1
|
Nie M, Zhang P, Pathak JL, Wang X, Wu Y, Yang J, Shen Y. Photodynamic therapy in periodontitis: A narrative review. PHOTODERMATOLOGY, PHOTOIMMUNOLOGY & PHOTOMEDICINE 2024; 40:e12946. [PMID: 38288767 DOI: 10.1111/phpp.12946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 12/20/2023] [Accepted: 12/25/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Periodontitis, a chronic infectious disease, is primarily caused by a dysbiotic microbiome, leading to the destruction of tooth-supporting tissues and tooth loss. Photodynamic therapy (PDT), which combines excitation light with photosensitizers (PS) and oxygen to produce antibacterial reactive oxygen species, is emerging as a promising adjuvant treatment for periodontitis. METHODS This review focuses on studies examining the antibacterial effects of PDT against periodontal pathogens. It also explores the impact of PDT on various aspects of periodontal health, including periodontal immune cells, human gingival fibroblasts, gingival collagen, inflammatory mediators, cytokines in the periodontium, vascular oxidative stress, vascular behavior, and alveolar bone health. Clinical trials assessing the types of PSs and light sources used in PDT, as well as its effects on clinical and immune factors in gingival sulcus fluid and the bacterial composition of dental plaque, are discussed. RESULTS The findings indicate that PDT is effective in reducing periodontal pathogens and improving markers of periodontal health. It has shown positive impacts on periodontal immune response, tissue integrity, and alveolar bone preservation. Clinical trials have demonstrated improvements in periodontal health and alterations in the microbial composition of dental plaque when PDT is used alongside conventional treatments. CONCLUSIONS PDT offers a promising adjunctive treatment for periodontitis, with benefits in bacterial reduction, tissue healing, and immune modulation. This article highlights the potential of PDT in periodontal therapy and emphasizes the need for further research to refine its clinical application and efficacy.
Collapse
Affiliation(s)
- Min Nie
- Department of Periodontics, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Periodontics, State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Peipei Zhang
- Department of Oral Medicine, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, China
| | - Janak Lal Pathak
- Department of Periodontics, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Xiaoyu Wang
- Department of Periodontics, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yafei Wu
- Department of Periodontics, State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Jingmei Yang
- Department of Periodontics, State Key Laboratory of Oral Disease & National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yuqin Shen
- Department of Periodontics, Guangdong Engineering Research Center of Oral Restoration and Reconstruction, Guangzhou Key Laboratory of Basic and Applied Research of Oral Regenerative Medicine, Affiliated Stomatology Hospital of Guangzhou Medical University, Guangzhou, China
| |
Collapse
|
2
|
Quintana RM, Scarparo RK, Münchow EA, Pinheiro LS, Tavares CO, Kopper PMP. Does aPDT reduce bacterial load in endodontic infected teeth? A systematic review and meta-analysis. Lasers Med Sci 2023; 38:268. [PMID: 37981598 DOI: 10.1007/s10103-023-03938-4] [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: 08/28/2023] [Accepted: 11/14/2023] [Indexed: 11/21/2023]
Abstract
This systematic review investigated whether antimicrobial photodynamic therapy (aPDT) after chemomechanical root canal disinfection (CD) yields a greater microbial load reduction than only CD. An electronic literature search was conducted on four databases up to November 2022, with no language or publication date restrictions. Randomized and non-randomized clinical trials were included if participants had a primary endodontic infection in permanent teeth, and if microbial loads before and after using aPDT were compared. Two researchers independently screened titles and abstracts to determine study eligibility. Assessments included risk of bias and methodological quality. This review was registered in PROSPERO (CRD42020181783). Eight studies were included in the qualitative analysis, and six were eligible for meta-analysis. In the random effects model, aPDT significantly improved the results of root canal disinfection when compared with standard protocols for cleaning and shaping (p = 0.04, 95% CI -1.72, -0.05). Subgroup analysis suggested that aPDT has a better effect on reducing the load of anaerobic microorganisms (p = 0.003, 95% CI -3.36, -0.69). The use of aPDT as an adjunct to chemomechanical disinfection promotes additional reduction of the microbial load and, therefore, seems to improve the results of root canal treatments in permanent teeth with a primary endodontic infection. However, certainty of evidence should be improved.
Collapse
Affiliation(s)
- Ramiro Martins Quintana
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul (UFRGS), Ramiro Barcellos, 2492. Santa Cecícila, Porto Alegre, RS, Brazil
| | - Roberta Kochenborger Scarparo
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul (UFRGS), Ramiro Barcellos, 2492. Santa Cecícila, Porto Alegre, RS, Brazil
| | - Eliseu Aldrighi Münchow
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul (UFRGS), Ramiro Barcellos, 2492. Santa Cecícila, Porto Alegre, RS, Brazil
| | - Lucas Siqueira Pinheiro
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul (UFRGS), Ramiro Barcellos, 2492. Santa Cecícila, Porto Alegre, RS, Brazil
| | - Cauana Oliva Tavares
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul (UFRGS), Ramiro Barcellos, 2492. Santa Cecícila, Porto Alegre, RS, Brazil
| | - Patricia Maria Poli Kopper
- Graduate Program in Dentistry, School of Dentistry, Federal University of Rio Grande Do Sul (UFRGS), Ramiro Barcellos, 2492. Santa Cecícila, Porto Alegre, RS, Brazil.
| |
Collapse
|
3
|
Sologova D, Petukhova M, Podoplelova P, Davletshin D, Firsova A, Grishin A, Grin M, Suvorov N, Vasil’ev Y, Dydykin S, Rysanova E, Shchelkova V, Tarasenko S, Diachkova E. Effectiveness of Photodynamic Therapy as Antiseptic Measure for Oral Cavity and Pharynx: A Systematic Review. Dent J (Basel) 2023; 11:192. [PMID: 37623288 PMCID: PMC10453266 DOI: 10.3390/dj11080192] [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: 05/20/2023] [Revised: 07/31/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND The complex traditional treatment of inflammation diseases in oral cavity includes the prescription of antibiotic and antiseptic therapy. This systematic review aims to evaluate the effect of photodynamic therapy as a part of management of inflammatory diseases in oral cavity; Methods: The study is presented in accordance with the preferred reporting points for systematic reviews and meta-analyses (PRISMA). This systematic review was conducted using electronic databases such as Medline PubMed, Scopus and the Cochrane Central Register of Controlled Trials. All the studies in this systematic review, were randomized, the risk of bias 2 (ROB 2) were assessed; Results: Considering the inclusion and exclusion criteria, we included 10 randomized clinical trials, published up to 2023 investigating the application of photodynamic therapy as a part of management of inflammatory diseases in oral cavity. The diode laser was used in the oral cavity in the zone of inflammatory process (gingivitis, mucositis, periimplantitis, marginal periodontitis, abscess, periostitis, osteomyelitis etc.) in nine studies or in the zone before surgical procedures in one study; Conclusion: Based on the results of clinical studies, it can be stated that photodynamic therapy shows good results for operations performed in the oral cavity and pharynx.
Collapse
Affiliation(s)
- Diana Sologova
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia; (M.P.); (P.P.); (D.D.); (A.F.); (S.T.); (E.D.)
| | - Marina Petukhova
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia; (M.P.); (P.P.); (D.D.); (A.F.); (S.T.); (E.D.)
| | - Polina Podoplelova
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia; (M.P.); (P.P.); (D.D.); (A.F.); (S.T.); (E.D.)
| | - Dinislam Davletshin
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia; (M.P.); (P.P.); (D.D.); (A.F.); (S.T.); (E.D.)
| | - Anna Firsova
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia; (M.P.); (P.P.); (D.D.); (A.F.); (S.T.); (E.D.)
| | - Andrey Grishin
- Maxillofacial Surgery Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Street 8\2, 119991 Moscow, Russia;
| | - Mikhail Grin
- Department of Chemistry and Technology of Biologically Active Compounds, Medicinal and Organic Chemistry, Institute of Fine Chemical Technologies, MIREA-Russian Technological University, 86 Vernadsky Avenue, 119571 Moscow, Russia; (M.G.); (N.S.)
| | - Nikita Suvorov
- Department of Chemistry and Technology of Biologically Active Compounds, Medicinal and Organic Chemistry, Institute of Fine Chemical Technologies, MIREA-Russian Technological University, 86 Vernadsky Avenue, 119571 Moscow, Russia; (M.G.); (N.S.)
| | - Yuriy Vasil’ev
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Street bldg. 8\2, 119435 Moscow, Russia; (Y.V.); (S.D.)
| | - Sergey Dydykin
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Street bldg. 8\2, 119435 Moscow, Russia; (Y.V.); (S.D.)
| | - Elena Rysanova
- Moscow Regional Research and Clinical Institute, Street Schepkina 61/2, 129110 Moscow, Russia; (E.R.); (V.S.)
| | - Victoria Shchelkova
- Moscow Regional Research and Clinical Institute, Street Schepkina 61/2, 129110 Moscow, Russia; (E.R.); (V.S.)
| | - Svetlana Tarasenko
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia; (M.P.); (P.P.); (D.D.); (A.F.); (S.T.); (E.D.)
| | - Ekaterina Diachkova
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia; (M.P.); (P.P.); (D.D.); (A.F.); (S.T.); (E.D.)
| |
Collapse
|
4
|
Li Y, Sun G, Xie J, Xiao S, Lin C. Antimicrobial photodynamic therapy against oral biofilm: influencing factors, mechanisms, and combined actions with other strategies. Front Microbiol 2023; 14:1192955. [PMID: 37362926 PMCID: PMC10288113 DOI: 10.3389/fmicb.2023.1192955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/16/2023] [Indexed: 06/28/2023] Open
Abstract
Oral biofilms are a prominent cause of a wide variety of oral infectious diseases which are still considered as growing public health problems worldwide. Oral biofilms harbor specific virulence factors that would aggravate the infectious process and present resistance to some traditional therapies. Antimicrobial photodynamic therapy (aPDT) has been proposed as a potential approach to eliminate oral biofilms via in situ-generated reactive oxygen species. Although numerous types of research have investigated the effectiveness of aPDT, few review articles have listed the antimicrobial mechanisms of aPDT on oral biofilms and new methods to improve the efficiency of aPDT. The review aims to summarize the virulence factors of oral biofilms, the progress of aPDT in various oral biofilm elimination, the mechanism mediated by aPDT, and combinatorial approaches of aPDT with other traditional agents.
Collapse
Affiliation(s)
- Yijun Li
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen, China
| | - Guanwen Sun
- Department of Stomatology, Fujian Medical University Xiamen Humanity Hospital, Xiamen, China
| | - Jingchan Xie
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen, China
| | - Suli Xiao
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen, China
| | - Chen Lin
- Department of Endodontics, Stomatological Hospital of Xiamen Medical College, Xiamen, China
| |
Collapse
|
5
|
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.
Collapse
|
6
|
Sobral SS, da Silva Brandão EH, de Barros Gallo C, Molon A, Sobral APT, de Fátima Teixeira da Silva D, Motta LJ, Dos Santos Franco AL, Rodrigues MFSD. Analysis of the psychopathological profile, quality of life, and cost-effectiveness of oral lichen planus patients treated with photobiomodulation. Clin Oral Investig 2021; 26:719-728. [PMID: 34251533 DOI: 10.1007/s00784-021-04050-z] [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: 04/23/2021] [Accepted: 06/22/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To evaluate the effect of PBM on the psychological profile and quality of life of patients with oral lichen planus (OLP) in comparison to corticoid and to investigate the cost-effectiveness of both treatments. MATERIALS AND METHODS Patients were randomized into two groups: Control (clobetasol propionate 0.05%) and Photobiomodulation (660 nm, 100mW, 177 J/cm2, 5 s, 0.5 J) twice a week for 30 days. The Hospital Anxiety and Depression Scale (HADS) and OHIP-14 were used in different treatment time points and at follow-up. The cost-effectiveness was calculated using the improvement in OHIP-14 after treatment. RESULTS OLP patients showed detected levels of anxiety, depression, and poor quality of life at baseline. No improvement in anxiety and depression was noticed after treatments. However, PBM and corticoid significantly improved the quality of life of OLP patients, considering the OHIP-14-T and the physical pain domain. The treatment with corticoid was more cost-effective than PBM. CONCLUSIONS Psychological distress was not improved after both treatments and PBM is as effective as corticoids in promoting a better quality of life in OLP patients, despite its higher cost. CLINICAL RELEVANCE This study highlights the need for additional therapeutic interventions in OLP patients, to early recognize and to manage the alterations in their psychological profile. Moreover, PBM is an effective therapy in OLP patient's quality of live and although it was a more expensive, the advantage of being a minimally invasive therapy associated with no side effects must be considered in clinical practice, especially in those patients with refractory disease. TRIAL REGISTRATION This study is registered at ClinicalTrials.gov; the registration number is NCT03320460, registered in 17/10/2017.
Collapse
Affiliation(s)
- Sérgio Sousa Sobral
- Postgraduate Program in Biophotonics Applied To Health Sciences, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, São Paulo, CEP 01504-001, Brazil
| | - Eloíza Helena da Silva Brandão
- Postgraduate Program in Biophotonics Applied To Health Sciences, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, São Paulo, CEP 01504-001, Brazil
| | - Camila de Barros Gallo
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Angela Molon
- Postgraduate Program in Biophotonics Applied To Health Sciences, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, São Paulo, CEP 01504-001, Brazil
| | - Ana Paula Taboada Sobral
- Postgraduate Program in Biophotonics Applied To Health Sciences, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, São Paulo, CEP 01504-001, Brazil.,Postgraduate Program in Health and Environment, Universidade Metropolitana de Santos (UNIMES), Santos, Brazil
| | - Daniela de Fátima Teixeira da Silva
- Postgraduate Program in Biophotonics Applied To Health Sciences, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, São Paulo, CEP 01504-001, Brazil
| | - Lara Jansiski Motta
- Postgraduate Program in Biophotonics Applied To Health Sciences, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, São Paulo, CEP 01504-001, Brazil
| | - Adriana Lino Dos Santos Franco
- Postgraduate Program in Biophotonics Applied To Health Sciences, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, São Paulo, CEP 01504-001, Brazil
| | - Maria Fernanda Setúbal Destro Rodrigues
- Postgraduate Program in Biophotonics Applied To Health Sciences, Nove de Julho University, UNINOVE, R. Vergueiro, 235/249, São Paulo, CEP 01504-001, Brazil.
| |
Collapse
|