Clinical, microbiological and immunological outcomes with photodynamic therapy as an adjunct to full-mouth scaling in patients undergoing fixed orthodontic treatment

Lima

Journal of Periodontology

et al. 2023

BackgroundProspective studies have reported conflicting results regarding the adjunctive effect of antimicrobial photodynamic therapy (aPDT) on clinical and microbiological parameters in individuals under periodontal maintenance therapy (PMT). This study aimed to evaluate the clinical and microbiological adjunctive effects of aPDT using indocyanine green (ICG) in residual sites with probing depth (PD) ≥5 mm during PMT in comparison with scaling and root planing (SRP) alone.MethodsA split‐mouth randomized controlled clinical trial was conducted with 24 individuals in a PMT program. Contralateral quadrants with eligible residual sites were randomly assigned to either SRP + aPDT (test group) or SRP alone (control). aPDT included ICG dye and diode laser (909 nm) performed together with SRP and repeated 15 days after. Periodontal clinical parameters, periodontal inflamed surface area (PISA) index, and subgingival biofilm samples were collected at baseline (T1), 3 (T2), and 6 months later (T3). Microbiological analyses were performed by quantitative real‐time polymerase chain reaction.ResultsSignificant improvements were observed in all clinical and microbiological parameters in both groups from T1 to T3. However, no significant differences were observed regarding plaque index, PD, and clinical attachment level. Test group showed significantly greater reductions in bleeding on probing (BOP), PISA index, and Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans levels, when compared with controls.ConclusionsBoth treatments resulted in significant clinical periodontal improvements, but with no significant differences between groups except from inflammation parameters. aPDT using ICG resulted in significant reductions in BOP and PISA index, as well as in P. gingivalis and A. actinomycetemcomitans levels.

Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Adjunctive effects of photodynamic therapy using indocyanine green in residual pockets during periodontal maintenance therapy: A split‐mouth randomized controlled trial

Lima

Journal of Periodontology

et al. 2023

“…It was possible to isolate enterococci from the samples collected from the majority of dogs at the start ( n = 17/20) and at the end ( n = 18/20) of the clinical study, allowing us to observe a reduction in enterococci counts from T0 to T90 in the animals from both test groups (CG or TG). Considering that, we believe that the dental application of the nisin–biogel had no direct effect on bacterial counts, and the observed reduction may be attributed to the dental plaque scaling procedure performed on all animals at T0, as suggested by other studies [ 32 , 33 , 34 ]. In fact, the animals from both groups (CG and TC) showed a reduction in their periodontal indices (gingivitis, dental plaque accumulation and periodontal pocket depth) at the end of the clinical trial [ 31 ], which was also related to the scaling procedure, in agreement with the results from the present report.…”

Section: Discussionmentioning

confidence: 62%

In Vivo Effect of a Nisin–Biogel on the Antimicrobial and Virulence Signatures of Canine Oral Enterococci

et al. 2023

Periodontal disease is a relevant oral disease in dogs and nisin–biogel has been previously proposed to be used in its control. Enterococci, as inhabitants of the oral cavity with a high genetic versatility, are a reliable bacterial model for antimicrobial studies. Our goal was to evaluate the in vivo influence of the long-term dental application of the nisin–biogel on the virulence and antimicrobial signatures of canine oral enterococci. Twenty dogs were randomly allocated to one of two groups (treatment group—TG with nisin–biogel dental application, or control group—CG without treatment) and submitted to dental plaque sampling at day 0 and after 90 days (T90). Samples were processed for Enterococcus spp. isolation, quantification, identification, molecular typing and antimicrobial and virulence characterization. From a total of 140 enterococci, molecular typing allowed us to obtain 70 representative isolates, mostly identified as E. faecalis and E. faecium. No significant differences (p > 0.05) were observed in the virulence index of the isolates obtained from samples collected from the TG and CG at T90. At T90, a statistically significant difference (p = 0.0008) was observed in the antimicrobial resistance index between the isolates from the TC and CG. Oral enterococci were revealed to be reservoirs of high resistant and virulent phenotypes.

“…The US-PDT group showed a significant decrease in IL-6 in week three and for TNF-a in week six. The amount of P. intermedia and P. gingivalis in the plaque samples was much lower in both follow-up periods in the case of the adjunct PDT group [31]. Malik et al (2020) also compared the efficacy of aPDT in combination with US to US alone, but against oral yeast.…”

Section: Comparison Of Ultrasonic Scaling and Ultrasonic Scaling With Adjunct Antimicrobial Photodynamic Therapymentioning

confidence: 99%

Photodynamic Therapy in Orthodontics: A Literature Review

Olek

Machorowska-Pieniążęk

Stós

et al. 2021

Pharmaceutics

Treatment of malocclusions using fixed orthodontic appliances makes it difficult for patients to perform hygiene procedures. Insufficient removal of bacterial biofilm can cause enamel demineralization, manifesting by visible white spot lesions or periodontal diseases, such as gingivitis periodontitis or gingival hyperplasia. The classic methods of preventing the above problems include, in addition to proper hygiene, ultrasonic scaling, periodontal debridement, and oral rinses based on chlorhexidine. New alternative methods of reducing plaque around brackets are being developed. There is a growing interest among researchers in the possibility of using photodynamic therapy in orthodontics. A literature search for articles corresponding to the topic of this review was performed using the PubMed and Scopus databases and the following keywords: ‘photodynamic therapy’, ‘orthodontics’, and ‘photosensitizer(s)’. Based on the literature review, two main directions of research can be distinguished: clinical research on the use of photodynamic therapy in the prevention of white spot lesions and periodontal diseases, and ex vivo research using a modified orthodontic adhesive by adding photosensitizers to them. Methylene blue is the most frequently used photosensitizer in clinical trials. The effectiveness of antimicrobial photodynamic therapy is mainly compared to the ultrasonic scaler as a single therapy or as an adjunct to the ultrasonic scaler. In their conclusions, the researchers most often emphasize the effectiveness of antimicrobial photodynamic therapy in reducing microbial levels in patients treated with fixed appliances and the possibility of using it as an alternative to routine procedures aimed at maintaining a healthy periodontium. The authors suggest further research on the use of photodynamic therapy to prove the validity of this method in orthodontics. It should also not be forgotten that proper hygiene is the basis for maintaining oral cavity health, and its neglect is a contraindication to orthodontic treatment.