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Ahrens M, Spörer M, Deppe H, Ritschl LM, Mela P. Bacterial reduction and temperature increase of titanium dental implant models treated with a 445 nm diode laser: an in vitro study. Sci Rep 2024; 14:18053. [PMID: 39103382 DOI: 10.1038/s41598-024-68780-2] [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: 04/19/2024] [Accepted: 07/29/2024] [Indexed: 08/07/2024] Open
Abstract
In this in vitro study, the use of a 445 nm diode laser was investigated for the decontamination of titanium dental implants. Different irradiation protocols and the effect of repetitive laser irradiation on temperature increase and decontamination efficacy were evaluated on titanium implant models. An automated setup was developed to realize a scanning procedure for a full surface irradiation to recapitulate a clinical treatment. Three irradiation parameter sets A (continuous wave, power 0.8 W, duty cycle (DC) 100%, and 5 s), B (pulsed mode, DC 50%, power 1.0 W, and 10 s), and C (pulsed mode, DC 10%, power 3.0 W, and 20 s) were used to treat the rods for up to ten consecutive scans. The resulting temperature increase was measured by a thermal imaging camera and the decontamination efficacy of the procedures was evaluated against Escherichia coli and Staphylococcus aureus, and correlated with the applied laser fluence. An implant's temperature increase of 10 °C was set as the limit accepted in literature to avoid thermal damage to the surrounding tissue in vivo. Repeated irradiation of the specimens resulted in a steady increase in temperature. Parameter sets A and B caused a temperature increase of 11.27 ± 0.81 °C and 9.90 ± 0.37 °C after five consecutive laser scans, respectively, while parameter set C resulted in a temperature increase of only 8.20 ± 0.53 °C after ten surface scans. The microbiological study showed that all irradiation parameter sets achieved a complete bacterial reduction (99.9999% or 6-log10) after ten consecutive scans, however only parameter set C did not exceed the temperature threshold. A 445 nm diode laser can be used to decontaminate dental titanium rods, and repeated laser irradiation of the contaminated areas increases the antimicrobial effect of the treatment; however, the correct choice of parameters is needed to provide adequate laser fluence while preventing an implant's temperature increase that could cause damage to the surrounding tissue.
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Affiliation(s)
- Markus Ahrens
- Chair of Medical Materials and Implants, Department of Mechanical Engineering, TUM School of Engineering and Design, Munich Institute of Biomedical Engineering; Munich Institute of Integrated Materials, Energy and Process Engineering, Technical University of Munich, Munich, Germany
| | - Melanie Spörer
- Chair of Medical Materials and Implants, Department of Mechanical Engineering, TUM School of Engineering and Design, Munich Institute of Biomedical Engineering; Munich Institute of Integrated Materials, Energy and Process Engineering, Technical University of Munich, Munich, Germany
| | - Herbert Deppe
- Department of Oral and Maxillofacial Surgery, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Lucas M Ritschl
- Chair of Medical Materials and Implants, Department of Mechanical Engineering, TUM School of Engineering and Design, Munich Institute of Biomedical Engineering; Munich Institute of Integrated Materials, Energy and Process Engineering, Technical University of Munich, Munich, Germany
- Department of Oral and Maxillofacial Surgery, TUM School of Medicine, Technical University of Munich, Munich, Germany
| | - Petra Mela
- Chair of Medical Materials and Implants, Department of Mechanical Engineering, TUM School of Engineering and Design, Munich Institute of Biomedical Engineering; Munich Institute of Integrated Materials, Energy and Process Engineering, Technical University of Munich, Munich, Germany.
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Gómez C, Schuele G, Alberdi E. Medium-term antifungal effects of methylene blue versus flavin mononucleotide in the treatment of moderate toenail onychomycosis. Mycoses 2024; 67:e13661. [PMID: 37840157 DOI: 10.1111/myc.13661] [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: 09/04/2023] [Accepted: 10/08/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Methylene blue (MB) and flavin mononucleotide (FMN)-mediated photodynamic therapy (PDT) have demonstrated local antimicrobial effect, but no direct comparative study has been published so far for the treatment of toenail onychomycosis. OBJECTIVES To directly compare the short and medium-term efficacy of MB versus FMN as photosensitizers in PDT for toenail onychomycosis by applying them in a 40% w/w urea cream in two different dye concentrations. METHODS Forty toenails with distal and lateral subungual moderate onychomycosis due to dermatophyte fungi were randomised to receive 10 weekly sessions of PDT mediated by four topical formulations including MB or FMN at two different concentrations: Group I: 0.1% w/w MB; Group II: 2% w/w MB; Group III: 0.1% w/w FMN; and Group IV: 2% w/w FMN. Photographs were used for onychomycosis severity index (OSI) estimation allowing clinical assessment at any point of the study. Microscopic and microbiological evaluations were carried out at baseline, 27- and 35-week follow-ups. Side effects were recorded along with patient satisfaction. RESULTS At week 27, mycological cure rates were 60%, 30%, 50% and 40% and complete cure rates were 0%, 20%, 10% and 20%, for Groups I, II, III and IV respectively. At week 35, mycological cure rates were 70%, 70%, 70% and 60% and complete cure rates were 30%, 50%, 70% and 30%, for Groups I, II, III and IV respectively. All cream formulations were safe and patients were fairly satisfied. CONCLUSIONS Results of the present work confirm PDT as a therapeutic alternative for onychomycosis. Although all cream formulations were safe and effective, with a good degree of satisfaction, higher cure rates were obtained with 2% w/w MB cream and 0.1% w/w FMN cream.
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Affiliation(s)
- Clara Gómez
- Institute of Physical Chemistry Blas Cabrera, CSIC, Madrid, Spain
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Qamar Z, Abdul NS, Soman C, Shenoy M, Bamousa B, Rabea S, Albahkaly HS. Clinical and radiographic peri-implant outcomes with riboflavin loaded Poly-L-glycolic acid nanoparticles incorporated in aloe-vera gel treating peri-implantitis in chronic hyperglycemic patients. Photodiagnosis Photodyn Ther 2023; 44:103752. [PMID: 37595657 DOI: 10.1016/j.pdpdt.2023.103752] [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: 06/16/2023] [Revised: 07/30/2023] [Accepted: 08/15/2023] [Indexed: 08/20/2023]
Abstract
AIM The objective of the current study was to compare the effectiveness of antimicrobial photodynamic therapy (PDT) versus Poly-L-glycolic acid nanoparticles loaded riboflavin incorporated in aloe vera gel (PGA/RF/AV) on periimplant parameters and bacterial counts in chronic hyperglycemic patients having periimplantitis. METHODS One hundred and two diabetic patients undergoing mechanical debridement (MD) were equally divided into three groups: Group 1: PGA/RF/AV+ MD, Group 2: PDT + MD, and Group 3: MD alone. Periimplant parameters [Bleeding on probing (BoP), probing depth (PD), plaque index (PI), marginal bone level (MBL)] were recorded in all three groups. Periimplant plaque samples were studied to record the levels of Tannerella forsythia (Tf) and Porphyromonas gingivalis (Pg). The recordings were taken at baseline, 3 months and 6 months post treatment. RESULTS All three groups showed a reduction in severity of periimplantitis measured in terms of PD, PI, MBL and BoP. A statistically significant reduction in PD, PI and MBL was found in patients in Group 2 whereas participants of Group 1 were found to have a significant decrease in BoP. A statistically significant decline in the numbers of both the bacterial species was seen in Group 2 at the three-month follow-up whereas at the six-month follow-up, a statistically significant reduction was observed in treatment Group 2 in the levels of Tf species only. CONCLUSION Riboflavin-loaded nanocarrier incorporated in aloe vera gel showed greater clinical efficacy than PDT alone in the treatment of periimplantitis in chronic hyperglycemic individuals.
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Affiliation(s)
- Zeeshan Qamar
- Department of O&MFS and Diagnostic Sciences, Faculty of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia.
| | - Nishath Sayed Abdul
- Department of OMFS and Diagnostic Sciences (Oral Pathology), Faculty of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Cristalle Soman
- Oral Medicine & Maxillofacial Radiologist, Department of OMFS & DOS, Faculty of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Mahesh Shenoy
- Department of OMFS and Diagnostic Sciences (Oral Pathology), Faculty of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Badr Bamousa
- Department of Periodontology, Faculty of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Salem Rabea
- Faculty of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
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Pordel E, Ghasemi T, Afrasiabi S, Benedicenti S, Signore A, Chiniforush N. The Effect of Different Output Powers of Blue Diode Laser along with Curcumin and Riboflavin against Streptococcus mutans around Orthodontic Brackets: An In Vitro Study. Biomedicines 2023; 11:2248. [PMID: 37626744 PMCID: PMC10452080 DOI: 10.3390/biomedicines11082248] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 07/28/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
OBJECTIVES The aim of the present study was to determine the effects of antimicrobial photodynamic therapy (aPDT) using the blue diode laser (BDL) with different output powers and the photosensitizers riboflavin and curcumin on reducing the number of Streptococcus mutans around orthodontic brackets. MATERIALS AND METHODS A total of 36 orthodontic brackets were contaminated with S. mutans and randomly assigned to 12 groups as follows: control, riboflavin alone, riboflavin + BDL with an output power of 200, 300, 400, or 500 mW, and curcumin alone, curcumin + BDL with an output power of 200, 300, 400, or 500 mW, and 0.2% chlorhexidine (CHX-positive control). Orthodontic brackets were irradiated with a BDL (wavelength 445 nm) at a power density of 0.4-1.0 W/cm2 for 30 s. All orthodontic brackets were examined under a stereomicroscope at 10× magnification. Mean colony-forming units (CFUs)/mL were measured before and after treatment. A one-way analysis of variance with Tukey's post hoc test was performed to compare CFU/mL between groups. RESULTS CHX and curcumin plus BDL with an output power of 500 mW had the highest reduction in S. mutans colony numbers (p < 0.001). The curcumin groups were more effective than the riboflavin groups. Riboflavin alone and riboflavin + BDL with an output power of 200 mW showed no significant difference from the control group (p = 0.99 and 0.74, respectively). CONCLUSION Our results suggest that aPDT using curcumin as a photosensitizer plus BDL with an output power of 500 mW and a power density of 1.0 W/cm2 at a wavelength of 445 nm can effectively reduce colonies of S. mutans around stainless steel brackets.
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Affiliation(s)
- Edris Pordel
- Department of Pediatric Dentistry, Dental School, Sabzevar University of Medical Sciences, Sabzevar 9613875389, Iran;
| | | | - Shima Afrasiabi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran 1441987566, Iran
| | - Stefano Benedicenti
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy;
| | - Antonio Signore
- Therapeutic Dentistry Department, Institute of Dentistry, I.M. Sechenov First Moscow State Medical University, Trubetskaya Str. 8, b. 2, 119992 Moscow, Russia;
| | - Nasim Chiniforush
- Department of Surgical Sciences and Integrated Diagnostics, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy;
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Katalinić I, Smojver I, Morelato L, Vuletić M, Budimir A, Gabrić D. Evaluation of the Photoactivation Effect of 3% Hydrogen Peroxide in the Disinfection of Dental Implants: In Vitro Study. Biomedicines 2023; 11:biomedicines11041002. [PMID: 37189620 DOI: 10.3390/biomedicines11041002] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/05/2023] [Accepted: 03/07/2023] [Indexed: 05/17/2023] Open
Abstract
Photoactivation of 3% hydrogen peroxide with a 445 nm diode laser represents a relatively new, insufficiently researched antimicrobial method in the treatment of peri-implantitis. The purpose of this work is to evaluate the effect of photoactivation of 3% hydrogen peroxide with a 445 nm diode laser, and to compare the obtained results with 0.2% chlorhexidine treatment and 3% hydrogen peroxide treatment without photoactivation, in vitro, on the surface of dental implants contaminated with S. aureus and C. albicans biofilms. Previously, 80 infected titanium implants with S. aureus and C. albicans cultures were divided into four groups: G1-negative control (no treatment), G2-positive control (0.2% chlorhexidine), G3 (3% hydrogen peroxide), and G4 (photoactivated 3% hydrogen peroxide). The number of viable microbes in each sample was determined by the colony forming unit (CFU) count. The results were statistically processed and analyzed, showing a statistically significant difference across all groups compared to the negative control (G1), and the absence of a statistically significant difference between groups G1-G3. The new antimicrobial treatment, according to the results, could be worthy of further analysis and research.
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Affiliation(s)
| | - Igor Smojver
- Specialty Hospital St. Catherine, 10000 Zagreb, Croatia
| | - Luka Morelato
- Department of Oral Surgery, Faculty of Dental Medicine, University of Rijeka, 51000 Rijeka, Croatia
| | - Marko Vuletić
- Department of Oral Surgery, School of Dental Medicine, University Hospital Centre Zagreb, University of Zagreb, 10000 Zagreb, Croatia
| | - Ana Budimir
- Department of Clinical and Molecular Microbiology, School of Medicine, University Hospital Centre Zagreb, University of Zagreb, 10000 Zagreb, Croatia
| | - Dragana Gabrić
- Department of Oral Surgery, School of Dental Medicine, University Hospital Centre Zagreb, University of Zagreb, 10000 Zagreb, Croatia
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