A Novel Technique for Disinfection Treatment of Contaminated Dental Implant Surface Using 0.1% Riboflavin and 445 nm Diode Laser—An In Vitro Study

Abstract

Background: Antimicrobial photodynamic therapy (PDT) has been introduced as a potential option for peri-implantitis treatment. The aim of this study is to evaluate the antimicrobial effect of a novel technique involving a combination of 445 nm diode laser light with 0.1% riboflavin solution (used as a photosensitizing dye) as applied on a bacterial–fungal biofilm formed on implants and to compare the performance of this technique with that of the commonly used combination of 660 nm diode laser with 0.1% methylene blue dye. Methods: An in vitro study was conducted on 80 titanium dental implants contaminated with Staphylococcus aureus (SA) and Candida albicans (CA) species. The implants were randomly divided into four groups: negative control (NC), without surface treatment; positive control (PC), treated with a 0.2% chlorhexidine (CHX)-based solution; PDT1, 660 nm (EasyTip 320 µm, 200 mW, Q power = 100 mW, 124.34 W/cm2, 1240 J/cm2) with a 0.1% methylene blue dye; and PDT2, 445 nm (EasyTip 320 µm, 200 mW, Q power = 100 mW, 100 Hz, 124.34 W/cm2, 1.24 J/cm2) with a 0.1% riboflavin dye. Results: The PDT1 and PDT2 groups showed greater reduction of SA and CA in comparison to the NC group and no significant differences in comparison to the PC group. No statistically significant differences between the PDT1 and PDT2 groups were observed. Conclusions: A novel antimicrobial treatment involving a combination of 445 nm diode laser light with riboflavin solution showed efficiency in reducing SA and CA biofilm formation on dental implant surfaces comparable to those of the more commonly used PDT treatment consisting of 660 nm diode laser light with methylene blue dye or 0.2% CHX treatment.

Evaluation of the Photoactivation Effect of 3% Hydrogen Peroxide in the Disinfection of Dental Implants: In Vitro Study

“…The specified wavelength of the diode laser was first examined in the concrete disinfection protocol by Katalinic et al [ 40 ], however not in peri-implant conditions, but on endodontic intracanal biofilms composed of E. faecalis, C. albicans , and S. aureus , where promising results were obtained. The same laser was then tested in peri-implantitis therapy, but as part of photodynamic therapy with 0.1% riboflavin, where a positive antimicrobial effect was also demonstrated [ 41 ]. By reviewing the literature available to the authors, it is not possible to find research similar to the current one.…”

Medium‐term antifungal effects of methylene blue versus flavin mononucleotide in the treatment of moderate toenail onychomycosis

“…In the dental field, PDT mediated by 0.1% riboflavin has been tested on Staphylococcus aureus , Candida albicans and Enterococcus faecalis in endodontics with promising results 24 . In addition, PDT mediated by 0.1% riboflavin led to a significant reduction in viable micro‐organisms comparable to that achieved by 0.2% chlorhexidine (CHX) in the disinfection of contaminated dental implant surface 25 . From a practical point of view, FMN offers some advantages as a PS because it is highly biocompatible and thus it can be used without reservation 26 …”

“…24 In addition, PDT mediated by 0.1% riboflavin led to a significant reduction in viable micro-organisms comparable to that achieved by 0.2% chlorhexidine (CHX) in the disinfection of contaminated dental implant surface. 25 From a practical point of view, FMN offers some advantages as a PS because it is highly biocompatible and thus it can be used without reservation. 26 In this study, both MB and FMN have been incorporated into the cream at high concentrations, which may favour their aggregation, altering their behaviour as PS.…”

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

“…However, BDL alone at 200 mW to 500 mW showed no significant difference between the different output powers [ 26 ]. Other studies have shown that BDL or blue LED with riboflavin as a photosensitizer reduces colony numbers of S. mutans , E. faecalis , Staphylococcus aureus , and Escherichia coli to varying degrees [ 9 , 26 , 27 , 28 , 29 ]. The differences in the results on the efficacy of aPDT with riboflavin may be due to different bacterial strains, the site of the procedure, the concentration of the photosensitizer substance, the duration of the light source, and different laser parameters.…”

“…While we observed a large difference between riboflavin-containing groups and CHX, Morelato et al recently showed that aPDT at 445 nm (Q power = 100 mW, 100 Hz, 124.34 W/cm 2 , 1.24 J/cm 2 ) with a 0.1% riboflavin dye is as effective as 0.2% CHX. This contradiction may be explained by the microbial species used ( S. aureus and Candida albicans ) or the procedure [ 29 ].…”