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Nunes GP, de Oliveira Alves R, Ragghianti MHF, Martins TP, Dos Reis Prado AH, Nunes LP, Poli MCF, Silva ANA, Benetti F. Antimicrobial photodynamic therapy in the nonsurgical treatment of periodontitis in patients with HIV infection: a systematic review and meta-analysis. Lasers Med Sci 2024; 39:155. [PMID: 38865020 DOI: 10.1007/s10103-024-04087-y] [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: 08/29/2023] [Accepted: 05/15/2024] [Indexed: 06/13/2024]
Abstract
The aim of this systematic review and meta-analysis (SRM) was to evaluate the effectiveness of the adjunctive use of antimicrobial photodynamic therapy (aPDT) in non-surgical periodontal treatment (NSPT) in subjects with Human Immunodeficiency Virus (HIV) and periodontitis. This SRM was registered in PROSPERO (CRD42023410180) and followed the guidelines of PRISMA 2020. Searches were performed in different electronic databases. Risk of bias was performed using the Cochrane Risk of Bias tool (RoB 2.0) for randomized clinical trials (RCT). Meta-analysis was performed using Rev Man software. The mean difference (MD) measure of effect was calculated, the random effect model was applied with a 95% confidence interval, and heterogeneity was tested by the I2 index. The certainty of the evidence was rated using GRADE. A total of 1118 records were screened, and four studies were included. There was a greater reduction in the microbial load of periodontopathogens after NSPT with aPDT. Meta-analysis showed that probing depth (post 3 and 6 months) and clinical attachment loss (post 6 months) were lower for the aPDT-treated group than the NSPT alone: MD -0.39 [-0.74; -0.05], p = 0.02; MD -0.70 [-0.99; -0.41], p < 0.0001; MD -0.84 [-1,34; -0.34], p = 0.0001, respectively. Overall, the studies had a low risk of bias and, the certainty of evidence was rated as moderate. It is suggested that aPDT is a promising adjuvant therapy, showing efficacy in the reduction of the microbial load and in some clinical parameters of individuals with periodontitis and HIV.
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Affiliation(s)
- Gabriel Pereira Nunes
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil.
| | - Renata de Oliveira Alves
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Matheus Henrique Faccioli Ragghianti
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Tamires Passadori Martins
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Alexandre Henrique Dos Reis Prado
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Larissa Pereira Nunes
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Maria Clara Faria Poli
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Arles Naisa Amaral Silva
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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ALHarthi SS. Efficacy of antimicrobial photodynamic therapy in reducing oral yeasts growth in individuals wearing implant overdentures: A systematic review of clinical trials. Photodiagnosis Photodyn Ther 2024; 46:104050. [PMID: 38548040 DOI: 10.1016/j.pdpdt.2024.104050] [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: 03/03/2024] [Revised: 03/08/2024] [Accepted: 03/13/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVE The aim was to systematically review clinical studies that investigated the efficacy of antimicrobial photodynamic therapy (aPDT) in reducing oral yeasts growth (OYG) in individuals wearing implant overdentures (IO). METHODS The focused question was "Is aPDT effective in reducing OYG in patients wearing IO?" Literature search was performed in accordance with PRISMA guidelines. Indexed databases were searched without time and language restrictions up to and including January 2024. Clinical studies were included; and letters to the Editor, case-reports/case-series, perspectives/commentaries, in-vitro/ex-vivo studies, studies on animal models and expert opinions were excluded. The risk of bias was also assessed. RESULTS Two clinical studies were included and processed for data extraction. The study population comprised of 100 (mean age: 58.5 years) and 53 (mean age: 58.5 years) individuals. The numbers of males and females included in these studies ranged between 33 and 35 males and 18-67 females, respectively. In both studies, follow-up evaluations were performed after 60 days. In both studies, aPDT was performed using a 660 nm diode laser at a power of 100 mW and using methylene-blue as photosensitizer. Results from both studies showed that aPDT is effective in significantly reducing oral yeasts CFU/ml and improvement of OHRQoL of individuals using IO. CONCLUSION The aPDT is useful in reducing OYG on IO; however, further well-designed and power-adjusted studies are needed in this area of research.
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Affiliation(s)
- Shatha Subhi ALHarthi
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
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Aseri AA. Clinical and Radiographic Outcomes of Adjunctive Phototherapy Versus Antibiotic Therapy Against Peri-Implant Diseases: A Systematic Review and Meta-Analysis. Photobiomodul Photomed Laser Surg 2024; 42:189-199. [PMID: 38512322 DOI: 10.1089/photob.2023.0157] [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] [Indexed: 03/22/2024] Open
Abstract
Background: Peri-implantitis, an inflammatory condition in implant tissues, requires bacterial eradication and implant surface decontamination, with aPDT as a helpful surgical adjunct. Objective:This project was designed to investigate the effect of antibiotic therapy versus aPDT, as adjuncts to conventional mechanical debridement (MD), on the peri-implant clinical and/or radiographic parameters among patients with peri-implant diseases. Methods: A comprehensive search was conducted across electronic databases, including PubMed, Scopus, and Web of Science, up to and including April 2023, without any restriction on the language and year of publication, focusing the following research question: "Does adjunctive aPDT improve the peri-implant clinical and/or radiographic parameters in treating peri-implant diseases compared to antibiotic therapy?" Statistical analysis was performed on peri-implant clinical [plaque index (PI), probing depth (PD), and bleeding on probing (BOP)] and radiographic parameters [marginal bone loss (MBL)]. The study included six randomized controlled trials and one clinical (nonrandomized) study. Results: The systematic review findings indicate that the application of aPDT as an adjunct to MD is equally effective as adjunctive antibiotic therapy in improving peri-implant clinical parameters and radiographic parameters in patients with peri-implant diseases. Only two studies were classified as having a low risk of bias (RoB), two were assessed as having an unclear RoB, and the remaining three studies were determined to have a high RoB. However, the meta-analysis results revealed no statistically significant difference in peri-implant PI, PD, and MBL scores between patients treated with adjunct aPDT or adjunct antibiotic therapy. Notably, there was a statistically significant difference favoring adjunct aPDT in peri-implant BOP values compared to the control group. Conclusions: Despite the limited number of included studies and the significant heterogeneity among them, the findings suggest that aPDT yields comparable peri-implant clinical and radiographic outcomes to adjunctive antibiotic therapy, as adjuncts to MD, for the potential treatment of peri-implant diseases.
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Affiliation(s)
- Abdulrahman A Aseri
- Department of Preventive Dental Sciences, College of Dentistry, Najran University, Najran, Kingdom of Saudi Arabia
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Straub A, Stapf M, Utz C, Vollmer A, Flesch J, Kübler A, Scherf-Clavel O, Lâm TT, Hartmann S. Antimicrobial effects of clindamycin-loaded platelet-rich fibrin (PRF). Clin Oral Investig 2024; 28:144. [PMID: 38351376 PMCID: PMC10864470 DOI: 10.1007/s00784-024-05532-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/28/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVES Recent research has demonstrated that platelet-rich fibrin (PRF) is an appropriate carrier for ampicillin/sulbactam. The aim of the study was to investigate whether PRF is also a suitable bio-carrier for clindamycin (CLI). METHODS PRF membranes were produced from 36 patients receiving intravenous therapy with CLI (e.g. due to the diagnosis of an osteonecrosis of the jaw or infections). Concentrations of CLI in PRF membranes were measured with liquid chromatography-tandem mass spectrometry, and the antimicrobial effects were investigated in vitro in agar diffusion tests with fresh PRF and PRF stored for 24 h. Storage was performed in an incubator at 36 °C to simulate the in-vivo situation. RESULTS The mean concentration of CLI in plasma was 1.0 ± 0.3 μg/100 mg plasma; in resulting PRF membranes 0.7 ± 0.4 μg/100 mg PRF. Agar diffusion tests were performed with Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus mitis, Porphyromonas gingivalis, and Fusobacterium nucleatum. Mean inhibition zones, in mm, for fresh PRF were 17.3, 12.2, 18.8, 17.1, 25.8 and 18.1, 12.7, 19.2, 17.3, and 26.3 for stored PRF, respectively. CONCLUSION The results demonstrate that PRF is a suitable bio-carrier for CLI when administered systemically to patients. The concentration in PRF generated from patients after infusion of 600 mg CLI dose suffices to target clinically relevant bacteria. CLINICAL RELEVANCE Using PRF as a carrier for local antibiotic application can prevent infections in oral and maxillofacial surgery. Within the study limitations, the findings could expand the scope of PRF application by adding CLI as a new antibiotic to the spectrum of PRF therapy.
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Affiliation(s)
- Anton Straub
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany.
| | - Maximilian Stapf
- Institute for Pharmacy and Food Chemistry, University of Würzburg, Am Hubland, 97074, Würzburg, Germany
| | - Chiara Utz
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Andreas Vollmer
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Julia Flesch
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Alexander Kübler
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
| | - Oliver Scherf-Clavel
- Department of Pharmacy, University of München, Butenandtstraße 5, 81377, Munich, Germany
| | - Thiên-Trí Lâm
- Institute for Hygiene and Microbiology, University of Würzburg, Josef-Schneider-Straße 2/E1, 97080, Würzburg, Germany
| | - Stefan Hartmann
- Department of Oral and Maxillofacial Plastic Surgery, University Hospital Würzburg, Pleicherwall 2, 97070, Würzburg, Germany
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Herrera D, van Winkelhoff AJ, Matesanz P, Lauwens K, Teughels W. Europe's contribution to the evaluation of the use of systemic antimicrobials in the treatment of periodontitis. Periodontol 2000 2023. [PMID: 37314038 DOI: 10.1111/prd.12492] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Revised: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 06/15/2023]
Abstract
This narrative review celebrates Europe's contribution to the current knowledge on systemically administered antimicrobials in periodontal treatment. Periodontitis is the most frequent chronic noncommunicable human disease. It is caused by dysbiotic bacterial biofilms and is commonly treated with subgingival instrumentation. However, some sites/patients do not respond adequately, and its limitations and shortcomings have been recognized. This has led to the development of alternative or adjunctive therapies. One is the use of antimicrobials to target bacteria in subgingival biofilms in the periodontal pocket, which can be targeted directly through the pocket entrance with a locally delivered antibiotic or systemically by oral, intravenous, or intramuscular methods. Since the early 20th century, several studies on systemic antibiotics have been undertaken and published, especially between 1990 and 2010. Europe's latest contribution to this topic is the first European Federation of Periodontology, S3-level Clinical Practice Guideline, which incorporates recommendations related to the use of adjuncts to treat stage I-III periodontitis. Understanding the etiopathogenesis of periodontal diseases, specifically periodontitis, has influenced the use of systemic periodontal antibiotic therapy. Randomized clinical trials and systematic reviews with meta-analyses have demonstrated the clinical advantages of adjunctive systemic antimicrobials. However, current recommendations are restrictive due to concerns about antibiotic misuse and the increase in microbial antibiotic resistance. European researchers have contributed to the use of systemic antimicrobials in the treatment of periodontitis through clinical trials and by providing rational guidelines. Nowadays, European researchers are exploring alternatives and directing clinical practice by providing evidence-based guidelines to limit the use of systemic antimicrobials.
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Affiliation(s)
- David Herrera
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Arie Jan van Winkelhoff
- Center for Dentistry and Oral Hygiene, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Paula Matesanz
- ETEP (Etiology and Therapy of Periodontal and Peri-Implant Diseases) Research Group, University Complutense, Madrid, Spain
| | - Katalina Lauwens
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Wim Teughels
- Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals Leuven, Leuven, Belgium
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Silva PGBD, Guimarães L, Oliveira F, Miranda LO, Esteves RP. The effect of antimicrobial photodynamic therapy adjunct to non-surgical periodontal therapy on the treatment of periodontitis in individuals with type 2 diabetes mellitus: a systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2023; 42:103573. [PMID: 37062511 DOI: 10.1016/j.pdpdt.2023.103573] [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: 01/22/2023] [Revised: 04/12/2023] [Accepted: 04/13/2023] [Indexed: 04/18/2023]
Abstract
BACKGROUND The purpose of the present systematic review and meta-analysis was to assess the impact of antimicrobial photodynamic therapy adjunct to non-surgical periodontal treatment on individuals with type 2 diabetes mellitus. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-analyses statement was followed. Searches were carried out in six databases without restriction regarding publication year. Studies comparing periodontal clinical parameters among individuals submitted to non-surgical periodontal therapy associated with antimicrobial photodynamic therapy and a control group of individuals submitted to only non-surgical periodontal treatment were included. Study selection, data extraction, and risk of bias assessment (RoB 2.0) were performed by two review authors. Meta-analysis was performed. Mean difference (MD) and 95% confidence interval (CI) were provided. RESULTS Two hundred and five studies were identified and 11 studies were included. The meta-analysis demonstrated that antimicrobial photodynamic therapy adjunctive to periodontal therapy, in individuals with diabetes, resulted in a greater reduction of bleeding on probing at 6 months and in probing depth at 3 and 6 months in comparison to periodontal treatment alone (p<0.05). The included studies exhibited low risk of bias. CONCLUSION Antimicrobial photodynamic therapy adjunct to periodontal therapy contributes to the improvement of periodontal clinical parameter bleeding on probing and probing depth in individuals with type 2 diabetes mellitus.
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Affiliation(s)
- Pierre Geraldo Braz da Silva
- Department of Dental Clinics, Oral Pathology and Oral Surgery, Periodontology Division, School of Dentistry, Federal University de Minas Gerais. Antônio Carlos Avenue 6627, Pampulha, Belo Horizonte, Minas Gerais, Brazil, zip code 31270-901
| | - Lucas Guimarães
- Department of Child and Adolescent Oral Health, School of Dentistry, Federal University of Minas Gerais. Antônio Carlos Avenue 6627, Pampulha, Belo Horizonte, Minas Gerais, Brazil, zip code 31270-901
| | - Fernando Oliveira
- Department of Dental Clinics, Oral Pathology and Oral Surgery, Periodontology Division, School of Dentistry, Federal University de Minas Gerais. Antônio Carlos Avenue 6627, Pampulha, Belo Horizonte, Minas Gerais, Brazil, zip code 31270-901
| | - Luís Otávio Miranda
- Department of Dental Clinics, Oral Pathology and Oral Surgery, Periodontology Division, School of Dentistry, Federal University de Minas Gerais. Antônio Carlos Avenue 6627, Pampulha, Belo Horizonte, Minas Gerais, Brazil, zip code 31270-901
| | - Rafael Paschoal Esteves
- Department of Dental Clinics, Oral Pathology and Oral Surgery, Periodontology Division, School of Dentistry, Federal University de Minas Gerais. Antônio Carlos Avenue 6627, Pampulha, Belo Horizonte, Minas Gerais, Brazil, zip code 31270-901.
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AlGhamdi AS, Qamar Z, AlSheikh R, Al Hinai MTA, Abdul NS, Aljoghaiman EA, Ali S. Clinical efficacy of 5-aminolevulinic acid-mediated photodynamic therapy versus topical antifungal agent and surgical excision for the treatment of hyperplastic candidiasis. Photodiagnosis Photodyn Ther 2022; 41:103258. [PMID: 36592782 DOI: 10.1016/j.pdpdt.2022.103258] [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: 12/08/2022] [Revised: 12/27/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Hyperplastic candidiasis (HC) is a chronic infection of oral mucosa caused by Candida. Owing to its potential for malignant transformation, its intervention requires attention. Conventional surgical resection might lead to irreversible damage and impact the patient's quality of life. Hence, this study aimed to evaluate the clinical efficacy of 5-aminolevulinic acid (5-ALA)-mediated photodynamic therapy (PDT) alone and in combination with topical antifungal therapy (i.e., nystatin [combination therapy]) in comparison with nystatin and surgical resection for the treatment of HC. METHODS Forty subjects with clinical and histopathological diagnoses of HC were included in the study. Four study groups, with 10 participants each, were formed as follows: Group-I - receiving antifungal agent [nystatin]; Group-II - receiving surgical resection; Group-III - receiving PDT; and Group-IV - receiving 5-ALA-mediated PDT and nystatin [combination therapy]. Salivary and mucosal samples were collected for the quantification of Candida albicans and the treatment responses to different interventions were recorded at week-4, week-6, and week-8 after finishing therapies. RESULTS At the 3rd follow-up (i.e., at end of the 8th week after the interventions), complete improvement in 3 (30%), 2 (20%), 1 (10%), and 5 (50%) patients in group-I, group-II, group-III, and group-IV, respectively was observed. A statistically significant difference was obtained when the intervention responses were compared at week-4 (p<0.01), week-6 (p<0.01), and week-8 (p<0.0001) follow-ups in group-I, group-II, and group-IV subjects. At the 8-week follow-up regarding the salivary and mucosal samples, the lowest colony-forming units/milliliter score of C. albicans was observed in group-IV subjects. CONCLUSION The application of 5-ALA-mediated PDT in combination with nystatin gel possesses the potential as a well-tolerated and safe therapeutic modality for the treatment of patients with HC.
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Affiliation(s)
- AbdulRahman Saeed AlGhamdi
- Department of Restorative and Prosthetic Dentistry, College of Dentistry, Dar Al Uloom University, Riyadh, Saudi Arabia.
| | - Zeeshan Qamar
- Department of O&MFS and Diagnostic Sciences, Faculty of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Rasha AlSheikh
- Department of Restorative Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam, Saudi Arabia
| | - Muntasar Talib Ali Al Hinai
- Dental and Maxillofacial Surgery Department, Sultan Qaboos University Hospital Sultan Qaboos University, Muscat Oman
| | - Nishath Sayed Abdul
- Department of OMFS and Diagnostic Sciences (Oral Pathology), Faculty of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Eman Ahmed Aljoghaiman
- Department of Preventive Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam, Saudi Arabia
| | - Saqib Ali
- Department of Biomedical Dental Sciences, College of Dentistry, Imam Abdulrahman Bin Faisal University, P.O. Box 1982, Dammam, Saudi Arabia
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Polizzi A, Donzella M, Nicolosi G, Santonocito S, Pesce P, Isola G. Drugs for the Quorum Sensing Inhibition of Oral Biofilm: New Frontiers and Insights in the Treatment of Periodontitis. Pharmaceutics 2022; 14:pharmaceutics14122740. [PMID: 36559234 PMCID: PMC9781207 DOI: 10.3390/pharmaceutics14122740] [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: 10/26/2022] [Revised: 12/01/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Chemical molecules are used by microorganisms to communicate with each other. Quorum sensing is the mechanism through which microorganisms regulate their population density and activity with chemical signaling. The inhibition of quorum sensing, called quorum quenching, may disrupt oral biofilm formation, which is the main etiological factor of oral diseases, including periodontitis. Periodontitis is a chronic inflammatory disorder of infectious etiology involving the hard and soft periodontal tissues and which is related to various systemic disorders, including cardiovascular diseases, diabetes and obesity. The employment of adjuvant therapies to traditional scaling and root planing is currently being studied to further reduce the impact of periodontitis. In this sense, using antibiotics and antiseptics involves non-negligible risks, such as antibiotic resistance phenomena and hinders the re-establishment of eubiosis. Different quorum sensing signal molecules have been identified in periodontal pathogenic oral bacteria. In this regard, quorum sensing inhibitors are emerging as some interesting solutions for the management of periodontitis. Therefore, the aim of this review is to summarize the current state of knowledge on the mechanisms of quorum sensing signal molecules produced by oral biofilm and to analyze the potential of quorum sensing inhibitors for the management of periodontitis.
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Affiliation(s)
- Alessandro Polizzi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via Sofia 78, 95125 Catania, Italy
- Department of Surgical Sciences (DISC), University of Genova, 16132 Genoa, Italy
| | - Martina Donzella
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via Sofia 78, 95125 Catania, Italy
| | - Giada Nicolosi
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via Sofia 78, 95125 Catania, Italy
| | - Simona Santonocito
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via Sofia 78, 95125 Catania, Italy
- Correspondence: (S.S.); (G.I.); Tel.: +39-095-378-2638 (S.S. & G.I.)
| | - Paolo Pesce
- Department of Surgical Sciences (DISC), University of Genova, 16132 Genoa, Italy
| | - Gaetano Isola
- Department of General Surgery and Surgical-Medical Specialties, School of Dentistry, University of Catania, Via Sofia 78, 95125 Catania, Italy
- Correspondence: (S.S.); (G.I.); Tel.: +39-095-378-2638 (S.S. & G.I.)
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Next-Generation Examination, Diagnosis, and Personalized Medicine in Periodontal Disease. J Pers Med 2022; 12:jpm12101743. [PMID: 36294882 PMCID: PMC9605396 DOI: 10.3390/jpm12101743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/13/2022] [Accepted: 10/14/2022] [Indexed: 01/10/2023] Open
Abstract
Periodontal disease, a major cause of tooth loss, is an infectious disease caused by bacteria with the additional aspect of being a noncommunicable disease closely related to lifestyle. Tissue destruction based on chronic inflammation is influenced by host and environmental factors. The treatment of periodontal disease varies according to the condition of each individual patient. Although guidelines provide standardized treatment, optimization is difficult because of the wide range of treatment options and variations in the ideas and skills of the treating practitioner. The new medical concepts of “precision medicine” and “personalized medicine” can provide more predictive treatment than conventional methods by stratifying patients in detail and prescribing treatment methods accordingly. This requires a new diagnostic system that integrates information on individual patient backgrounds (biomarkers, genetics, environment, and lifestyle) with conventional medical examination information. Currently, various biomarkers and other new examination indices are being investigated, and studies on periodontal disease-related genes and the complexity of oral bacteria are underway. This review discusses the possibilities and future challenges of precision periodontics and describes the new generation of laboratory methods and advanced periodontal disease treatment approaches as the basis for this new field.
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Tonon CC, Ashraf S, de Souza Rastelli AN, Ghosh G, Hasan T, Xu Q, Greer A, Lyons AM. Evaluation of photosensitizer-containing superhydrophobic surfaces for the antibacterial treatment of periodontal biofilms. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2022; 233:112458. [PMID: 35691161 PMCID: PMC10373426 DOI: 10.1016/j.jphotobiol.2022.112458] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/18/2022] [Accepted: 04/22/2022] [Indexed: 06/15/2023]
Abstract
Antimicrobial photodynamic therapy (aPDT) is a promising approach to control biofilms involved in periodontal diseases. However, certain challenges, such as staining of teeth, preferential interaction of photosensitizer (PS) with Gram-positive versus Gram-negative bacteria, and insufficient oxygen in hypoxic periodontal pockets have presented barriers to its use in the clinic. To overcome these challenges, a novel superhydrophobic (SH) film that generates airborne singlet oxygen has been developed. The SH-aPDT approach isolates the PS onto a topologically rough solid SH film on which channels allow air to diffuse to the PS surface, thus ensuring sufficient oxygen supply. Upon illumination, gas phase singlet oxygen (1O2) is produced and diffuses from the SH surface to the underlying biofilm. The killing efficacy was assessed as a function of transmitted fluence (17.9-89.5 J/cm2) and chorin e6 loading (96-1110 nmol/cm2) by counting of colony forming units, biofilm metabolism by XTT and confocal microscopy. The decrease in viability of both Gram-positive and Gram-negative bacteria in a multi-species biofilm was found to be linearly dependent on the fluence as well as the loading of the PS up to 71.6 J/cm2 when 1110 nmols/cm2 of chlorin e6 was used. A > 4.6 log bacterial reduction was observed under these conditions (p < 0.05). This novel SH-aPDT approach shows promise as an effective method to disinfect multi-species bacterial biofilms associated with periodontal disease and will be evaluated in animal models in future studies.
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Affiliation(s)
- Caroline Coradi Tonon
- Wellman Center for Photomedicine, Massachusetts General Hospital and Harvard Medical School, 40 Blossom St, Boston, MA 02114, United States
| | - Shoaib Ashraf
- 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, São Paulo State University-UNESP, 1680 Humaitá St., Araraquara, SP 14801-903, Brazil
| | - Goutam Ghosh
- SingletO(2) Therapeutics LLC, TechBox, Suite 3, 75 Clinton St, Staten Island, NY 10304, 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
- SingletO(2) Therapeutics LLC, TechBox, Suite 3, 75 Clinton St, Staten Island, NY 10304, United States
| | - Alexander Greer
- SingletO(2) Therapeutics LLC, TechBox, Suite 3, 75 Clinton St, Staten Island, NY 10304, United States; 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, Brooklyn College, City University of New York, Brooklyn, NY 11210, United States.
| | - Alan M Lyons
- SingletO(2) Therapeutics LLC, TechBox, Suite 3, 75 Clinton St, Staten Island, NY 10304, United States; Department of Chemistry, College of Staten Island, City University of New York, Staten Island, New York 10314, United States; Ph.D. Program in Chemistry, The Graduate Center of the City University of New York, 365 Fifth Avenue, New York, NY 10016, United States.
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11
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The Potential Application of Natural Photosensitizers Used in Antimicrobial Photodynamic Therapy against Oral Infections. Pharmaceuticals (Basel) 2022; 15:ph15060767. [PMID: 35745686 PMCID: PMC9227410 DOI: 10.3390/ph15060767] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 02/05/2023] Open
Abstract
Oral health problems and the emergence of antimicrobial resistance among pathogenic bacterial strains have become major global challenges and are essential elements that negatively affect general well-being. Antimicrobial photodynamic therapy (APDT) is based on a light source and oxygen that activates a nontoxic photosensitizer, resulting in microbial destruction. Synthetic and natural products can be used to help the APDT against oral microorganisms. The undesirable consequences of conventional photosensitizers, including toxicity, and cost encourage researchers to explore new promising photosensitizers based on natural compounds such as curcumin, chlorella, chlorophyllin, phycocyanin, 5-aminolevulinic acid, and riboflavin. In this review, we summarize in vitro studies describing the potential use of APDT therapy conjugated with some natural products against selected microorganisms that are considered to be responsible for oral infections.
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12
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Zheng J, Zhang Y, Zhang S. Sustained release of azithromycin from lipid liquid-crystalline nanoparticles laden in situ gel for the treatment of periodontitis: In vitro and efficacy study. J Biomater Appl 2022; 37:482-492. [PMID: 35499959 DOI: 10.1177/08853282221095395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Periodontitis is a chronic inflammatory disease affecting teeth, periodontal ligament and alveolar bone. Current treatment options include surgery or oral antibiotics. Oral dosage forms shows systemic side effects due to frequent dosing and it failed to reach the therapeutic concentration in the periodontal cavity. In this work, a novel in situ gel loaded with azithromycin laden lipid liquid-crystalline nanoparticles (cubosomes) was formulated for effective treatment of periodontitis. Cubosomes were prepared using DL-α-monoolein (MO) and Pluronic®F-127, and characterized for size, zeta potential, shape, and entrapment efficacy. In situ gel laden cubosomes were evaluated for pH, drug content, viscosity, syringeability, mucoadhesive strength, texture profile, gelation temperature, gel strength, in vitro release profile, antimicrobial activity and in vivo efficacy in rat model. Cubosomal size (137-450 nm) and entrapment efficacy (74-88%) increases with increase in the level of MO. The in situ gel-cubosomal batches showed sufficient viscosity (878-956 cp), syringeability (125-150N), mucoadhesive strength (25.7-26.2 dyne/cm2), gelation temperature (34.3-35.3oC), gel strength (45-51 s), and texture profile for periodontal application. The in vitro release profiles showed sustain azithromycin release for 24h from the in situ gel-cubosomal gels compared to 4h from the marketed azithromycin gel. The in vivo studies (alveolar bone loss and histopathology) in rat model confirmed the efficacy of in situ gel to treat periodontitis at low frequency of dosing compared to marketed gel. In conclusion, the study demonstrated the potential of cubosomes to sustain the release of azithromycin from in situ gelling system for effective treatment of periodontitis.
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Affiliation(s)
- Jing Zheng
- 117878The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, China
| | - Yuwen Zhang
- 117878The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, China
| | - Suxin Zhang
- 117878The Fourth Affiliated Hospital of Hebei Medical University, Shijiazhuang, China
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13
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Besegato JF, de Melo PBG, Tamae PE, Alves APAR, Rondón LF, Leanse LG, Dos Anjos C, Casarin HH, Chinelatti MA, Faria G, Dai T, Bagnato VS, Rastelli ANDS. How can biophotonics help dentistry to avoid or minimize cross infection by SARS-CoV-2? Photodiagnosis Photodyn Ther 2021; 37:102682. [PMID: 34910994 PMCID: PMC8666148 DOI: 10.1016/j.pdpdt.2021.102682] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 09/30/2021] [Accepted: 12/10/2021] [Indexed: 12/23/2022]
Abstract
Biophotonics is defined as the combination of biology and photonics (the physical science of the light). It is a general term for all techniques that deal with the interaction between biological tissues/cells and photons (light). Biophotonics offers a great variety of techniques that can facilitate the early detection of diseases and promote innovative theragnostic approaches. As the COVID-19 infection can be transmitted due to the face-to-face communication, droplets and aerosol inhalation and the exposure to saliva, blood, and other body fluids, as well as the handling of sharp instruments, dental practices are at increased risk of infection. In this paper, a literature review was performed to explore the application of Biophotonics approaches in Dentistry focusing on the COVID-19 pandemic and how they can contribute to avoid or minimize the risks of infection in a dental setting. For this, search-related papers were retrieved from PubMED, Scielo, Google Schoolar, and American Dental Association and Centers for Disease Control and Prevention databases. The body of evidence currently available showed that Biophotonics approaches can reduce microorganism load, decontaminate surfaces, air, tissues, and minimize the generation of aerosol and virus spreading by minimally invasive, time-saving, and alternative techniques in general. However, each clinical situation must be individually evaluated regarding the benefits and drawbacks of these approaches, but always pursuing less-invasive and less aerosol-generating procedures, especially during the COVID-19 pandemic.
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Affiliation(s)
- João Felipe Besegato
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Priscila Borges Gobbo de Melo
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Patrícia Eriko Tamae
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Ana Paula Aparecida Raimundo Alves
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Luis Felipe Rondón
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Leon G Leanse
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | - Carolina Dos Anjos
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | - Heitor Hussni Casarin
- Dentistry School, Central Paulista University Center - UNICEP, São Carlos 13563-470, SP, Brazil
| | | | - Gisele Faria
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil.
| | - Tianhong Dai
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | | | - Alessandra Nara de Souza Rastelli
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil.
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14
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ALHarthi SS, Alamry NZ, BinShabaib MS. Effect of multiple sessions of photodynamic therapy on bone regeneration around dental implants among patients with peri-implantitis. Photodiagnosis Photodyn Ther 2021; 37:102612. [PMID: 34740836 DOI: 10.1016/j.pdpdt.2021.102612] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 10/22/2021] [Accepted: 10/29/2021] [Indexed: 12/24/2022]
Abstract
OBJECTIVE The aim of the present study was to assess the effect of multiple sessions of antimicrobial photodynamic therapy (aPDT) on bone regeneration around dental implants among patients with peri-implantitis. METHODS Patients with peri-implantitis were included. Therapeutically, patients were randomly divided into 4 groups: (a) Group-I: Mechanical debridement (MD) alone; (b) Group-II: MD at baseline followed by a single session of adjunct a PDT; (c) Group-III: MD at baseline followed by aPDT at baseline and at 3-months of follow-up; and Group-IV: MD at baseline followed by aPDT at baseline and at 3- and 6-months of follow-up. Demographic data was collected and peri-implant clinical (plaque index [PI], gingival index [GI], and probing depth [PD]) and radiographic (crestal bone loss [CBL]) parameters were assessed at baseline and after 9 months. Sample-size estimation was done on data from a pilot investigation and group comparisons were done using one-way analysis of variance and Bonferroni post-hoc adjustment tests. Level of significance was set at P<0.01. RESULTS Twenty-two, 22, 22 and 22 patients with peri-implantitis were enrolled in groups -I, -II, -III and -IV. The mean age of individuals in groups -I, -II, -III and -IV were 59.2 ± 5.3, 60.5 ± 2.8, 59.6 ± 3.1 and 58.7 ± 0.8 years, respectively. Compared with Group-I, there was a statistically significant reduction in PI (P<0.01), GI (P<0.01) and PD (P<0.01) in all groups at 9-months follow-up. There was no significant difference in PI, GI and PD in groups -II, -III and -IV at 9-months follow-up. There was no statistically significant difference in CBL in all groups at baseline and at 9-months-follow-up. CONCLUSION The use of aPDT as an adjunct to MD reduces the severity of peri-implant mucositis but does not contribute towards bone regeneration in peri-implant osseous defects.
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Affiliation(s)
- Shatha Subhi ALHarthi
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Nujud Zayed Alamry
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Munerah Saleh BinShabaib
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
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15
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Cláudio MM, Nuernberg MAA, Rodrigues JVS, Belizário LCG, Batista JA, Duque C, Garcia VG, Theodoro LH. Effects of multiple sessions of antimicrobial photodynamic therapy (aPDT) in the treatment of periodontitis in patients with uncompensated type 2 diabetes: A randomized controlled clinical study. Photodiagnosis Photodyn Ther 2021; 35:102451. [PMID: 34303029 DOI: 10.1016/j.pdpdt.2021.102451] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/15/2021] [Accepted: 07/19/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND The aim of this study was to compare, through clinical and microbiological analysis, the use of multiple applications of aPDT as an adjuvant therapy to non-surgical periodontal treatment of stage III and IV grade C periodontitis in type 2 diabetic (DM2) patients. METHODS Thirty-four patients with non-compensated DM2 and periodontitis were randomly divided into two groups: SRP Group (n = 17): scaling and root planing (SRP); and SRP+aPDT Group (n = 17): SRP followed by 3 consecutive aPDT applications, immediately, 48 and 96 h after in pockets with probing depth (PD) ≥5 mm. In SRP+aPDT, after 1 min of irrigation with methylene blue (10 mg/ml), the sites were irradiated with a 660 nm diode laser for 50 s (157 J/cm2, 4.7 J, 100 mW). Porphyromonas gingivalis (P. gingivalis) and Prevotella intermedia (P. intermedia) were quantified by real-time qPCR. Periodontal clinical and microbiological data (baseline, 90 and 180 days) were statistically analyzed (α = 5%). RESULTS There was a significant reduction in PD and bleeding on probing at 90 and 180 days post-treatment in both groups (p<0.05). The SRP+aPDT group presented a significant reduction in the number of residual pockets at 90 and 180 days (p<0.05). The SRP+aPDT group presented reduced PD means in deep pockets 180 days post-treatment (p<0.05). No differences were observed in P. gingivalis and P. intermedia levels (p>0.05). CONCLUSION The results of present study indicate that the use of multiples aPDT sessions as adjuvant therapy in the periodontal treatment of uncompensated diabetic patients with periodontitis promotes additional clinical benefits.
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Affiliation(s)
- Marina Módolo Cláudio
- Department of Diagnostic and Surgery, Periodontics Division, São Paulo State University - UNESP, Dentistry School of Araçatuba, Araçatuba, SP, Brazil
| | - Marta Aparecida Alberton Nuernberg
- Department of Diagnostic and Surgery, Periodontics Division, São Paulo State University - UNESP, Dentistry School of Araçatuba, Araçatuba, SP, Brazil
| | - João Victor Soares Rodrigues
- Department of Diagnostic and Surgery, Periodontics Division, São Paulo State University - UNESP, Dentistry School of Araçatuba, Araçatuba, SP, Brazil
| | - Lícia Clara Garcia Belizário
- Department of Diagnostic and Surgery, Periodontics Division, São Paulo State University - UNESP, Dentistry School of Araçatuba, Araçatuba, SP, Brazil
| | - Júlia Arruda Batista
- Department of Diagnostic and Surgery, Periodontics Division, São Paulo State University - UNESP, Dentistry School of Araçatuba, Araçatuba, SP, Brazil
| | - Cristiane Duque
- Department of Preventive and Restorative Dentistry, São Paulo State University - UNESP, Dentistry School of Araçatuba, Araçatuba, SP, Brazil
| | - Valdir Gouveia Garcia
- Latin American Institute of Dental Research and Teaching (ILAPEO), Curitiba, PR, Brazil
| | - Letícia Helena Theodoro
- Department of Diagnostic and Surgery, Periodontics Division, São Paulo State University - UNESP, Dentistry School of Araçatuba, Araçatuba, SP, Brazil.
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16
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Luchian I, Goriuc A, Martu MA, Covasa M. Clindamycin as an Alternative Option in Optimizing Periodontal Therapy. Antibiotics (Basel) 2021; 10:antibiotics10070814. [PMID: 34356735 PMCID: PMC8300806 DOI: 10.3390/antibiotics10070814] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/24/2021] [Accepted: 07/02/2021] [Indexed: 11/29/2022] Open
Abstract
Periodontal disease is an oral infectious and inflammatory disease caused by microorganisms that determine the host-mediated destruction of soft and hard periodontal tissues, which ultimately leads to tooth loss. Periodontitis affects a large part of the population, with various degrees of severity. Treatment consists of etiologic therapy: the removal of biofilm through mechanical debridement plus microbial elimination by supplementary measures. Antibiotic administration, either systemically or through local delivery, has been shown to improve clinical outcomes after mechanical periodontal treatment. Clindamycin is a lincosamide with a broad spectrum, being active against aerobic, anaerobic, and β-lactamase-producing bacteria. This antibiotic offers several advantages and some disadvantages and has been used in periodontal treatment both systemically and locally with various degrees of success. Among the properties that recommend it for periodontal treatment is the bacteriostatic effect, the inhibition of bacterial proteins synthesis, the enhancement of neutrophil chemotaxis, phagocytosis and the oxidative burst–oxidative stress storm. Furthermore, it is easily absorbed at the level of oral tissues in a considerable amount. This substantial tissue penetration, especially inside the bone, is synergistic with a stimulating effect on the host immune system. The aim of this review is to explore the applicability of this antibiotic agent and to evaluate its antimicrobial potential and limitations at the level of the oral biofilm associated with periodontal disease.
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Affiliation(s)
- Ionut Luchian
- Department of Periodontology, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania;
| | - Ancuta Goriuc
- Department of Biochemistry, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania
- Correspondence: (A.G.); (M.A.M.); Tel.: +40-723-438-089 (A.G.); +40-742-189-178 (M.A.M.)
| | - Maria Alexandra Martu
- Department of Periodontology, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 16 Universității Street, 700115 Iași, Romania;
- Correspondence: (A.G.); (M.A.M.); Tel.: +40-723-438-089 (A.G.); +40-742-189-178 (M.A.M.)
| | - Mihai Covasa
- Department of Health and Human Development, University “Stefan cel Mare” Suceava, 13 Universității Street, 720229 Suceava, Romania;
- Department of Basic Medical Sciences, College of Osteopathic Medicine, Western University of Health Sciences, 309E Second Street, Pomona, CA 91766, USA
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17
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Souza EQM, da Rocha TE, Toro LF, Guiati IZ, Freire JDOA, Ervolino E, Brandini DA, Garcia VG, Theodoro LH. Adjuvant effects of curcumin as a photoantimicrobial or irrigant in the non-surgical treatment of periodontitis: Systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2021; 34:102265. [PMID: 33781908 DOI: 10.1016/j.pdpdt.2021.102265] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 01/16/2021] [Accepted: 03/19/2021] [Indexed: 12/11/2022]
Abstract
AIM Curcumin (CUR) has been used clinically in several studies as a subgingival irrigant or as a photoantimicrobial in combination with a blue light-emitting diode (LED) in antimicrobial photodynamic therapy (aPDT) adjuvant to scaling and root planing (SRP). The aim of this study was to assess the effectiveness of CUR as an irrigant or as a photoantimicrobial in conjunction with the blue LED in aPDT adjuvant to SRP, compared to SRP as conventional mechanical treatment. MATERIALS AND METHODS Fifteen randomized controlled trials (RCT) were included in a qualitative analysis after researching the databases: PubMed / MEDLINE, SCOPUS, EMBASE, Cochrane Central, Web of Science and Scielo. Manual searches were also performed. Five studies were submitted to quantitative analysis, evaluating periodontal clinical parameters such as probing depth (PD) and clinical attachment level (CAL). RESULTS The obtained results have shown clinical benefits in PD reduction and CAL gains at 3 months with the use of CUR as adjuvant therapy to SRP, both as an irrigant or photoantimicrobial, in comparison with SRP monotherapy. CONCLUSION Currently, there is evidence that treatment with CUR applied as irrigant or in conjunction with the blue LED as aPDT presents superior clinical results in the short term, for clinical periodontics parameters like as PD reduction and CAL gain, when compared to SRP monotherapy in the non-surgical treatment of periodontitis. However, these results cannot be proven in the long term.
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Affiliation(s)
- Eduardo Quintão Manhanini Souza
- Department of Diagnostic and Surgery, School of Dentistry of Araçatuba, São Paulo State University (UNESP), Araçatuba, SP, Brazil.
| | - Tiago Esgalha da Rocha
- Department of Diagnostic and Surgery, School of Dentistry of Araçatuba, São Paulo State University (UNESP), Araçatuba, SP, Brazil.
| | - Luan Felipe Toro
- Institute of Biosciences of Botucatu - IBB (UNESP), Botucatu, SP, Brazil.
| | | | | | - Edilson Ervolino
- Department of Basic Sciences, School of Dentistry of Araçatuba, São Paulo State University (UNESP), Araçatuba, SP, Brazil.
| | - Daniela Atili Brandini
- Department of Diagnostic and Surgery, School of Dentistry of Araçatuba, São Paulo State University (UNESP), Araçatuba, SP, Brazil.
| | - Valdir Gouveia Garcia
- Latin American Institute of Dental Research and Education (ILAPEO), Curitiba, PR, Brazil.
| | - Letícia Helena Theodoro
- Department of Diagnostic and Surgery, School of Dentistry of Araçatuba, São Paulo State University (UNESP), Araçatuba, SP, Brazil.
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18
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Zhao Y, Pu R, Qian Y, Shi J, Si M. Antimicrobial photodynamic therapy versus antibiotics as an adjunct in the treatment of periodontitis and peri-implantitis: A systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2021; 34:102231. [PMID: 33621702 DOI: 10.1016/j.pdpdt.2021.102231] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Revised: 01/29/2021] [Accepted: 02/16/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Clinical efficacy of antimicrobial photodynamic therapy (aPDT) as compared to antibiotics in periodontitis and peri-implantitis has been tested in several clinical trials. Yet controversial results were reported. The aim of the present study was to answer the question: "Will adjunctive antimicrobial photodynamic therapy be more effective than antibiotics agent in the treatment of periodontitis and peri-implantitis?". METHODS Publications compared outcomes between aPDT and antibiotics in adult patients with periodontitis or peri-implantitis, containing more than 3-month follow-up duration, were involved in the systematic review and meta-analysis. PubMed, EMBASE and Cochrane Central were searched until December of 2020. Clinical parameters including pocket probing depth (PPD), clinical attachment level (CAL), and bleeding on probing (BOP) were evaluated. The risk of bias was assessed by Cochrane Collaboration Tool. Weighted mean differences (WMD), 95 % confidence interval(CI) and heterogeneity were estimated by Review Manager software. RESULTS 10 trials in periodontitis and 5 trials in peri-implantitis were included. Meta-analysis outcomes revealed equal clinical evidence for aPDT and antibiotics in periodontitis and peri-implantitis. In addition, aPDT significantly reduced the red complex in both diseases. However, owing to the heterogeneity of protocols in articles and the limited number of studies, the comparative conclusion remained unconfirmed. CONCLUSION aPDT can be considered as an alternative to antibiotics in the treatment of peri-implantitis and periodontitis. Given that high heterogeneity in outcome was found in this review, future long-term clinical trials with standard aPDT and antibiotic treatment should be tested to arrive at a firm conclusion.
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Affiliation(s)
- Yuxin Zhao
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China
| | - Rui Pu
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China
| | - Yinjie Qian
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China
| | - Jue Shi
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China
| | - Misi Si
- The Affiliated Hospital of Stomatology, School of Stomatology, Zhejiang University School of Medicine, and Key Laboratory of Oral Biomedical Research of Zhejiang Province, Hangzhou, Zhejiang, 310006, China.
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19
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Matsushima Y, Yashima A, Fukaya M, Shirakawa S, Ohshima T, Kawai T, Nagano T, Gomi K. Effects of Antimicrobial Photodynamic Therapy on Organic Solution and Root Surface In Vitro. Antibiotics (Basel) 2021; 10:101. [PMID: 33494221 PMCID: PMC7909815 DOI: 10.3390/antibiotics10020101] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/13/2021] [Accepted: 01/19/2021] [Indexed: 11/16/2022] Open
Abstract
Antimicrobial photodynamic therapy (a-PDT) is attracting attention as a new form of dental treatment. While it is primarily applied to produce an antibacterial effect, it decreases lipopolysaccharide (LPS) and protease activity. Here, we evaluated differences in the antibacterial activity of a-PDT on three types of bacteria and the effects on the organic substances (i.e., albumin and LPS). Furthermore, we investigated the effects of a-PDT on root surfaces. A FotoSan630® and toluidine blue were used to perform a-PDT in this study. We measured its antimicrobial activity against Porphyromonas gingivalis, Streptococcus mutans, and Enterococcus faecalis. Antimicrobial testing revealed strong antimicrobial action and P. gingivalis, E. faecalis, and S. mutans were almost undetectable after 50, 120, and 100 s, respectively. In organic resolution tests, albumin was significantly decreased from 1 min after a-PDT application onward, while LPS significantly decreased at 5 min after the application. The root surfaces after a-PDT were confirmed to be cleaner than the controls without suffering any damage. Depending on the bacterial species, a-PDT exhibited antimicrobial activity against various types of bacteria and sensitivity differed. Moreover, we reported that a-PDT resolves protein and LPS, enabling the formation of a healthy root surface without any damage.
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Affiliation(s)
- Yuji Matsushima
- Department of Periodontology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi ku, Yokohama 230-8501, Japan; (Y.M.); (A.Y.); (M.F.); (S.S.); (T.N.)
| | - Akihiro Yashima
- Department of Periodontology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi ku, Yokohama 230-8501, Japan; (Y.M.); (A.Y.); (M.F.); (S.S.); (T.N.)
| | - Meri Fukaya
- Department of Periodontology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi ku, Yokohama 230-8501, Japan; (Y.M.); (A.Y.); (M.F.); (S.S.); (T.N.)
| | - Satoshi Shirakawa
- Department of Periodontology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi ku, Yokohama 230-8501, Japan; (Y.M.); (A.Y.); (M.F.); (S.S.); (T.N.)
| | - Tomoko Ohshima
- Department of Oral Microbiology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi ku, Yokohama 230-8501, Japan; (T.O.); (T.K.)
| | - Tomomi Kawai
- Department of Oral Microbiology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi ku, Yokohama 230-8501, Japan; (T.O.); (T.K.)
| | - Takatoshi Nagano
- Department of Periodontology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi ku, Yokohama 230-8501, Japan; (Y.M.); (A.Y.); (M.F.); (S.S.); (T.N.)
| | - Kazuhiro Gomi
- Department of Periodontology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi ku, Yokohama 230-8501, Japan; (Y.M.); (A.Y.); (M.F.); (S.S.); (T.N.)
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