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Bueno-Silva B, Parma-Garcia J, Frigo L, Suárez LJ, Macedo TT, Uyeda FH, Melo MARDC, Sacco R, Mourão CF, Feres M, Shibli JA, Figueiredo LC. Antimicrobial Activity of Methylene Blue Associated with Photodynamic Therapy: In Vitro Study in Multi-Species Oral Biofilm. Pathogens 2024; 13:342. [PMID: 38668297 PMCID: PMC11054395 DOI: 10.3390/pathogens13040342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 04/11/2024] [Accepted: 04/18/2024] [Indexed: 04/29/2024] Open
Abstract
The control of infectious diseases caused by biofilms is a continuing challenge for researchers due to the complexity of their microbial structures and therapeutic implications. Photodynamic therapy as an adjunctive anti-infective treatment has been described as a possible valid approach but has not been tested in polymicrobial biofilm models. This study evaluated the effect of photodynamic therapy in vitro with methylene blue (MB) 0.01% and red LEDs (λ = 660 nm, power density ≈ 330 mW/cm2, 2 mm distance from culture) on the metabolic activity and composition of a multispecies subgingival biofilm. Test Groups LED and MB + LED showed a more significant reduction in metabolic activity than the non-LED application group (~50 and 55%, respectively). Groups LED and MB equally affected (more than 80%) the total bacterial count in biofilms. No differences were noted in the bacterial biofilm composition between the groups. In vitro LED alone or the MB + LED combination reduced the metabolic activity of bacteria in polymicrobial biofilms and the total subgingival biofilm count.
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Affiliation(s)
- Bruno Bueno-Silva
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil; (B.B.-S.); (J.P.-G.); (L.F.); (L.J.S.); (M.F.); (J.A.S.); (L.C.F.)
- Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas, Piracicaba 13414-903, Brazil
| | - Javier Parma-Garcia
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil; (B.B.-S.); (J.P.-G.); (L.F.); (L.J.S.); (M.F.); (J.A.S.); (L.C.F.)
| | - Lucio Frigo
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil; (B.B.-S.); (J.P.-G.); (L.F.); (L.J.S.); (M.F.); (J.A.S.); (L.C.F.)
- Faculdade de Odontologia da Associação Paulista de Cirurgiões Dentistas (FAOA), São Paulo 02011-000, Brazil
| | - Lina J. Suárez
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil; (B.B.-S.); (J.P.-G.); (L.F.); (L.J.S.); (M.F.); (J.A.S.); (L.C.F.)
- Departamento de Ciencias Básicas y Medicina Oral, Facultad de Odontología, Universidad Nacional de Colombia, Cra 45 # 26-85, Bogotá 11001, Colombia
| | - Tatiane Tiemi Macedo
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil; (B.B.-S.); (J.P.-G.); (L.F.); (L.J.S.); (M.F.); (J.A.S.); (L.C.F.)
| | - Fábio Hideaki Uyeda
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil; (B.B.-S.); (J.P.-G.); (L.F.); (L.J.S.); (M.F.); (J.A.S.); (L.C.F.)
| | - Marcelo Augusto Ruiz da Cunha Melo
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil; (B.B.-S.); (J.P.-G.); (L.F.); (L.J.S.); (M.F.); (J.A.S.); (L.C.F.)
| | - Roberto Sacco
- Department of Oral Surgery, Faculty of Dentistry, Oral & Craniofacial Sciences, King’s College London, London SE1 9SP, UK
| | - Carlos Fernando Mourão
- Department of Periodontology, Dental Research Division, Tuft University School of Dental Medicine, Boston, MA 02111, USA;
| | - Magda Feres
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil; (B.B.-S.); (J.P.-G.); (L.F.); (L.J.S.); (M.F.); (J.A.S.); (L.C.F.)
- Department of Oral Medicine, Infection, and Immunity, Division of Periodontology, Harvard School of Dental Medicine, Boston, MA 02115, USA
| | - Jamil Awad Shibli
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil; (B.B.-S.); (J.P.-G.); (L.F.); (L.J.S.); (M.F.); (J.A.S.); (L.C.F.)
| | - Luciene Cristina Figueiredo
- Department of Periodontology, Dental Research Division, Guarulhos University, Guarulhos 07023-070, Brazil; (B.B.-S.); (J.P.-G.); (L.F.); (L.J.S.); (M.F.); (J.A.S.); (L.C.F.)
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Hart I, Wells C, Tsigarida A, Bezerra B. Effectiveness of mechanical and chemical decontamination methods for the treatment of dental implant surfaces affected by peri-implantitis: A systematic review and meta-analysis. Clin Exp Dent Res 2024; 10:e839. [PMID: 38345466 PMCID: PMC10847712 DOI: 10.1002/cre2.839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 12/20/2023] [Accepted: 12/30/2023] [Indexed: 02/15/2024] Open
Abstract
OBJECTIVE To assess which decontamination method(s) used for the debridement of titanium surfaces (disks and dental implants) contaminated with bacterial, most efficiently eliminate bacterial biofilms. MATERIAL AND METHODS A systematic search was conducted in four electronic databases between January 1, 2010 and October 31, 2022. The search strategy followed the PICOS format and included only in vitro studies completed on either dental implant or titanium disk samples. The assessed outcome variable consisted of the most effective method(s)-chemical or mechanical- removing bacterial biofilm from titanium surfaces. A meta-analysis was conducted, and data was summarized through single- and multi-level random effects model (p < .05). RESULTS The initial search resulted in 5260 articles after the removal of duplicates. After assessment by title, abstract, and full-text review, a total of 13 articles met the inclusion criteria for this review. Different decontamination methods were assessed, including both mechanical and chemical, with the most common method across studies being chlorhexidine (CHX). Significant heterogeneity was noted across the included studies. The meta-analyses only identified a significant difference in biofilm reduction when CHX treatment was compared against PBS. The remaining comparisons did not identify significant differences between the various decontamination methods. CONCLUSIONS The present results do not demonstrate that one method of decontamination is superior in eliminating bacterial biofilm from titanium disk and implant surfaces.
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Affiliation(s)
- Iain Hart
- Department of Periodontology, Eastman Institute for Oral HealthUniversity of RochesterRochesterNew YorkUSA
| | - Christine Wells
- Statistical Methods and Data AnalyticsUCLA Office of Advanced Research ComputingLos AngelesCaliforniaUSA
| | - Alexandra Tsigarida
- Department of Periodontology, Eastman Institute for Oral HealthUniversity of RochesterRochesterNew YorkUSA
| | - Beatriz Bezerra
- Section of Periodontics, Division of Regenerative and Reconstructive SciencesUCLA School of DentistryLos AngelesCaliforniaUSA
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Afrasiabi S, Benedicenti S, Signore A, Arshad M, Chiniforush N. Simultaneous Dual-Wavelength Laser Irradiation against Implant-Adherent Biofilms of Staphylococcus aureus, Escherichia coli, and Candida albicans for Improved Antimicrobial Photodynamic Therapy. Bioengineering (Basel) 2024; 11:48. [PMID: 38247925 PMCID: PMC10813184 DOI: 10.3390/bioengineering11010048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/28/2023] [Accepted: 12/30/2023] [Indexed: 01/23/2024] Open
Abstract
The efficiency of antimicrobial photodynamic therapy (PDT) might be improved by using multiple wavelengths. This study investigates the sensitivity of implant-adherent biofilms of Staphylococcus aureus, Escherichia coli, and Candida albicans to indocyanine green (ICG)-808 nm diode laser, toluidine blue O (TBO)-635 nm diode laser, and hydrogen peroxide (HP)-980 nm diode laser and their combination when irradiated with dual-wavelength laser irradiation (simultaneously 980-635 nm or 980-808 nm). After an incubation period of 72 h, the infected implants were randomly divided into seven different treatment modalities: Control, HP, HP-PDT, TBO-PDT, HP-TBO-PDT, ICG-PDT, and HP-ICG-PDT. After the treatments, the colony-forming units (CFUs)/mL and reactive oxygen species (ROS) generation were determined. All evaluated disinfection methods were significantly effective against the three investigated bacteria compared to the control. The combined treatment of HP-ICG-PDT or HP-TBO-PDT had the greatest antibacterial effect compared to each treatment alone. There were statistical differences between HP-ICG-PDT and ICG-PDT or HP-TBO-PDT and TBO-PDT for all three bacteria studied. PDT with simultaneous dual-wavelength laser irradiation is an efficient strategy to improve the therapeutic effect of PDT.
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Affiliation(s)
- Shima Afrasiabi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1441987566, Iran;
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy;
| | - Antonio Signore
- Therapeutic Dentistry Department, Institute of Dentistry, I.M. Sechenov First Moscow State Medical University, Trubetskaya Str. 8, b. 2, 119992 Moscow, Russia;
| | - Mahnaz Arshad
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1441987566, Iran;
- Department of Prosthodontics, School of Dentistry, International Campus, Tehran University of Medical Sciences, Tehran 1441987566, Iran
| | - Nasim Chiniforush
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy;
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Aghili SS, Jahangirnia A, Alam M, Oskouei AB, Golkar M, Badkoobeh A, Abbasi K, Mohammadikhah M, Karami S, Soufdoost RS, Namanloo RA, Talebi S, Amookhteh S, Hemmat M, Sadeghi S. The effect of photodynamic therapy in controlling the oral biofilm: A comprehensive overview. J Basic Microbiol 2023; 63:1319-1347. [PMID: 37726220 DOI: 10.1002/jobm.202300400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/16/2023] [Accepted: 08/26/2023] [Indexed: 09/21/2023]
Abstract
Several resistance mechanisms are involved in dental caries, including oral biofilms. An accumulation of bacteria on the surface of teeth is called plaque. Periodontitis and gingivitis are caused by dental plaque. In this review article, we aimed to review the studies associated with the application of photodynamic therapy (PDT) to prevent and treat various microbial biofilm-caused oral diseases in recent decades. There are several studies published in PubMed that have described antimicrobial photodynamic therapy (APDT) effects on microorganisms. Several in vitro and in vivo studies have demonstrated the potential of APDT for treating endodontic, periodontal, and mucosal infections caused by bacteria as biofilms. Reactive oxygen species (ROS) are activated in the presence of oxygen by integrating a nontoxic photosensitizer (PS) with appropriate wavelength visible light. By causing irreversible damage to microorganisms, ROS induces some biological and photochemical events. Testing several wavelengths has been conducted to identify potential PS for APDT. A standard protocol is not yet available, and the current review summarizes findings from dental studies on APDT.
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Affiliation(s)
- Seyedeh Sara Aghili
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mostafa Alam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asal Bagherzadeh Oskouei
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Golkar
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ashkan Badkoobeh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Qom University of Medical Sciences, Qom, Iran
| | - Kamyar Abbasi
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Meysam Mohammadikhah
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
| | | | | | | | - Sahar Talebi
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Samira Amookhteh
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Hemmat
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sima Sadeghi
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Huang S, Lin S, Qin H, Jiang H, Liu M. The Parameters Affecting Antimicrobial Efficiency of Antimicrobial Blue Light Therapy: A Review and Prospect. Biomedicines 2023; 11:biomedicines11041197. [PMID: 37189815 DOI: 10.3390/biomedicines11041197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/06/2023] [Accepted: 04/12/2023] [Indexed: 05/17/2023] Open
Abstract
Antimicrobial blue light (aBL) therapy is a novel non-antibiotic antimicrobial approach which works by generating reactive oxygen species. It has shown excellent antimicrobial ability to various microbial pathogens in many studies. However, due to the variability of aBL parameters (e.g., wavelength, dose), there are differences in the antimicrobial effect across different studies, which makes it difficult to form treatment plans for clinical and industrial application. In this review, we summarize research on aBL from the last six years to provide suggestions for clinical and industrial settings. Furthermore, we discuss the damage mechanism and protection mechanism of aBL therapy, and provide a prospect about valuable research fields related to aBL therapy.
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Affiliation(s)
- Shijie Huang
- School of Information Science and Technology, Fudan University, 2005th Songhu Road, Shanghai 200438, China
| | - Shangfei Lin
- Academy for Engineering and Technology, Fudan University, 220th Handan Road, Shanghai 200433, China
- Zhongshan Fudan Joint Innovation Center, 6th Xiangxing Road, Zhongshan 528403, China
| | - Haokuan Qin
- Academy for Engineering and Technology, Fudan University, 220th Handan Road, Shanghai 200433, China
| | - Hui Jiang
- Academy for Engineering and Technology, Fudan University, 220th Handan Road, Shanghai 200433, China
| | - Muqing Liu
- School of Information Science and Technology, Fudan University, 2005th Songhu Road, Shanghai 200438, China
- Zhongshan Fudan Joint Innovation Center, 6th Xiangxing Road, Zhongshan 528403, China
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Piksa M, Lian C, Samuel IC, Pawlik KJ, Samuel IDW, Matczyszyn K. The role of the light source in antimicrobial photodynamic therapy. Chem Soc Rev 2023; 52:1697-1722. [PMID: 36779328 DOI: 10.1039/d0cs01051k] [Citation(s) in RCA: 49] [Impact Index Per Article: 49.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Antimicrobial photodynamic therapy (APDT) is a promising approach to fight the growing problem of antimicrobial resistance that threatens health care, food security and agriculture. APDT uses light to excite a light-activated chemical (photosensitiser), leading to the generation of reactive oxygen species (ROS). Many APDT studies confirm its efficacy in vitro and in vivo against bacteria, fungi, viruses and parasites. However, the development of the field is focused on exploring potential targets and developing new photosensitisers. The role of light, a crucial element for ROS production, has been neglected. What are the main parameters essential for effective photosensitiser activation? Does an optimal light radiant exposure exist? And finally, which light source is best? Many reports have described the promising antibacterial effects of APDT in vitro, however, its application in vivo, especially in clinical settings remains very limited. The restricted availability may partially be due to a lack of standard conditions or protocols, arising from the diversity of selected photosensitising agents (PS), variable testing conditions including light sources used for PS activation and methods of measuring anti-bacterial activity and their effectiveness in treating bacterial infections. We thus sought to systematically review and examine the evidence from existing studies on APDT associated with the light source used. We show how the reduction of pathogens depends on the light source applied, radiant exposure and irradiance of light used, and type of pathogen, and so critically appraise the current state of development of APDT and areas to be addressed in future studies. We anticipate that further standardisation of the experimental conditions will help the field advance, and suggest key optical and biological parameters that should be reported in all APDT studies. More in vivo and clinical studies are needed and are expected to be facilitated by advances in light sources, leading to APDT becoming a sustainable, alternative therapeutic option for bacterial and other microbial infections in the future.
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Affiliation(s)
- Marta Piksa
- Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Science, Weigla 12, 53-114, Wroclaw, Poland
| | - Cheng Lian
- Organic Semiconductor Centre, SUPA, School of Physics and Astronomy, University of St Andrews, Fife, KY16 9SS, UK.
| | - Imogen C Samuel
- School of Medicine, University of Manchester, Manchester, M13 9PL, UK
| | - Krzysztof J Pawlik
- Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Science, Weigla 12, 53-114, Wroclaw, Poland
| | - Ifor D W Samuel
- Organic Semiconductor Centre, SUPA, School of Physics and Astronomy, University of St Andrews, Fife, KY16 9SS, UK.
| | - Katarzyna Matczyszyn
- Institute of Advanced Materials, Faculty of Chemistry, Wroclaw University of Science and Technology, Wyb. Wyspianskiego 27, 50-370 Wroclaw, Poland.
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Park GH, Lee SY, Lee JB, Chang BS, Lee JK, Um HS. Effect of photodynamic therapy according to differences in photosensitizers on Staphylococcus aureus biofilm on titanium. Photodiagnosis Photodyn Ther 2023; 41:103317. [PMID: 36738904 DOI: 10.1016/j.pdpdt.2023.103317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 01/25/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023]
Abstract
PURPOSE This study aimed to evaluate the antimicrobial effect of photodynamic therapy (PDT) against Staphylococcus aureus biofilm on a titanium surface and to compare the differences in the effect of PDT using toluidine blue O (TBO) and methylene blue (MB) as a photosensitizer. METHODS The bacterial strain S. aureus ATCC 25,923 was used. Sandblasted and acid-etched (SLA) disks were divided into the following six groups: phosphate buffer saline (PBS), TBO, MB, PBS with laser (PBS + L), TBO with laser (TBO + L), and MB with laser (MB + L). The laser group samples were irradiated by a cold diode laser for 60 s. After treatment, the number of surviving bacteria was calculated by counting the colony-forming units (CFUs) and confocal laser scanning microscopy (CLSM) was applied to observe the bacteria on the disk surface. RESULTS The TBO + L and MB + L groups showed significantly lower CFU/ml than the other groups (p < 0.01). The TBO + L group showed significantly lower CFU/ml than the MB + L group (p = 0.032). There was no significant difference between the PBS, TBO, MB, and PBS + L groups. Within the limitations of this in vitro study, PDT with TBO and MB can effectively reduce S. aureus biofilm on SLA titanium surfaces. TBO is more effective than MB as a photosensitizer. PDT with TBO may be applied to the treatment of peri‑implant disease in the future.
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Affiliation(s)
- Geun Hee Park
- Department of Periodontology, Gangneung-Wonju National University College of Dentistry, Gangneung 25457, South Korea
| | - Si Young Lee
- Department of Microbiology and Immunology, Gangneung-Wonju National University, Gangneung 25457, South Korea; Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung 25457, South Korea
| | - Jong-Bin Lee
- Department of Periodontology, Gangneung-Wonju National University College of Dentistry, Gangneung 25457, South Korea; Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung 25457, South Korea
| | - Beom-Seok Chang
- Department of Periodontology, Gangneung-Wonju National University College of Dentistry, Gangneung 25457, South Korea; Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung 25457, South Korea
| | - Jae-Kwan Lee
- Department of Periodontology, Gangneung-Wonju National University College of Dentistry, Gangneung 25457, South Korea; Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung 25457, South Korea.
| | - Heung-Sik Um
- Department of Periodontology, Gangneung-Wonju National University College of Dentistry, Gangneung 25457, South Korea; Research Institute of Oral Sciences, Gangneung-Wonju National University College of Dentistry, Gangneung 25457, South Korea.
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Mishra S, Gupta A, Upadhye V, Singh SC, Sinha RP, Häder DP. Therapeutic Strategies against Biofilm Infections. LIFE (BASEL, SWITZERLAND) 2023; 13:life13010172. [PMID: 36676121 PMCID: PMC9866932 DOI: 10.3390/life13010172] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023]
Abstract
A biofilm is an aggregation of surface-associated microbial cells that is confined in an extracellular polymeric substance (EPS) matrix. Infections caused by microbes that form biofilms are linked to a variety of animals, including insects and humans. Antibiotics and other antimicrobials can be used to remove or eradicate biofilms in order to treat infections. However, due to biofilm resistance to antibiotics and antimicrobials, clinical observations and experimental research clearly demonstrates that antibiotic and antimicrobial therapies alone are frequently insufficient to completely eradicate biofilm infections. Therefore, it becomes crucial and urgent for clinicians to properly treat biofilm infections with currently available antimicrobials and analyze the results. Numerous biofilm-fighting strategies have been developed as a result of advancements in nanoparticle synthesis with an emphasis on metal oxide np. This review focuses on several therapeutic strategies that are currently being used and also those that could be developed in the future. These strategies aim to address important structural and functional aspects of microbial biofilms as well as biofilms' mechanisms for drug resistance, including the EPS matrix, quorum sensing (QS), and dormant cell targeting. The NPs have demonstrated significant efficacy against bacterial biofilms in a variety of bacterial species. To overcome resistance, treatments such as nanotechnology, quorum sensing, and photodynamic therapy could be used.
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Affiliation(s)
- Sonal Mishra
- Laboratory of Photobiology and Molecular Microbiology, Centre of Advanced Study in Botany, Institute of Science, Banaras Hindu University, Varanasi 221005, Uttar Pradesh, India
| | - Amit Gupta
- Laboratory of Photobiology and Molecular Microbiology, Centre of Advanced Study in Botany, Institute of Science, Banaras Hindu University, Varanasi 221005, Uttar Pradesh, India
| | - Vijay Upadhye
- Department of Microbiology, Parul Institute of Applied Science (PIAS), Center of Research for Development (CR4D), Parul University, Vadodara 391760, Gujarat, India
| | - Suresh C. Singh
- Pathkits Healthcare Pvt. Ltd., Gurugram 122001, Haryana, India
| | - Rajeshwar P. Sinha
- Laboratory of Photobiology and Molecular Microbiology, Centre of Advanced Study in Botany, Institute of Science, Banaras Hindu University, Varanasi 221005, Uttar Pradesh, India
| | - Donat-P. Häder
- Department of Botany, Emeritus from Friedrich-Alexander University, 91096 Möhrendorf, Germany
- Correspondence: ; Tel.: +49-913-148-730
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Clinical Efficacy and Safety of Antimicrobial Photodynamic Therapy in Residual Periodontal Pockets during the Maintenance Phase. Pharmaceuticals (Basel) 2022; 15:ph15080924. [PMID: 35893748 PMCID: PMC9332381 DOI: 10.3390/ph15080924] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 07/19/2022] [Accepted: 07/24/2022] [Indexed: 02/04/2023] Open
Abstract
Antimicrobial photodynamic therapy (a-PDT) in combination with scaling root planing (SRP) is more effective at improving periodontal status than SRP alone. However, the effectiveness of a-PDT in combination with irrigation for patients undergoing periodontal maintenance has not been clarified. This study evaluated the efficacy and safety of a-PDT in the maintenance phase. Patients who had multiple sites with bleeding on probing (BOP) and periodontal probing depth (PPD) of 4–6 mm in the maintenance phase were treated with a split-mouth design. These sites were randomly assigned to one of two groups: the a-PDT group and the irrigation group. In the a-PDT group, the periodontal pockets were treated with light-sensitive toluidine blue and a light irradiator. In the irrigation group, the periodontal pockets were simply irrigated using an ultrasonic scaler. After 7 days, the safety and efficacy of a-PDT were assessed. The mean PPD of the a-PDT group had reduced from 4.50 mm to 4.13 mm, whereas negligible change was observed in the irrigation group. BOP significantly improved from 100% to 33% in the PDT group, whereas it hardly changed in the irrigation group. No adverse events were observed in any patients. a-PDT may be useful as a noninvasive treatment in the maintenance phase, especially in patients with relatively deep periodontal pocket.
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A Novel Technique for Disinfection Treatment of Contaminated Dental Implant Surface Using 0.1% Riboflavin and 445 nm Diode Laser—An In Vitro Study. Bioengineering (Basel) 2022; 9:bioengineering9070308. [PMID: 35877359 PMCID: PMC9311919 DOI: 10.3390/bioengineering9070308] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/06/2022] [Accepted: 07/09/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Antimicrobial photodynamic therapy (PDT) has been introduced as a potential option for peri-implantitis treatment. The aim of this study is to evaluate the antimicrobial effect of a novel technique involving a combination of 445 nm diode laser light with 0.1% riboflavin solution (used as a photosensitizing dye) as applied on a bacterial–fungal biofilm formed on implants and to compare the performance of this technique with that of the commonly used combination of 660 nm diode laser with 0.1% methylene blue dye. Methods: An in vitro study was conducted on 80 titanium dental implants contaminated with Staphylococcus aureus (SA) and Candida albicans (CA) species. The implants were randomly divided into four groups: negative control (NC), without surface treatment; positive control (PC), treated with a 0.2% chlorhexidine (CHX)-based solution; PDT1, 660 nm (EasyTip 320 µm, 200 mW, Q power = 100 mW, 124.34 W/cm2, 1240 J/cm2) with a 0.1% methylene blue dye; and PDT2, 445 nm (EasyTip 320 µm, 200 mW, Q power = 100 mW, 100 Hz, 124.34 W/cm2, 1.24 J/cm2) with a 0.1% riboflavin dye. Results: The PDT1 and PDT2 groups showed greater reduction of SA and CA in comparison to the NC group and no significant differences in comparison to the PC group. No statistically significant differences between the PDT1 and PDT2 groups were observed. Conclusions: A novel antimicrobial treatment involving a combination of 445 nm diode laser light with riboflavin solution showed efficiency in reducing SA and CA biofilm formation on dental implant surfaces comparable to those of the more commonly used PDT treatment consisting of 660 nm diode laser light with methylene blue dye or 0.2% CHX treatment.
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Multi-photonic Adjunctive Therapy for the Management of Periodontitis: Recent Advances and New Treatment Approach. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1373:341-352. [DOI: 10.1007/978-3-030-96881-6_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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12
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Dhaliwal JS, Abd Rahman NA, Ming LC, Dhaliwal SKS, Knights J, Albuquerque Junior RF. Microbial Biofilm Decontamination on Dental Implant Surfaces: A Mini Review. Front Cell Infect Microbiol 2021; 11:736186. [PMID: 34692562 PMCID: PMC8531646 DOI: 10.3389/fcimb.2021.736186] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Accepted: 09/09/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction After insertion into the bone, implants osseointegrate, which is required for their long-term success. However, inflammation and infection around the implants may lead to implant failure leading to peri-implantitis and loss of supporting bone, which may eventually lead to failure of implant. Surface chemistry of the implant and lack of cleanliness on the part of the patient are related to peri-implantitis. The only way to get rid of this infection is decontamination of dental implants. Objective This systematic review intended to study decontamination of microbial biofilm methods on titanium implant surfaces used in dentistry. Methods The electronic databases Springer Link, Science Direct, and PubMed were explored from their inception until December 2020 to identify relevant studies. Studies included had to evaluate the efficiency of new strategies either to prevent formation of biofilm or to treat matured biofilm on dental implant surfaces. Results and Discussion In this systematic review, 17 different groups of decontamination methods were summarized from 116 studies. The decontamination methods included coating materials, mechanical cleaning, laser treatment, photodynamic therapy, air polishing, anodizing treatment, radiation, sonication, thermal treatment, ultrasound treatment, chemical treatment, electrochemical treatment, antimicrobial drugs, argon treatment, and probiotics. Conclusion The findings suggest that most of the decontamination methods were effective in preventing the formation of biofilm and in decontaminating established biofilm on dental implants. This narrative review provides a summary of methods for future research in the development of new dental implants and decontamination techniques.
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Affiliation(s)
- Jagjit Singh Dhaliwal
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei, Darussalam, Gadong, Brunei
| | - Nurul Adhwa Abd Rahman
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei, Darussalam, Gadong, Brunei
| | - Long Chiau Ming
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei, Darussalam, Gadong, Brunei
| | - Sachinjeet Kaur Sodhi Dhaliwal
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei, Darussalam, Gadong, Brunei
| | - Joe Knights
- Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei, Darussalam, Gadong, Brunei
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Genetic Factors Affect the Survival and Behaviors of Selected Bacteria during Antimicrobial Blue Light Treatment. Int J Mol Sci 2021; 22:ijms221910452. [PMID: 34638788 PMCID: PMC8508746 DOI: 10.3390/ijms221910452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 12/26/2022] Open
Abstract
Antimicrobial resistance is a global, mounting and dynamic issue that poses an immediate threat to human, animal, and environmental health. Among the alternative antimicrobial treatments proposed to reduce the external use of antibiotics is electromagnetic radiation, such as blue light. The prevailing mechanistic model is that blue light can be absorbed by endogenous porphyrins within the bacterial cell, inducing the production of reactive oxygen species, which subsequently inflict oxidative damages upon different cellular components. Nevertheless, it is unclear whether other mechanisms are involved, particularly those that can affect the efficacy of antimicrobial blue light treatments. In this review, we summarize evidence of inherent factors that may confer protection to a selected group of bacteria against blue light-induced oxidative damages or modulate the physiological characteristics of the treated bacteria, such as virulence and motility. These include descriptions of three major photoreceptors in bacteria, chemoreceptors, SOS-dependent DNA repair and non-SOS protective mechanisms. Future directions are also provided to assist with research efforts to increase the efficacy of antimicrobial blue light and to minimize the development of blue light-tolerant phenotypes.
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Camacho-Alonso F, Salinas J, Sánchez-Siles M, Pato-Mourelo J, Cotrina-Veizaga BD, Ortega N. Synergistic antimicrobial effect of photodynamic therapy and chitosan on the titanium-adherent biofilms of Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa: An in vitro study. J Periodontol 2021; 93:e104-e115. [PMID: 34541685 DOI: 10.1002/jper.21-0306] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/02/2021] [Accepted: 09/03/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND To date, no studies on the combined use of photodynamic therapy (PDT) and chitosan against peri-implantitis have been published. The aim of this study was to evaluate the possible synergistic antimicrobial effect of PDT and chitosan on the titanium-adherent biofilms of Staphylococcus aureus, Escherichia coli, and Pseudomonas aeruginosa. METHODS A total of 60 titanium discs were included in this study. The discs were randomized into three bacterial contaminations (n = 20 discs per bacterium). After being cultured (incubated for 48 hours) they were randomized again into four different disinfection modalities (n = 5 discs per treatment): control (without treatment), PDT, chitosan 3 mg/mL, and PDT + chitosan 3 mg/mL. After the treatments, the colony forming units (CFU) were measured to determine antimicrobial effects, and field emission scanning electron microscopy (FESEM) was used to study cell morphology and titanium adherence. RESULTS For all the evaluated bacteria and all the variables studied the order from highest to lowest antimicrobial effectiveness was: PDT + chitosan 3 mg/mL > chitosan 3 mg/mL > PDT > control. Although, all disinfection methods were significantly effective when compared to control, the combined treatment of PDT + chitosan 3 mg/mL had the greatest antimicrobial effect against the three studied bacteria. CONCLUSIONS The combination of PDT and chitosan has a synergistic antimicrobial effect against the bacteria S. aureus, E. coli, and P. aeruginosa, all closely related to peri-implantitis. However, further in vivo studies are needed because this study provides data based on an in vitro scenario that might not be extrapolated to patients with peri-implantitis.
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Affiliation(s)
| | - Jesús Salinas
- Department of Animal Health, University of Murcia, Murcia, Spain
| | | | | | | | - Nieves Ortega
- Department of Animal Health, University of Murcia, Murcia, Spain
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15
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Khalifa AA, Bakr HM, Farouk OA. Biomaterials and technologies in the management of periprosthetic infection after total hip arthroplasty: An updated review. JOURNAL OF MUSCULOSKELETAL SURGERY AND RESEARCH 2021; 5:142-151. [DOI: 10.25259/jmsr_51_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Although total hip arthroplasty (THA) is considered one of the most efficacious procedures for managing various hip conditions, failures due to different mechanisms are still being reported. Periprosthetic joint infection (PJI) is one of the devastating causes of failure and revision of THA. PJI carries a burden on the patient, the surgeon, and the health-care system. The diagnosis and management of PJIs carry many morbidities and increased treatment costs. The development of PJI is multifactorial, including issues related to the patient’s general condition, the surgeon’s efficiency, surgical technique, and the implants used. Recent advances in the area of diagnosis and predicting PJI as well as introducing new technologies and biomaterials update for the prevention and treatment of PJI. Local implant coatings, advancement in the bearing surfaces technologies, and new technologies such as immunotherapy and bacteriophage therapy were introduced and suggested as contemporary PJI eradication solutions. In this review, we aimed at discussing some of the newly introduced materials and technologies for the sake of PJI control.
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Affiliation(s)
- Ahmed A. Khalifa
- Department of Orthopedics, Qena Faculty of Medicine and University Hospital, South Valley University, Qena, Egypt
| | - Hatem M. Bakr
- Department of Orthopedics and Traumatology, Assiut University Hospital, Assiut, Egypt,
| | - Osama A. Farouk
- Department of Orthopedics and Traumatology, Assiut University Hospital, Assiut, Egypt,
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Khan J, Tarar SM, Gul I, Nawaz U, Arshad M. Challenges of antibiotic resistance biofilms and potential combating strategies: a review. 3 Biotech 2021; 11:169. [PMID: 33816046 DOI: 10.1007/s13205-021-02707-w] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Accepted: 02/23/2021] [Indexed: 02/07/2023] Open
Abstract
In this modern era, medicine is facing many alarming challenges. Among different challenges, antibiotics are gaining importance. Recent years have seen unprecedented increase in knowledge and understanding of various factors that are root cause of the spread and development of resistance in microbes against antibiotics. The infection results in the formation of microbial colonies which are termed as biofilms. However, it has been found that a multiple factors contribute in the formation of antimicrobial resistance. Due to higher dose of Minimum Bactericidal Concentration (MBC) as well as of Minimum Inhibitory Concentration (MIC), a large batch of antibiotics available today are of no use as they are ineffective against infections. Therefore, to control infections, there is dire need to adopt alternative treatment for biofilm infection other than antibiotics. This review highlights the latest techniques that are being used to cure the menace of biofilm infections. A wide range of mechanisms has been examined with particular attention towards avenues which can be proved fruitful in the treatment of biofilms. Besides, newer strategies, i.e., matrix centered are also discussed as alternative therapeutic techniques including modulating microbial metabolism, matrix degrading enzyme, photodynamic therapy, natural compounds quorum sensing and nanotechnology which are being used to disrupt extra polymeric substances (EPS) matrix of desired bacterial biofilms.
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Affiliation(s)
- Javairia Khan
- Institute of Environmental Sciences and Engineering, School of Civil and Environmental Engineering, National University of Sciences and Technology (NUST), Islamabad, Pakistan
| | - Sumbal Mudassar Tarar
- Institute of Environmental Sciences and Engineering, School of Civil and Environmental Engineering, National University of Sciences and Technology (NUST), Islamabad, Pakistan
| | - Iram Gul
- Department of Earth and Environmental Sciences, Hazara University, Mansehra, Pakistan
| | - Uzam Nawaz
- Department of Statistics, The Women University Multan, Multan, Pakistan
| | - Muhammad Arshad
- Institute of Environmental Sciences and Engineering, School of Civil and Environmental Engineering, National University of Sciences and Technology (NUST), Islamabad, Pakistan
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Hadi J, Wu S, Brightwell G. Antimicrobial Blue Light versus Pathogenic Bacteria: Mechanism, Application in the Food Industry, Hurdle Technologies and Potential Resistance. Foods 2020; 9:E1895. [PMID: 33353056 PMCID: PMC7767196 DOI: 10.3390/foods9121895] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 12/12/2020] [Accepted: 12/16/2020] [Indexed: 12/12/2022] Open
Abstract
Blue light primarily exhibits antimicrobial activity through the activation of endogenous photosensitizers, which leads to the formation of reactive oxygen species that attack components of bacterial cells. Current data show that blue light is innocuous on the skin, but may inflict photo-damage to the eyes. Laboratory measurements indicate that antimicrobial blue light has minimal effects on the sensorial and nutritional properties of foods, although future research using human panels is required to ascertain these findings. Food properties also affect the efficacy of antimicrobial blue light, with attenuation or enhancement of the bactericidal activity observed in the presence of absorptive materials (for example, proteins on meats) or photosensitizers (for example, riboflavin in milk), respectively. Blue light can also be coupled with other treatments, such as polyphenols, essential oils and organic acids. While complete resistance to blue light has not been reported, isolated evidence suggests that bacterial tolerance to blue light may occur over time, especially through gene mutations, although at a slower rate than antibiotic resistance. Future studies can aim at characterizing the amount and type of intracellular photosensitizers across bacterial species and at assessing the oxygen-independent mechanism of blue light-for example, the inactivation of spoilage bacteria in vacuum-packed meats.
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Affiliation(s)
- Joshua Hadi
- AgResearch Ltd., Hopkirk Research Institute, Cnr University and Library Road, Massey University, Palmerston North 4442, New Zealand; (J.H.); (S.W.)
| | - Shuyan Wu
- AgResearch Ltd., Hopkirk Research Institute, Cnr University and Library Road, Massey University, Palmerston North 4442, New Zealand; (J.H.); (S.W.)
| | - Gale Brightwell
- AgResearch Ltd., Hopkirk Research Institute, Cnr University and Library Road, Massey University, Palmerston North 4442, New Zealand; (J.H.); (S.W.)
- New Zealand Food Safety Science and Research Centre, Tennent Drive, Massey University, Palmerston North 4474, New Zealand
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Balderrama ÍDF, Stuani VDT, Cardoso MV, Oliveira RC, Lopes MMR, Greghi SLA, Adriana Campos Passanezi S. The influence of implant surface roughness on decontamination by antimicrobial photodynamic therapy and chemical agents: A preliminary study in vitro. Photodiagnosis Photodyn Ther 2020; 33:102105. [PMID: 33217567 DOI: 10.1016/j.pdpdt.2020.102105] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 10/06/2020] [Accepted: 11/13/2020] [Indexed: 11/17/2022]
Abstract
BACKGROUND The aim of this preliminary study was to analyze the effectiveness of three different protocols of decontamination on five commercial moderate rough implants. MATERIAL AND METHODS The types of implants investigated were: Neoporos Drive CM (CM; Neodent®), Drive CM Acqua (ACQ; Neodent®), SLActive (SLA; Straumann®), Osseotite (OT; Biomet 3i®) and Nanotite (NT; Biomet 3i®). Implant surface properties (n = 2/type of implant; control groups) were analyzed by scanning electron microscopy (SEM) images to determine surface roughness parameters (SRP) and energy disperse X-ray spectrometry to determine the chemical composition. Implants were then inoculated with Aggregatibacter actinomycetencomitans in vitro (n = 6/type of implant;experimental groups) and the contaminated areas were determined in SEM images (500x magnifications). Decontamination of implants was performed in duplicate by three protocols: antimicrobial photodynamic therapy (aPDT), EDTA associated with citric acid (EDTA + CA) and 0.12 % chlorhexidine (CHX). The remaining contaminated area (rCtA) was determined in SEM images (500x magnifications). All quantitative analysis through SEM images were analyzed in ImageJ® software for two-dimensional parameters. RESULTS No significant differences were found in SRP among implants (control group), except for Rv (lowest valley) between SLA vs. OT (p=0.0031; Kruskal Wallis post hoc Dunn). NT implants showed highest contaminated area vs. ACQ implants (68.19 % ± 8.63 % and 57.32 % ± 5.38 %, respectively; p = 0.0016, Tukey's test). SRP after decontamination showed statistical difference for Ra (arithmetical mean deviation) for all decontamination groups when compared to control (p < 0.05; ANOVA with post-hoc Tukey's multiple comparisons test), only CM implants showed statistical difference when compared decontamination protocols to control with highest modification of SRP for EDTA + AC group. For decontamination analysis, for applicability of different protocols in the same type of implant, only SLA showed statistical significant difference for aPDT vs. EDTA + CA (p = 0.0114; ANOVA with post-hoc Tukey's multiple comparisons test) with lowest rCTA for aPDT, however for ACQ implants the aPDT showed lowest rCTA with no statistical difference (p > 0.05; ANOVA with post-hoc Tukey's multiple comparisons test). No statistical difference was observed between the decontamination protocols at other implant types. CONCLUSION It can be suggested that the chemical-physical characteristics of dental implants can be effected by the process of contamination and decontamination by aPDT and chemical agents.
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Affiliation(s)
- Ísis de Fátima Balderrama
- Department of Diagnosis and Surgery, Araraquara School of Dentistry, Sao Paulo State University, Araraquara, SP, Brazil; Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil.
| | - Vitor de Toledo Stuani
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil.
| | - Matheus Völz Cardoso
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil.
| | - Rodrigo Cardoso Oliveira
- Department of Biological Science, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil.
| | | | - Sebastião Luiz Aguiar Greghi
- Department of Prosthodontics and Periodontics, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil.
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De Silva P, Saad MA, Thomsen HC, Bano S, Ashraf S, Hasan T. Photodynamic therapy, priming and optical imaging: Potential co-conspirators in treatment design and optimization - a Thomas Dougherty Award for Excellence in PDT paper. J PORPHYR PHTHALOCYA 2020; 24:1320-1360. [PMID: 37425217 PMCID: PMC10327884 DOI: 10.1142/s1088424620300098] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Photodynamic therapy is a photochemistry-based approach, approved for the treatment of several malignant and non-malignant pathologies. It relies on the use of a non-toxic, light activatable chemical, photosensitizer, which preferentially accumulates in tissues/cells and, upon irradiation with the appropriate wavelength of light, confers cytotoxicity by generation of reactive molecular species. The preferential accumulation however is not universal and, depending on the anatomical site, the ratio of tumor to normal tissue may be reversed in favor of normal tissue. Under such circumstances, control of the volume of light illumination provides a second handle of selectivity. Singlet oxygen is the putative favorite reactive molecular species although other entities such as nitric oxide have been credibly implicated. Typically, most photosensitizers in current clinical use have a finite quantum yield of fluorescence which is exploited for surgery guidance and can also be incorporated for monitoring and treatment design. In addition, the photodynamic process alters the cellular, stromal, and/or vascular microenvironment transiently in a process termed photodynamic priming, making it more receptive to subsequent additional therapies including chemo- and immunotherapy. Thus, photodynamic priming may be considered as an enabling technology for the more commonly used frontline treatments. Recently, there has been an increase in the exploitation of the theranostic potential of photodynamic therapy in different preclinical and clinical settings with the use of new photosensitizer formulations and combinatorial therapeutic options. The emergence of nanomedicine has further added to the repertoire of photodynamic therapy's potential and the convergence and co-evolution of these two exciting tools is expected to push the barriers of smart therapies, where such optical approaches might have a special niche. This review provides a perspective on current status of photodynamic therapy in anti-cancer and anti-microbial therapies and it suggests how evolving technologies combined with photochemically-initiated molecular processes may be exploited to become co-conspirators in optimization of treatment outcomes. We also project, at least for the short term, the direction that this modality may be taking in the near future.
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Affiliation(s)
- Pushpamali De Silva
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Mohammad A. Saad
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Hanna C. Thomsen
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Shazia Bano
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Shoaib Ashraf
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Tayyaba Hasan
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- Division of Health Sciences and Technology, Harvard University and Massachusetts Institute of Technology, Cambridge, MA 02139, USA
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Ohba S, Sato M, Noda S, Yamamoto H, Egahira K, Asahina I. Assessment of safety and efficacy of antimicrobial photodynamic therapy for peri-implant disease. Photodiagnosis Photodyn Ther 2020; 31:101936. [PMID: 32791295 DOI: 10.1016/j.pdpdt.2020.101936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/24/2020] [Accepted: 07/27/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND There is no reliable treatment procedure for peri-implant disease, despite the rise in its incidence. This study sought to evaluate the short-term safety and efficacy of antimicrobial photodynamic therapy (a-PDT) on peri-implantitis by assessing the volume of pus discharge after a-PDT. METHODS Patients with pus discharge from a peri-implant pocket were recruited from December 1st, 2019 to April 30th, 2020. The enrolled implants were randomly assigned to one of two groups, the irrigation and a-PDT groups. Their peri-implant pocket was irrigated with normal saline in the irrigation group, and a saline irrigation and subsequent a-PDT with toluidine blue (TB) was performed in the a-PDT group. The safety and efficacy of a-PDT were assessed 7 days after treatment. RESULTS Twenty-five implants in 21 patients (irrigation group; 13 implants, a-PDT group; 12 implants) were registered. No complication was observed after a-PDT. Pus discharge was decreased in 7 of 12 implants (58.3 %) in the a-PDT group, and in 2 of 13 implants (15.4 %) in the irrigation group. According to Fisher's exact test, a-PDT resulted in a statistically significant decrease in pus discharge compared to irrigation alone (p = 0.0414). CONCLUSIONS a-PDT was confirmed to be a safe treatment for peri-implantitis, and the short-term efficacy of a-PDT with TB on peri-implantitis was clarified. Nevertheless, its efficacy remains restricted, and a new combination therapy of a-PDT and decontamination procedures is expected to be developed in future.
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Affiliation(s)
- Seigo Ohba
- Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan; Center for Oral and Maxillofacial Implants, Nagasaki University Hospital, Japan.
| | - Mika Sato
- Department of Dental Hygiene, Nagasaki University Hospital, Japan
| | - Sawako Noda
- Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan; Center for Oral and Maxillofacial Implants, Nagasaki University Hospital, Japan
| | - Hideyuki Yamamoto
- Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Kazuhiro Egahira
- Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan
| | - Izumi Asahina
- Department of Regenerative Oral Surgery, Nagasaki University Graduate School of Biomedical Sciences, Japan; Center for Oral and Maxillofacial Implants, Nagasaki University Hospital, Japan
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Li Y, Ge H, Wu L, Lei L, Wang Y, Jiang S, Cai Z, Huang X. Pretreatment of Root Canal with Photodynamic Therapy Facilitates Adhesion, Viability and Differentiation of Stem Cells of the Apical Papilla. Photochem Photobiol 2020; 96:890-896. [PMID: 32105341 DOI: 10.1111/php.13240] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 01/05/2020] [Indexed: 10/24/2022]
Abstract
This study was to test the hypothesis that root canal pretreated with photodynamic therapy (PDT) would promote stem cells from the apical papilla (SCAP) adhesion, proliferation and differentiation without affecting smear layer removal and microhardness of root canal. Standardized root canals were randomized into four groups (n = 30/group): (1) sodium hypochlorite(NaOCl) group, (2) NaOCl + ethylene diaminetetraacetic acid (EDTA) group, (3) NaOCl + PDT group, (4) NaOCl + EDTA + PDT group. After treatments, smear layer removal and microhardness of root canal were evaluated. SCAP with hydroxyapatite-based scaffolds were seeded into root canals for 7 days. SCAP adhesion was observed by scanning electron microscope (SEM), and viable cells were calculated by CellTiter-Glo Luminescent kit. Platelet-derived growth factor (PDGF) and vascular endothelial growth factor (VEGF) expression of SCAP were evaluated by Quantitative Reverse Transcriptase-Polymerase Chain Reaction. There was no significant difference in the smear layer removal and microhardness of root dentin between the groups with and without PDT treatment (P > 0.05). SCAP with elongated cytoplasmic processes and cell-cell contact were observed on the dentin surfaces treated with PDT. Elevated cell viability, PDGF and VEGF expression were found in root canal treated with PDT (P < 0.05). Under the experimental conditions, PDT could provide positive microenvironment for SCAP growth.
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Affiliation(s)
- Yijun Li
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Huan Ge
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.,Department of Stomatology, Rui Jin Hospital North, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Lixuan Wu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China.,Department of Stomatology and Affiliated, Stomatological Hospital of Xiamen Medical College, Fujian, China
| | - Lishan Lei
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Yanhuang Wang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
| | - Shan Jiang
- Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Pokfulam, Hong Kong SAR, China
| | - Zhiyu Cai
- Department of Stomatology, Fujian Medical University Union Hospital, Fuzhou, China
| | - Xiaojing Huang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China
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Santos DDA, Crugeira PJL, Nunes IP, de Almeida PF, Pinheiro ALB. A novel technique of antimicrobial photodynamic therapy – aPDT using 1,9-dimethyl-methylene blue zinc chloride double salt-DMMB and polarized light on Staphylococcus aureus. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2019; 200:111646. [DOI: 10.1016/j.jphotobiol.2019.111646] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 09/17/2019] [Accepted: 10/06/2019] [Indexed: 01/16/2023]
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Wu H, Xie L, He M, Zhang R, Tian Y, Liu S, Gong T, Huo F, Yang T, Zhang Q, Guo S, Tian W. A wear-resistant TiO 2 nanoceramic coating on titanium implants for visible-light photocatalytic removal of organic residues. Acta Biomater 2019; 97:597-607. [PMID: 31398472 DOI: 10.1016/j.actbio.2019.08.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Revised: 07/25/2019] [Accepted: 08/02/2019] [Indexed: 12/18/2022]
Abstract
An effective treatment for peri-implantitis is to completely remove all the bacterial deposits from the contaminated implants, especially the organic residues, to regain biocompatibility and re-osseointegration, but none of the conventional decontamination treatments has achieve this goal. The photocatalytic activity of TiO2 coating on titanium implants to degrade organic contaminants has attracted researchers' attention recently. But a pure TiO2 coating only responses to harmful ultraviolet light. Additionally, the poor coating mechanical properties are unable to protect the coating integrity versus initial mechanical decontamination. To address these issues, a unique TiO2 nanoceramic coating was fabricated on titanium substrates through an innovative plasma electrolytic oxidation (PEO) based procedure, which showed a disordered layer with oxygen vacancies on the outmost part. As a result, the coating could decompose methylene blue, rhodamine B, and pre-adsorbed lipopolysaccharide (LPS) under visible light. Additionally, the coating showed two-fold higher hardness than untreated titanium and excellent wear resistance against steel decontamination instruments, which could be attributed to the specific micro-structure, including the densely packed nanocrystals and good metallurgical combination. Moreover, the in vitro response of MG63 cells confirmed that the coating had comparable biocompatibility and osteoconductivity to untreated titanium substrates. This study provides a unique coating technique as well as a photocatalytic cleaning strategy to enhance decontamination of titanium dental implants, which will favour the development of peri-implantitis treatments. STATEMENT OF SIGNIFICANCE: The treatment of peri-implantitis is based on the complete removal of bacterial deposits, especially the organic residues, but conventional decontamination treatments are hard to achieve it. The photocatalytic activity of TiO2 coating on titanium implants to degrade organic contaminants provides a promising strategy for deeper decontamination, but its nonactivation to visible light and poor mechanical properties have limited its application. To address these issues, a unique TiO2 nanoceramic coating was fabricated on titanium substrates based on plasma electrolytic oxidation. The coating showed enhanced visible-light photocatalytic activity, excellent wear resistance and satisfied biocompatibility. Based on this functional coating, it is promising to develop a more efficient strategy for deep decontamination of implant surface, which will favour the development of peri-implantitis treatments.
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Photonic Therapy in Periodontal Diseases an Overview with Appraisal of the Literature and Reasoned Treatment Recommendations. Int J Mol Sci 2019; 20:ijms20194741. [PMID: 31554277 PMCID: PMC6801906 DOI: 10.3390/ijms20194741] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 09/13/2019] [Accepted: 09/21/2019] [Indexed: 12/26/2022] Open
Abstract
Recent reviews and meta-analyses of the literature over the past quarter-century have failed to provide enough evidence to prove or disprove the actual utility of photonic therapy in periodontitis, alone or adjunctive to conventional approaches. This apparent paradox has been explained by the many physical, molecular, biological, anatomical, and technical variables of photonic treatments, which can differ in light-emitting devices (laser or LED), wavelengths, irradiation power and modes, clinical objectives, follow-up times, disease grading, and assessment methods. This multi-faceted, controversial scenario has led practitioners to underestimate the actual potential of photonic therapy in periodontal diseases. In this critical appraisal of the literature, we have briefly summarized the main photonic therapies and instruments used in Periodontology, highlighting their main characteristics and limitations. Then, we have tried to identify and discuss the key methodological issues which can have an impact on the outcome of photonic therapies. Our main goal was to identify the best parameters, settings, and methodologies to perform effective periodontal photonic treatments and to extrapolate some recommendations for clinical use. Should these recommendations find a consensus among periodontologists and be adopted in future clinical studies, they will hopefully contribute to dissipate the present confusion and uncertainty on this complex matter.
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Benli M, Petit C, Tenenbaum H, Huck O. In vitro Assessment of Peri-implantitis Treatment Procedures: A Review. Open Dent J 2019. [DOI: 10.2174/1874210601913010267] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
The prevalence of peri-implantitis is increasing continuously and such a biological complication significantly decreases implant survival and success. Although various treatment modalities have been identified for peri-implantitis, no completely efficient method has yet been established.
Objective:
The aim of this review was to evaluate the scientific literature regarding the in vitro effects of peri-implantitis treatment.
Methods:
A review of the literature was performed by using Google Scholar, PubMed/ MEDLINE and Science Direct databases. In vitro studies on peri-implantitis treatment modalities were selected. The search strategy identified 57 eligible studies. After selection, 21 articles met all the inclusion criteria and were included in the present review.
Results:
Included in vitro studies evaluated different types of peri-implantitis treatment modalities such as mechanical, chemical, combination and laser therapies. Combination therapies with the aid of adjuvants were found to be more effective compared to the studies that used only one type of treatment modality. Laser systems were also tested and displayed interesting results in terms of surface decontamination with a variability associated with selected parameters.
Conclusion:
This review was performed to evaluate the efficacy of the treatment modalities used for peri-implantitis in vitro. Although there are various effective treatment methods, none has been completely successful in removing the biofilms related to peri-implantitis. The findings imply the need for further studies to develop more effective antimicrobial treatment procedures.
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Calixto GMF, de Annunzio SR, Victorelli FD, Frade ML, Ferreira PS, Chorilli M, Fontana CR. Chitosan-Based Drug Delivery Systems for Optimization of Photodynamic Therapy: a Review. AAPS PharmSciTech 2019; 20:253. [PMID: 31309346 DOI: 10.1208/s12249-019-1407-y] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 04/26/2019] [Indexed: 02/08/2023] Open
Abstract
Drug delivery systems (DDS) can be designed to enrich the pharmacological and therapeutic properties of several drugs. Many of the initial obstacles that impeded the clinical applications of conventional DDS have been overcome with nanotechnology-based DDS, especially those formed by chitosan (CS). CS is a linear polysaccharide obtained by the deacetylation of chitin, which has potential properties such as biocompatibility, hydrophilicity, biodegradability, non-toxicity, high bioavailability, simplicity of modification, aqueous solubility, and excellent chemical resistance. Furthermore, CS can prepare several DDS as films, gels, nanoparticles, and microparticles to improve delivery of drugs, such as photosensitizers (PS). Thus, CS-based DDS are broadly investigated for photodynamic therapy (PDT) of cancer and fungal and bacterial diseases. In PDT, a PS is activated by light of a specific wavelength, which provokes selective damage to the target tissue and its surrounding vasculature, but most PS have low water solubility and cutaneous photosensitivity impairing the clinical use of PDT. Based on this, the application of nanotechnology using chitosan-based DDS in PDT may offer great possibilities in the treatment of diseases. Therefore, this review presents numerous applications of chitosan-based DDS in order to improve the PDT for cancer and fungal and bacterial diseases.
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Silva DF, Toledo Neto JL, Machado MF, Bochnia JR, Garcez AS, Foggiato AA. Effect of photodynamic therapy potentiated by ultrasonic chamber on decontamination of acrylic and titanium surfaces. Photodiagnosis Photodyn Ther 2019; 27:345-353. [PMID: 31279916 DOI: 10.1016/j.pdpdt.2019.06.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 06/07/2019] [Accepted: 06/14/2019] [Indexed: 01/19/2023]
Abstract
Photodynamic Therapy (PDT) is an alternative to surface decontamination that is based on the interaction between a non-toxic photosensitizer (PS) and a light source to allow for the formation of reactive oxygen species. The objective of this study was to test a new patented device - the "Ultrasonic Photodynamic Inactivation Device" (UPID) under the patent deposit MU-BR 20.2018.00.9356-3 - for the photodynamic inactivation on contaminated acrylic plates and titanium disk. This new low cost device contains light emitting diodes (LEDs) and was built in a stainless-steel container for better light distribution. In addition, 28 waterproof red LEDs plates, with a wavelength of 660 nm were used, containing three irradiators in each plate, for which the irradiation distribution and the spectral irradiance on all 6 internal faces of this device were calculated. The effect of red LED irradiation (660 nm) methylene blue (MB) (100 μmol/L) diluted in water or 70% alcohol on three types of microorganisms: Candida albicans ATCC 10231, Staphylococcus aureus ATCC 25923 and Escherichia coli ATCC 25922. In order to estimate the effects of PDI, acrylic plates and Titanium disks were contaminated by bacterial suspensions (3 × 108 CFU/mL), then treated with a solution of MB for 30 min, followed by irradiation for 30 min (0.45 J/cm2). Microbial inhibition was evaluated by counting the number of colony forming units (CFU), compared to the control group. The results showed that the UPID promoted significant reduction (p < 0.001) of the microorganism when compared with the positive control. The new device promoted an effective microbial inhibition on the surfaces tested and, thus, makes possible new studies. The perspective is that this new device may be a low-cost and non-toxic alternative to the disinfection of biomedical devices, non-critical instruments and also for use in the food industry.
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Affiliation(s)
- Douglas Fernandes Silva
- Health Science Center - Dentistry, Paraná Northern State University - UENP, Jacarezinho, PR, Brazil; Medical and Dental Institute of Phototherapy Foggiato, Jacarezinho, PR, Brazil.
| | - João Lopes Toledo Neto
- Health Science Center - Dentistry, Paraná Northern State University - UENP, Jacarezinho, PR, Brazil.
| | - Milena Ferreira Machado
- Health Science Center - Dentistry, Paraná Northern State University - UENP, Jacarezinho, PR, Brazil.
| | - Jetter Ribeiro Bochnia
- Department of Prosthodontics and Dental Materials, School of Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
| | | | - Augusto Alberto Foggiato
- Health Science Center - Dentistry, Paraná Northern State University - UENP, Jacarezinho, PR, Brazil; Medical and Dental Institute of Phototherapy Foggiato, Jacarezinho, PR, Brazil.
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Huang TC, Chen CJ, Chen CC, Ding SJ. Enhancing osteoblast functions on biofilm-contaminated titanium alloy by concentration-dependent use of methylene blue-mediated antimicrobial photodynamic therapy. Photodiagnosis Photodyn Ther 2019; 27:7-18. [PMID: 31117001 DOI: 10.1016/j.pdpdt.2019.05.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/07/2019] [Accepted: 05/17/2019] [Indexed: 02/06/2023]
Abstract
The concentration of methylene blue (MB) photosensitizer could affect the eradication efficacy of antimicrobial photodynamic therapy (aPDT) in the treatment of contaminated implants, which is linked to the osseointegration of the implant. We evaluated osteoblast functions on the contaminated SLA (sandblasting, large-grit and acid-etching) Ti alloy surfaces after the concentration-dependent use of MB-aPDT. Totally 1164 SLA discs were randomly distributed for the analyses of antibacterial efficacy and osteoblast functions. Gram-negative (Aggregatibacter actinomycetemcomitans; A. actinomycetemcomitans) or Gram-positive (Streptococcus mutans; S. mutans) adhered on disc samples was subjected to aPDT with different MB concentrations (200, 250, 300, 350, and 400 μg/mL) using 660 nm diode laser with maximum output 80 mW for 1 min irradiation (4.8 J/cm2). Bactericidal effect was examined by viability, morphology, and lipopolysaccharide (LPS) assays. The disinfected disc surfaces by MB-aPDT to support osteoblast-like MG63 attachment, proliferation, differentiation, and mineralization were assessed for the predetermined culture time intervals. The statistical differences between the means were performed using a one-way analysis of variance (ANOVA) with a post hoc Scheffe test. The results of the morphology observation and bacterial survival examination consistently indicated a remarkably lower quantity of bacterial colonies on biofilm-contaminated surfaces after the aPDT treatment with higher MB concentration. Similarly, the higher MB concentration in aPDT resulted in the lower LPS amounts remaining on the A. actinomycetemcomitans-contaminated surfaces. Intriguingly, the expression of osteoblast cultured on disinfected surfaces using aPDT with higher MB concentration was comparable to the control without contamination. Within the limits of this in vitro model, this formulation of 400 μg/mL MB used in aPDT may be not only the lethal concentration against the 2 bacteria-contaminated implants, but it could also enhance the osteoblast functions on the contaminated implants. Nevertheless, the efficacy in the clinical practice for peri-implantitis therapy remains to be studied.
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Affiliation(s)
- Tsun-Chin Huang
- Institute of Oral Science, Chung Shan Medical University, Taichung City 402, Taiwan
| | - Chun-Ju Chen
- Institute of Oral Science, Chung Shan Medical University, Taichung City 402, Taiwan
| | - Chun-Cheng Chen
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung City 402, Taiwan; School of Dentistry, Chung Shan Medical University, Taichung City 402, Taiwan.
| | - Shinn-Jyh Ding
- Institute of Oral Science, Chung Shan Medical University, Taichung City 402, Taiwan; Department of Stomatology, Chung Shan Medical University Hospital, Taichung City 402, Taiwan.
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Abstract
The emergence of antimicrobial drug resistance requires development of alternative therapeutic options. Multidrug-resistant strains of Enterococcus spp., Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumanii, Pseudomonas aeruginosa and Enterobacter spp. are still the most commonly identified antimicrobial-resistant pathogens. These microorganisms are part of the so-called 'ESKAPE' pathogens to emphasize that they currently cause the majority of hospital acquired infections and effectively 'escape' the effects of antibacterial drugs. Thus, alternative, safer and more efficient antimicrobial strategies are urgently needed, especially against 'ESKAPE' superbugs. Antimicrobial photodynamic inactivation is a therapeutic option used in the treatment of infectious diseases. It is based on a combination of a photosensitizer, light and oxygen to remove highly metabolically active cells.
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Cai Z, Li Y, Wang Y, Chen S, Jiang S, Ge H, Lei L, Huang X. Antimicrobial effects of photodynamic therapy with antiseptics on Staphylococcus aureus biofilm on titanium surface. Photodiagnosis Photodyn Ther 2019; 25:382-388. [DOI: 10.1016/j.pdpdt.2019.01.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 12/29/2018] [Accepted: 01/18/2019] [Indexed: 02/07/2023]
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Alasqah MN. Antimicrobial efficacy of photodynamic therapy on dental implant surfaces: A systematic review of in vitro studies. Photodiagnosis Photodyn Ther 2019; 25:349-353. [DOI: 10.1016/j.pdpdt.2019.01.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 01/09/2019] [Accepted: 01/11/2019] [Indexed: 12/21/2022]
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Khatoon Z, McTiernan CD, Suuronen EJ, Mah TF, Alarcon EI. Bacterial biofilm formation on implantable devices and approaches to its treatment and prevention. Heliyon 2018; 4:e01067. [PMID: 30619958 PMCID: PMC6312881 DOI: 10.1016/j.heliyon.2018.e01067] [Citation(s) in RCA: 551] [Impact Index Per Article: 91.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Revised: 12/17/2018] [Accepted: 12/17/2018] [Indexed: 02/06/2023] Open
Abstract
In living organisms, biofilms are defined as complex communities of bacteria residing within an exopolysaccharide matrix that adheres to a surface. In the clinic, they are typically the cause of chronic, nosocomial, and medical device-related infections. Due to the antibiotic-resistant nature of biofilms, the use of antibiotics alone is ineffective for treating biofilm-related infections. In this review, we present a brief overview of concepts of bacterial biofilm formation, and current state-of-the-art therapeutic approaches for preventing and treating biofilms. Also, we have reviewed the prevalence of such infections on medical devices and discussed the future challenges that need to be overcome in order to successfully treat biofilms using the novel technologies being developed.
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Affiliation(s)
- Zohra Khatoon
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, K1Y 4W7, Canada
| | - Christopher D. McTiernan
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, K1Y 4W7, Canada
| | - Erik J. Suuronen
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, K1Y 4W7, Canada
| | - Thien-Fah Mah
- Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, Ontario, Canada
| | - Emilio I. Alarcon
- Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, K1Y 4W7, Canada
- Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, Ontario, Canada
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Huang TC, Chen CJ, Ding SJ, Chen CC. Antimicrobial efficacy of methylene blue-mediated photodynamic therapy on titanium alloy surfaces in vitro. Photodiagnosis Photodyn Ther 2018; 25:7-16. [PMID: 30439531 DOI: 10.1016/j.pdpdt.2018.11.008] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2018] [Revised: 11/03/2018] [Accepted: 11/09/2018] [Indexed: 12/18/2022]
Abstract
Bacterial elimination using antimicrobial photodynamic therapy (aPDT) has been considered an alternative therapeutic modality in peri-implantitis treatment. The present in vitro study evaluated the dose-dependent and pH-dependent bactericidal effects of methylene blue (MB)-mediated aPDT at eliminating Gram-negative (P. gingivalis and A. actinomycetemcomitans) and Gram-positive (S. mutans) bacteria on sandblasting, large-grit and acid-etching (SLA)-pretreated titanium alloy. The effects of different MB concentrations (50, 100, and 200 μg/mL), the pH of the MB (4, 7, and 10), and irradiation time (0, 30, and 60 s) on the bacterial viability and residual lipopolysaccharide (LPS) levels were examined. The variations in the pH of the MB solution after aPDT for 60 s on the uncontaminated and contaminated specimens were also detected. The experimental results indicated that MB-mediated PDT could effectively kill the majority of bacteria on the titanium alloy surfaces of biofilm-contaminated implants compared with the MB alone. Of note, aPDT exhibited better antibacterial efficacy with increase in the MB concentration and irradiation time. While treated in an acidic solution on the biofilm-contaminated specimens, aPDT caused the pH to increase. By contrast, the initially high alkaline pH decreased to a value of about pH 8.5 after aPDT. Intriguingly, the neutral pH had minor changes, independent of the MB concentration and bacterial species. As expected, aPDT with higher MB concentration at higher pH environment significantly lowered the LPS concentration of A. actinomycetemcomitans and P. gingivalis. On the basis of the data, the aPDT with 200 μg/mL MB at pH 10 for 60 s of irradiation time might be an effectively treatment to eliminate bacteria and LPS adherent to titanium surface, however, the use of the multispecies biofilm model and the evaluation of in vitro osteogenesis needed to be further evaluated.
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Affiliation(s)
- Tsun-Chin Huang
- Institute of Oral Science, Chung Shan Medical University, Taichung City 402, Taiwan
| | - Chun-Ju Chen
- Institute of Oral Science, Chung Shan Medical University, Taichung City 402, Taiwan
| | - Shinn-Jyh Ding
- Institute of Oral Science, Chung Shan Medical University, Taichung City 402, Taiwan; Department of Stomatology, Chung Shan Medical University Hospital, Taichung City 402, Taiwan.
| | - Chun-Cheng Chen
- Department of Stomatology, Chung Shan Medical University Hospital, Taichung City 402, Taiwan; School of Dentistry, Chung Shan Medical University, Taichung City 402, Taiwan.
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Foggiato AA, Silva DF, Castro RCFR. Effect of photodynamic therapy on surface decontamination in clinical orthodontic instruments. Photodiagnosis Photodyn Ther 2018; 24:123-128. [PMID: 30219341 DOI: 10.1016/j.pdpdt.2018.09.003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 07/17/2018] [Accepted: 09/10/2018] [Indexed: 12/16/2022]
Abstract
The objective was to develop, characterize and test a box containing light emission diode (LED), Patent Deposit MU-BR20.2017.002297-3, which was named "Photodynamic Inactivation Device" (PID) and verify if it's suitable in microbial reduction or disinfection action of solid surfaces using PID. The equipment was made in a container of polypropylene with a lid of the same material and, for a better use of irradiation the internal part was covered with a layer of reflective aluminum. In addition, sixty boards of red LED 660 nm wavelength, containing three radiators each, for which the distribution of irradiation and spectral irradiance in all of the six internal faces were calculated in this device. That way, a low cost alternative was tested over three types of microorganisms present on the human microbiota: two strains Gram-positive (Gram +), Staphylococcus aureus and Streptococcus mutans and one strain Gram-negative (Gram -), Escherichia coli, inoculated in orthodontic instruments previously autoclaved. To assess the Photodynamic Inactivation (PDI) over these bacteria, instruments were contaminated by bacterial suspensions (3 × 10⁸ CFU/mL) and ulterior treatment with a solution of 100 μmol/L of MB for 20 min, and irradiated for another 20 min (energy density of 026 J/cm²). Microbial reduction was assessed by number counting of Colony Forming Units (CFU). At the end, microbial reduction of the surface of orthodontic metal instruments was compared with the positive group of each group. Results showed that PID caused a significant reduction (p < 0.05) of the microbial charge stuck in the orthodontic instruments. Thus, the photo prototype of the drawing is appropriate for phototherapy studies, granting it´s advantageous to the low level light therapy as well as for the antimicrobial photodynamic therapy. The perspective is that PID may potentialize the dissemination of phototherapy studies for determining its proper use in health science. And, thus, propose a low cost and atoxic alternative for disinfection of biomedical appliances as non-critical instruments, allowing also for use in the food industry.
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Affiliation(s)
- Augusto Alberto Foggiato
- Health Science Center - Dentistry, Paraná Northern State University - UENP, Jacarezinho, PR, Brazil; São Leopoldo Mandic Dental Research Institute, Campinas, SP, Brazil.
| | - Douglas Fernandes Silva
- Health Science Center - Dentistry, Paraná Northern State University - UENP, Jacarezinho, PR, Brazil
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Taha M, Abdelbary H, Ross FP, Carli AV. New Innovations in the Treatment of PJI and Biofilms-Clinical and Preclinical Topics. Curr Rev Musculoskelet Med 2018; 11:380-388. [PMID: 29926287 PMCID: PMC6105481 DOI: 10.1007/s12178-018-9500-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE OF REVIEW Periprosthetic joint infection (PJI) is a devastating complication after total joint replacement. A main source for antibiotic tolerance and treatment failure is bacterial production of biofilm-a resilient barrier against antibiotics, immune system, and mechanical debridement. The purpose of this review is to explore some novel approaches to treat PJI and biofilm-related infections. RECENT FINDINGS Innovative treatment strategies of bacterial and biofilm infections revolve around (a) augmenting current therapies, such as improving the delivery and efficiency of conventional antibiotics and enhancing the efficacy of antiseptics and (b) administrating completely new therapeutic modalities, such as using immunotherapy, nanoparticles, lytic bacteriophages, photodynamic therapy, novel antibiotics, and antimicrobial peptides. Several promising treatment strategies for PJI are available to be tested further. The next requirement for most of the novel treatments is reproducing their effects in clinically representative animal models of PJI against clinical isolates of relevant bacteria.
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Affiliation(s)
- Mariam Taha
- Ottawa Hospital Research Institute, Ottawa, ON, Canada
- Division of Orthopedic Surgery Ottawa, The Ottawa Hospital, Ottawa, ON, Canada
| | - Hesham Abdelbary
- Division of Orthopedic Surgery Ottawa, The Ottawa Hospital, Ottawa, ON, Canada
| | - F Patrick Ross
- Hospital for Special Surgery, 535 E 70th St, New York, NY, 10021, USA
| | - Alberto V Carli
- Division of Orthopedic Surgery Ottawa, The Ottawa Hospital, Ottawa, ON, Canada.
- Hospital for Special Surgery, 535 E 70th St, New York, NY, 10021, USA.
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Tani A, Chellini F, Giannelli M, Nosi D, Zecchi-Orlandini S, Sassoli C. Red (635 nm), Near-Infrared (808 nm) and Violet-Blue (405 nm) Photobiomodulation Potentiality on Human Osteoblasts and Mesenchymal Stromal Cells: A Morphological and Molecular In Vitro Study. Int J Mol Sci 2018; 19:ijms19071946. [PMID: 29970828 PMCID: PMC6073131 DOI: 10.3390/ijms19071946] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 06/15/2018] [Accepted: 06/29/2018] [Indexed: 01/08/2023] Open
Abstract
Photobiomodulation (PBM) has been used for bone regenerative purposes in different fields of medicine and dentistry, but contradictory results demand a skeptical look for its potential benefits. This in vitro study compared PBM potentiality by red (635 ± 5 nm) or near-infrared (NIR, 808 ± 10 nm) diode lasers and violet-blue (405 ± 5 nm) light-emitting diode operating in a continuous wave with a 0.4 J/cm2 energy density, on human osteoblast and mesenchymal stromal cell (hMSC) viability, proliferation, adhesion and osteogenic differentiation. PBM treatments did not alter viability (PI/Syto16 and MTS assays). Confocal immunofluorescence and RT-PCR analyses indicated that red PBM (i) on both cell types increased vinculin-rich clusters, osteogenic markers expression (Runx-2, alkaline phosphatase, osteopontin) and mineralized bone-like nodule structure deposition and (ii) on hMSCs induced stress fiber formation and upregulated the expression of proliferation marker Ki67. Interestingly, osteoblast responses to red light were mediated by Akt signaling activation, which seems to positively modulate reactive oxygen species levels. Violet-blue light-irradiated cells behaved essentially as untreated ones and NIR irradiated ones displayed modifications of cytoskeleton assembly, Runx-2 expression and mineralization pattern. Although within the limitations of an in vitro experimentation, this study may suggest PBM with 635 nm laser as potential effective option for promoting/improving bone regeneration.
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Affiliation(s)
- Alessia Tani
- Department of Experimental and Clinical Medicine-Section of Anatomy and Histology, University of Florence, Largo Brambilla 3, 50134 Florence, Italy.
| | - Flaminia Chellini
- Department of Experimental and Clinical Medicine-Section of Anatomy and Histology, University of Florence, Largo Brambilla 3, 50134 Florence, Italy.
| | - Marco Giannelli
- Odontostomatologic Laser Therapy Center, via dell' Olivuzzo 162, 50143 Florence, Italy.
| | - Daniele Nosi
- Department of Experimental and Clinical Medicine-Section of Anatomy and Histology, University of Florence, Largo Brambilla 3, 50134 Florence, Italy.
| | - Sandra Zecchi-Orlandini
- Department of Experimental and Clinical Medicine-Section of Anatomy and Histology, University of Florence, Largo Brambilla 3, 50134 Florence, Italy.
| | - Chiara Sassoli
- Department of Experimental and Clinical Medicine-Section of Anatomy and Histology, University of Florence, Largo Brambilla 3, 50134 Florence, Italy.
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Hu X, Huang YY, Wang Y, Wang X, Hamblin MR. Antimicrobial Photodynamic Therapy to Control Clinically Relevant Biofilm Infections. Front Microbiol 2018; 9:1299. [PMID: 29997579 PMCID: PMC6030385 DOI: 10.3389/fmicb.2018.01299] [Citation(s) in RCA: 236] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Accepted: 05/28/2018] [Indexed: 12/15/2022] Open
Abstract
Biofilm describes a microbially-derived sessile community in which microbial cells are firmly attached to the substratum and embedded in extracellular polymeric matrix. Microbial biofilms account for up to 80% of all bacterial and fungal infections in humans. Biofilm-associated pathogens are particularly resistant to antibiotic treatment, and thus novel antibiofilm approaches needed to be developed. Antimicrobial Photodynamic therapy (aPDT) had been recently proposed to combat clinically relevant biofilms such as dental biofilms, ventilator associated pneumonia, chronic wound infections, oral candidiasis, and chronic rhinosinusitis. aPDT uses non-toxic dyes called photosensitizers (PS), which can be excited by harmless visible light to produce reactive oxygen species (ROS). aPDT is a multi-stage process including topical PS administration, light irradiation, and interaction of the excited state with ambient oxygen. Numerous in vitro and in vivo aPDT studies have demonstrated biofilm-eradication or substantial reduction. ROS are produced upon photo-activation and attack adjacent targets, including proteins, lipids, and nucleic acids present within the biofilm matrix, on the cell surface and inside the microbial cells. Damage to non-specific targets leads to the destruction of both planktonic cells and biofilms. The review aims to summarize the progress of aPDT in destroying biofilms and the mechanisms mediated by ROS. Finally, a brief section provides suggestions for future research.
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Affiliation(s)
- Xiaoqing Hu
- State Key Laboratory of Food Science and Technology, School of Biotechnology, Jiangnan University, Wuxi, China
- International Joint Laboratory on Food Safety, Jiangnan University, Wuxi, China
- The Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, United States
- Department of Dermatology, Harvard Medical School, Boston, MA, United States
| | - Ying-Ying Huang
- The Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, United States
- Department of Dermatology, Harvard Medical School, Boston, MA, United States
| | - Yuguang Wang
- The Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, United States
- Department of Dermatology, Harvard Medical School, Boston, MA, United States
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xiaoyuan Wang
- State Key Laboratory of Food Science and Technology, School of Biotechnology, Jiangnan University, Wuxi, China
| | - Michael R. Hamblin
- The Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, MA, United States
- Department of Dermatology, Harvard Medical School, Boston, MA, United States
- Harvard-MIT Division of Health Sciences and Technology, Cambridge, MA, United States
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Treatment of severe periodontitis with a laser and light-emitting diode (LED) procedure adjunctive to scaling and root planing: a double-blind, randomized, single-center, split-mouth clinical trial investigating its efficacy and patient-reported outcomes at 1 year. Lasers Med Sci 2018; 33:991-1002. [PMID: 29349511 DOI: 10.1007/s10103-018-2441-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 01/08/2018] [Indexed: 10/18/2022]
Abstract
Broad methodological heterogeneity makes the literature on the clinical effects of laser treatment in periodontitis, both as monotherapy and adjunct to non-surgical therapy, which is difficult to interpret. The present split-mouth study was performed: (i) to determine the efficacy and safety of a photoablative-photodynamic diode laser therapy, including antiseptic LED irradiation, in adjunct to scaling and root planing (iPAPD+SRP) vs. sham-treatment+SRP for the treatment of diffuse severe periodontitis and (ii) to estimate the patient-reported outcomes. Twenty-four patients with severe periodontitis were treated with iPAPD+SRP or sham-treatment+SRP. iPAPD+SRP consisted of the following: (1) intra-/extra-pocket de-epithelization with photoablative λ 810 nm laser, (2) disinfection with λ 405 nm LED, (3) SRP, and (4) 10 weekly antiseptic/anti-inflammatory photodynamic treatments with λ 635 nm laser and 0.1% toluidine blue as photosensitizer. Clinical and cytofluorescent periodontal markers and patient-reported results were analyzed. At 1-year follow-up, both groups showed a significant reduction of several severity markers of periodontitis, namely probing depth (PD) and bleeding on probing (BoP), as well as of bacteria, polymorphonuclear cells, erythrocytes and damaged epithelial cells in exfoliative samples, as compared with day 0. The quadrants subjected to iPAPD+SRP showed significantly better values of these parameters as well as of clinical attachment level (CAL) as compared with those undergoing sham-treatment+SRP. The patients' perceived pain/discomfort, and overall liking was also in favor of the iPAPD+SRP treatment. This study confirms the efficacy of combined phototherapy in adjunct to SRP which had emerged from previous clinical trials, extending its field of application to severe periodontitis.
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Liang L, Bi W, Chen W, Lin Y, Tian Y. Combination of MPPa-PDT and HSV1-TK/GCV gene therapy on prostate cancer. Lasers Med Sci 2018; 33:227-232. [DOI: 10.1007/s10103-017-2331-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 09/18/2017] [Indexed: 12/13/2022]
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Wang Y, Wang Y, Wang Y, Murray CK, Hamblin MR, Hooper DC, Dai T. Antimicrobial blue light inactivation of pathogenic microbes: State of the art. Drug Resist Updat 2017; 33-35:1-22. [PMID: 29145971 DOI: 10.1016/j.drup.2017.10.002] [Citation(s) in RCA: 162] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 06/28/2017] [Accepted: 10/02/2017] [Indexed: 12/20/2022]
Abstract
As an innovative non-antibiotic approach, antimicrobial blue light in the spectrum of 400-470nm has demonstrated its intrinsic antimicrobial properties resulting from the presence of endogenous photosensitizing chromophores in pathogenic microbes and, subsequently, its promise as a counteracter of antibiotic resistance. Since we published our last review of antimicrobial blue light in 2012, there have been a substantial number of new studies reported in this area. Here we provide an updated overview of the findings from the new studies over the past 5 years, including the efficacy of antimicrobial blue light inactivation of different microbes, its mechanism of action, synergism of antimicrobial blue light with other angents, its effect on host cells and tissues, the potential development of resistance to antimicrobial blue light by microbes, and a novel interstitial delivery approach of antimicrobial blue light. The potential new applications of antimicrobial blue light are also discussed.
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Affiliation(s)
- Yucheng Wang
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Cancer Center, Aviation General Hospital, Beijing, China; Department of Medical Oncology, Beijing Institute of Translational Medicine, Chinese Academy of Sciences, Beijing, China
| | - Ying Wang
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Laser Medicine, Chinese PLA General Hospital, Beijing, China
| | - Yuguang Wang
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Center of Digital Dentistry, School and Hospital of Stomatology, Peking University, Beijing, China
| | - Clinton K Murray
- Infectious Disease Service, San Antonio Military Medical Center, JBSA-Fort Sam Houston, TX, USA
| | - Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - David C Hooper
- Division of Infectious Diseases, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Tianhong Dai
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
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Giannelli M, Bani D, Tani A, Materassi F, Chellini F, Sassoli C. Effects of an Erbium:Yttrium-Aluminum-Garnet Laser and Ultrasonic Scaler on Titanium Dioxide-Coated Titanium Surfaces Contaminated With Subgingival Plaque: An In Vitro Study to Assess Post-Treatment Biocompatibility With Osteogenic Cells. J Periodontol 2017; 88:1211-1220. [PMID: 28691887 DOI: 10.1902/jop.2017.170195] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Effects of conventional ultrasonic scaler versus an erbium:yttrium-aluminum-garnet (Er:YAG) laser on titanium surfaces contaminated with subgingival plaque from patients with peri-implantitis are evaluated in terms of: 1) plaque and biocorroded titanium oxide coating removal; 2) surface change induction; and 3) residual biocompatibility toward osteoblasts. METHODS Subgingival plaque-coated titanium disks with a moderately rough surface were fixed with ethanol and treated with an ultrasonic scaler (metal tip) or Er:YAG laser (20.3 or 38.2 J/cm2) in non-contact mode. Fluorescent detection of residual plaque was performed. Disk surface morphology was evaluated by scanning electron microscopy. Viability, attachment, proliferation, and differentiation of Saos-2 osteoblasts on new and treated disks were assayed by propidium iodide/DNA stain assay and confocal microscopic analysis of cytoskeleton, Ki67, expression of osteopontin and alkaline phosphatase, and formation of mineralized nodules. RESULTS Both methods resulted in effective debridement of treated surfaces, the plaque area being reduced to 11.7% with the ultrasonic scaler and ≤0.03% with the Er:YAG laser (38.2 J/cm2). Ultrasound-treated disks showed marked surface changes, incomplete removal of the titanium dioxide (TiO2) layer, and scanty plaque aggregates, whereas the Er:YAG laser (38.2 J/cm2) completely stripped away the plaque and TiO2 layer, leaving a micropitted surface. Both treatments maintained a good biocompatibility of surfaces to Saos-2 osteoblasts. Air-water cooling kept disk temperature below the critical threshold of 47°C. CONCLUSION This study shows that an ultrasonic scaler with metal tip is less efficient than high-energy Er:YAG irradiation to remove the plaque and TiO2 layer on anodized disks, although both procedures appear capable of restoring an adequate osseoconductivity of treated surfaces.
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Affiliation(s)
| | - Daniele Bani
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, Florence, Italy
| | - Alessia Tani
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, Florence, Italy
| | | | - Flaminia Chellini
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, Florence, Italy
| | - Chiara Sassoli
- Department of Experimental and Clinical Medicine, Section of Anatomy and Histology, University of Florence, Florence, Italy
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