Repeated Home-Applied Dual-Light Antibacterial Photodynamic Therapy Can Reduce Plaque Burden, Inflammation, and aMMP-8 in Peri-Implant Disease—A Pilot Study

Abstract

Until now, in clinical dentistry, antibacterial photodynamic therapy (aPDT) has been restricted to in-office treatments, which hampers repeated applications. This pilot study tested the benefit of a commercially available Lumoral® device designed for regular periodontal dual-light aPDT treatment at home. Seven patients with peri-implant disease applied dual-light aPDT daily in addition to their normal dental hygiene for four weeks. A single Lumoral® treatment includes an indocyanine green mouth rinse followed by 40 J/cm2 radiant exposure to a combination of 810 nm and 405 nm light. A point-of-care analysis of active-matrix metalloproteinase (aMMP-8), visible plaque index (VPI), bleeding on probing (BOP), and peri-implant pocket depth (PPD) measurements was performed on day 0, day 15, and day 30. Reductions in aMMP-8 (p = 0.047), VPI (p = 0.03), and BOP (p = 0.03) were observed, and PPD was measured as being 1 mm lower in the implant (p = ns). These results suggest a benefit of regular application of dual-light aPDT in peri-implantitis. Frequently repeated application can be a promising approach to diminishing the microbial burden and to lowering the tissue destructive proteolytic and inflammatory load around dental implants. Further studies in larger populations are warranted to show the long-term benefits.

A Randomized Trial of Home-Applied Dual-Light Photodynamic Therapy in Stable Chronic Periodontitis -Three-Month Interim Results

“…In the NSPT group, less than 2/3 of patients reduced the number of deep pockets, and 1/3 of patients reduced the number of deep periodontal pockets by 50% or more. These results are in agreement with our previously reported effects of regular dual-light treatment, where a significant reduction in aMMP-8, BOP, and VPI were seen in periodontal patients with intensive, regular, up to twice daily, Lumoral® use [9]. Similarly, a recently published case report showed a significant improvement in periodontal disease status after regular Lumoral® use in a patient with difficulties in the mechanical performance of oral hygiene at home [15].…”

“…However, not surprisingly, because in most studies, the treatment has been applied sparsely, actually, in most studies only once or twice [7,8]. The treatment has appeared more effective in studies which have reported repetitive aPDT treatment [9][10][11]. Thus, the frequency of treatment can have a significant effect on the response.…”

“…Dual-light therapy is a combined application of aPDT and aBL, and it has shown significant antibacterial efficacy in biofilms and a reduction in dental plaque development [12][13][14]9]. Lumoral® is a novel CE-marked medical device which provides simultaneous 405 nm aBL and 810 nm near-infrared (NIR) LED light in a mouthguard form.…”

“…Selective adherence of ICG to plaque and bacteria leads to targeted antibacterial activity at the dental plaque [12,13]. In regular home use, the dual-light treatment by Lumoral® reduced inflammation and inflammatory markers in peri-implant disease and has shown benefits when used to support oral hygiene at home [9,15]. This clinical study was designed for the evaluation of effectiveness of home-applied dual-light aPDT on periodontal disease symptoms and clinical appearance.…”

aMMP-8 Oral Fluid PoC Test in Relation to Oral and Systemic Diseases

“…Our findings also-for the first time-demonstrate that aMMP-8 PoCT is a quantitative online and real-time biomarker to be well-implemented in the new staging and grading classification of periodontitis in patients receiving radiotherapy for their head and neck cancer [47]. Noteworthy, aMMP-8 PoCT-technology can thus be well adapted to quantitatively real-time online and quantitatively chairside monitor and follow the outcomes of the emerging host modulating treatments [110,120,121]. Further studies are warranted in this area.…”