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Karuppan Perumal MK, Rajan Renuka R, Manickam Natarajan P. Evaluating the potency of laser-activated antimicrobial photodynamic therapy utilizing methylene blue as a treatment approach for chronic periodontitis. FRONTIERS IN ORAL HEALTH 2024; 5:1407201. [PMID: 38872983 PMCID: PMC11169725 DOI: 10.3389/froh.2024.1407201] [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: 03/26/2024] [Accepted: 05/15/2024] [Indexed: 06/15/2024] Open
Abstract
Chronic periodontitis is a ubiquitous inflammatory disease in dental healthcare that is challenging to treat due to its impact on bone and tooth loss. Conventional mechanical debridement has been challenging in eliminating complex subgingival biofilms. Hence, adjunctive approaches like low-level laser antimicrobial photodynamic therapy (A-PDT) utilising methylene blue (MB) have been emerging approaches in recent times. This review evaluates the latest research on the use of MB-mediated A-PDT to decrease microbial count and enhance clinical results in chronic periodontitis. Studies have shown the interaction between laser light and MB generates a phototoxic effect thereby, eliminating pathogenic bacteria within periodontal pockets. Moreover, numerous clinical trials have shown that A-PDT using MB can reduce probing depths, improve clinical attachment levels, and decrease bleeding during probing in comparison to traditional treatment approaches. Notably, A-PDT shows superior antibiotic resistance compared to conventional antibiotic treatments. In conclusion, the A-PDT using MB shows promise as an adjunctive treatment for chronic periodontitis. Additional research is required to standardize treatment protocols and assess long-term outcomes of A-PDT with MB in the treatment of periodontitis.
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Affiliation(s)
- Manoj Kumar Karuppan Perumal
- Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Remya Rajan Renuka
- Center for Global Health Research, Saveetha Medical College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Prabhu Manickam Natarajan
- Department of Clinical Sciences, College of Dentistry, Centre of Medical and Bio-Allied Health Sciences and Research, Ajman University, Ajman, United Arab Emirates
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Cláudio MM, Garcia VG, Freitas RM, Rodrigues JVS, Wainwright M, Casarin RCV, Duque C, Theodoro LH. Association of active oxygen-releasing gel and photodynamic therapy in the treatment of residual periodontal pockets in type 2 diabetic patients: A randomized controlled clinical study. J Periodontol 2024; 95:360-371. [PMID: 38112075 DOI: 10.1002/jper.23-0125] [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: 02/24/2023] [Revised: 08/14/2023] [Accepted: 09/18/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the effect of active oxygen-releasing gel as an adjuvant, with and without antimicrobial photodynamic therapy (aPDT), in the treatment of residual pockets in periodontal patients with type 2 diabetes mellitus (DM2). METHODS Patients with residual pockets with probing depth (PD) ≥4 mm and bleeding on probing (BOP) were divided into the following groups: SI (n = 17)-subgingival instrumentation in a single session; BM (n = 17)-SI followed by local application of active oxygen-releasing gel inside the periodontal pocket for 3 min; BM + aPDT (n = 17)-SI followed by application of BM for 3 min and pocket irrigation with methylene blue, and 660-nm diode laser irradiation at 100 mW for 50 s. The periodontal clinical parameters, serum levels of glycated hemoglobin, and immunological analysis of crevicular fluid were evaluated. All data were submitted to statistical analysis (α = 5%). RESULTS A significant reduction in BOP was verified at 90 and 180 days in the BM + aPDT group. The percentage of sites with PD ≥ 4 mm was significantly reduced at 90 days in BM + aPDT and BM, whereas after 180 days only BM showed a significant reduction. In the BM + aPDT group, there was a significant reduction in tumor necrosis factor α levels at 90 days. There were no differences between the treatments. CONCLUSION The use of adjuvant active oxygen-releasing gel, with or without aPDT, resulted in the same clinical benefits as SI in the treatment of residual pockets in poorly controlled DM2 patients.
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Affiliation(s)
- Marina M Cláudio
- Department of Diagnostics and Surgery, Periodontics Division, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Valdir G Garcia
- Latin American Institute of Dental Research and Teaching (ILAPEO), Curitiba, PR, Brazil
| | - Rubens M Freitas
- Latin American Institute of Dental Research and Teaching (ILAPEO), Curitiba, PR, Brazil
| | - João Victor S Rodrigues
- Department of Diagnostics and Surgery, Periodontics Division, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
- Center for Dental Assistance to Persons with Disabilities (CAOE), School of Dentistry, Araçatuba, SP, Brazil
| | - Mark Wainwright
- Department of Biology, Edge Hill University, Ormskirk, Lancashire, UK
| | - Renato C V Casarin
- Department of Periodontics, State University of Campinas, Piracicaba, SP, Brazil
| | - Cristiane Duque
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Leticia H Theodoro
- Department of Diagnostics and Surgery, Periodontics Division, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
- Center for Dental Assistance to Persons with Disabilities (CAOE), School of Dentistry, Araçatuba, SP, Brazil
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Yamaguchi Y, Yoshii D, Katsuragi H, Shinkai K. Effect of Laser Irradiation Modes and Photosensitizer Types on Antimicrobial Photodynamic Therapy (aPDT) for Streptococcus sobrinus in the Crown Dentin of Bovine Teeth: An Experimental In Vitro Study. Dent J (Basel) 2024; 12:59. [PMID: 38534283 DOI: 10.3390/dj12030059] [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: 10/20/2023] [Revised: 02/27/2024] [Accepted: 02/28/2024] [Indexed: 03/28/2024] Open
Abstract
This study aimed to assess the impact of different laser irradiation modes and photosensitizer types on the bactericidal efficacy of antimicrobial photodynamic therapy (aPDT). Dentin plates were prepared by sectioning the crown dentin of bovine teeth infected with Streptococcus sobrinus (n = 11). Nine aPDTs involving the combination of three 1% solutions of photosensitizers (brilliant blue, BB; acid red, AR; and methylene blue, MB) and three irradiation modes of semiconductor lasers (50 mW for 120 s, 100 mW for 60 s, and 200 mW for 30 s) were performed for each infected dentin plate, and the control consisted of the specimens not applied with aPDT. The bactericidal effects in 10 groups were evaluated using both assays of the colony count (colony-forming-unit: CFU) and adenosine triphosphate (ATP) (relative-light-unit: RLU). The data obtained were analyzed using the Kruskal-Wallis test (α = 0.05). The most aPDT groups exhibited significantly lower RLU and CFU values compared with the control (p < 0.05). The effect of irradiation modes on RLU and CFU values was significant in the aPDT group using BB (p < 0.05) but not in the aPDT group using AR or MB. The aPDT performed with AR or MB exerted a remarkable bactericidal effect.
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Affiliation(s)
- Yohei Yamaguchi
- Advance Operative Dentistry-Endodontics, The Nippon Dental University Graduate School of Life Dentistry at Niigata, 1-8 Hamauracho, Chuo-ku, Niigata 951-8580, Japan
| | - Daiki Yoshii
- Department of Operative Dentistry, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamauracho, Chuo-ku, Niigata 951-8580, Japan
| | - Hiroaki Katsuragi
- Research Center for Odontology, The Nippon Dental University School of Life Dentistry, 1-9-20 Fujimi, Chiyoda-ku, Tokyo 102-8159, Japan
| | - Koichi Shinkai
- Advance Operative Dentistry-Endodontics, The Nippon Dental University Graduate School of Life Dentistry at Niigata, 1-8 Hamauracho, Chuo-ku, Niigata 951-8580, Japan
- Department of Operative Dentistry, The Nippon Dental University School of Life Dentistry at Niigata, 1-8 Hamauracho, Chuo-ku, Niigata 951-8580, Japan
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Garcia VG, Rocha TED, Gomes NA, Miessi DMJ, Nuernberg MAA, Rodrigues JVS, Cardoso JDM, Ervolino E, Theodoro LH. Adjuvant effects of Saccharomyces cerevisiae in the treatment of experimental periodontitis in rats undergoing chemotherapy. J Appl Oral Sci 2023; 31:e20230135. [PMID: 37991087 DOI: 10.1590/1678-7757-2023-0135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Accepted: 09/17/2023] [Indexed: 11/23/2023] Open
Abstract
Surgical procedures, radiotherapy, and chemotherapy, individually or in association, are current oncological treatments. Among the most used chemotherapy drugs, 5-fluorouracil (5FU) is an antimetabolite with a broad spectrum of action. This study evaluated the effects of probiotics (PRO) as an adjuvant to the treatment of experimental periodontitis (EP) in rats immunosuppressed with 5FU.108 rats were randomly allocated to six different groups: EP; SS - systemic treatment with saline solution (SS); 5FU - systemic treatment with 5FU; 5FU+PRO - systemic treatment with 5FU, followed by the local administration of Saccharomyces cerevisiae ; 5FU+SRP - systemic treatment with 5-FU, followed by scaling and root planing (SRP); and 5FU+SRP+PRO - systemic treatment with 5FU followed by local treatments with SRP and PRO. Immunosuppression was obtained at two points: at the time of ligature installation and after 48 h. Six animals from each group were euthanized at seven, 15, and 30 d and hemimandibles were collected and processed for histopathological, histometric, and immunohistochemical analysis. Data were subjected to statistical analysis (α=5%). At 7 d, the 5FU+PRO group showed less bone resorption and better structured connective tissue compared with the EP, SS, 5FU+SRP, and 5FU+SRP+PRO groups. At 15 d, the 5FU+SRP group showed a greater intensity of the inflammatory response (p<0.05). At 30 d, the 5FU+SRP+PRO group showed better structured bone tissue and a higher percentage of bone tissue (PBT) than the EP, SS, 5FU, and 5FU+PRO groups (p<0.05). The use of Saccharomyces cerevisiae as monotherapy or as an adjuvant to periodontal therapy may have a positive effect on bone repair in immunosuppressed conditions.
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Affiliation(s)
- Valdir Gouveia Garcia
- Instituto Latino Americano de Pesquisa e Ensino Odontológico (ILAPEO), Curitiba , PR , Brasil
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba , Departamento de Diagnóstico e Cirurgia , Divisão Periodontia, Araçatuba , SP , Brasil
| | - Tiago Esgalha da Rocha
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba , Departamento de Diagnóstico e Cirurgia , Divisão Periodontia, Araçatuba , SP , Brasil
| | - Natália Amanda Gomes
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba , Departamento de Diagnóstico e Cirurgia , Divisão Periodontia, Araçatuba , SP , Brasil
| | - Daniela Maria Janjácomo Miessi
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba , Departamento de Diagnóstico e Cirurgia , Divisão Periodontia, Araçatuba , SP , Brasil
| | - Marta Aparecida Alberton Nuernberg
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba , Departamento de Diagnóstico e Cirurgia , Divisão Periodontia, Araçatuba , SP , Brasil
| | - João Victor Soares Rodrigues
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba , Departamento de Diagnóstico e Cirurgia , Divisão Periodontia, Araçatuba , SP , Brasil
| | | | - Edilson Ervolino
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba , Departamento de Ciências Básicas , Araçatuba , SP , Brasil
| | - Letícia Helena Theodoro
- Universidade Estadual Paulista (UNESP), Faculdade de Odontologia de Araçatuba , Departamento de Diagnóstico e Cirurgia , Divisão Periodontia, Araçatuba , SP , Brasil
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Harris DM, Sulewski JG. Photoinactivation and Photoablation of Porphyromonas gingivalis. Pathogens 2023; 12:1160. [PMID: 37764967 PMCID: PMC10535405 DOI: 10.3390/pathogens12091160] [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: 07/20/2023] [Revised: 08/31/2023] [Accepted: 09/02/2023] [Indexed: 09/29/2023] Open
Abstract
Several types of phototherapy target human pathogens and Porphyromonas gingivitis (Pg) in particular. The various approaches can be organized into five different treatment modes sorted by different power densities, interaction times, effective wavelengths and mechanisms of action. Mode 1: antimicrobial ultraviolet (aUV); mode 2: antimicrobial blue light (aBL); mode 3: antimicrobial selective photothermolysis (aSP); mode 4: antimicrobial vaporization; mode 5: antimicrobial photodynamic therapy (aPDT). This report reviews the literature to identify for each mode (a) the putative molecular mechanism of action; (b) the effective wavelength range and penetration depth; (c) selectivity; (d) in vitro outcomes; and (e) clinical trial/study outcomes as these elements apply to Porphyromonas gingivalis (Pg). The characteristics of each mode influence how each is translated into the clinic.
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Affiliation(s)
- David M. Harris
- Bio-Medical Consultants, Inc., Canandaigua, NY 14424, USA
- Department of Periodontics, Rutgers School of Dental Medicine, Newark, NJ 07103, USA
| | - John G. Sulewski
- Institute for Advanced Dental Technologies, Huntington Woods, MI 48070, USA
- Millennium Dental Technologies, Inc., Cerritos, CA 90703, USA
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Thankappan P, Gopalakrishnan D, Manandhar S. Emerging role of photodynamic therapy as an adjunct to nonsurgical periodontal therapy on periodontal status and glycemic control in patients with type 2 diabetes: A clinical study. J Indian Soc Periodontol 2023; 27:508-514. [PMID: 37781335 PMCID: PMC10538516 DOI: 10.4103/jisp.jisp_7_23] [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: 01/06/2023] [Revised: 05/15/2023] [Accepted: 05/19/2023] [Indexed: 10/03/2023] Open
Abstract
Background Periodontal disease is considered to be the sixth most common complication of diabetes mellitus (DM). Antibiotics (systemic and local) enhance the outcome of conventional mechanical debridement but frequent use of antimicrobials may develop resistance to microorganisms. To overcome this complicacy, the current study assessed the effectiveness of photodynamic therapy (PDT) in chronic periodontitis patients with type 2 diabetes when used as a combination therapy to standard periodontal therapy by assessing the various clinical and glycemic parameters. Materials and Methods A total of 16 known cases of chronic Periodontitis patients who were suffering from type 2 DM were allocated into two groups. The test group (n = 8) was treated with standard scaling and root planing (SRP) along with PDT while the control group was treated with SRP alone. Various clinical parameters assessed were plaque index, gingival index, pocket probing depth, clinical attachment level, and Glycated hemoglobin level at baseline and 90 days after therapy. Results At the end of the study, both the groups showed improvements with regard to all clinical and glycemic parameters compared to baseline. However, the test group presented statistically significant favorable results (all P < 0.05). Conclusion Conventional periodontal treatment aided with PDT proved to be a beneficial therapeutic measure and effective alternative in patients with chronic periodontitis with diabetes when compared with standard periodontal therapy alone.
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Affiliation(s)
- Prasanth Thankappan
- Department of Periodontology, Dr. D. Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Dharmarajan Gopalakrishnan
- Department of Periodontology, Dr. D. Y. Patil Dental College and Hospital, Dr. D.Y. Patil Vidyapeeth, Pune, Maharashtra, India
| | - Sumita Manandhar
- Department of Periodontology, Armed Forces Medical Colleges, Pune, Maharashtra, India
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Wu Z, Wang G, Li Z, Li Z, Huang D, Huang M, Lin M. Dental Bleaching with Phthalocyanine Photosensitizers: Effects on Dentin Color and Collagen Content. Molecules 2023; 28:molecules28104223. [PMID: 37241963 DOI: 10.3390/molecules28104223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/21/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
With the increasing demand for tooth bleaching in esthetic dentistry, its safety has been the focus of a comprehensive body of literature. In this context, the aim of the present study was to evaluate the application effects of pentalysine β-carbonylphthalocyanine zinc (ZnPc(Lys)5)-mediated photodynamic therapy in dentin bleaching and its effects on dentin collagen. We first established a new and reproducible tooth staining model using dentin blocks stained by Orange II and then bleached with ZnPc(Lys)5 (25 μM) and hydrogen peroxide (10% or 30%). Data were analyzed with one- and two-way ANOVA and a significance level of p < 0.05. ZnPc(Lys)5 effectively bleached the dentin samples to an extent comparable to hydrogen peroxide at either 10% or 30% concentrations. Further studies on the dentin morphology, chemical element distribution, and protein constituents, using an electron microscope, energy dispersive spectroscopy, X-ray photoelectron spectroscopy, and SDS-PAGE, demonstrated that treatment with the photosensitizer preserved the dentin structure and, at the same time, the major organic component, collagen type I. For comparison, hydrogen peroxide (10% or 30%) treatment significantly degraded the collagen protein. This work indicated that the photosensitizer exerts potent bleaching effects on dentin staining; importantly, does not damage dentin and its collagen content; and opens up a new strategy to further explore various photosensitizers for the bleaching of both tooth enamel and dentin.
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Affiliation(s)
- Zhouyan Wu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou 350002, China
- The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, 282 Wusi Road, Fuzhou 350003, China
| | - Guodong Wang
- College of Chemistry, Fuzhou University, 2 Xueyuan Road, Fuzhou 350108, China
| | - Zhiming Li
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou 350002, China
| | - Zhengquan Li
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou 350002, China
| | - Dandan Huang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou 350002, China
| | - Mingdong Huang
- College of Chemistry, Fuzhou University, 2 Xueyuan Road, Fuzhou 350108, China
| | - Minkui Lin
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China
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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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Laser treatments as an adjunct to non-surgical periodontal therapy in subjects with periodontitis and type 2 diabetes mellitus: a systematic review and meta-analysis. Clin Oral Investig 2023; 27:1311-1327. [PMID: 36849595 PMCID: PMC10101891 DOI: 10.1007/s00784-023-04873-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 01/22/2023] [Indexed: 03/01/2023]
Abstract
OBJECTIVES Periodontal disease and diabetes have an extensively investigated bidirectional correlation. Non-surgical periodontal treatment (NSPT) was proven to contribute to glycemic control. Moreover, it may benefit from the association of adjunctive therapies. The aim of the present systematic review is to assess the clinical efficacy of NSPT in association with laser (LT) or photodynamic therapy (PDT) in controlled or uncontrolled diabetic patients, and to grade the level of evidence. MATERIALS AND METHODS Randomized controlled clinical trials with at least 3-month follow-up were searched in MEDLINE via OVID, EMBASE, and Cochrane Central, screened for inclusion, and grouped based on the performed treatments, follow-up time, type of diabetes, and level of glycemic control. RESULTS Eleven RCTs with 504 total subjects were included. The adjunct of PDT showed a statistically significant 6-month difference in PD changes (with low certainty of evidence), but not in CAL changes, while a significant difference in 3-month PD and CAL changes was found with the adjunct of LT (low certainty of evidence). Patients treated with PDT registered a higher decrease in HbA1c levels at 3 months, but no significant difference was noted at 6 months; LT also led to better HbA1c changes at 3 months with a moderate certainty of evidence. CONCLUSION Despite the promising short-term HbA1c decrease, the results should be interpreted with caution due to the small effect sizes and the statistical heterogeneity, and further evidence from well-designed RCTs is needed to support the routine use of PDT or LT in adjunct to NSPT.
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Gholami L, Shahabi S, Jazaeri M, Hadilou M, Fekrazad R. Clinical applications of antimicrobial photodynamic therapy in dentistry. Front Microbiol 2023; 13:1020995. [PMID: 36687594 PMCID: PMC9850114 DOI: 10.3389/fmicb.2022.1020995] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/30/2022] [Indexed: 01/07/2023] Open
Abstract
Given the emergence of resistant bacterial strains and novel microorganisms that globally threaten human life, moving toward new treatment modalities for microbial infections has become a priority more than ever. Antimicrobial photodynamic therapy (aPDT) has been introduced as a promising and non-invasive local and adjuvant treatment in several oral infectious diseases. Its efficacy for elimination of bacterial, fungal, and viral infections and key pathogens such as Streptococcus mutans, Porphyromonas gingivalis, Candida albicans, and Enterococcus faecalis have been investigated by many invitro and clinical studies. Researchers have also investigated methods of increasing the efficacy of such treatment modalities by amazing developments in the production of natural, nano based, and targeted photosensitizers. As clinical studies have an important role in paving the way towards evidence-based applications in oral infection treatment by this method, the current review aimed to provide an overall view of potential clinical applications in this field and summarize the data of available randomized controlled clinical studies conducted on the applications of aPDT in dentistry and investigate its future horizons in the dental practice. Four databases including PubMed (Medline), Web of Science, Scopus and Embase were searched up to September 2022 to retrieve related clinical studies. There are several clinical studies reporting aPDT as an effective adjunctive treatment modality capable of reducing pathogenic bacterial loads in periodontal and peri-implant, and persistent endodontic infections. Clinical evidence also reveals a therapeutic potential for aPDT in prevention and reduction of cariogenic organisms and treatment of infections with fungal or viral origins, however, the number of randomized clinical studies in these groups are much less. Altogether, various photosensitizers have been used and it is still not possible to recommend specific irradiation parameters due to heterogenicity among studies. Reaching effective clinical protocols and parameters of this treatment is difficult and requires further high quality randomized controlled trials focusing on specific PS and irradiation parameters that have shown to have clinical efficacy and are able to reduce pathogenic bacterial loads with sufficient follow-up periods.
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Affiliation(s)
- Leila Gholami
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Shiva Shahabi
- Dental Implants Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Marzieh Jazaeri
- Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahdi Hadilou
- Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran,International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran,*Correspondence: Reza Fekrazad,
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Garcia de Carvalho G, Pacheco Mateo R, Costa E Silva R, Maquera Huacho PM, de Souza Rastelli AN, de Oliveira KT, Chierici Marcantonio RA, Zandim-Barcelos DL, Palomari Spolidorio DM. Chlorin-based photosensitizer under blue or red-light irradiation against multi-species biofilms related to periodontitis. Photodiagnosis Photodyn Ther 2022; 41:103219. [PMID: 36473689 DOI: 10.1016/j.pdpdt.2022.103219] [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: 09/05/2022] [Revised: 10/17/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022]
Abstract
In our previous study, Chlorin-e6 (Ce6) demonstrated a significant reduction of microorganisms' viability against single-species biofilm related to periodontitis once irradiated by red light (660 nm). Also, higher bacteria elimination was observed under blue light (450 nm) irradiation. However, the use of blue light irradiation of Ce6 for antimicrobial administration is poorly explored. This study evaluated the effect of chlorin-e6-mediated antimicrobial photodynamic therapy (aPDT) using different wavelengths (450 or 660 nm) against multi-species biofilms related to periodontitis. Streptococcus oralis, Fusobacterium nucleatum, Porphyromonas gingivalis, and Aggregatibacter actinomycetemcomitans composed the mature biofilm developed under proper conditions for five days. aPDT was performed using different concentrations of Ce6 (100 and 200 μM), wavelengths (450 or 660 nm), and comparisons were made after qPCR assay and confocal laser scanning microscopy (CLSM) analysis. The greatest bacterial elimination was observed in the groups where Ce6 was used with blue light, for S. orallis (2.05 Log10 GeQ mL-1, p < 0.0001) and P. gingivalis (1.4 Log10 GeQ mL-1, p < 0.0001), aPDT with red light showed significant bacteria reduction only for S. orallis. aPDT with blue light demonstrated statistically higher elimination in comparison with aPDT with red light. The aPDT did not show a statistically significant effect when tested against A. actinomycetemcomitans and F. nucleatum (p=0.776 and 0.988, respectively). The aPDT using blue light showed a promising higher photobiological effect, encouraging researchers to consider it in the irradiation of Ce6 for further investigations.
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Affiliation(s)
- Gabriel Garcia de Carvalho
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, Araraquara, SP 14801-903, Brazil
| | - Rafaela Pacheco Mateo
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, Araraquara, SP 14801-903, Brazil
| | - Rodrigo Costa E Silva
- Department of Chemistry, Federal University of São Carlos (UFSCar), São Carlos, SP 13565-905, Brazil
| | - Patricia Milagros Maquera Huacho
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, Araraquara, SP 14801-903, Brazil
| | - Alessandra Nara de Souza Rastelli
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, Araraquara, SP 14801-903, Brazil
| | - Kleber Thiago de Oliveira
- Department of Chemistry, Federal University of São Carlos (UFSCar), São Carlos, SP 13565-905, Brazil
| | | | - Daniela Leal Zandim-Barcelos
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, Araraquara, SP 14801-903, Brazil
| | - Denise Madalena Palomari Spolidorio
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, Araraquara, SP 14801-903, Brazil.
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12
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Kassa CT, Salviatto LTC, Tortamano ACAC, Rost-Lima KS, Damante CA, Pavani C, Deana A, Kato IT, Wainwright M, Prates RA. Antimicrobial photodynamic therapy mediated by methylene blue in surfactant vehicle as adjuvant to periodontal treatment. Randomized, controlled, double-blind clinical trial. Photodiagnosis Photodyn Ther 2022; 41:103194. [PMID: 36402375 DOI: 10.1016/j.pdpdt.2022.103194] [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: 06/08/2022] [Revised: 11/02/2022] [Accepted: 11/03/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Antimicrobial photodymanic therapy mediated by methylene blue has been investigated as an adjunctive to periodontal treatment but the dimerization of photosensitizer molecules reduces the phototoxic effects. Sodium dodecyl sulfate is a surfactant that may control this aggregation. The aim of this study was evaluated the photodynamic effect of methylene blue in sodium dodecyl sulfate in periodontitis. METHODS 36 participants with periodontitis were selected and allocated randomly in two group for intervention and other two for control - all of them were treated with scaling and root planing before aPDT. Three periodontal evaluations were done: at the selection time, at the day of intervention and thirty-day after this. Pre-irradiation time was 1 min and 2 min for irradiation. Laser (Therapy XT, DMC, São Carlos, Brazil) with wavelength of 660 nm and 100 mW of power was used. Two photosensitizer solutions with 100 µM methylene blue was used, one of them was in water and other in 0,25% of sodium dodecyl sulfate. Two sites of each participant were selected for the experimental procedures. Microbiological evaluations were performed to quantify microorganisms before and immediately after intervention. Quantitative microbiological evaluation was the primary outcome; morphological aspects of bacterial colony, and clinical probing depth was the secondary one. RESULTS There was no significant difference between the groups in both bacterial reduction and the clinical parameter evaluated. CONCLUSION The effect of methylene blue in surfactant did not cause enough phototoxic effects that could promote reduction of periodontal pocket depth.
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Affiliation(s)
- Claudio Teruo Kassa
- Biophotonics Program, Biophotonics Applied to Health Science Post Graduate program, Nove de Julho University, UNINOVE, Rua Vergueiro 235/249 - Liberdade, São Paulo, SP 01504-001, Brazil
| | - Luciana Toledo Costa Salviatto
- Biophotonics Program, Biophotonics Applied to Health Science Post Graduate program, Nove de Julho University, UNINOVE, Rua Vergueiro 235/249 - Liberdade, São Paulo, SP 01504-001, Brazil
| | - Ana Carolina A C Tortamano
- Biophotonics Program, Biophotonics Applied to Health Science Post Graduate program, Nove de Julho University, UNINOVE, Rua Vergueiro 235/249 - Liberdade, São Paulo, SP 01504-001, Brazil
| | - Ketlyn Sthefany Rost-Lima
- Biophotonics Program, Biophotonics Applied to Health Science Post Graduate program, Nove de Julho University, UNINOVE, Rua Vergueiro 235/249 - Liberdade, São Paulo, SP 01504-001, Brazil
| | - Carla Andreotti Damante
- Discipline of Periodontics, Bauru School of Dentistry, University of São Paulo (USP), Bauru, Brazil
| | - Christiane Pavani
- Biophotonics Program, Biophotonics Applied to Health Science Post Graduate program, Nove de Julho University, UNINOVE, Rua Vergueiro 235/249 - Liberdade, São Paulo, SP 01504-001, Brazil
| | - Alessandro Deana
- Biophotonics Program, Biophotonics Applied to Health Science Post Graduate program, Nove de Julho University, UNINOVE, Rua Vergueiro 235/249 - Liberdade, São Paulo, SP 01504-001, Brazil
| | - Ilka Tiemy Kato
- Department of Biomedical Engineering, ABC Federal University (UFABC), São Bernardo do Campo, SP, Brazil
| | - Mark Wainwright
- School of Pharmacy & Biomolecular Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK
| | - Renato Araujo Prates
- Biophotonics Program, Biophotonics Applied to Health Science Post Graduate program, Nove de Julho University, UNINOVE, Rua Vergueiro 235/249 - Liberdade, São Paulo, SP 01504-001, Brazil.
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13
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Zhang J, Jia Q, Yue Z, Huo J, Chai J, Yu L, Nie R, Shao H, Zhao Y, Li P, Huang W. An Electroluminodynamic Flexible Device for Highly Efficient Eradication of Drug-Resistant Bacteria. ADVANCED MATERIALS (DEERFIELD BEACH, FLA.) 2022; 34:e2200334. [PMID: 35194842 DOI: 10.1002/adma.202200334] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/17/2022] [Indexed: 06/14/2023]
Abstract
Photodynamic therapy (PDT) has attracted wide attention in antibacterial applications due to its advantages of spatial-temporal selectivity, noninvasiveness, and low incidence to develop drug resistance. To make it more convenient, universal, and manipulatable for clinical application, a conceptually antibacterial strategy, namely "electroluminodynamic therapy" (ELDT), is presented by nanoassembly of an electroluminescent (EL) material and a photosensitizer, which is capable of generating reactive oxygen species (ROS) in situ under an electric field, i.e., the fluorescence emitted by the EL molecules excites the photosensitizer to generate singlet oxygen (1 O2 ), for the oxidative damage of pathogens. Based on the scheme of ELDT, a flexible therapeutic device is fabricated through a hydrogel loading with ELDT nanoagents, followed by integration with a flexible battery, satisfying the requirements of being light and wearable for wound dressings. The ELDT-based flexible device presents potent ROS-induced killing efficacies against drug-resistant bacteria (>99.9%), so as to effectively inhibit the superficial infection and promote the wound healing. This research reveals a proof-of-concept ELDT strategy as a prospective alternative to PDT, which avoids the utilization of a physical light source, and achieves convenient and effective killing of drug-resistant bacteria through a hydrogel-based flexible therapeutic device.
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Affiliation(s)
- Jianhong Zhang
- Frontiers Science Center for Flexible Electronics (FSCFE), Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering (IBME), Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, 710072, China
| | - Qingyan Jia
- Frontiers Science Center for Flexible Electronics (FSCFE), Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering (IBME), Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, 710072, China
- State Key Laboratory for Organic Electronics and Information Displays (SKLOEID), Institute of Advanced Materials (IAM), Nanjing University of Posts & Telecommunications, 9 Wenyuan Road, Nanjing, 210023, China
| | - Zilin Yue
- Frontiers Science Center for Flexible Electronics (FSCFE), Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering (IBME), Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, 710072, China
| | - Jingjing Huo
- Frontiers Science Center for Flexible Electronics (FSCFE), Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering (IBME), Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, 710072, China
| | - Jin Chai
- Frontiers Science Center for Flexible Electronics (FSCFE), Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering (IBME), Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, 710072, China
| | - Luofeng Yu
- Frontiers Science Center for Flexible Electronics (FSCFE), Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering (IBME), Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, 710072, China
| | - Renhao Nie
- Frontiers Science Center for Flexible Electronics (FSCFE), Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering (IBME), Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, 710072, China
| | - Han Shao
- Frontiers Science Center for Flexible Electronics (FSCFE), Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering (IBME), Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, 710072, China
| | - Yang Zhao
- Frontiers Science Center for Flexible Electronics (FSCFE), Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering (IBME), Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, 710072, China
| | - Peng Li
- Frontiers Science Center for Flexible Electronics (FSCFE), Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering (IBME), Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, 710072, China
| | - Wei Huang
- Frontiers Science Center for Flexible Electronics (FSCFE), Xi'an Institute of Flexible Electronics (IFE) and Xi'an Institute of Biomedical Materials & Engineering (IBME), Northwestern Polytechnical University, 127 West Youyi Road, Xi'an, 710072, China
- State Key Laboratory for Organic Electronics and Information Displays (SKLOEID), Institute of Advanced Materials (IAM), Nanjing University of Posts & Telecommunications, 9 Wenyuan Road, Nanjing, 210023, China
- Key Laboratory of Flexible Electronics (KLOFE) and Institute of Advanced Materials (IAM), Nanjing Tech University, Nanjing, 211816, China
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