Polymeric design strategies in chitosan-based biomaterials for periodontal applications

Chitosan is a cationic polysaccharide that is derived as a result of partial deacetylation of chitin and has received great interest as an effective functional polymer in localized drug delivery systems. In periodontal usage, molecular weight distribution, degree of deacetylation, crystallinity and crosslinking architecture are key determinants of the therapeutic performance of chitosan matrices, which determine swelling behavior, mechanical stability, degradation kinetics and diffusion of drugs. This review is based on a polymer-based approach to understanding chitosan-based systems designed to carry out intra-pocket drug delivery, in particular, strategies of macromolecular design that facilitate controlled and sustained release. Despite extensive experimental exploration, clinical translation of chitosan-based periodontal delivery systems remains limited due to variability in release kinetics, microenvironmental clearance, and manufacturing standardization challenges. This review critically examines these translational bottlenecks and correlates polymer characteristics with therapeutic performance to identify design principles that may enhance clinical reliability and scalability. Lastly, new directions, and key issues in connection with scalability, reproducibility, and regulatory acceptance are also brought to the fore to inform the rational development of next-generation chitosan-based periodontal therapies.