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Bahrami R, Pourhajibagher M, Gharibpour F. Antimicrobial photodynamic therapy for the management of gingivitis and white spot lesions in fixed orthodontic patients: A systematic review. Int Orthod 2024; 22:100821. [PMID: 37992475 DOI: 10.1016/j.ortho.2023.100821] [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: 09/06/2023] [Revised: 10/04/2023] [Accepted: 10/13/2023] [Indexed: 11/24/2023]
Abstract
AIM We conducted this review to evaluate the safety and efficacy of antimicrobial photodynamic therapy (aPDT) for the management of gingivitis and white spot lesions (WSLs) in fixed orthodontic patients. METHODS The PubMed/MEDLINE, Cochrane Library, Scopus, and Google Scholar databases were searched for randomized controlled trials and clinical trials assessing the clinical effectiveness of aPDT for the management of gingivitis and WSLs in fixed orthodontic patients without time limitation. Primary outcomes were the changes in clinical parameters such as DIAGNOdent, plaque index (PI), bleeding on probing (BOP), and gingival index (GI). Secondary outcomes included measurements of microbial and inflammatory factors, such as cytokine levels (tumor necrosis factor alpha [TNF-α], interleukin-1 beta [IL-1β], and interleukin-6 [IL-6]), and bacterial counts. RESULTS Our search yielded a total of 12 studies that met the inclusion criteria. Among the 11 studies that evaluated gingivitis, the majority employed a diode laser (670nm, 150 mW, 22J/cm2, 60seconds) as the light source and methylene blue at a concentration of 0.0005% (applied for 3minutes) as the photosensitizer in a single treatment session. The included studies reported positive effects of aPDT on gingivitis management, with more improvements observed in PI, BOP, and GI following aPDT treatment. Additionally, aPDT was found to reduce the counts of periopathogens such as Porphyromonas gingivalis, as well as inflammatory factors (TNF-α, IL-1β, and IL-6). Two studies demonstrated that aPDT, particularly when administered in multiple sessions, effectively controlled the extent of WSLs during orthodontic treatment and yielded favorable outcomes that persisted for several months after treatment. CONCLUSION Based on the available evidence, aPDT appears to be a safe and effective treatment option for managing WSLs and gingivitis in patients with fixed orthodontic appliances. However, further high-quality RCTs are necessary to investigate the impact of potential confounding factors on the efficacy of aPDT.
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Affiliation(s)
- Rashin Bahrami
- Dental Sciences Research Center, Department of Orthodontics, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran.
| | - Maryam Pourhajibagher
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fateme Gharibpour
- Dental Sciences Research Center, Department of Orthodontics, School of Dentistry, Guilan University of Medical Sciences, Rasht, Iran.
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Shafaee H, Asgari R, Bardideh E, Rangrazi A, Sedigh S, Kerayechian N. The effects of low-level laser therapy and photodynamic therapy on oral health of fixed orthodontics patients. A systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2023; 44:103759. [PMID: 37604216 DOI: 10.1016/j.pdpdt.2023.103759] [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: 06/24/2023] [Revised: 07/23/2023] [Accepted: 08/18/2023] [Indexed: 08/23/2023]
Abstract
Objective To investigate the effect of low-level laser and photodynamic therapy on the oral health, and periodontal tissue of fixed orthodontic patients and the effect of using photobiomodulation methods compared to routine plaque removal methods and the amount of plaque in fixed orthodontic patients. Method and materials First, the title and summary of related articles were collected by using the search strategy electronic databases PUBMED, EMBASE, Cochrane's CENTRAL, Scopus, ISI and all the articles that were published from the beginning to February 2023 were evaluated. The title, abstracts and full texts of all the relevant studies were reviewed respectively, and those meeting the criteria were entered into our study. Finally, the quality of the studies was examined and the results of the studies were pooled by means of random effects inverse variance meta-analysis. Results Eighteen randomized studies, conducted between 2015 and December 2022, were selected for meta-analysis. Five studies were conducted as split-mouth, twelve as parallel-group, and one as a cross-over design. Among the studies, five examined the effects of low-level laser therapy and twelve assessed the effects of photodynamic therapy. The meta-analysis revealed that photodynamic therapy significantly reduced probing depth compared to scaling (MD=-0.2 mm, P<0.001), though the difference does not seem to be clinically significant. But no significant differences between photodynamic therapy and scaling or low-level laser therapy and control groups in terms of plaque index, or bleeding on probing, gingival crevicular fluid volume, gingival recession, clinical attachment loss, bacterial load and concentrations of inflammatory substances across multiple follow-up periods. Conclusion Moderate evidence indicates that photodynamic therapy (PDT) is comparable to conventional methods in improving oral health, as measured by periodontal indices, inflammatory proteins, bacterial colonies, and white spot lesions, making it a suitable alternative. Limited evidence suggests low-level laser therapy (LLLT) may improve oral health, particularly addressing caries, but further research is needed.
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Affiliation(s)
- Hooman Shafaee
- Dental Materials Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Erfan Bardideh
- Department of Orthodontics, Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad blvd, Mashhad, Iran.
| | - Abdolrasoul Rangrazi
- Department of Orthodontics, Dental Research Center, School of Dentistry, Mashhad University of Medical Sciences, Vakilabad blvd, Mashhad, Iran
| | - Sadaf Sedigh
- Student of Dentistry, University of Pittsburgh School of Dental Medicine, PA, USA
| | - Navid Kerayechian
- Department of Biomaterials and Biomimetics, New York University, New York, NY, USA
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Silva T, Lunardi AJL, Barros ACSM, Mandetta ARH, Grudzien E, San-Martín M, Horliana ACRT, Bussadori SK, Motta LJ. Application of Photodynamic Therapy in Pediatric Dentistry: Literature Review. Pharmaceutics 2023; 15:2335. [PMID: 37765303 PMCID: PMC10537059 DOI: 10.3390/pharmaceutics15092335] [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: 08/07/2023] [Revised: 08/29/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Microbiological control of dental pathologies presents a significant clinical challenge for dental surgeons, particularly considering drug-resistant microorganisms. To address this issue, Antimicrobial Photodynamic Therapy (PDT) has emerged as an effective and complementary technique for microbial reduction. This therapy involves the application of a photosensitizer dye (PS) either topically or systemically, followed by exposure to low-power lasers with appropriate visible light wavelengths. PDT has found a valuable place in dentistry across various specialties, including surgery, periodontics, endodontics, dentistry, implantology, orthodontics, and pediatrics. In the realm of pediatric dentistry, managing microorganisms during dental treatments has become a major challenge. Considering its promising results and ease of application, Photodynamic Therapy presents an interesting alternative for clinical practice. However, it is important to note that specific protocols must be followed for each application, encompassing the type of photosensitizer, concentration, pre-irradiation time, light type, wavelength, energy, power, and mode of light delivery. Researchers have been steadily refining these protocols to facilitate PDT's integration into clinical practice. The objective of this review is to describe in which procedures and oral health problems in children PDT can be applied. In this sense, we list what the literature brings about the possibilities of applying PDT in a pediatric dentistry clinic.
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Affiliation(s)
- Tamiris Silva
- Postgraduate Program in Biophotonics Applied to the Health Sciences, Nove de Julho University, São Paulo 01525-000, SP, Brazil (S.K.B.)
| | - Ana Júlia Lacerda Lunardi
- Postgraduate Program in Biophotonics Applied to the Health Sciences, Nove de Julho University, São Paulo 01525-000, SP, Brazil (S.K.B.)
| | | | - Amanda Rafaelly Honório Mandetta
- Postgraduate Program in Biophotonics Applied to the Health Sciences, Nove de Julho University, São Paulo 01525-000, SP, Brazil (S.K.B.)
| | - Elizabeth Grudzien
- Departamento de Bienestar y Salud, Universidad Católica del Uruguay, Av. 8 de Octubre 2738, Montevideo 11600, Uruguay
| | - Magdalena San-Martín
- Departamento de Bienestar y Salud, Universidad Católica del Uruguay, Av. 8 de Octubre 2738, Montevideo 11600, Uruguay
| | | | - Sandra Kalil Bussadori
- Postgraduate Program in Biophotonics Applied to the Health Sciences, Nove de Julho University, São Paulo 01525-000, SP, Brazil (S.K.B.)
| | - Lara Jansiski Motta
- Postgraduate Program in Biophotonics Applied to the Health Sciences, Nove de Julho University, São Paulo 01525-000, SP, Brazil (S.K.B.)
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Du Y, Zhao F, Tao R, Liu B. Effect of forceful suction and air disinfection machines on aerosol removal. BMC Oral Health 2023; 23:652. [PMID: 37684672 PMCID: PMC10492290 DOI: 10.1186/s12903-023-03369-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
BACKGROUNDS Dental procedures involving drilling and grinding can produce a significant amount of suspended aerosol particles (PM) and bioaerosols. This study aims to analyze the size and concentration of aerosol particles generated during drilling and to investigate the effectiveness of two air exchange systems, namely forceful suction (FS) and air disinfection machines (DM), in removing PM. METHODS For this study, 100 extracted permanent teeth were collected and divided into three groups: without suction (n = 50), suction with forceful suction (n = 25), and suction with air disinfection machines (n = 25). The removal rate of suspended aerosol particles was analyzed using particle counters and air data multimeter. RESULTS When drilling and grinding were performed without vacuum, 0.75% of the aerosol particles generated were PM2.5-10, 78.25% of total suspended aerosol particles (TSP) were PM2.5, and 98.68% of TSP were PM1. The nanoanalyzer measurements revealed that the aerodynamic diameter of most aerosol particles was below 60 nm, with an average particle diameter of 52.61 nm and an average concentration of 2.6*1011 ultrafine aerosol particles. The air change per hour (ACH) was significantly lower in the air disinfection machines group compared to the forceful suction group. Additionally, the number of aerosol particles and mass concentration was significantly lower in the air disinfection machines group compared to the forceful suction group in terms of PM2.5 levels. However, the forceful suction group also reduced the mass concentration in PM10 level than the air disinfection machines group. CONCLUSION In conclusion, the air exchange system can reduce the aerosol particles generated during drilling and grinding. Comparing the two air exchange systems, it was found that the air disinfection machines group reduces the number of aerosol particles and mass concentration in PM2.5 levels, while the forceful suction group reduces the mass concentration in PM10 level.
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Affiliation(s)
- Yaru Du
- Department of hospital allergy, Medical department, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Fei Zhao
- Department of Periodontal I, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Ran Tao
- Medical department, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China
| | - Bing Liu
- Department of Periodontal I, Hebei Key Laboratory of Stomatology, Hebei Clinical Research Center for Oral Diseases, School and Hospital of Stomatology, Hebei Medical University, Shijiazhuang, 050017, PR China.
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Kara O, Seseogullari Dirihan R, Sayin Ozel G, Tezvergil Mutluay A, Usumez A. Inhibition of cathepsin-K and matrix metalloproteinase by photodynamic therapy. Dent Mater 2021; 37:e485-e492. [PMID: 34503836 DOI: 10.1016/j.dental.2021.08.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVES The objective of this study was to determine the effects of antimicrobial photodynamic therapy (aPDT) with indocyanine green (ICG) and toluidine blue (TB) on protease activity (matrix-bound cathepsin K and matrix metalloproteinase (MMP) and dentin bond strength. METHODS Caries-free human third molars were assigned to five groups: 1-control group, 2-application of ICG with activation using an 810 nm diode (aPDT), 3-application of ICG, 4-application of TB with activation using a 660 nm diode (aPDT), and 5-application of TB. For the enzymatic investigation, dentin beams were incubated for either 3 days or 3 weeks. Aliquots of the incubation media were analyzed by ELISA for CTX (C-terminal cross-linked telopeptide of type I Collagen) and ICTP (cross-linked carboxy-terminal telopeptide of type I collagen). For microtensile bond strength testing (μTBS), composite resins were layered onto the tooth surface; the samples were then subjected to μTBS. Kruskall-Wallis and Mann-Whitney U tests were applied for statistical analysis of CTX and ICTP, one way-ANOVA and Tukey's test were applied for statistical analysis of μTBS. RESULTS Pretreating the dentin matrices with aPDT decreased the endogenous protease activity. ICG with laser activation resulted in the highest μTBS. Therefore, aPDT should be considered as a treatment method because it can reduce MMP-mediated dentin degradation and increase the μTBS. SIGNIFICANCE Inhibiting endogenous protease activity improves the stability of the dentin-adhesive bond and the durability of the bond strength.
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Affiliation(s)
- Ozlem Kara
- Department of Prosthodontics, BezmialemVakif University, Faculty of Dentistry, Istanbul, Turkey.
| | - Roda Seseogullari Dirihan
- Adhesive Dentistry Research Group, Institute of Dentistry, University of Turku and TYKS, University of Turku Hospital, Turku, 20520, Finland.
| | - Gulsum Sayin Ozel
- Department of Prosthodontics, Faculty of Dentistry, Istanbul Medipol University, Istanbul, Turkey.
| | - Arzu Tezvergil Mutluay
- Adhesive Dentistry Research Group, Institute of Dentistry, University of Turku and TYKS, University of Turku Hospital, Turku, 20520, Finland.
| | - Aslihan Usumez
- Private Practicer, Dental Plus Clinic Bakirkoy, Istanbul, Turkey.
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