1
|
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.
Collapse
Affiliation(s)
- Shatha Subhi ALHarthi
- Department of Preventive Dental Sciences, College of Dentistry, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
| |
Collapse
|
2
|
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
|
3
|
Shetty B, Divakar DD, Jameel AHA, Almalki SA, Gowdar IM, Dewan H. Effect of non-surgical periodontal therapy with adjunct photodynamic therapy on periodontal and glycemic statuses in prediabetic patients with periodontal disease. Photodiagnosis Photodyn Ther 2023; 42:103362. [PMID: 36841278 DOI: 10.1016/j.pdpdt.2023.103362] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 02/19/2023] [Accepted: 02/21/2023] [Indexed: 02/27/2023]
Abstract
OBJECTIVE Studies have shown that non-surgical periodontal therapy (NSPT) helps reduce periodontal inflammation and glycemic levels in patients with type-2 diabetes mellitus; however, the role of NSPT with adjunct photodynamic therapy on glycemic status and periodontal parameters in prediabetic patients remains unclear. The aim of the present study was to assess the effect of NSPT with and without adjunct PDT on periodontal and glycemic statuses in prediabetic patients with periodontal disease. METHODS Prediabetic (Group-1) and non-diabetic (Group-2) patients diagnosed with periodontal inflammation were included. In both groups, patients were randomly assigned to test and control-groups. In the test- and control groups, patients underwent NSPT with and without adjunct PDT, respectively. The following parameters were assessed at baseline and at four weeks' follow-up: plaque index (PI); gingival index (GI), probing depth (PD), clinical attachment loss (CAL) and hemoglobin A1c (HbA1c). Collection of demographic data and assessment of full mouth marginal bone loss was performed at baseline. Level of significance was set at P < 0.05. RESULTS At baseline, there was no difference in PI, GI and PD among patients with and without prediabetes. At 3-weeks' follow up there was no difference in PI, GI and PD among patients without prediabetes. PI (P < 0.01), GI (P < 0.01) and PD (P < 0.01) were significantly higher in the control-group compared with the test-group at 3-weeks' follow-up in patients without prediabetes. The HbA1c levels were significantly higher in patients with prediabetes throughout the study duration compared with individuals without prediabetes. CONCLUSION One session of NSPT with or without PDT reduce periodontal inflammation but do not influence glycemic levels in prediabetic patients.
Collapse
Affiliation(s)
- Bharathraj Shetty
- Nitte (Deemed to be University), AB Shetty Memorial Institute of Dental Sciences, (ABSMIDS), Department of Prosthodontics and Crown & Bridge, Mangalore, India.
| | - Darshan Devang Divakar
- Department of Oral Medicine and Radiology, Sharavathi Dental College and Hospital, Shivamogga, Karnataka 577204, India; Department of Oral Medicine and Radiology, Faculty of Dentistry, Ministry of Health, Levy Mwanawasa Medical University (LMMU), Lusaka 10101, Zambia
| | - AlBandary Hassan Al Jameel
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, P. O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Sultan Abdulrahman Almalki
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin AbdulAziz University, P.O Box 173, Al-kharj 11942, Saudi Arabia
| | - Inderjit Murugendrappa Gowdar
- Department of Preventive Dental Sciences, College of Dentistry, Prince Sattam Bin AbdulAziz University, P.O Box 173, Al-kharj 11942, Saudi Arabia
| | - Harisha Dewan
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia
| |
Collapse
|
4
|
Short-term influence of antimicrobial photodynamic therapy as an adjuvant to mechanical debridement in reducing soft-tissue inflammation and subgingival yeasts colonization in patients with peri-implant mucositis. Photodiagnosis Photodyn Ther 2023; 42:103320. [PMID: 36737030 DOI: 10.1016/j.pdpdt.2023.103320] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/13/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The objective of this short-term follow-up study was to evaluate the influence of antimicrobial photodynamic therapy (aPDT) as an adjuvant to mechanical debridement (MD) in reducing soft-tissue inflammation and subgingival yeasts colonization (SYC) in patients with peri‑implant mucositis (PiM). METHODS Individuals diagnosed with PiM were included. Demographic data was collected using a questionnaire. Peri-implant plaque index (PI), bleeding index (BI), probing depth (PD), crestal bone levels and SYC were measured at baseline. Therapeutically, these individuals were divided into test and control groups. In the control-group patients underwent MD and in the test-group patients underwent MD with adjunct single session of aPDT. Clinical peri‑implant parameters and SYC were reassessed after 12-weeks. Correlation between age, gender and duration of implants with SYC and clinical peri‑implant status was assessed using logistic regression models. P < 0.05 was selected as an indicator of statistical significance. RESULTS The test and control-groups comprised of 24 and 23 individuals, respectively. In the test and control groups, toothbrushing twice daily was reported by 7 (29.2%) and 5 (21.7%) individuals, respectively. None of the individuals had ever used a dental floss. At baseline, there was no difference in peri‑implant PI, BI, PD and CBL in the test and control groups. At follow-up, peri‑implant PI (P < 0.01), BI (P < 0.01) and PD (P < 0.01) were significantly higher in the control compared with the test-group. At baseline, SYC in the test and control groups were 1865.3 ± 403.4 CFU/ml and 1963.7 ± 512.4 CFU/ml, respectively. At 90 days' follow-up, SYC in the test and control groups were 1472 ± 202.7 and 1538.4 ± 331.7 CFU/ml, respectively. There was no significant difference in SYC in both groups when baseline values were compared with 90 days' follow-up. CONCLUSION One session of aPDT after MC with adjunct aPDT is effective in reducing soft tissue inflammation but not SYC in patients with PiM.
Collapse
|
5
|
Periodontal status and whole salivary adipokines after scaling and root planing with and without adjunct antimicrobial photodynamic therapy in obese patients with periodontitis. Photodiagnosis Photodyn Ther 2022; 40:103112. [PMID: 36089266 DOI: 10.1016/j.pdpdt.2022.103112] [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: 08/23/2022] [Revised: 08/26/2022] [Accepted: 09/06/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Whole-salivary (WS) adiponectin and leptin levels after scaling and root planing (SRP) with and without antimicrobial-photodynamic-therapy (aPDT) in obese and normal-weight individuals with periodontitis remain uninvestigated. This study compared the effect of SRP without and with adjuvant aPDT on periodontal status and WS leptin and adiponectin levels (LAL) in obese patients with periodontitis. METHODS Groups 1 and 2 entailed obese patients without and with periodontitis. Groups 3 and 4 had normal weight individuals without and with periodontitis. Therapeutically, individuals with periodontitis were categorized into test- (SRP+aPDT) and control- (SRP alone) subgroups. All patients without periodontitis underwent routine dental prophylaxis. Clinical attachment loss (AL), gingival and plaque index (GI and PI), probing depth (PD), missing teeth (MT) and WS LAL were measured at baseline and at three months of follow-up. P<5% were graded statistically significant. RESULTS At baseline, clinicoradiographic variables were significantly higher among patients in test- and control-groups in groups 1 (P<0.01) and 3 (P<0.01) versus 2 and 4. In group 2 and 3, LL were significantly high at baseline compared with follow-up (P<0.01). There was no difference in periodontal parameters and WS adiponectin and LL in the test and control-groups at of follow-up. No correlation existed between salivary LAL and clinical periodontal parameters (PI, GI, PD and clinical AL). No correlation existed between age, gender and BMI and WS LAL. CONCLUSION In the short-term, SRP with or without aPDT is ineffective in the treatment of periodontitis in obese patients with periodontitis.
Collapse
|
6
|
Is a single session of antimicrobial photodynamic therapy as an adjuvant to non-surgical scaling and root planing effective in reducing periodontal inflammation and subgingival presence of Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans in patients with periodontitis? Photodiagnosis Photodyn Ther 2022; 38:102847. [PMID: 35367618 DOI: 10.1016/j.pdpdt.2022.102847] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The aim was to assess the influence of a single session of antimicrobial photodynamic therapy (aPDT) as an adjunct to non-surgical scaling and root planing (SRP) in reducing periodontal inflammation and subgingival presence of Porphyromonas gingivalis (P. gingivalis) and Aggregatibacter actinomycetemcomitans (A. actinomycetemcomitans) in patients with periodontitis. METHODS Patients diagnosed with periodontitis were included. Information regarding age and gender was recorded using a questionnaire. All patients underwent full mouth non-surgical SRP and the following parameters were assessed at baseline: (a) marginal bone loss (MBL); (b) probing depth (PD) (c) clinical attachment loss (CAL); and (d) presence of supra-and subgingival bleeding and plaque (GI and PI). Identification of A. actinomycetemcomitans and P. gingivalis was performed using polymerase chain reaction. For aPDT (test-group), methylene-blue (MB) (0.005%) was used as photosensitizer and it was applied over and inside the buccal pockets of teeth. Using a Diode laser at 660 nm and 150 mW, irradiation was performed All clinical parameters except for MBL and microbiological evaluations were re-assessed at 3-months of follow-up. Level of significance was set at P<0.05. RESULTS At 3-months of follow-up A. actinomycetemcomitans and P. gingivalis were identified in significantly lower number of patients in groups 1 and 2 compared with their respective baseline values. Number of patients in whom A. actinomycetemcomitans and P. gingivalis were identified at 3-months of follow-up were similar in both groups. At baseline, there was no statistically significant difference in PI, GI, PD, CAL and MBL among patients in groups 1 and 2. In groups 1 and 2, scores of PI (P<0.001), GI (P<0.001) and PD (P<0.001) were significantly higher at baseline compared with their respective 3-months' follow-up scores. CONCLUSION One application of aPDT with non-surgical SRP is ineffective in managing periodontal inflammation and presence of P. gingivalis and A. actinomycetemcomitans in periodontitis patients.
Collapse
|
7
|
Shetty B, Ali D, Ahmed S, Ibraheem WI, Preethanath RS, Vellappally S, Divakar DD. Role of antimicrobial photodynamic therapy in reducing subgingival oral yeasts colonization in patients with peri-implant mucositis. Photodiagnosis Photodyn Ther 2022; 38:102803. [DOI: 10.1016/j.pdpdt.2022.102803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 03/08/2022] [Accepted: 03/10/2022] [Indexed: 10/18/2022]
|
8
|
Alrefaie RM, John J, Alsiwat AJ, Ibraheem WI, Preethanath RS, Divakar DD. Efficacy of antimicrobial photodynamic therapy in reducing oral yeasts carriage among individuals using electronic nicotine delivery systems. Photodiagnosis Photodyn Ther 2022; 37:102724. [PMID: 35051663 DOI: 10.1016/j.pdpdt.2022.102724] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/07/2022] [Accepted: 01/14/2022] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The aim was to assess the efficacy of antimicrobial photodynamic therapy (aPDT) in reducing oral yeasts carriage among individuals using electronic nicotine delivery systems (ENDS). METHODS Self-reported ENDS users and non-users (individuals that reported to have never used any nicotinic product) were included. Demographic data was collected using a questionnaire. Patients were divided into 2 subgroups: (a) aPDT group; and (b) sham aPDT group. aPDT was performed using a curcumin-based photosensitizer that was exposed to a central wavelength of 660 nm and an estimated average fluency of 200 J/cm2. The system delivered light by uniform diffusion for 5 minutes. Sham aPDT was performed using a non-activated laser tip. Oral yeasts colony forming units were determined using standard techniques. Oral yeasts were assessed at baseline and at 3-months of follow-up. Level of significance was set at P<0.05. RESULTS Twenty-three ENDS-users (19 males and 4 females) and 23 controls (17 males and 6 females) were included. ENDS-users were vaping for 8.3 ± 0.6 years and were using their ENDS devices 13.6 ± 2.7 times daily. Toothbrushing twice daily was reported by 8.7% and 21.7% of ENDS-users and controls, respectively. Tongue brushing was reported by none of the individuals. At baseline, oral yeasts CFU/ml were significantly higher among ENDS-users in the PDT (P<0.05) and sham PDT (P<0.05) groups compared with controls (Table 2; Figure 1). At 3-months of follow-up, CFU/ml were significantly higher among ENDS-users in the PDT (P<0.05) and sham PDT (P<0.05) groups compared with controls CONCLUSION: : A single session of aPDT is ineffective in reducing the oral yeasts CFU/ml in ENDS-users. Further studies are needed to assess the impact of multiple sessions of aPDT in reducing the oral yeasts CFU/ml in ENDS-users.
Collapse
Affiliation(s)
| | - Jacob John
- Department of Dentistry, DM Wayanad Institute of Medical Sciences (DM WIMS), Meppadi, Kerala, India
| | - Areej Jaber Alsiwat
- Dental Health Department, College of Applied Medical Sciences, King Saud University, P.O. Box: 10219, Riyadh, 11433, Saudi Arabia
| | - Wael Ibraheem Ibraheem
- Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - Reghunathan S Preethanath
- Department of Oral Medicine and Radiology, Sharavathi Dental College and Hospital, Shivamogga, Karnataka 577204, India
| | - Darshan Devang Divakar
- Department of Oral Medicine and Radiology, Sharavathi Dental College and Hospital, Shivamogga, Karnataka 577204, India.; Department of Oral Medicine and Radiology, Faculty of Dentistry, Levy Mwanawasa Medical University (LMMU), Ministry of Health, Lusaka 10101, Zambia.
| |
Collapse
|
9
|
Abdulkareem A, Abdulbaqi H, Gul S, Milward M, Chasib N, Alhashimi R. Classic vs. Novel Antibacterial Approaches for Eradicating Dental Biofilm as Adjunct to Periodontal Debridement: An Evidence-Based Overview. Antibiotics (Basel) 2021; 11:antibiotics11010009. [PMID: 35052887 PMCID: PMC8773342 DOI: 10.3390/antibiotics11010009] [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: 11/13/2021] [Revised: 12/10/2021] [Accepted: 12/20/2021] [Indexed: 12/14/2022] Open
Abstract
Periodontitis is a multifactorial chronic inflammatory disease that affects tooth-supporting soft/hard tissues of the dentition. The dental plaque biofilm is considered as a primary etiological factor in susceptible patients; however, other factors contribute to progression, such as diabetes and smoking. Current management utilizes mechanical biofilm removal as the gold standard of treatment. Antibacterial agents might be indicated in certain conditions as an adjunct to this mechanical approach. However, in view of the growing concern about bacterial resistance, alternative approaches have been investigated. Currently, a range of antimicrobial agents and protocols have been used in clinical management, but these remain largely non-validated. This review aimed to evaluate the efficacy of adjunctive antibiotic use in periodontal management and to compare them to recently suggested alternatives. Evidence from in vitro, observational and clinical trial studies suggests efficacy in the use of adjunctive antimicrobials in patients with grade C periodontitis of young age or where the associated risk factors are inconsistent with the amount of bone loss present. Meanwhile, alternative approaches such as photodynamic therapy, bacteriophage therapy and probiotics showed limited supportive evidence, and more studies are warranted to validate their efficiency.
Collapse
Affiliation(s)
- Ali Abdulkareem
- College of Dentistry, University of Baghdad, Medical City of Baghdad, Baghdad 10011, Iraq; (H.A.); (N.C.); (R.A.)
- Correspondence:
| | - Hayder Abdulbaqi
- College of Dentistry, University of Baghdad, Medical City of Baghdad, Baghdad 10011, Iraq; (H.A.); (N.C.); (R.A.)
| | - Sarhang Gul
- College of Dentistry, University of Sulaimani, Sulaymaniyah 40062, Iraq;
| | - Mike Milward
- College of Dentistry, University of Birmingham, Birmingham B5 7EG, UK;
| | - Nibras Chasib
- College of Dentistry, University of Baghdad, Medical City of Baghdad, Baghdad 10011, Iraq; (H.A.); (N.C.); (R.A.)
| | - Raghad Alhashimi
- College of Dentistry, University of Baghdad, Medical City of Baghdad, Baghdad 10011, Iraq; (H.A.); (N.C.); (R.A.)
| |
Collapse
|
10
|
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.
Collapse
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.
| |
Collapse
|
11
|
Tan OL, Safii SH, Razali M. Clinical Efficacy of Repeated Applications of Local Drug Delivery and Adjunctive Agents in Nonsurgical Periodontal Therapy: A Systematic Review. Antibiotics (Basel) 2021; 10:1178. [PMID: 34680759 PMCID: PMC8532920 DOI: 10.3390/antibiotics10101178] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 09/20/2021] [Accepted: 09/24/2021] [Indexed: 01/19/2023] Open
Abstract
The aim of this systematic review is to compare the clinical efficacy of repeated applications of local drug delivery and adjunctive agents (LDAs) in nonsurgical periodontal therapy (NSPT) compared to subgingival mechanical debridement (SMD) alone. The Cochrane Central Register of Controlled Trials, MEDLINE, PubMed, EMBASE, Web of Science, hand-searched literature and grey literature databases were searched for randomized controlled clinical trials (RCTs) with a minimum of 6-month follow-up. The outcomes of interest were changes in probing pocket depth and clinical attachment level as well as patient-centred outcomes. Of 1094 studies identified, 16 RCTs were included in the qualitative analysis. Across 11 different adjuncts analysed, only two studies utilizing minocycline gel/ointment and antimicrobial photodynamic therapy (aPDT) with indocyanine green photosensitizer had statistically significant differences in primary outcomes when compared to their control groups. Only one study on aPDT methylene blue 0.005% had compared single versus multiple applications against its control group. A mean range of 0.27-3.82 mm PD reduction and -0.09-2.82 mm CAL gain were observed with repeated LDA application. Considerable clinical heterogeneity and methodological flaws in the included studies preclude any definitive conclusions regarding the clinical efficacy of repeated LDA applications. Future RCTs with a direct comparison between single and repeated applications should be conducted to confirm or refute the clinical advantages of repeated LDA application in the nonsurgical management of periodontitis.
Collapse
Affiliation(s)
- Oi Leng Tan
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
- Oral Health Division, Ministry of Health Malaysia, Putrajaya 62590, Malaysia
| | - Syarida Hasnur Safii
- Department of Restorative Dentistry, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Malaysia;
| | - Masfueh Razali
- Department of Restorative Dentistry, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| |
Collapse
|
12
|
Al-Askar MH, Abdullatif FA, Alshihri AA, Ahmed A, Divakar DD, Almoharib H, Alzoman H. Comparison of photobiomodulation and photodynamic therapy as adjuncts to mechanical debridement for the treatment of peri-implantitis. Technol Health Care 2021; 30:389-398. [PMID: 34250918 DOI: 10.3233/thc-213062] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND OBJECTIVE The aim of this study was to compare the efficacy of photobiomodulation therapy (PBMT) and photodynamic therapy (PDT) as adjuncts to mechanical debridement (MD) for the treatment of peri-implantitis. The present study is based on the null hypothesis that there is no difference in the peri-implant inflammatory parameters (modified plaque index [mPI], modified gingival index [mGI], probing depth [PD]) and crestal bone loss (CBL) following MD either with PBMT or PDT in patients with peri-implantitis. METHODS Forty-nine patients with peri-implantitis were randomly categorized into three groups. In Groups 1 and 2, patients underwent MD with adjunct PBMT and PDT, respectively. In Group 3, patients underwent MD alone (controls). Peri-implant inflammatory parameters were measured at baseline and 3-months follow-up. P-values < 0.01 were considered statistically significant. RESULTS At baseline, peri-implant clinicoradiographic parameters were comparable in all groups. Compared with baseline, there was a significant reduction in mPI (P< 0.001), mGI (P< 0.001) and PD (P< 0.001) in Groups 1 and 2 at 3-months follow-up. In Group 3, there was no difference in the scores of mPI, mGI and PD at follow-up. At 3-months follow-up, there was no difference in mPI, mGI and PD among patients in Groups 1 and 2. The mPI (P< 0.001), mGI (P< 0.001) and PD (P< 0.001) were significantly higher in Group 3 than Groups 1 and 2. The CBL was comparable in all groups at follow-up. CONCLUSION PBMT and PDT seem to be useful adjuncts to MD for the treatment of peri-implant soft-tissue inflammation among patients with peri-implantitis.
Collapse
Affiliation(s)
- Mansour H Al-Askar
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Fahad A Abdullatif
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Abdulmonem A Alshihri
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Asma Ahmed
- Department of Dentistry, VPS Healthcare, Abu Dhabi, United Arab Emirates.,Department of Laser Dentistry, RWTH Aachen University, Aachen, Germany
| | - Darshan Devang Divakar
- Dental Biomaterials Research Chair, Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Hani Almoharib
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| | - Hamad Alzoman
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
| |
Collapse
|
13
|
Labban N, Shibani NA, Al-Kattan R, Alfouzan AF, Binrayes A, Assery MK. Clinical, bacterial, and inflammatory outcomes of indocyanine green-mediated photodynamic therapy for treating periimplantitis among diabetic patients: A randomized controlled clinical trial. Photodiagnosis Photodyn Ther 2021; 35:102350. [PMID: 34033934 DOI: 10.1016/j.pdpdt.2021.102350] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 04/14/2021] [Accepted: 05/14/2021] [Indexed: 12/20/2022]
Abstract
Background This 6-months randomized controlled clinical trial aimed to assess the efficacy of indocyanine green mediated photodynamic therapy (ICG-PDT) as an adjunct to peri‑implant manual debridement (PIMD) versus PIMD alone among Diabetes Mellitus (DM) patients in the treatment of peri‑implantitis. Methods A total of 48 DM patients having 64 implants were treated with either ICG-PDT + PIMD (n = 35 implants) or PIMD alone (n = 29 implants). Clinical (probing depth [PD], bleeding on probing [BOP], and plaque index [PI]) and radiographic (peri‑implant crestal bone loss [PCBL]) peri‑implant variables were recorded. Bacterial species including Porphyromonas gingivalis and Treponema denticola were evaluated from peri‑implant plaque biofilms. Levels of interleukin (IL)-1β and IL-6 were assessed after the collection of peri‑implant sulcular fluid. All the evaluations were carried out at baseline, 3- and 6-months. The significance level was set to p < 0.05. Results All clinical parameters significantly reduced within both treatment groups (P<0.05). Intra-group comparison indicates that there was statistically significant reduction in PD and suppuration for ICG-PDT group (P<0.05). There was a statistically significant difference in the BOP between ICG-PDT and PIMD groups at both follow-up periods (P<0.001). However, there was a significant difference for PD (P = 0.001), suppuration (P = 0.01), and PCBL (P = 0.04) on 6 months follow-up between ICG-PDT and PIMD groups, respectively. Only ICG-PDT showed a significant reduction in P. gingivalis and T. denticola on both 3 months and 6 months follow-up compared to baseline. PIMD showed a statistically significant reduction only on 3 months follow-up compared to baseline. This reduction was maintained for both the species when dental implants were treated with ICG-PDT. However, PIMD failed to maintain this reduction until 6 months. Only at 3 months assessment that both treatment groups showed statistically significant reduction in IL-1β and IL-6 with no significant difference between the groups. Both biomarkers failed to maintain the reduction in both groups and significantly increased levels for IL-1β was noted at 6 months follow up Conclusion Multiple application of indocyanine-green mediated photodynamic therapy resulted in improved clinical and microbial parameters among type 2 DM subjects in the treatment of peri‑implantitis. This clinical trial was registered in the ClinicalTrials.gov Protocol Registration and Results System with registration record number: NCT04833569.
Collapse
Affiliation(s)
- Nawaf Labban
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University. P. O. Box 60169, Riyadh 11545, Saudi Arabia.
| | - Nouf Al Shibani
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University. P. O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Reem Al-Kattan
- Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University. P. O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Afnan F Alfouzan
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University. P. O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Abdulaziz Binrayes
- Department of Prosthetic Dental Sciences, College of Dentistry, King Saud University. P. O. Box 60169, Riyadh 11545, Saudi Arabia
| | - Mansour K Assery
- Department of Prosthodontics, Riyadh Elm University, Riyadh, Saudi Arabia
| |
Collapse
|
14
|
Role of antimicrobial photodynamic therapy in reducing whole salivary oral yeasts colonization in type-2 diabetic and non-diabetic patients with and without dental implants. Photodiagnosis Photodyn Ther 2021; 33:102183. [PMID: 33454393 DOI: 10.1016/j.pdpdt.2021.102183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Revised: 12/31/2020] [Accepted: 01/08/2021] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The aim was to assess the impact of antimicrobial photodynamic therapy (aPDT) in reducing whole salivary oral yeasts colonization in type-2 diabetic and non-diabetic patients with dental implants. METHODS Type-2 diabetic and self-reported non-diabetic patients were included. Participants were divided into the following groups: Group-1: Type-2 diabetic patients with dental implants; Group-2: Non-diabetic patients with dental implants; Group-3: Type-2 diabetic patients without dental prostheses; Group-4: Non-diabetic patients without dental prostheses. In each group, participants were subdivided into 2-sub-groups. In the test-subgroup, participants received routine oral hygiene maintenance instructions (OHMI) and underwent full mouth disinfection using aPDT; and in the control-group, participants received OHMI alone. Unstimulated whole saliva samples were collected, hemoglobin A1c levels were measured and yeast colonization was assessed at baseline and at 3-months' follow-up in all groups. Sample-size estimation was done and group-comparisons were done. P-values <0.01 were considered statistically significant. RESULTS At baseline, the mean oral yeasts colonization was significantly higher among patients in Group-1 (P < 0.001) and 3 (P < 0.001) compared with individuals in groups 2 (P < 0.001) and 4 (P < 0.001). At baseline and at 3-months of follow-up, the mean HbA1c levels and oral yeasts colonization were significantly higher among patients in Group-1 (P < 0.001) and 3 (P < 0.001) compared with individuals in groups 2 (P < 0.001) and 4 (P < 0.001). CONCLUSION In the short-term, routine OHMI with adjunct aPDT is more effective in reducing whole salivary oral yeasts counts than OHMI alone in patients with and without dental implants.
Collapse
|