Repeated Daily Use of Dual-Light Antibacterial Photodynamic Therapy in Periodontal Disease—A Case Report

Development of a New Curcumin-Loaded Dental Varnish for Antimicrobial Photodynamic Therapy Application

The main objective of this study was to develop a natural curcumin-loaded varnish that responds to blue light in an antimicrobial photodynamic therapy-based approach with photoelimination of targeted cells. Fluoride-free curcumin-loaded varnish (CUR-V) consisting of gum rosin (80 wt%) and ethanol (20 wt%) was loaded with 0, 0.25, and 10.0 wt% curcumin and then analyzed with FTIR. Subsequent investigation included applying ~19 mW/cm2 blue light for 15, 30, or 60 min (in order of increasing energy dose) to the varnishes and measuring the change in varnish color and the production of reactive oxygen species (singlet oxygen and superoxide anion), as well as performing CFU count and XTT assays of 24-h mono-species biofilms of Streptococcus mutans and Candida albicans. Lastly, a 72-h dual-species biofilm of both species was assessed with a CFU count assay. As the light energy applied to the 0.25% CUR-V and 0.00% CUR-V samples increased, there was a reduced and quantifiable difference in color between these two varnish groups (p < 0.001). In addition, singlet oxygen production was most dependent on curcumin loading in the varnish, while superoxide anion production appeared more dependent on blue light energy (p < 0.001 for both). In subsequent investigations of mono- and dual-species biofilms, the ability to induce an agonistic antimicrobial response as a function of curcumin loading in the natural varnish and blue light energy was demonstrated. Inherently, as curcumin loading and blue light energy increased, the photoelimination of both species investigated increased. As expected, the impact of aPDT on the 72-h biofilm was less than that observed for the 24-h biofilm; however, the more mature dual-species biofilm still observed a photoelimination effect with greater curcumin concentration. This study provides early evidence toward the development of a new natural curcumin-loaded fluoride-free varnish that, when combined with blue light irradiation, shows significant potential to effectively provide a targeted antimicrobial response against cariogenic species. To date, there is no similar approach that can serve as a natural, fluoride-free over-the-counter alternative to assist in caries prevention and treatment.

Revisiting Periodontal Disease in Dogs: How to Manage This New Old Problem?

Periodontal disease (PD) is one of the most prevalent oral inflammatory diseases in dogs. PD onset begins with the formation of a polymicrobial biofilm (dental plaque) on the surface of the teeth, followed by a local host inflammatory response. To manage this disease, several procedures focusing on the prevention and control of dental plaque establishment, as well as on the prevention of local and systemic PD-related consequences, are essential. The removal of dental plaque and the inhibition of its formation can be achieved by a combination of dental hygiene homecare procedures including tooth brushing, the application of different oral products and the use of specific diet and chew toys, and regular professional periodontal procedures. Additionally, in some cases, periodontal surgery may be required to reduce PD progression. Associated with these measures, host modulation therapy, antimicrobial therapy, and other innovative therapeutic options may be useful in PD management. Moreover, PD high prevalence and its relation with potential local and systemic consequences reinforce the need for investment in the development of new preventive measures, treatments, and oral procedures to improve the control of this disease in dogs. Knowledge on the specific guidelines and diversity of the available products and procedures are fundamental to apply the most adequate treatment to each dog with PD.

Home-Applied Dual-Light Photodynamic Therapy in the Treatment of Stable Chronic Periodontitis (HOPE-CP)-Three-Month Interim Results

A single-site, randomized clinical trial was designed to determine the efficacy of regular home use of Lumoral® dual-light antibacterial aPDT in periodontitis patients. For the study, 200 patients were randomized to receive non-surgical periodontal treatment (NSPT), including standardized hygiene instructions and electric toothbrush, scaling and root planing, or NSPT with adjunctive Lumoral® treatment. A complete clinical intraoral examination was conducted in the beginning, at three months, and at six months. This report presents the three-month results of the first 59 consecutive randomized subjects. At three months, bleeding on probing (BOP) was lower in the NSPT + Lumoral®-group than in the NSPT group (p = 0.045), and more patients in the NSPT + Lumoral®-group had their BOP below 10% (54% vs. 22%, respectively, p = 0.008). In addition, patients in the NSPT + Lumoral®-group improved their oral hygiene by visible-plaque-index (p = 0.0003), while the NSPT group showed no statistical improvement compared to the baseline. Both groups significantly reduced the number of deep periodontal pockets, but more patients with a reduction in their deep pocket number were found in the NSPT + Lumoral® group (92% vs. 63%, p = 0.02). Patients whose number of deep pockets was reduced by 50% or more were also more frequent in the NSPT + Lumoral®-group (71% vs. 33%, p = 0.01). Patients with initially less than ten deep pockets had fewer deep pockets at the three-month follow-up in the Lumoral® group (p = 0.01). In conclusion, adjunctive use of Lumoral® in NSPT results in improved treatment outcomes at three months post-therapy.