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
|
Tonon CC, de Souza Rastelli AN, Bodahandi C, Ghosh G, Hasan T, Xu Q, Greer A, Lyons AM. Superhydrophobic Tipped Antimicrobial Photodynamic Therapy Device for the In Vivo Treatment of Periodontitis Using a Wistar Rat Model. ACS APPLIED MATERIALS & INTERFACES 2023; 15:50083-50094. [PMID: 37862708 PMCID: PMC10800031 DOI: 10.1021/acsami.3c12820] [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] [Indexed: 10/22/2023]
Abstract
Limited options exist for treatment of periodontitis; scaling and root planing (SRP) are not sufficient to eradicate P. gingivalis and the resulting inflammatory disease. Chlorhexidine (CHX), used as an adjuvant to SRP, may reduce bacterial loads but leads to pain and staining, while evidence for its efficacy is lacking. Antibiotics are effective but can lead to drug-resistance. The rising concern of antibiotic resistance limits the future use of this treatment approach. This study evaluates the efficacy of a novel superhydrophobic (SH) antimicrobial photodynamic therapy (aPDT) device as an adjuvant to SRP for the treatment of periodontitis induced in a Wistar rat in vivo model relative to CHX. The SH-aPDT device comprises an SH silicone rubber strip coated with verteporfin photosensitizer (PS), sterilized, and secured onto a tapered plastic optical fiber tip connected to a red diode laser. The superhydrophobic polydimethylsiloxane (PDMS) strips were fabricated by using a novel soluble template method that creates a medical-grade elastomer with hierarchical surface roughness without the use of nanoparticles. Superhydrophobicity minimizes direct contact of the PS-coated surface with bacterial biofilms. Upon insertion of the device tip into the pocket and energizing the laser, the device generates singlet oxygen that effectively targets and eliminates bacteria within the periodontal pocket. SH-aPDT treatment using 125 J/cm2 of red light on three consecutive days reduced P. gingivalis significantly more than SRP-CHX controls (p < 0.05). Clinical parameters significantly improved (p < 0.05), and histology and stereometry results demonstrated SH-aPDT to be the most effective treatment for improving healing and reducing inflammation, with an increase in fibroblast cells and extracellular matrix and a reduction in vascularization, inflammatory cells, and COX-2 expression. The SH-aPDT approach resulted in complete disease clearance assessed 30 days after treatment initiation with significant reduction of the periodontal pocket and re-formation of the junctional epithelium at the enamel-cementum junction. PS isolation on a SH strip minimizes the potential for bacteria to develop resistance, where the treatment may be aided by the oxygen supply retained within the SH surface.
Collapse
Affiliation(s)
- Caroline Coradi Tonon
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, 40 Blossom St, Boston, MA 02114, United States
| | - Alessandra Nara de Souza Rastelli
- Department of Restorative Dentistry, School of Dentistry, Araraquara, Sao Paulo State University-UNESP, 1680 Humaita St., Araraquara, SP 14801-903, Brazil
| | - Chathuna Bodahandi
- Ph.D. Program in Chemistry, The Graduate Center of the City University of New York, 365 Fifth Avenue, New York, NY 10016, United States
- Department of Chemistry, College of Staten Island, City University of New York, Staten Island, New York 10314, United States
| | - Goutam Ghosh
- SingletO2 Therapeutics LLC, VentureLink, Room 524B, 211 Warren St, Newark, NJ 07103, United States
| | - Tayyaba Hasan
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, 40 Blossom St, Boston, MA 02114, United States
- Division of Health Sciences and Technology, Harvard University and Massachusetts Institute of Technology, Cambridge, MA 02139, United States
| | - QianFeng Xu
- SingletO2 Therapeutics LLC, VentureLink, Room 524B, 211 Warren St, Newark, NJ 07103, United States
| | - Alexander Greer
- Ph.D. Program in Chemistry, The Graduate Center of the City University of New York, 365 Fifth Avenue, New York, NY 10016, United States
- SingletO2 Therapeutics LLC, VentureLink, Room 524B, 211 Warren St, Newark, NJ 07103, United States
- Department of Chemistry, Brooklyn College, City University of New York, Brooklyn, NY 11210, United States
| | - Alan M. Lyons
- Ph.D. Program in Chemistry, The Graduate Center of the City University of New York, 365 Fifth Avenue, New York, NY 10016, United States
- Department of Chemistry, College of Staten Island, City University of New York, Staten Island, New York 10314, United States
- SingletO2 Therapeutics LLC, VentureLink, Room 524B, 211 Warren St, Newark, NJ 07103, United States
| |
Collapse
|
3
|
de Sousa GR, Soares LO, Soares BM, de Carvalho Cruz R, Uliana Junior P, Santiago T, Farias LM, Magalhães PP, Silveira LB, Almeida Lopes L, Mancini MW, Huebner R, Ferreira MVL. In vitro evaluation of physical and chemical parameters involved in aPDT of Aggregatibacter actinomycetemcomitans. Lasers Med Sci 2021; 37:391-401. [PMID: 33559803 DOI: 10.1007/s10103-021-03267-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 02/01/2021] [Indexed: 11/30/2022]
Abstract
Periodontitis is an infectious disease characterized by the destruction of supporting tissues. Antimicrobial photodynamic therapy (aPDT) has been proposed as an improved method for eliminating microorganisms. Its efficiency depends on the correct use of physical and chemical parameters. Thus, these parameters and their relations were evaluated in this study with the purpose of establishing lethal conditions for combating bacterial agents. Diode lasers and light-emitting diodes (LEDs) were characterized to evaluate the absorption profile and resonance of methylene blue (MB) and toluidine blue O (TBO). The relations between light energy density and photosensitizer absorption were determined. Two methodologies were used to evaluate the effects of aPDT against Aggregatibacter actinomycetemcomitans. LED light exhibited a broad emission spectrum with a peak light wavelength of 637 nm and 99% purity. The resonance intensity of MB was higher with diode laser irradiation, and TBO showed higher resonance intensity with LED irradiation. There was no difference in the absorption profile of photosensitizers using diode lasers or LEDs, and variations in power density did not result in an increasing or decrease in light absorption. A. actinomycetemcomitans was susceptible to photodynamic processes. Emission spectra and peak light wavelengths of light sources combined with the absorption profiles of photosensitizers were the main parameters involved in determining the efficiency of photodynamic effects. Power density did not alter the light absorption of photosensitizers. The association between adequate irradiation characteristics and photosensitizer absorption results in complete inactivation of A. actinomycetemcomitans. In addition, the bactericidal effect was not altered by an increase in energy densities.
Collapse
Affiliation(s)
- Gerdal Roberto de Sousa
- Bioengineering Laboratory, Department of Mechanical Engineering, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, MG, 31270-901, Belo Horizonte, Brazil. .,Faculty of Dentistry, Faculdade Arnaldo, Belo Horizonte, MG, Brazil.
| | - Leandro O Soares
- Bioengineering Laboratory, Department of Mechanical Engineering, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, MG, 31270-901, Belo Horizonte, Brazil
| | - Betânia M Soares
- Bioengineering Laboratory, Department of Mechanical Engineering, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, MG, 31270-901, Belo Horizonte, Brazil.,Faculty of Dentistry, Faculdade Arnaldo, Belo Horizonte, MG, Brazil.,Universidade de Itaúna, MG, Itaúna, Brazil
| | - Rosana de Carvalho Cruz
- Bioengineering Laboratory, Department of Mechanical Engineering, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, MG, 31270-901, Belo Horizonte, Brazil.,Faculty of Dentistry, Faculdade Arnaldo, Belo Horizonte, MG, Brazil
| | - Paulo Uliana Junior
- Bioengineering Laboratory, Department of Mechanical Engineering, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, MG, 31270-901, Belo Horizonte, Brazil
| | - Thiago Santiago
- Bioengineering Laboratory, Department of Mechanical Engineering, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, MG, 31270-901, Belo Horizonte, Brazil
| | - Luiz M Farias
- Laboratory of Oral Microbiology and Anaerobes, Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Paula Prazeres Magalhães
- Laboratory of Oral Microbiology and Anaerobes, Department of Microbiology, Institute of Biological Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | - Lívio B Silveira
- Bioengineering Laboratory, Department of Mechanical Engineering, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, MG, 31270-901, Belo Horizonte, Brazil.,Faculty of Dentistry, Faculdade Arnaldo, Belo Horizonte, MG, Brazil
| | - Luciana Almeida Lopes
- Research and Education Center for Phototherapy in Health Sciences (NUPEN), São Carlos, SP, Brazil
| | | | - Rudolf Huebner
- Bioengineering Laboratory, Department of Mechanical Engineering, Universidade Federal de Minas Gerais, Av. Antônio Carlos, 6627, MG, 31270-901, Belo Horizonte, Brazil
| | - Marcus V L Ferreira
- Faculty of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| |
Collapse
|
4
|
Malta CP, Barcelos RCS, Rosa HZ, Bürger ME, Bento LW. Effect of cerebral palsy and dental caries on dental plaque index, salivary parameters and oxidative stress in children and adolescents. Eur Arch Paediatr Dent 2021; 22:21-28. [PMID: 32008171 DOI: 10.1007/s40368-020-00509-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 01/14/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE The aim of the present study was to investigate the effect of cerebral palsy and dental caries on dental plaque index, salivary parameters and oxidative stress in children and adolescents. METHODS Seventy children and adolescents aged 2-20 years were divided into four groups: neurotypical controls-inactive caries (NCIC; n = 19); neurotypical controls-active caries (NCAC; n = 16); cerebral palsy-inactive caries (CPIC; n = 19); and cerebral palsy-active caries (CPAC; n = 16). The visible dental plaque index was determined after drying the tooth surfaces and without any mechanical or chemical disclosing methods. Salivary pH and buffer capacity were measured 1 hour after collection using a digital pH meter. Saliva was used to evaluate oxidative status based on the levels of reactive species, lipid peroxidation and non-enzymatic antioxidants (reduced glutathione and vitamin C). RESULTS The CPIC and CPAC groups had lower salivary pH and a higher visible dental plaque index. CP was also associated with an increase in salivary levels of markers of oxidative stress and the modulation of salivary levels of non-enzymatic antioxidants. CONCLUSION Cerebral palsy exerts an influence on the salivary profile, oral health and oxidative stress. The individuals with CP had more acidic saliva and a higher dental plaque index, which were positively correlated with caries activity. CP was associated with high salivary levels of reactive species and lipid peroxidation, demonstrating an imbalance in salivary redox that was particularly associated with caries activity. These factors facilitate the development of oral diseases in individuals with cerebral palsy.
Collapse
Affiliation(s)
- C P Malta
- Graduate Program in Health and Life Sciences, Universidade Franciscana (UFN), 1175 Silva Jardim St, Santa Maria, RS, 97010-491, Brazil
| | - R C S Barcelos
- Graduate Program in Pharmacology, Universidade Federal de Santa Maria (UFSM), 1000 Roraima Ave, Santa Maria, RS, 97105-900, Brazil
| | - H Z Rosa
- Graduate Program in Pharmacology, Universidade Federal de Santa Maria (UFSM), 1000 Roraima Ave, Santa Maria, RS, 97105-900, Brazil
| | - M E Bürger
- Graduate Program in Pharmacology, Universidade Federal de Santa Maria (UFSM), 1000 Roraima Ave, Santa Maria, RS, 97105-900, Brazil
- Graduate Program in Toxicological Biochemistry, Universidade Federal de Santa Maria (UFSM), 1000 Roraima Ave, Santa Maria, RS, 97105-900, Brazil
| | - L W Bento
- Graduate Program in Health and Life Sciences, Universidade Franciscana (UFN), 1175 Silva Jardim St, Santa Maria, RS, 97010-491, Brazil.
| |
Collapse
|
5
|
Tavares LJ, de Avila ED, Klein MI, Panariello BHD, Spolidório DMP, Pavarina AC. Antimicrobial photodynamic therapy alone or in combination with antibiotic local administration against biofilms of Fusobacterium nucleatum and Porphyromonas gingivalis. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2018; 188:135-145. [PMID: 30267963 DOI: 10.1016/j.jphotobiol.2018.09.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 09/05/2018] [Accepted: 09/11/2018] [Indexed: 12/18/2022]
Abstract
Antimicrobial photodynamic therapy (aPDT) kills several planktonic pathogens. However, the susceptibility of biofilm-derived anaerobic bacteria to aPDT is poorly characterized. Here, we evaluated the effect of Photodithazine (PDZ)-mediated aPDT on Fusobacterium nucleatum and Porphyromonas gingivalis biofilms. In addition, aPDT was tested with metronidazole (MTZ) to explore the potential antimicrobial effect of the treatment. The minimum inhibitory concentration (MIC) of MTZ was defined for each bacterial species. Single-species biofilms of each species were grown on polystyrene plates under anaerobic conditions for five days. aPDT was performed by applying PDZ at concentrations of 50, 75 and 100 mg/L, followed by exposure to 50 J/cm2 LED light (660 nm) with or without MTZ. aPDT exhibited a significant reduction in bacterial viability at a PDZ concentration of 100 mg/L, with 1.12 log10 and 2.66 log10 reductions for F. nucleatum and P. gingivalis in biofilms, respectively. However, the antimicrobial effect against F. nucleatum was achieved only when aPDT was combined with MTZ at 100× MIC. Regarding P. gingivalis, the combination of PDZ-mediated aPDT at 100 mg/L with MTZ 100× MIC resulted in a 5 log10 reduction in the bacterial population. The potential antimicrobial effects of aPDT in combination with MTZ for both single pathogenic biofilms were confirmed by live/dead staining. These results suggest that localized antibiotic administration may be an adjuvant to aPDT to control F. nucleatum and P. gingivalis biofilms.
Collapse
Affiliation(s)
- Lívia J Tavares
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, Rua Humaitá, 1680, 14801-903 Araraquara, SP, Brazil
| | - Erica D de Avila
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, Rua Humaitá, 1680, 14801-903 Araraquara, SP, Brazil
| | - Marlise I Klein
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, Rua Humaitá, 1680, 14801-903 Araraquara, SP, Brazil
| | - Beatriz H D Panariello
- Department of Cariology, Operative Dentistry and Dental Public Health, Indiana University School of Dentistry, 1121 W Michigan St, DS406, Indianapolis, IN 46202, USA
| | - Denise M P Spolidório
- Department of Physiology and Pathology, São Paulo State University (Unesp), School of Dentistry, Araraquara, Rua Humaitá, 1680, 14801-903, Araraquara, SP, Brazil
| | - Ana Cláudia Pavarina
- Department of Dental Materials and Prosthodontics, São Paulo State University (Unesp), School of Dentistry, Araraquara, Rua Humaitá, 1680, 14801-903 Araraquara, SP, Brazil.
| |
Collapse
|