Light-induced modulation of Porphyromonas gingivalis growth

Application of Different Wavelengths of LED Lights in Antimicrobial Photodynamic Therapy for the Treatment of Periodontal Disease

Therapeutic light has been increasingly used in clinical dentistry for surgical ablation, disinfection, bio-stimulation, reduction in inflammation, and promotion of wound healing. Photodynamic therapy (PDT), a type of phototherapy, has been used to selectively destroy tumor cells. Antimicrobial PDT (a-PDT) is used to inactivate causative bacteria in infectious oral diseases, such as periodontitis. Several studies have reported that this minimally invasive technique has favorable therapeutic outcomes with a low probability of adverse effects. PDT is based on the photochemical reaction between light, a photosensitizer, and oxygen, which affects its efficacy. Low-power lasers have been predominantly used in phototherapy for periodontal treatments, while light-emitting diodes (LEDs) have received considerable attention as a novel light source in recent years. LEDs can emit broad wavelengths of light, from infrared to ultraviolet, and the lower directivity of LED light appears to be suitable for plaque control over large and complex surfaces. In addition, LED devices are small, lightweight, and less expensive than lasers. Although limited evidence exists on LED-based a-PDT for periodontitis, a-PDT using red or blue LED light could be effective in attenuating bacteria associated with periodontal diseases. LEDs have the potential to provide a new direction for light therapy in periodontics.

Photoinactivation and Photoablation of Porphyromonas gingivalis

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.

Light-emitting-diode-based antimicrobial photodynamic therapies in the treatment of periodontitis

The use of light-emitting diode (LED)-based photodynamic therapies in the treatment of periodontitis is increasing because these modalities are effective, safe, and painless. They are not subject to acquired drug resistance or environmental issues and are associated with no complications when used appropriately. These light sources have also been used in combination with pharmacological measures to synergize their effects and optimize therapeutic outcomes. This review focuses on optical devices used in treating periodontitis and delineates the current applications of various methods, including their utility and efficacy. The application of LEDs in periodontology is described.

Porphyrins and flavins as endogenous acceptors of optical radiation of blue spectral region determining photoinactivation of microbial cells

It is shown that exposure of suspensions of gram-positive Staphylococcus aureus, gram-negative Escherichia coli and yeast-like fungi Candida albicans to laser radiation of blue spectral region with 405 and 445 nm causes their growth inhibition without prior addition of exogenous photosensitizers. It is experimentally confirmed that compounds of flavin type capable of sensitizing the formation of reactive oxygen species can act as acceptors of optical radiation of blue spectral region determining its antimicrobial effect along with endogenous metal-free porphyrins (the role of endogenous porphyrins has been confirmed earlier by a number of researchers). The participation of these compounds in the antimicrobial effect of laser radiation is supported by the registration of porphyrin and flavin fluorescence in extracts of microbial cells upon excitation by radiation used to inactivate the pathogens. In addition, the intensity of the porphyrin fluorescence in extracts of microbial cells in the transition from radiation with λ = 405 nm to radiation with λ = 445 nm decreases by 15-30 times, whereas the photosensitivity of the cells under study in this transition decreases only 3.7-6.2 times. The contribution of porphyrin photosensitizers is most pronounced upon exposure to radiation with λ = 405 nm (absorption maximum of the Soret band of porphyrins), and flavins - upon exposure to radiation with λ = 445 nm (maximum in the flavin absorption spectrum and minimum in the absorption spectrum of porphyrins). The ratio between the intensity of the porphyrin and flavin components in the fluorescence spectrum of extracts depends on the type of microbial cells.

Antimicrobial efficacy of irradiation with visible light on oral bacteria in vitro: a systematic review

AIM

Resistances to antibiotics employed for treatment of infectious diseases have increased to alarming numbers making it more and more difficult to treat diseases caused by microorganisms resistant to common antibiotics. Consequently, novel methods for successful inactivation of pathogens are required. In this instance, one alternative could be application of light for treatment of topical infections. Antimicrobial properties of UV light are well documented, but due to its DNA-damaging properties use for medical purposes is limited. In contrast, irradiation with visible light may be more promising.

METHODS

Literature was systematically screened for research concerning inactivation of main oral bacterial species by means of visible light.

RESULTS

Inactivation of bacterial species, especially pigmented ones, in planktonic state showed promising results. There is a lack of research examining the situation when organized as biofilms.

CONCLUSION

More research concerning situation in a biofilm state is required.

Lethal effect of blue light-activated hydrogen peroxide, curcumin and erythrosine as potential oral photosensitizers on the viability of Porphyromonas gingivalis and Fusobacterium nucleatum

OBJECTIVES

Recently, photodynamic therapy (PDT) has been introduced as a new modality in oral bacterial decontamination. Current research aims to evaluate the effect of photodynamic killing of visible blue light in the presence of hydrogen peroxide, curcumin and erythrosine as potential oral photosensitizers on Porphyromonas gingivalis associated with periodontal bone loss and Fusobacterium nucleatum associated with soft tissue inflammation.

MATERIALS AND METHODS

Standard suspension of P. gingivalis and F. nucleatum were exposed to Light Emitting Diode (LED) (440-480 nm) in combination with erythrosine (22 µm), curcumin (60 µM) and hydrogen peroxide (0.3 mM) for 5 min. Bacterial samples from each treatment groups (radiation-only group, photosensitizer-only group and blue light-activated photosensitizer group) were subcultured onto the surface of agar plates. Survival of these bacteria was determined by counting the number of colony forming units (CFU) after incubation.

RESULTS

RESULTS for antibacterial assays on P. gingivalis confirmed that curcumin, Hydrogen peroxide and erythrosine alone exerted a moderate bactericidal effect which enhanced noticeably in conjugation with visible light. The survival rate of P. gingivalis reached zero present when the suspension exposed to blue light-activated curcumin and hydrogen peroxide for 2 min. Besides, curcumin exerted a remarkable antibacterial activity against F. nucleatum in comparison with erythrosine and hydrogen peroxide (P=0.00). Furthermore, the bactericidal effect of visible light alone on P. gingivalis as black-pigmented bacteria was significant.

CONCLUSION

Our result suggested that visible blue light in the presence of erythrosine, curcumin and hydrogen peroxide would be consider as a potential approach of PDT to kill the main gramnegative periodontal pathogens. From a clinical standpoint, this regimen could be established as an additional minimally invasive antibacterial treatment of plaque induced periodontal pathologies.

Bactericidal effect of visible light in the presence of erythrosine on Porphyromonas gingivalis and Fusobacterium nucleatum compared with diode laser, an in vitro study

OBJECTIVES

Recently, photodynamic therapy (PDT) has been introduced as a new modality in oral bacterial decontamination. Besides, the ability of laser irradiation in the presence of photosensitizing agent to lethal effect on oral bacteria is well documented. Current research aims to evaluate the effect of photodynamic killing of visible blue light in the presence of plaque disclosing agent erythrosine as photosensitizer on Porphyromonas gingivalis associated with periodontal bone loss and Fusobacterium nucleatum associated with soft tissue inflammation, comparing with the near-infrared diode laser.

MATERIALS AND METHODS

Standard suspension of P. gingivalis and F. nucleatum were exposed to Light Emitting Diode (LED) (440-480 nm) used to photopolymerize composite resine dental restoration in combination with erythrosine (22 µm) up to 5 minutes. Bacterial sample were also exposed to a near-infrared diode laser (wavelength, 830 nm), using identical irradiation parameters for comparison. Bacterial samples from each treatment groups (radiation-only group, erythrosine-only group and light or laser with erythrosine group) were subcultured onto the surface of agar plates. Survival of these bacteria was determined by counting the number of colony forming units (CFU) after incubation.

RESULTS

Exposure to visible blue light and diode laser in conjugation with erythrosine significantly reduced both species examined viability, whereas erythrosine-treated samples exposed to visible light suggested a statically meaningful differences comparing to diode laser. In addition, bactericidal effect of visible light or diode laser alone on P. gingivalis as black-pigmented bacteria possess endogenous porphyrins was noticeably.

CONCLUSION

Our result suggested that visible blue light source in the presence of plaque disclosing agent erythrosine could can be consider as potential approach of PDT to kill the main gram-negative periodontal pathogens. From a clinical standpoint, this regimen could be established as an additional minimally invasive antibacterial treatment of plaque induced periodontal pathologies.

Specific-wavelength visible light irradiation inhibits bacterial growth of Porphyromonas gingivalis

BACKGROUND AND OBJECTIVE

The effects of laser irradiation on Porphyromonas gingivalis have been reported, but the results are still controversial regarding the efficiency because of the differences of the light sources and irradiation conditions. The aim of this study was to determine the wavelength and irradiation conditions under which the most effective inhibitory effect on P. gingivalis growth was seen without any photosensitizers.

MATERIAL AND METHODS

Using an Okazaki large spectrograph, monochromatic light spectra ranging from 400 to 700 nm were evaluated to determine which spectra effectively inhibited bacterial growth. Moreover, using a monochromatic 405-nm irradiating device, the effects of various irradiating conditions on P. gingivalis growth were examined.

RESULTS

Growth of bacteria irradiated at 400 nm and 410 nm was significantly suppressed compared with a nonirradiated control, whereas wavelengths of 430 nm and longer produced no significant inhibition. A constant energy density of 15 J/cm2 was found to be enough to show an inhibitory effect. Significant inhibition of bacterial growth was found after only 1 min at 50 mW/cm2 irradiation.

CONCLUSION

These results indicate that P. gingivalis growth is specifically suppressed by 405-nm light irradiation, suggesting that visible blue light irradiation is a promising means for eradicating periodontopathogenic bacteria from periodontal lesions.

Mechanism of visible light phototoxicity on Porphyromonas gingivalis and Fusobacterium nucleatum

Phototoxicity of visible light laser on the porphyrin-producing bacteria, Porphyromonas gingivalis, in the absence of photosensitizers and under aerobic conditions was shown in previous studies. Recently, we found that the noncoherent visible light sources at wavelengths of 400-500 nm, commonly used in restorative dentistry, induced a phototoxic effect on P. gingivalis, as well as on Fusobacterium nucleatum, and to a lesser extent on the Streptococci sp. To elucidate the mechanism of this phototoxic effect, P. gingivalis and F. nucleatum were exposed to light (1) under aerobic and anaerobic environments and (2) in the presence of scavengers of reactive oxygen species (ROS). Phototoxic effect was not observed when the bacteria were exposed to light under anaerobic conditions. Dimethyl thiourea, a hydroxyl radical scavenger, was effective in reducing phototoxicity (P </= 0.05). Other scavengers, such as catalase, superoxide dismutase and ascorbic acid, were less effective when applied separately. These results support the assumption that the phototoxic effect of blue light on the periopathogenic bacteria is oxygen dependent and that hydroxyl radicals play an important role in this process.

Synergic antibacterial effect between visible light and hydrogen peroxide on Streptococcus mutans

OBJECTIVES

To evaluate the possibility of enhancing the phototoxic effect on Streptococcus mutans using a potentially antibacterial synergic effect between blue light and hydrogen peroxide (H2O2), and to investigate the antibacterial mechanism involved.

METHODS

Growth of S. mutans samples was determined after exposure to light in the presence and absence of H2O2. The effect of such light on H2O2 degradation, on reactive oxygen species (ROS) generation and on the exposed-medium temperature was examined.

RESULTS

The combination of light exposure for 20 s (approximately 23 J/cm2) and a concentration of 0.3 mM H2O2 yielded 96% growth inhibition, whereas, when applied separately, light exposure decreased bacterial growth by 3% and H2O2 by 30% compared with the control. The results showed no direct effect of the light on H2O2 degradation, a partial protective effect of ROS scavengers on S. mutans and a non-lethal increase in the medium temperature after light exposure.

CONCLUSIONS

An antibacterial synergic effect between blue light and H2O2 was observed. The mechanism of the phototoxic effect on S. mutans was basically a photochemical process, in which ROS were involved. Application of such light in combination with H2O2 to an infected tooth could be an alternative to or serve as an additional minimally invasive antibacterial treatment.