Use of hand held photopolymerizer to photoinactivate Streptococcus mutans

In vitro antibiofilm effect of different irradiation doses in infected root canal model

BACKGROUND

Eradication of endodontic biofilms from the infected root canal system is still the main concern in endodontics. In this study, the role of the power density parameter in the efficacy of antimicrobial photodynamic therapy (PDT) with toluidine blue O (TBO) and phycocyanin (PC) activated by a 635 nm diode laser (DL) against Enterococcus faecalis biofilm in the root canal model was investigated.

MATERIALS AND METHODS

The E. faecalis biofilm in the root canal was treated with TBO and PC with different power densities (636, 954, 1273, and 1592 W/cm2). The untreated biofilm represented the control group. After the treatments, the biofilms were analyzed based on the number of colonies per milliliter.

RESULTS

TBO and PC activated with 635 nm DL with a power density of 1592 W/cm2 were more efficient in removing E. faecalis biofilms within the root canals than those with a power density of 636 W/cm2 (p = 0.00).

CONCLUSION

The light power density optimized the bacterial reduction of E. faecalis biofilms in the root canal spaces. These results provide information on the decisive parameters for performing PDT on intracanal biofilms.

Gold nanomaterials for oral cancer diagnosis and therapy: Advances, challenges, and prospects

Early diagnosis and treatment of oral cancer are vital for patient survival. Since the oral cavity accommodates the second largest and most diverse microbiome community after the gut, the diagnostic and therapeutic approaches with low invasiveness and minimal damage to surrounding tissues are keys to preventing clinical intervention-related infections. Gold nanoparticles (AuNPs) are widely used in the research of cancer diagnosis and therapy due to their excellent properties such as surface-enhanced Raman spectroscopy, surface plasma resonance, controlled synthesis, the plasticity of surface morphology, biological safety, and stability. AuNPs had been used in oral cancer detection reagents, tumor-targeted therapy, photothermal therapy, photodynamic therapy, and other combination therapies for oral cancer. AuNPs-based noninvasive diagnosis and precise treatments further reduce the clinical intervention-related infections. This review is focused on the recent advances in research and application of AuNPs for early screening, diagnostic typing, drug delivery, photothermal therapy, radiotherapy sensitivity treatment, and combination therapy of oral cancer. Distinctive reports from the literature are summarized to highlight the latest advances in the development and application of AuNPs in oral cancer diagnosis and therapy. Finally, this review points out the challenges and prospects of possible applications of AuNPs in oral cancer diagnosis and therapy.

Rose Bengal and Future Directions in Larynx Tumor Photodynamic Therapy†

Photodynamic Therapy (PDT) seems to be a promising method in the treatment of larynx tumor tissues. The aim of the present analysis was the study of photosensitizer penetration of larynx tissue associated with the application of PDT in vitro. This study is based on the use of photosensitive compounds Rose Bengal (RB) that selectively accumulate in larynx tissue. The selection of the study group of patients who will undergo surgery in accordance with medical principles was of key importance for the project. Histopathological examination of samples subjected to PDT revealed numerous changes in the morphology of the cancer cells and surrounding tissues. After PDT treatment, the number of tumor cells decreased compared with the cells number before PDT and the arrangement was relatively loose. After PDT with RB the nuclei morphology was incomplete and fragmented. The effects of the applied PDT of larynx in vitro were assessed under an optical microscope. The future directions in larynx tumor PDT with the use of upconversion nanoparticles (UPCNP) is also discussed.

Molecular characteristics of the photosensitizer TONS504: Comparison of its singlet oxygen quantum yields and photodynamic antimicrobial effect with those of methylene blue

TONS504 (C51H58O5I2) is a chlorin derivative that exhibits a photodynamic antimicrobial effect (PAE) on various infectious keratitis pathogens. However, the molecular characteristics of TONS504 are not well understood. This study aimed to investigate the molecular characteristics of TONS504 by comparing its singlet oxygen (¹O₂) quantum yields and PAE with those of methylene blue (MB). To measure the ¹O₂ quantum yields, TONS504 and MB were dissolved in phosphate-buffered saline and phosphate-buffered saline containing 1% Triton X-100. The solutions were then activated by a Nd:YAG laser with an average output power of 8 mW. Near-infrared ¹O₂ luminescence was detected as an indicator of the ¹O₂ quantum yields. To evaluate the PAE, TONS504 and MB were activated by a light-emitting diode with a total light energy of 30 J/cm². We compared the minimum molar concentration of each photosensitizer to show apparent PAEs on Staphylococcus aureus, Pseudomonas aeruginosa, and Candida albicans. TONS504 exhibited higher ¹O₂ quantum yields than MB in PBS/Triton X-100 but not in PBS. S. aureus and C. albicans were reduced by TONS504 at lower concentrations than by MB, but this was not the case for P. aeruginosa. Our results provide insight on the molecular characteristics of TONS504 and suggest that TONS504 has excellent ¹O₂ quantum yields and PAE. Compared with MB, TONS504 in PBS has stronger efficacy toward some infectious keratitis pathogens but not others.

Rose bengal-mediated photodynamic inactivation against periodontopathogens in vitro

BACKGROUND

The main goal of periodontal therapy is to eliminate the spread of infection in the periodontium. Antimicrobial photodynamic therapy (aPDT) is a bactericidal method that has been recently introduced for controlling periodontal infection. The aim of this in vitro study was to evaluate the effect of aPDT using a combination of medium-power blue light-emitting diodes (LEDs) and rose bengal (RB) on selected key periodontopathogens.

METHODS

Porphyromonas gingivalis ATCC33277, Aggregatibacter actinomycetemcomitans ATCC29523 and Fusobacterium nucleatum ATCC10953 were used in the experiments. Each bacterial suspension was irradiated with a blue LED (BL) (450-470 nm, output power density of 1.2 W/cm²) for 20-60 s (6-18 J/cm²), treated with RB (1 min), or subjected to a combination of RB treatment and BL irradiation (40 s, 12 J/cm²). All bacterial suspensions were serially diluted, plated and incubated anaerobically or microaerobically, and the numbers of colony-forming units (CFUs) were counted on day 7. One-way analysis of variance (ANOVA) and Tukey's HSD tests were used for statistical analysis.

RESULTS

Treatment with BL irradiation from 6 to 18 J/cm² did not significantly reduce the number of CFUs, whereas treatment with RB alone induced a low-to-high reduction in the bacterial CFUs in a dye concentration-dependent manner. Furthermore, the difference in the effects obtained with 16 μg/mL and 160 μg/mL RB was not statistically significant. Treatment with the BL at 12 J/cm² combined with 160 μg/mL RB yielded maximal log reductions of 3.03, 4.2 and 2.23 in P. gingivalis, A. actinomycetemcomitans and F. nucleatum CFUs, respectively.

CONCLUSION

Within the limits of this study, the three periodontal pathogens, especially A. actinomycetemcomitans, were susceptible to photodynamic inactivation by the combination of the BL and RB. RB-mediated aPDT may offer a viable alternative tool for periodontal pathogen treatment, especially for A. actinomycetemcomitans eradication. aPDT may be a valuable tool for the treatment of periodontal diseases, particularly those in which A. actinomycetemcomitans is a dominating pathogen.

Current trends and future prospects of chemical management of oral biofilms

Oral biofilm, a tribulation encountered on a general basis is known to associate and contribute to many oral and systemic diseases. Eradication of these biofilms is a primary step in treatment of the underlying malady. Management of a biofilm is governed by various factors: the microenvironment within a biofilm, bond between the adhered surface and the biofilm, location of the biofilm, access to the biofilm for removal. Though annihilation is the priority, the mode of approach to achieve the same is equally important, because biofilm's heterogenic nature and location govern the strategical treatment required. Literature supports that the consequences of oral biofilms is not restricted to its home ground, but disseminated to other systems of the body. This contemplates us to procure knowledge on its development, structure and progression to aim its eradication. Therefore, this review attempts to recognize the type of biofilm based on location and enumerate all the possible chemical modes of management for the specific type of oral biofilms encountered. In addition, to the traditional strategies prescribed or administered, newer approaches which are gaining popularity due to their ease and efficiency are also addressed. Frontiers in the above field, under investigation and promising in near future are also compiled. Thus, the present review aims to provide a comprehensive elucidation of chemical management of oral biofilms, both the conventional and novel approaches under investigation.

Photoinhibition of Streptococcus mutans Biofilm-Induced Lesions in Human Dentin by Violet-Blue Light

This in vitro study determined the effectiveness of violet-blue light on Streptococcus mutans (UA159) biofilm induced dentinal lesions. Biofilm was formed on human dentin specimens in a 96-well microtiter plate and incubated for 13 h in the presence of tryptic soy broth (TSB) or TSB supplemented with 1% sucrose (TSBS). Violet-blue light (405 nm) from quantitative light-induced fluorescence (QLF^TM) was used to irradiate the biofilm. Supernatant liquid was removed, and the biofilm was irradiated continuously with QLF for 5 min twice daily with an interval of 6 h for 5 d, except with one treatment on the final day. Colony forming units (CFU) of the treated biofilm, changes in fluorescence (∆F; QLF-Digital Biluminator^TM), lesion depth (L), and integrated mineral loss (∆Z; both transverse microradiography) were quantified at the end of the fifth day. Statistical analysis used analysis of variance (ANOVA), testing at a 5% significance level. In the violet-blue light irradiated groups, there was a significant reduction (p < 0.05) of bacterial viability (CFU) of S. mutans with TSB and TSBS. Violet-blue light irradiation resulted in the reduction of ∆F and L of the dentinal surface with TSBS. These results indicate that violet-blue light has the capacity to reduce S. mutans cell numbers.

Gas Sensor Array System Properties for Detecting Bacterial Biofilms

Background:

Gas sensor array system is a device that mimics the work of how the nose smells using the gas sensors that could give response toward specific odors. It is used for characterizing the different blended gas that is suited with the biological working nose principle. Thus, it could be used to detect the dental and oral diseases. Periodontitis is one of the diseases caused by the damage on the teeth due to the chronic infection on the gingival structure marked with bacterial plaque and calculus. This study aims to develop an electric nose for odor detection application on the periodontal bacterial biofilm as early detection device for dental and oral disease.

Methods:

This device is designed as a portable device to ease the data acquisition. The measured data were stored at a database system connected to a real-time computer. A gas array sensor system with six gas sensors (TGS 826, TGS 2602, TGS 2600, TGS 2611, TGS 2612, and TGS 2620) has been assembled for the early detection application for dental and oral disease excreted by the bacterial biofilm that caused dental and oral disease, including Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis, Streptococcus mutans, and Enterococcus faecalis.

Results:

TGS 826 and TGS 2602 sensor had the best response showed by the high ADC delta value.

Conclusion:

GS 826 and TGS 2602 sensor could be used as a candidate for early detection device for dental and oral disease.

Susceptibility of oral bacteria to antibacterial photodynamic therapy

Effective methods for managing the oral microbiome are necessary to ensure not only the oral but also the systemic health of a human body. The purpose of this study was to determine the sensitivity of four photosensitizers (PSs) to blue light in six representative oral bacterial species that cause intraoral diseases. The following six strains were investigated: Actinomyces israelii, Enterococcus faecium, Fusobacterium nucleatum, Lactobacillus gasseri, Streptococcus mutans, Veillonella parvula. PS stock solutions (1 mg/ml) were prepared by dissolving curcumin and protoporphyrin-IX in dimethyl sulfoxide, and resazurin and riboflavin in distilled water. The inoculation of 20 ml of a bacterial suspension cultured for 24 hours was mixed with 1,980 ml of each test solution, and then a light source was placed in front of the mixture. The irradiation wavelength was 405 nm and its applied energy was 25.3 J. The independent-samples t-test and one-way analysis of variance within groups were performed to compare the antibacterial effects in the four PSs. The antibacterial susceptibility when using different PSs and visible blue-light irradiation differed between the bacterial strains. Antibacterial photodynamic therapy that includes light exposure and PSs can be used to control the oral bacteria strains related to oral disease.

Comparison of the Photosensitivity of Biofilms of Different Genera of Cariogenic Bacteria in Tooth Slices

This study compared the outcome of photosensitization on the viability of four different cariogens in planktonic form as well as biofilms in human dentine. Photodynamic therapy was carried out with a gallium aluminium arsenide laser (670 nm wavelength) using Toluidine blue O (TBO) as the photosensitizer. Cariogenic bacteria (Streptococcus mutans, Lactobacillus casei, Streptococcus salivarius and Actinomyces viscosus) were exposed to TBO and then to the laser for 1 minute in planktonic suspension. Then, tooth slices previously incubated for 24 hours with broth cultures of broth culture of the four cariogenic organisms were exposed to antimicrobial photosensitization. The control samples consisted of planktonic and sessile cells that were exposed to TBO alone, laser alone and the bacterial cells that were not treated with TBO or laser. The results showed significant reductions in the viability of S. mutans, L. casei and A. viscosus in both planktonic form (to 13%, 30%, and 55%, respectively) and sessile form hosted in dentinal tubules (to 19%, 13% and 52%, respectively), relative to the controls. S. salivarius was the least affected in planktonic (94% viability) and sessile form (86% viability). In conclusion, sensitivity to photosensitization is species-dependent and sessile biofilm cells are affected to the same extent as their planktonic counterparts.

Antibacterial application of covalently immobilized photosensitizers on a surface

Singlet oxygen produced by irradiating photosensitizers (PSs) can be used to kill pathogens during water treatment. Chemical immobilization of the PSs on surfaces can maintain their disinfection function long-term. In this study, two model PSs (rose bengal (RB) and hematoporphyrin (HP)) were immobilized on a glass surface using a silane coupling agent with an epoxide group, and their antibacterial properties were analyzed. Fourier transform infrared spectroscopy demonstrated that a covalent bond formed between the epoxide group and hydroxyl group in the PSs. A large proportion of the immobilized PSs (approximately 50%) was active in singlet oxygen production, which was evidenced by a comparative analysis with free PSs. RB was more effective at producing singlet oxygen than HP. The immobilized PSs were durable in terms of repeated use. On the other hand, singlet oxygen produced by the PSs was effective at killing bacteria, mostly for Gram-positive bacteria (> 90% death for 2 h of irradiation), by damaging the cell membrane. The preferable antibacterial property against Gram-positive bacteria compared with that against Gram-negative bacteria suggested efficient penetrability of singlet oxygen across the cell membrane, which led to cell death. Taken together, it was concluded that immobilization of PSs on surfaces using the silane coupling agent proposed in this study was effective at killing Gram-positive bacteria by forming singlet oxygen.

Antimicrobial photodynamic therapy using a plaque disclosing solution on Streptococcus mutans

OBJECTIVES

Photodynamic therapy with a bactericidal action is called antimicrobial photodynamic therapy (aPDT),which is a method of staining an object with a photosensitizing dye and then sterilizing by irradiating the dye at it's excitation wavelength. In this study, we aimed to investigate a caries pathogenic bactericidal method in a site difficult to mechanically remove, by examining aPDT effect on Streptococcus mutans (S. mutans), which is a typical caries pathogenic bacteria by applying the plaque disclosing solution as photosensitizing dye.

METHODS

The absorption wavelength spectrum of irradiating plaque staining agent phloxine B (PB) was analyzed using UV-vis. Reactive oxygen species (ROS) generated by photo excitation with blue LED irradiation was measured by electron spin resonance technique. S. mutans was cultured according to a conventional method and the effect of aPDT after PB staining was evaluated by a Colony Forming Unit (CFU). In addition, protein carbonyl (PC), an oxidative stress marker, was also measured by western blotting.

RESULTS

Singlet oxygen was generated by PB with blue light. As a result of aPDT treatment on S. mutans under this condition, it was recognized that CFU was suppressed dependent on irradiation intensity of blue light. In addition, the expression of PC was enhanced by aPDT.

CONCLUSIONS

aPDT is demonstrated by staining S. mutans with PB and irradiating blue light used for resin polymerization and tooth bleaching to generate ROS. Therefore, plaque-disclosing solution-based aPDT against S. mutans might represent a new method for cleaning pit and fissure grooves.

Effects of antibacterial photodynamic therapy on salivary mutans streptococci in 5- to 6-year-olds with severe early childhood caries

Antibacterial photodynamic therapy (A-PDT) has been shown to kill oral bacteria in the planktonic culture, dental plaque, and biofilm. This study sought to assess the antimicrobial effect of A-PDT with toluidine blue O (TBO) and diode laser on salivary mutans streptococci in 5-6-year-olds with severe early childhood caries (SECC). This case-control study was conducted on 56 children with SECC divided into four groups, namely 0.1 mg/mL TBO, diode laser (633 nm, 20 mW, 6 J/cm²), combination of the two, and no intervention control group. A-PDT was performed on days 1 and 3. Salivary samples were collected before and after A-PDT on days 1 and 3, and 1 and 2 weeks after the second intervention (day 3). Samples were cultured on mitis salivarius agar, and after incubation, the colonies were counted. Data were subjected to repeated measures ANOVA, ANCOVA, and paired comparisons with least square difference and Tukey's test. Bacterial count significantly decreased on days 1 and 3, and 1 and 2 weeks after the second intervention. Bacterial count also decreased following the use of TBO and laser separately, but these reductions were not significant (P > 0.05). Within the limitations of this study, antimicrobial efficacy of TBO + laser was higher than that of diode laser or TBO alone. Durability of treatment increased with double-dose therapy. This modality may be used to decrease the colony count of salivary mutans streptococci in children with SECC.

Antimicrobial properties of a new type of photosensitizer derived from phthalocyanine against planktonic and biofilm forms of Staphylococcus aureus

BACKGROUND

Bacterial infection is a common clinical problem. Community-associated Staphylococcus aureus (S. aureus) infections can cause extensive tissue damage and necrosis. Photodynamic antimicrobial chemotherapy (PACT) has recently attracted attention as a feasible bacterial therapy. Octa-cationic zinc phthalocyanines are newly identified photosensitizers derived from phthalocyanines bearing 1, 2-ethanediamine groups and quaternized derivatives with different numbers of positive charges (ZnPcⁿ⁺, n = 4 or 8). Here we report the antimicrobial effects of ZnPcⁿ⁺-mediated PACT on planktonic and biofilm cultures of S. aureus.

METHODS

ZnPcⁿ⁺ uptake was detected by photometry after alkaline lysis. Dark-toxicity and light-mediated antimicrobial effects of the drug was determined by the plate count method. The production of intracellular reactive oxygen species (ROS) was detected by flow cytometry. SYTO 9 and propidium iodide (PI) were used to detect the bacterial cell membrane permeability. DNA damage after ZnPcⁿ⁺-PACT was analyzed by flow cytometry and PI staining. The destruction of biofilm was evaluated by scanning electron microscope (SEM).

RESULTS

The study of uptake showed that the relative fluorescence intensity of ZnPcⁿ⁺ in S. aureus peaked at 15 min. Generation of reactive oxygen species (ROS) by ZnPcⁿ⁺ was enhanced in PACT treatment groups. SYTO 9 and PI staining indicated that cell membrane was damaged. Flow cytometry and PI staining revealed DNA damage. Biofilms were damaged in PACT treatment groups.

CONCLUSIONS

Our results suggest that light-activated ZnPcⁿ⁺ can efficiently inhibit planktonic and biofilm cultures of S. aureus.

Evaluation of photosensitizer penetration into sound and decayed dentin: A photoacoustic spectroscopy study

BACKGROUND

Photodynamic therapy (PDT) may have topical indications. In those cases it is important for a topical photosensitizer to penetrate into the tissue to which it has been applied. This study aimed to compare the penetration of two different concentrations of erythrosine into intact and in vitro decayed dentin samples.

METHODS

This in vitro study evaluated erythrosine (0.3 and 5%) penetration into sound (intact) and decayed dentin. A total of 11 dentin discs were prepared and divided into two equal halves, in order to keep one half sound while the other half was submitted to sterilization and an in vitro demineralization model for 5 days. Before erythrosine application, the organic and inorganic composition of all samples was evaluated by Fourier Transform Raman spectroscopy, and after erythrosine application for 30 min, the penetration depth was determined by Photoacoustic spectroscopy technique.

RESULTS

The results indicated that 0.3% erythrosine showed a higher penetration depth into sound dentin (p = 0.002); and 5% erythrosine higher penetration into decayed dentin (p < 0.001). However considering clinical parameters, no statistically significant difference was found between any of the conditions tested.

CONCLUSIONS

Erythrosine demonstrated ability to penetrate into dentin, irrespective of sound or decayed condition. Photoacoustic spectroscopy can be considered a method for estimating the penetration into hard tissues, and in conjunction with Raman spectroscopy, these are effective methods for evaluating the spectral response of dentin. Considering that erythrosine is capable of penetrating into decayed dentin, clinical trials are needed to test the effectiveness of this photosensitizer in Photodynamic therapy and Antimicrobial Photodynamic therapy.

Antibacterial photodynamic therapy with curcumin and Curcuma xanthorrhiza extract against Streptococcus mutans

BACKGROUND

Bacteria are becoming increasingly resistant to conventional antibacterial chemotherapy. This has prompted the application of antibacterial photodynamic therapy (aPDT) in bacteria-related diseases due to its excellent biocide effects. However, few studies have attempted to develop a novel photosensitizer based on natural components. The aim of the present study was to compare the aPDT effects of curcumin and Curcuma xanthorrhiza extract (CXE) against Streptococcus mutans.

METHODS

A planktonic suspension containing an S. mutans strain was treated in three separate groups: aPDT with curcumin, CXE, and a mixture of curcumin and CXE (ratio= 1:1) at concentrations of 0, 10, 10², 10³, and 10⁴ng/ml. Light irradiation with a center wavelength of 405nm was applied using an LED (power density of 84.5mW for 300s at an energy density of 25.3J/cm²). The phototoxicity of photosensitizers against S. mutans was investigated using a colony-forming-unit assay. Percentage logarithmic reductions [log₁₀(CFU/ml) values] were analyzed using one-way ANOVA followed by the Tukey test (p<0.05) and Student's independent t-test.

RESULTS

The viability of S. mutans in the presence of curcumin, CXE, and a mixture of these two components was substantially reduced during irradiation with 405nm light. The phototoxicity of the photosensitizer varied with its solubility and concentration.

CONCLUSION

These preliminary in vitro findings imply that combining curcumin and CXE with a 405nm LED may be a novel method of applying aPDT. This could be advantageous in preventing and treating dental caries using devices that are readily available in clinics.

Photodynamic Efficiency of Xanthene Dyes and Their Phototoxicity against a Carcinoma Cell Line: A Computational and Experimental Study

The aim of this study is to assess the insights of molecular properties of the xanthene dyes [fluorescein (FL), Rose Bengal (RB), erythrosin B (EB), and eosin Y (EY)] to correlate systematically their photodynamic efficiency as well as their phototoxicity against a carcinoma cell line. The phototoxicity was evaluated by comparing the values of the medium inhibitory concentration (IC50) upon HEp-2 cells with the xanthene corresponding photodynamic activity using the uric acid as a chemical dosimeter and their octanol-water partition coefficient (log⁡P). RB was the more cytotoxic dye against HEp-2 cell line and the most efficient photosensitizer in causing photoxidation of uric acid; nevertheless it was the only one characterized as being hydrophobic among the xanthenes studied here. On the other hand, it was observed that the halogen substituents increased the hydrophilicity and photodynamic activity, consistent with the cytotoxic experiments. Furthermore, the reactivity index parameters, electric dipole moment, molecular volume, and the frontier orbitals were also obtained by the Density Functional Theory (DFT). The lowest dipole moment and highest molecular volume of RB corroborate with its highest hydrophobicity due to heavy atom substituents like halogens, while the halogen substituents did not affect expressively the electronic features at all.

Rose bengal uptake by E. faecalis and F. nucleatum and light-mediated antibacterial activity measured by flow cytometry

Antibacterial photodynamic therapy (aPDT) using rose bengal (RB) and blue-light kills bacteria through the production of reactive oxygen derivates. However, the interaction mechanism of RB with bacterial cells remains unclear. This study investigated the uptake efficiency and the antibacterial activity of blue light-activated RB against Enterococcus faecalis and Fusobacterium nucleatum. Spectrophotometry and epifluorescence microscopy were used to evaluate binding of RB to bacteria. The antibacterial activity of RB after various irradiation times was assessed by flow cytometry in combination with cell sorting. Uptake of RB increased in a concentration dependent manner in both strains although E. faecalis displayed higher uptake values. RB appeared to bind specific sites located at the cellular poles of E. faecalis and at regular intervals along F. nucleatum. Blue-light irradiation of samples incubated with RB significantly reduced bacterial viability. After incubation with 10μM RB and 240s irradiation, only 0.01% (±0.01%) of E. faecalis cells and 0.03% (±0.03%) of F. nucleatum survived after treatment. This study indicated that RB can bind to E. faecalis and F. nucleatum in a sufficient amount to elicit effective aPDT. Epifluorescence microscopy showed a yet-unreported property of RB binding to bacterial membranes. Flow cytometry allowed the detection of bacteria with damaged membranes that were unable to form colonies on agars after cell sorting.

Inactivation of Vibrio parahaemolyticus by antimicrobial photodynamic technology using methylene blue

BACKGROUND

Vibrio parahaemolyticus is the leading causative pathogen of gastroenteritis often related to contaminated seafood. Photodynamic inactivation has been recently proposed as a strategy for killing cells and viruses. The objective of this study was to verify the bactericidal effects caused by photodynamic inactivation using methylene blue (MB) over V. parahaemolyticus via flow cytometry, agarose gel electrophoresis and sodium dodecyl sulfate polyacrylamide gel electrophoresis. Vibrio parahaemolyticus counts were determined using the most probable number method. A scanning electron microscope and a transmission electron microscope were employed to intuitively analyze internal and external cell structure.

RESULTS

Combination of MB and laser treatment significantly inhibited the growth of V. parahaemolyticus. The inactivation rate of V. parahaemolyticus was >99.99% and its counts were reduced by 5 log10 in the presence of 0.05 mg mL(-1) MB when illuminated with visible light (power density 200 mW cm(-2)) for 25 min. All inactivated cells showed morphological changes, leakage of cytoplasm and degradation of protein and DNA.

CONCLUSION

Results from this study indicated that photodynamic technology using MB produced significant inactivation of V. parahaemolyticus mainly brought about by the degradation of protein and DNA.

Repeated exposures to blue light-activated eosin Y enhance inactivation of E. faecalis biofilms, in vitro

BACKGROUND

In dentistry, antibacterial photodynamic therapy (a-PDT) has shown promising results for inactivating bacterial biofilms causing carious, endodontic and periodontal diseases. In the current study, we assessed the ability of eosin Y exposed to 3 irradiation protocols at inactivating Enterococcus faecalis biofilms, in vitro.

METHODS

E. faecalis biofilms formed on hydroxyapatite disks were incubated with eosin Y (10-80μM), then activated with blue light using different irradiation protocols. Biofilms exposed to continuous exposure were incubated for 40min before being light-activated for 960 s. For the intermittent exposure, biofilms were exposed 4 times to the light/photosensitizer combination (960 s total) without renewing the photosensitizer. For repeated a-PDT, the same light dose was delivered in a series of 4 irradiation periods separated by dark periods; fresh photosensitizer was added between each light irradiation. After treatment, bacteria were immediately labeled with LIVE/DEAD BacLight Bacterial Viability kit and viability was assessed by flow cytometry (FCM). Results were statistically analyzed using one-way ANOVA and Tukey multiple comparison intervals (α=0.05).

RESULTS

The viability of E. faecalis biofilms exposed to 10μM eosin Y, was significantly reduced compared to controls (light only-eosin Y only). After a second exposure to blue light-activated eosin Y, viability significantly decreased from 58% to 12% whereas 6.5% of the bacterial biofilm remained live after a third exposure (p<0.05). Only 3.5% of the bacterial population survived after the fourth exposure.

CONCLUSIONS

The results of this study indicate that blue light-activated eosin Y can photoinactivate E. faecalis biofilms grown on hydroxyapatite disks. Also, repeated exposures to blue light-activated eosin Y were shown to significantly improve efficacy. Further studies seem warranted to optimize the antibacterial activity of blue light-activated eosin Y on major oral pathogens.

Comparative effects of photodynamic therapy mediated by curcumin on standard and clinical isolate of Streptococcus mutans

AIM

The aim of this study was investigate the effect of photodynamic therapy (PDT) using curcumin (C) as a photosensitizing agent irradiated with an LED (L) in the blue wavelength as a light source on a standard and clinical isolate of Streptococcus mutans (S. mutans) in a planktonic suspension model.

MATERIALS AND METHODS

Suspensions of both strains were divided into 4 groups as follows: absence of C and L (control group: C-L-), with C and without L (C group: C+L-), absence of C with L (L group: C-L+) and presence of C and L (PDT group: C+L+). Three different concentrations of curcumin (0.75 mg/ml, 1.5 mg/ml and 3 mg/ml) and three light fluences of studied light source (24, 48 and 72 J cm(-2)) were tested. Aliquots of each studied group was plated in BHI agar and submitted to colony forming units counting (CFU/ml) and the data transformed into logarithmical scale.

RESULTS

A high photoinactivation rate of more than 70% was verified to standard S. mutans strain submitted to PDT whereas the clinical isolate showed a lower sensitivity to all the associations of curcumin and LED. A slight bacterial reduction was verified to C+L- and C-L+, demonstrating no toxic effects to the isolated application of light and photosensitizer to both S. mutans strains tested.

CONCLUSION

Photodynamic therapy using a combination of curcumin and blue LED presented a substantial antimicrobial effect on S. mutans standard strain in a planktonic suspension model with a less pronounced effect on its clinical isolate counterparts due to resistance to this alternative approach.

CLINICAL SIGNIFICANCE

Alternative antimicrobial approaches, as photodynamic therapy, should be encouraged due to optimal results against cariogenic bacteria aiming to prevent or treat dental caries.

The effectiveness of photodynamic therapy on planktonic cells and biofilms and its role in wound healing

ABSTRACT 

Photodynamic therapy (PDT) is the application of a photoactive dye followed by irradiation that leads to the death of microbial cells in the presence of oxygen. Its use for controlling biofilms has been documented in many areas, particularly oral care. However, the potential use of PDT in the treatment of chronic wound-associated microbial biofilms has sparked much interest in the field of wound care. The aim of this article is to provide an overview on the effectiveness of PDT on in vitro and in vivo biofilms, their potential application in both the prevention and management of wound biofilm infections and their prospective role in the enhancement of wound healing.

Flow cytometric assessment of Streptococcus mutans viability after exposure to blue light-activated curcumin

BACKGROUND

Streptococcus mutans biofilms are considered as primary causative agents of dental caries. Photodynamic antimicrobial chemotherapy (PACT) has been recently proposed as a strategy for inactivating dental biofilms. This study aimed to investigate the effect of blue light-activated curcumin on S. mutans viability and to explore its potential as a new anti-caries therapeutic agent. The effect of different concentrations and incubation times of photo-activated curcumin on the survival of S. mutans in planktonic and biofilm models of growth was assessed by flow cytometry.

METHODS

Streptococcus mutans in planktonic suspensions or biofilms formed on hydroxyapatite disks were incubated for 5 or 10min with curcumin prior to blue light activation. Bacteria were labeled with SYTO 9 and propidium iodide before viability was assessed by flow cytometry. Results were statistically analyzed using one-way ANOVA and Tukey multiple comparison intervals (α=0.05).

RESULTS

For planktonic cultures, 0.2μM of light-activated curcumin significantly reduced S. mutans viability (p<0.05). For biofilm cultures, light-activated curcumin at concentration of 40-60μM only suppressed viability by 50% (p<0.05). Independently of the mode of growth, incubation time has no significant effect on PACT efficiency.

CONCLUSION

This study indicates that blue light-activated curcumin can efficiently inactivate planktonic cultures of S. mutans whereas biofilms were more resistant to treatment. Flow cytometry allowed the detection of bacteria with damaged membranes that were unable to replicate and grow after cell sorting. Further studies seem warranted to optimize the efficacy of light-activated curcumin against S. mutans biofilms.

Comparison of the Effect of Nd:YAG and Diode Lasers and Photodynamic Therapy on Microleakage of Class V Composite Resin Restorations

Background and aims

Considering the importance of disinfecting dentin after cavity preparation and the possible effect of disinfection methods on induction of various reactions between the tooth structure and the adhesive restorative material, the aim of the present study was to evaluate microleakage of composite resin restorations after disinfecting the prepared dentin surface with Nd:YAG and Diode lasers and photodynamic therapy.

Materials and methods

Standard Class V cavities were prepared on buccal surfaces of 96 sound bovine teeth. The samples were randomly divided into 4 groups based on the disinfection method: Group 1: Nd:YAG laser; Group 2: Diode laser; Group 3: photodynamic therapy; and Group 4: the control. Self-etch bonding agent (Clearfil SE Bond) was applied and all the cavities were restored with composite resin (Z100). After thermocycling and immersing in 0.5% basic fuchsin, the samples were prepared for microleakage evaluation under a stereomicroscope. Data was analyzed with Kruskal-Wallis and Wilcoxon signed-rank tests at P<0.05.

Results

There were no significant differences in the microleakage of occlusal and gingival margins between the study groups (P>0.05). There were no significant differences in microleakage between the occlusal and gingival margins in the Nd:YAG laser group (P>0.05). In the other groups, microleakage at gingival margins was significantly higher than that at the occlusal margins (P<0.05).

Conclusion

Nd:YAG and Diode lasers and photodynamic therapy can be used to disinfect cavity preparations before composite resin restorations.

Photodynamic potential of curcumin and blue LED against Streptococcus mutans in a planktonic culture

BACKGROUND

The photodynamic therapy (PDT) involves the use of light of specific wavelength to activate a nontoxic photosensitizing agent or dye in the presence of oxygen for eradication of target cells. In dentistry, this therapy is used to suppress the growth of microorganisms involved directly with dental decay and periodontitis process. There are evidences that curcumin dye is able to control microbial activity when illuminated with specific wavelength. The purpose of this study was to evaluate the in vitro efficacy of PDT using curcumin dye (Cur-C) in combination with a blue LED (L) device on a planktonic model of Streptococcus mutans (S. mutans).

METHODS

Suspensions (0.5 mL) containing S. mutans at 1×10(7)CFU mL(-1) were prepared and divided into 4 groups: Group C-L- (control: no treatment and 1 experimental condition), Group C+L- (curcumin at 3 different concentrations: 2000; 4000 and 8000 μM and 3 experimental conditions), Group C-L+ (LED at 3 different dosages: 24, 48 and 72 Jcm(-2) and 3 experimental conditions), and Group C+L+ (PDT group: curcumin at respective concentrations combined to LED dosages and 9 experimental conditions). Samples of each experimental condition were cultured in Petri dishes of BHI agar. Incubation in micro-aerophilia at 37°C for 48 h was performed for subsequent visual counting of CFU/mL. Data were transformed into log10 and analyzed by two-way ANOVA and Tukey's test at p<0.05.

RESULTS

Group C+L+, in specific experimental conditions, demonstrated a log bacterial reduction 70% higher than Group C-L-. Both groups C-L+ and C+L- presented a slight decrease in log bacterial counting.

CONCLUSION

This in vitro method was able to reduce the number of S. mutans in a planktonic suspension.

Photodynamic inactivation of Streptococcus mutans and Streptococcus sanguinis biofilms in vitro

The purpose of this study was to evaluate specific effects of photodynamic inactivation (PDI) using erythrosine (ER) and Rose Bengal (RB) photosensitizers and a blue light-emitting diode (LED) on the viability of Streptococcus mutans and Streptococcus sanguinis biofilms. Biofilms were grown in acrylic disks immersed in broth to production of biofilms, inoculated with microbial suspension (10(6) cells/mL) and incubated for 48 h. After the formation of biofilms, the effects of the photosensitizers ER and RB at a concentration of 5 μM for 5 min and blue LED (455 ± 20 nm) for 180 s, photosensitizers alone and conjugated were evaluated. Next, the disks were placed in tubes with sterile physiological solution (0.9 % sodium chloride) and sonicated for to disperse the biofilms. Tenfold serial dilutions were carried and aliquots seeded in brain heart infusion agar which were then incubated for 48 h. Then the numbers colony-forming units per milliliter (CFU/mL; log10) were counted and analyzed statistically (ANOVA, Tukey test, P ≤ 0.05). Significant decreases in the viability of all microorganisms were observed for biofilms exposed to PDI mediated by both photosensitizers. The reductions with RB and ER were, 0.62 and 0.52 log10 CFU mL(-1) for S. mutans biofilms (p=0.001), and 0.95 and 0.88 log10 CFU mL(-1) for S. sanguinis biofilms (p=0.001), respectively. The results showed that biofilms formed in vitro by S. mutans and S. sanguinis, were sensitive to PDI using a blue LED associated with photosensitizers ER or RB, indicating its use in the control of caries and periodontal diseases.

The antimicrobial activity of photodynamic therapy against Streptococcus mutans using different photosensitizers

Several photosensitizers have been used against oral bacteria without standardization. Singlet oxygen ((1)O(2)) is an aggressive chemical species that can kill cells through apoptosis or necrosis.

OBJECTIVE

to compare the antimicrobial activity of photodynamic therapy (PDT) with different photosensitizers at the same concentration against Streptococcus mutans. In addition, the (1)O(2) production of each photosensitizer was determined. The photosensitizers (163.5 μM) methylene blue (MB), toluidine blue ortho (TBO) and malachite green (MG) were activated with a light-emitting diode (LED; λ=636 nm), while eosin (EOS), erythrosine (ERI) and rose bengal (RB) were irradiated with a curing light (λ=570 nm). Light sources were operated at 24 J cm(-2). For each photosensitizer, 40 randomized assays (n=10 per condition) were performed under one of the following experimental conditions: no light irradiation or photosensitizer, irradiation only, photosensitizer only or irradiation in the presence of a photosensitizer. After treatment, serial dilutions of S. mutans were seeded onto brain heart infusion agar to determine viability in colony-forming units per milliliter (CFU mL(-1)). Generation of (1)O(2) was analyzed by tryptophan photooxidation, and the decay constant was estimated. Results were analyzed by one-way ANOVA and the Tukey-Kramer test (p<0.05). PDT with irradiation in the presence of the photosensitizers TBO and MG was effective in reducing S. mutans counts by 3 and 1.4 logs, respectively (p<0.01), compared to their respective untreated controls. MB generated 1.3 times more (1)O(2) than TBO, and both produced significantly higher concentrations of singlet oxygen than the other photosensitizers. Since in vitro bulk (1)O(2) production does not indicate that (1)O(2) was generated in the bacterial activity site, the bactericidal action against S. mutans cannot be related to in vitro singlet O(2) generation rate. In vitroS. mutans-experiments demonstrated TBO as the only photosensitizer that effectively reduced 99.9% of these microorganisms.

Clinical use of photodynamic antimicrobial chemotherapy for the treatment of deep carious lesions

The purpose of this study was to assess photodynamic antimicrobial chemotherapy (PACT) via irradiation, using a low power laser associated with a photosensitization dye, as an alternative to remove cariogenic microorganisms by drilling. Remaining dentinal samples in deep carious lesions on permanent molars (n = 26) were treated with 0.01% methylene blue dye and irradiated with a low power laser (InGaAIP - indium gallium aluminum phosphide; λ = 660 nm; 100 mW; 320 Jcm(-2); 90 s; 9J). Samples of dentin from the pulpal wall region were collected with a micropunch before and immediately after PACT and kept in a transport medium for microbiological analysis. Samples were cultured in plates of Brucella blood agar, Mitis Salivarius Bacitracin agar and Rogosa SL agar to determine the total viable bacteria, mutans streptococci and Lactobacillus spp. counts, respectively. After incubation, colony-forming units were counted and microbial reduction was calculated for each group of bacteria. PACT led to statistically significant reductions in mutans streptococci (1.38 log), Lactobacillus spp. (0.93 log), and total viable bacteria (0.91 log). This therapy may be an appropriate approach for the treatment of deep carious lesions using minimally invasive procedures.

Evaluation of the effect of photoactivated disinfection with Radachlorin(®) against Streptococcus mutans (an in vitro study)

BACKGROUND

The use of photoactivated disinfection has had a significant medical and technological effect in bacterial inactivation, as an alternative to conventional antimicrobial methods. The main goal of this study was to investigate the effect of photoactivated disinfection on Streptococcus mutans, when Radachlorin(®) was used as a photosensitizer.

METHODS

Streptococcus mutans samples of two different initial concentrations were treated with Radachlorin(®) gel (0.1%), irradiated by the light of a He-Ne laser (633nm), with energy density of 6J/cm(2), and cell viability was evaluated after culturing.

RESULTS

It was observed that the combination of Radachlorin(®) and laser was more effective than Radachlorin(®) or laser alone (p<0.05), in reduction of S. mutans and Radachlorin(®) was cytotoxic, in the dark, only for the lower concentration of bacteria. Lower concentration of S. mutans resulted in higher amount of killing, in the case of using Radachlorin(®) with or without laser.

CONCLUSIONS

The photoactivation of Radachlorin(®) using a He-Ne laser could inactivate S. mutans to a significant level. In addition Radachlorin(®) might be cytotoxic in the dark, for the lower concentration of bacteria.