1
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Afrasiabi S, Heidari M, Younespour S, Chiniforush N. Evaluating the effect of mechanical debridement with adjunctive antimicrobial photodynamic therapy in comparison with mechanical debridement alone on the peri-implant parameters in type 2 diabetic mellitus patients with peri-implantitis: a systematic review and meta-analysis. BMC Oral Health 2023; 23:751. [PMID: 37828479 PMCID: PMC10571232 DOI: 10.1186/s12903-023-03337-9] [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: 05/10/2023] [Accepted: 08/19/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is a major risk factor for localized diseases such as peri-implantitis that may affect ideal implant treatment. This study was aimed to evaluate the effect of mechanical debridement (MD) + antimicrobial photodynamic therapy (a-PDT) in patients with peri-implantitis who have T2DM in terms of bleeding on probing (BOP) and probing depth (PD) as primary outcomes and plaque index (PI) and crestal bone loss (CBL) as secondary outcomes. METHODS Publications compared outcomes between MD + aPDT and MD alone in T2DM patients with peri-implantitis, containing more than 3-month follow-up duration, were involved in the systematic review and meta-analysis. Literature until July 2023 using MEDLINE (through PubMed), Scopus, Cochrane Library, Embase, Web of Science, and Google Scholar were collected. RESULTS Two randomized controlled trials (RCTs, 88 individuals) and one controlled clinical trial (CCT, 67 individuals) with follow-up periods ranged from 3 to 12 months were recruited. All studies used diode laser with wavelengths ranged from 660 to 810 nm. The results demonstrated that the MD + aPDT group showed significant benefits for BOP reduction after 6 months (SMD = -2.15, 95% CI: -3.78 to -0.51, p = 0.01). However, a great amount of heterogeneity was observed (I2 = 91.52%, p < 0.001). Moreover, there was a significant difference between MD + aPDT and MD alone groups in CBL (SMD = -0.69, 95% CI: -1.07 to -0.30, p < 0.001). In addition, homogeneity assumption was satisfied (I2 = 22.49%, p = 0.28). Significant differences in PD and PI reduction were not found except for PI reduction after 3 months (SMD = -0.79, 95% CI: -1.24 to -0.33, p < 0.001. Also, no heterogeneity was observed (I2 = 0.00%, p = 0.47). CONCLUSION Given that high heterogeneity in BOP and PD outcome was found in this systematic review, future long-term CTs with MD + aPDT should be examined to arrive at a firm conclusion.
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Affiliation(s)
- Shima Afrasiabi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohadeseh Heidari
- Dental Implant Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shima Younespour
- Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nasim Chiniforush
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Genoa, Italy.
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2
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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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3
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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: 20] [Impact Index Per Article: 20.0] [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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4
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Afrasiabi S, Barikani HR, Chiniforush N. Comparison of bacterial disinfection efficacy using blue and red lights on dental implants contaminated with Aggregatibacter actinomycetemcomitans. Photodiagnosis Photodyn Ther 2022; 40:103178. [PMID: 36602065 DOI: 10.1016/j.pdpdt.2022.103178] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVES The purpose of this study was to determine the bacterial disinfection efficacy of four photosensitizers (PSs; curcumin, riboflavin, toluidine blue O, and phycocyanin) with blue diode laser (Blue DL) and blue light-emitting diode (Blue LED) or Red DL and Red LED in dental implants contaminated with Aggregatibacter actinomycetemcomitans. MATERIALS AND METHODS A total of 60 dental implants were contaminated with A. actinomycetemcomitans. All implants were then randomized into ten different disinfection modalities (n = 6 implants per group). The irradiation wavelength in Blue DL and Blue LED or Red DL and Red LED was 450, 430-460, 635, and 630 nm, respectively and its applied energy density was 60 J/cm2 in all groups. Group IX was served as the control group and in group X disinfection was performed with 0.2% chlorhexidine. After the treatments, the colony forming units (CFUs)/ml were calculated to determine antimicrobial effects of each treatment. RESULTS All disinfection methods significantly reduced bacteria amounts of dental implants inoculated with A. actinomycetemcomitans compared to control group. The CFU/ml in LED group was significantly lower than the DL in all studied groups. CONCLUSION aPDT could be an effective supplement in dental implants disinfection. The LED, proved to be better in reducing CFU/ml of A. actinomycetemcomitans on dental implants surface than DL.
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Affiliation(s)
- Shima Afrasiabi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Hamid Reza Barikani
- Dental Implant Research Center, Dental Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nasim Chiniforush
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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5
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The benefit of antimicrobial photodynamic therapy to mechanical debridement in the treatment of smokers with peri-implant diseases: a systematic review and meta-analysis. Lasers Med Sci 2022; 37:3051-3066. [PMID: 35896900 DOI: 10.1007/s10103-022-03592-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 06/09/2022] [Indexed: 10/16/2022]
Abstract
Antimicrobial photodynamic therapy (aPDT) has been proposed as an adjunctive treatment strategy for peri-implant diseases. This systematic review aimed to determine whether aPDT as an adjunct to mechanical debridement has an additional benefit for smokers with peri-implant diseases. Randomized controlled trials (RCTs), which evaluated the clinical outcomes of mechanical debridement alone versus mechanical debridement + aPDT among smokers, were considered eligible to be included. The primary outcome was bleeding on probing (BOP) and secondary outcomes included probing depth (PD), plaque index (PI), and crestal bone loss (CBL). Meta-analyses using a random-effects model were conducted to calculate the mean difference (MD) with a 95% confidence interval (CI). The quality of evidence was assessed according to Grading of Recommendations Assessment, Development and Evaluation (GRADE). A total of four RCTs (188 participants) were included. The aPDT group showed significantly improved PD (MD = - 1.26, 95% CI = - 2.19 to - 0.32, p = 0.008) and PI (MD = - 10.6%, 95% CI = - 14.46 to - 6.74%, p = 0.0001) compared with mechanical debridement group at 3-month follow-up. No significant difference in bleeding on probing (BOP) was observed at 3-month follow-up (MD = - 0.60%, 95% CI = - 2.36 to 1.16%, p = 0.50). The subgroup analyses on photosensitizers demonstrated significant differences between the two groups on PD (MD = - 1.23, 95% CI = - 2.41 to - 0.05, p = 0.04) and PI (MD = - 12.33, 95% CI = - 14.74 to - 9.92, p < 0.00001) by the use of methylene blue (MB). Within the limitation of this study, compared with mechanical debridement alone, combined use of aPDT was more effective in reducing PD and PI in smokers at 3-month follow-up. MB was a predictable photosensitizer for aPDT. However, the findings should be interpreted with caution due to the limited number of included studies, methodological deficiencies, and heterogeneity between studies.
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6
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Rahman B, Acharya AB, Siddiqui R, Verron E, Badran Z. Photodynamic Therapy for Peri-Implant Diseases. Antibiotics (Basel) 2022; 11:antibiotics11070918. [PMID: 35884171 PMCID: PMC9311944 DOI: 10.3390/antibiotics11070918] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 06/28/2022] [Accepted: 07/05/2022] [Indexed: 11/16/2022] Open
Abstract
Peri-implant diseases are frequently presented in patients with dental implants. This category of inflammatory infections includes peri-implant mucositis and peri-implantitis that are primarily caused by the oral bacteria that colonize the implant and the supporting soft and hard tissues. Other factors also contribute to the pathogenesis of peri-implant diseases. Based on established microbial etiology, mechanical debridement has been the standard management approach for peri-implant diseases. To enhance the improvement of therapeutic outcomes, adjunctive treatment in the form of antibiotics, probiotics, lasers, etc. have been reported in the literature. Recently, the use of photodynamic therapy (PDT)/antimicrobial photodynamic therapy (aPDT) centered on the premise that a photoactive substance offers benefits in the resolution of peri-implant diseases has gained attention. Herein, the reported role of PDT in peri-implant diseases, as well as existing observations and opinions regarding PDT, are discussed.
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Affiliation(s)
- Betul Rahman
- Periodontology Unit, Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates; (B.R.); (A.B.A.)
| | - Anirudh Balakrishna Acharya
- Periodontology Unit, Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates; (B.R.); (A.B.A.)
| | - Ruqaiyyah Siddiqui
- College of Arts and Sciences, University City, American University of Sharjah, Sharjah P.O. Box 26666, United Arab Emirates;
| | - Elise Verron
- CNRS, UMR 6230, CEISAM, UFR Sciences et Techniques, Université de Nantes, 2, rue de la Houssinière, BP 92208, CEDEX 3, 44322 Nantes, France;
| | - Zahi Badran
- Periodontology Unit, Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates; (B.R.); (A.B.A.)
- Correspondence:
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7
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Pourhajibagher M, Bahador A. Enhanced reduction of polymicrobial biofilms on the orthodontic brackets and enamel surface remineralization using zeolite-zinc oxide nanoparticles-based antimicrobial photodynamic therapy. BMC Microbiol 2021; 21:273. [PMID: 34620084 PMCID: PMC8499451 DOI: 10.1186/s12866-021-02324-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Accepted: 09/06/2021] [Indexed: 11/10/2022] Open
Abstract
The aim of this study was to evaluate the anti-biofilm and anti-metabolic activities of zeolite-zinc oxide nanoparticles (Zeo/ZnONPs)-based antimicrobial photodynamic therapy (aPDT) against pre-formed polymicrobial biofilms on the orthodontic brackets, as well as, assess the remineralization efficacy on polymicrobial biofilms induced enamel lesions. Following synthesis and characterization of Zeo/ZnONPs, cell cytotoxicity, hemolytic effect, and intracellular reactive oxygen species (ROS) production were determined. The anti-biofilm and anti-metabolic activities of aPDT using different concentrations of Zeo/ZnONPs were investigated. Microhardness tester and DIAGNOdent Pen were used to evaluate the changes of remineralization degree on the treated enamel slabs duration 1 and 3 months. No significant cytotoxicity and erythrocyte hemolysis were observed in treated cells with Zeo/ZnONPs. When irradiated, suggesting that the Zeo/ZnONPs were photoactivated, generating ROS and leading to reduce dose-dependently the cell viability and metabolic activity of polymicrobial biofilms. Also, the enamel surface microhardness value of exposed enamel showed a steady increase with the concentration of Zeo/ZnONPs. No statistically significant differences were shown between aPDT and sodium fluoride varnish as the control group. Overall, Zeo/ZnONPs-based aPDT with the greatest remineralization efficacy of enamel surface can be used as an anti-biofilm therapeutic method, which is involved with their potent ability to produce ROS.
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Affiliation(s)
- Maryam Pourhajibagher
- Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Bahador
- Oral Microbiology Laboratory, Department of Microbiology, School of Medicine, Tehran University of Medical Sciences|, Tehran, Iran.
- Fellowship in Clinical Laboratory Sciences, BioHealth Lab, Tehran, Iran.
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8
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Parhi S, Pal S, Das SK, Ghosh P. Strategies toward development of antimicrobial biomaterials for dental healthcare applications. Biotechnol Bioeng 2021; 118:4590-4622. [PMID: 34599764 DOI: 10.1002/bit.27948] [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: 05/28/2021] [Revised: 08/19/2021] [Accepted: 09/26/2021] [Indexed: 12/25/2022]
Abstract
Several approaches for elimination of oral pathogens are being explored at the present time since oral diseases remain prevalent affecting approximately 3.5 billion people worldwide. Need for antimicrobial biomaterials in dental healthcare include but is not restricted to designing resin composites and adhesives for prevention of dental caries. Constant efforts are also being made to develop antimicrobial strategies for clearance of endodontic space prior root canal treatment and for treatment of periimplantitis and periodontitis. This article discusses various conventional and nanotechnology-based strategies to achieve antimicrobial efficacy in dental biomaterials. Recent developments in the design and synthesis of antimicrobial peptides and antifouling zwitterionic polymers to effectively lessen the risks of antimicrobial drug resistance are also outlined in this review. Further, the role of contemporary strategies such as use of smart biomaterials, ionic solvent-based biomaterials and quorum quenchers incorporated biomaterials in the elimination of dental pathogens are described in detail. Lastly, we mentioned the approach of using polymers to print custom-made three-dimensional antibacterial dental products via additive manufacturing technologies. This review provides a critical perspective on the chemical, biomimetic, and engineering strategies intended for developing antimicrobial biomaterials that have the potential to substantially improve the dental health.
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Affiliation(s)
- Shivangi Parhi
- Division of Structural Biology and Bioinformatics, CSIR-Indian Institute of Chemical Biology, Kolkata, India.,Academy of Scientific and Innovative Research (AcSIR), AcSIR Headquarters CSIR-HRDC Campus, Ghaziabad, India
| | - Sreyasi Pal
- Division of Structural Biology and Bioinformatics, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| | - Sujoy K Das
- Academy of Scientific and Innovative Research (AcSIR), AcSIR Headquarters CSIR-HRDC Campus, Ghaziabad, India.,Division of Infectious Diseases and Immunology, CSIR-Indian Institute of Chemical Biology, Kolkata, India
| | - Paulomi Ghosh
- Division of Structural Biology and Bioinformatics, CSIR-Indian Institute of Chemical Biology, Kolkata, India.,Academy of Scientific and Innovative Research (AcSIR), AcSIR Headquarters CSIR-HRDC Campus, Ghaziabad, India
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9
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Tonin MH, Brites FC, Mariano JR, Freitas KMS, Ortiz MAL, Salmeron S. Low-Level Laser and Antimicrobial Photodynamic Therapy Reduce Peri-implantitis-related Microorganisms Grown In Vitro. Eur J Dent 2021; 16:161-166. [PMID: 34598294 PMCID: PMC8890912 DOI: 10.1055/s-0041-1731926] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Currently, dental implants are a predictable treatment option for oral rehabilitation; however, complications such as peri-implant diseases are increasing every day. Thus, the aim of this study was to verify the efficacy, in vitro, of two protocols against cultures of periodontal biofilm and Staphylococcus aureus. MATERIAL AND METHODS Petri dishes for each of the following groups were used: control groups (C)-plates inoculated with periodontal biofilm (C.B; n = 4) or S. aureus (C.SA; n = 4) without any treatment; laser groups-plates inoculated with periodontal biofilm (low-level laser therapy [LLLT].B; n = 4) or S. aureus (LLLT.SA; n = 4) and treated with LLLT (660 nm, 30 mW, 50 J/cm2, and 47 seconds); antimicrobial photodynamic therapy groups (aPDT)-plates inoculated with periodontal biofilm (aPDT.B; n = 4) or S. aureus (aPDT.SA; n = 4) and treated with aPDT (red laser 660 nm, 30 mW, 50 J/cm2, 47 seconds + toluidine blue O (TBO) 100 µg/mL, and 1 minute). After treatments were performed, the contents of all plates were diluted and seeded for counting colony-forming units (CFUs). STATISTICAL ANALYSIS Results were analyzed with one-way analysis of variance (ANOVA), Tukey's test, comparison of percentages, and independent t-tests with a 5% significance level. RESULTS Both treatments, LLLT and aPDT, significantly reduced the number of CFUs for the two types of culture, LLLT.B (3.69 × 106 ± 0.20), aPDT.B (2.79 × 106 ± 0.13), LLLT.SA (4.10 × 106 ± 0.12), and aPDT.SA (3.23 × 106 ± 0.10) when compared with control groups C.B (5.18 × 106 ± 0.43) and C.SA (5.81 × 106 ± 0.16; p = 0.000). When treatment groups were compared separately, there was also a statistically significant difference (p = 0.000). None of the protocols were able to eliminate cultured microorganisms. CONCLUSION The LLLT and aPDT protocols effectively reduced cultures of periodontal biofilm and S. aureus in vitro, with the superiority of aPDT.
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Affiliation(s)
- Marcelo H Tonin
- Department of Implantology, Ingá University Center, Maringá, Paraná, Brazil
| | - Fabiano C Brites
- Department of Implantology, Ingá University Center, Maringá, Paraná, Brazil
| | - José R Mariano
- Department of Implantology, Unieuro University Center, Brasília, Brazil
| | - Karina M S Freitas
- Department of Orthodontics, Ingá University Center, Maringá, Paraná, Brazil
| | - Mariana A L Ortiz
- Department of Microbiology, Ingá University Center, Maringá, Paraná, Brazil
| | - Samira Salmeron
- Department of Periodontics and Implant Dentistry, Ingá University Center, Maringá, Brazil
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10
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de Souza Rastelli AN. Antimicrobial Photodynamic Therapy (aPDT) as a Disinfection and Biomodulation Approach in Implant Dentistry. Photochem Photobiol 2021; 97:1155-1160. [PMID: 34420213 DOI: 10.1111/php.13509] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 08/20/2021] [Indexed: 01/03/2023]
Abstract
This article is a highlight of the paper by Choe et al. in this issue of Photochemistry and Photobiology. In that review paper, the disinfection and biomodulation outcomes promoted by antimicrobial photodynamic therapy (aPDT) on peri-implantitis infection were stated and discussed. The killing of the oral pathogens by aPDT is based on the generation of reactive oxygen species (ROS). Besides that, biomodulation can also be provided by aPDT and improve the healing and modulate the inflammatory process. Although aPDT has shown positive effects on the treatment of peri-implantitis disease mainly as a complimentary technique, the authors suggested that more and standardize clinical studies are needed to support the clinical application of aPDT for that purpose. Also, the standardization of parameters related to the light source and photosensitizers is required. In addition, nano-based materials may improve aPDT performance against oral biofilms and could increase the hopes of overcoming dental implant failures.
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11
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Guimarães LDS, da Silva EAB, Hespanhol FG, Fontes KBFDC, Antunes LAA, Antunes LS. Effect of photobiomodulation on post-operative symptoms in teeth with asymptomatic apical periodontitis treated with foraminal enlargement: A randomized clinical trial. Int Endod J 2021; 54:1708-1719. [PMID: 34173988 DOI: 10.1111/iej.13593] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 11/26/2022]
Abstract
AIM To assess the efficacy of photobiomodulation in reducing post-operative symptoms and use of analgesics in teeth with asymptomatic apical periodontitis treated with foraminal enlargement in a single visit. METHODOLOGY This prospective double-blind, controlled, superiority, randomized clinical trial enrolled 70 patients requiring root canal treatment of one single-rooted tooth with asymptomatic apical periodontitis. The participants were randomized into one of the following two groups: 35 patients in the control group (C.G) - root canal treatment with foraminal enlargement, without any additional treatment and 35 patients in the photobiomodulation group (PBM.G) - root canal treatment with foraminal enlargement associated with photobiomodulation (antimicrobial photodynamic therapy and low-level laser therapy). The outcome variables were post-operative pain, tenderness, oedema and the use of analgesics. Pain intensity was measured using a visual analogue scale (recorded every day for 7 days, then the 14th and 30th days after root canal treatment). Facial oedema was assessed subjectively by two independent evaluators using photographs taken by one of the researchers at 48 h, 72 h and 7 days after the procedures. Data were tabulated and analysed using the Mann-Whitney U, Chi-Square, Fisher`s Exact, Student T and Ordinal Logistic Regression by Generalized Estimating Equations tests in SPSS software. RESULTS There were no significant differences in post-operative pain and tenderness between the groups at any observation period (p > .05). Photobiomodulation (beta = -0.77 / p = .01), time (beta = -0.23 / p < .01), and male gender (beta = -1.20 / p < .01) were associated with decreased post-operative pain. Only time (beta: -0.10; p < .01) and male gender (beta: -1.04; p < .01) were associated with decreased tenderness. For oedema and use of analgesics, there was no difference between the groups (p > .05). CONCLUSIONS Photobiomodulation had no significant effect on post-operative pain, tenderness, oedema and the use of analgesics after root canal treatment with foraminal enlargement, in single-rooted teeth treated in a single visit. Register of Clinical Trials: NCT03704857. Research Ethics Committee: no 2.353.996 / CAAE 74185417.9.0000.5626.
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Affiliation(s)
| | | | | | | | - Livia Azeredo Alves Antunes
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Niterói, Brazil.,Department of Specific Formation, School of Dentistry, Fluminense Federal University, Nova Friburgo, Brazil.,Postgraduate Program in Dentistry of Health Institute of Nova Friburgo, Fluminense Federal University, Nova Friburgo, Brazil
| | - Leonardo Santos Antunes
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Niterói, Brazil.,Department of Specific Formation, School of Dentistry, Fluminense Federal University, Nova Friburgo, Brazil.,Postgraduate Program in Dentistry of Health Institute of Nova Friburgo, Fluminense Federal University, Nova Friburgo, Brazil
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12
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Batalha VC, Bueno RA, Fronchetti Junior E, Mariano JR, Santin GC, Freitas KMS, Ortiz MAL, Salmeron S. Dental Implants Surface in vitro Decontamination Protocols. Eur J Dent 2020; 15:407-411. [PMID: 33285571 PMCID: PMC8382458 DOI: 10.1055/s-0040-1721550] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objective
The number of patients rehabilitated with dental implants has contributed to increased incidence of peri-implant diseases. Due to complex and difficult treatment, peri-implantitis is a challenge and an efficient clinical protocol is not yet established. Aim of this study was to evaluate the efficacy of two protocols for
in vitro
decontamination of dental implants surface.
Materials and Methods
Twenty titanium implants (BioHE-Bioconect) were used. Implants were divided into five groups (
n
= 4). NC group (negative control): sterile implants; PC group (positive control): biofilm contaminated implants; S group: biofilm contaminated implants, brushed with sterile saline; SB group: biofilm contaminated implants, brushed with sterile saline and treated with air-powder abrasive system with sodium bicarbonate (1 minute); and antimicrobial photodynamic therapy (aPDT) group: biofilm contaminated implants, brushed with sterile saline and treated with antimicrobial photodynamic therapy (red laser + toluidine blue O). The implants were contaminated
in vitro
with subgingival biofilm and distributed in groups PC, S, SB, and aPDT. Each group received the respective decontamination treatment, except groups NC and PC. Then, all implants were placed in tubes containing culture medium for later sowing and counting of colony-forming units (CFUs).
Statistical Analysis
One-way analysis of variance and Tukey tests were performed, at 5% significance level.
Results
Significantly fewer CFUs were observed in the aPDT group (19.38 × 10
5
) when compared with groups SB (26.88 × 10
5
), S (47.75 × 10
5
), and PC (59.88 × 10
5
) (
p
< 0.01). Both the aPDT and SB groups were statistically different from the NC group (
p
< 0.01).
Conclusion
Proposed protocols, using air-powder abrasive system with sodium bicarbonate and aPDT, showed to be efficacious in the decontamination of dental implants surface
in vitro
.
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Affiliation(s)
- Vanessa Coelho Batalha
- Department of Periodontics and Implant Dentistry, Ingá University Center-Uningá, Maringá, Brazil
| | - Raquel Abreu Bueno
- Department of Periodontics and Implant Dentistry, Ingá University Center-Uningá, Maringá, Brazil
| | - Edemar Fronchetti Junior
- Department of Periodontics and Implant Dentistry, Ingá University Center-Uningá, Maringá, Brazil
| | | | | | | | | | - Samira Salmeron
- Department of Periodontics and Implant Dentistry, Ingá University Center-Uningá, Maringá, Brazil
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13
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Fraga RS, Antunes LAA, Fialho WLS, Valente MI, Gomes CC, Fontes KBFC, Antunes LS. Do Antimicrobial Photodynamic Therapy and Low-Level Laser Therapy Minimize Postoperative Pain and Edema After Molar Extraction? J Oral Maxillofac Surg 2020; 78:2155.e1-2155.e10. [DOI: 10.1016/j.joms.2020.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 08/03/2020] [Accepted: 08/04/2020] [Indexed: 12/28/2022]
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14
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Kotsailidi EA, Michelogiannakis D, Al-Zawawi AS, Javed F. Surgical or non-surgical treatment of peri-implantitis — what is the verdict?,. SURGERY IN PRACTICE AND SCIENCE 2020. [DOI: 10.1016/j.sipas.2020.100010] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
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15
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Electrochemical Disinfection of Dental Implants Experimentally Contaminated with Microorganisms as a Model for Periimplantitis. J Clin Med 2020; 9:jcm9020475. [PMID: 32050444 PMCID: PMC7074531 DOI: 10.3390/jcm9020475] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 02/03/2020] [Accepted: 02/06/2020] [Indexed: 12/16/2022] Open
Abstract
Despite several methods having been described for disinfecting implants affected by periimplantitis, none of these are universally effective and may even alter surfaces and mechanical properties of implants. Boron-doped diamond (BDD) electrodes were fabricated from niobium wires and assembled as a single instrument for implant cleaning. Chemo-mechanical debridement and air abrasion were used as control methods. Different mono-species biofilms, formed by bacteria and yeasts, were allowed to develop in rich medium at 37 °C for three days. In addition, natural multi-species biofilms were treated. Implants were placed in silicone, polyurethane foam and bovine ribs for simulating different clinical conditions. Following treatment, the implants were rolled on blood agar plates, which were subsequently incubated at 37 °C and microbial growth was analyzed. Complete electrochemical disinfection of implant surfaces was achieved with a maximum treatment time of 20 min for Candida albicans, Candida dubliniensis, Enterococcus faecalis, Roseomonas mucosa, Staphylococcus epidermidis and Streptococcus sanguinis, while in case of spore-forming Bacillus pumilus and Bacillus subtilis, a number of colonies appeared after BDD electrode treatment indicating an incomplete disinfection. Independent of the species tested, complete disinfection was never achieved when conventional techniques were used. During treatment with BDD electrodes, only minor changes in temperature and pH value were observed. The instrument used here requires optimization so that higher charge quantities can be applied in shorter treatment times.
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16
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Göltz M, Koch M, Detsch R, Karl M, Burkovski A, Rosiwal S. Influence of In-Situ Electrochemical Oxidation on Implant Surface and Colonizing Microorganisms Evaluated by Scanning Electron Microscopy. MATERIALS (BASEL, SWITZERLAND) 2019; 12:E3977. [PMID: 31801251 PMCID: PMC6926823 DOI: 10.3390/ma12233977] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 11/22/2019] [Accepted: 11/28/2019] [Indexed: 02/07/2023]
Abstract
Peri-implantitis is a worldwide increasing health problem, caused by infection of tissue and bone around an implant by biofilm-forming microorganisms. Effects of peri-implantitis treatment using mechanical debridement, air particle abrasion and electrochemical disinfection on implant surface integrity were compared. Dental implants covered with bacterial biofilm were cleaned using mechanical debridement and air particle abrasion. In addition, implants were disinfected using a novel electrochemical technique based on an array of boron-doped diamond (BDD) coated electrodes. Following treatment and preparation, the implants were inspected by scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX). Mechanical debridement led to changes in surface topography destroying the manufacturer's medium-rough surface by scratch formation. Air particle abrasion led to accumulation of the abrasive used on the implant surface. With both treatment options, appearance of bacteria and yeasts was not affected. In contrast, electrochemical disinfection did not cause alterations of the implant surface but resulted in distorted microbial cells. Electrochemical disinfection of implant surfaces using BDD electrodes may constitute a promising treatment option for cleaning dental implant surfaces without negatively affecting materials and surface properties.
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Affiliation(s)
- Maximilian Göltz
- Division of Ultra-Hard Coatings, Department of Material Sciences, University of Erlangen-Nuremberg, 91058 Erlangen, Germany; (M.G.); (S.R.)
| | - Maximilian Koch
- Microbiology Division, Department of Biology, University of Erlangen-Nuremberg, 91058 Erlangen, Germany; (M.K.); (A.B.)
| | - Rainer Detsch
- Institute of Biomaterials, Department of Material Sciences, University of Erlangen-Nuremberg, 91058 Erlangen, Germany;
| | - Matthias Karl
- Department of Prosthodontics, Saarland University, 66424 Homburg/Saar, Germany
| | - Andreas Burkovski
- Microbiology Division, Department of Biology, University of Erlangen-Nuremberg, 91058 Erlangen, Germany; (M.K.); (A.B.)
| | - Stefan Rosiwal
- Division of Ultra-Hard Coatings, Department of Material Sciences, University of Erlangen-Nuremberg, 91058 Erlangen, Germany; (M.G.); (S.R.)
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17
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Photodynamic antimicrobial chemotherapy has an overt killing effect on periodontal pathogens? A systematic review of experimental studies. Lasers Med Sci 2019; 34:1527-1534. [PMID: 31111263 DOI: 10.1007/s10103-019-02806-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 05/10/2019] [Indexed: 12/19/2022]
Abstract
The periodontal disease (PD) etiology is mainly associated with some bacterial strains, such as Porphyromonas gingivalis (P. gingivalis). Nonsurgical root scaling (e.g., antibiotics) may achieve a temporary decrease in the P. gingivalis level, yet it cannot eradicate the microorganism. Moreover, antibiotics can lead to bacterial resistance and undesirable side effects. This systematic review was performed to identify animal data defining antimicrobial photodynamic therapy (PACT) role on experimental PD models in the treatment of P. gingivalis. Embase, MEDLINE, and PubMed were examined for studies published from January 1980 to August 2018. MeSH terms and Scopus data were used to find more related keywords. Four studies were selected and reviewed by two independent researches with a structured tool for rating the research quality. The beneficial effect of PACT included reductions in P. gingivalis counts, bleeding on probing, redness, and inflammation on multiple sites (i.e., first molar, dental implants; subgingival; and mandibular premolars). Although our results suggest that PACT displays antimicrobial action on P. gingivalis, thus improving the PD, a nonuniformity in the PACT protocol and the limited number of studies included lead to consider that the bactericidal efficacy of PACT against periodontal pathogens in PD remains unclear.
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