iodoform with 0.02% eugenol. FT-IR, DSC, and XRD analyses confirmed the absence of interactions between the drug and excipients in the polymeric membrane. According to the cellular toxicity tests conducted, none of the nanofibers exhibited cytotoxicity against fibroblast cells.
Conclusion: Based on the conducted investigations, it can be concluded that iodoform and eugenol can be successfully loaded into chitosan and polyethylene oxide nanofibers. The obtained fibers possess mechanical strength and controlled drug release profiles, making them suitable for dry socket dressings, which should be further evaluated in in vivo tests.