Treatment of Peri-Implant Mucositis with Standard of Care and Bioptron Hyperlight Therapy: A Randomized Clinical Trial

Effect of led photobiomodulation on tooth movement, gingival hypertrophy and pain in response to treatment with fixed orthodontic appliance

Photobiomodulation (PBM) is a form of treatment that uses low-power red and near-infrared light to stimulate tissue repair and regeneration at the cellular level. 32 subjects (198 teeth examined), 10 males and 22 females aged 14.6 ± 2.0 years, with mild dental crowding were included in a randomised, controlled clinical trial. The patients were treated with a fixed orthodontic appliance (FOA). Subjects were randomised into an experimental group (a PBM group irradiated with an LED light source with wavelengths of 625 nm, 660 nm and 850 nm simultaneously and an irradiance of 16 mW/cm²) and a placebo control group that received non-therapeutic irradiation with visible light. PBM therapy began within the first 2 days of appliance insertion and was administered twice weekly for 4 weeks. The rate of tooth movement (a change in distance at the same selected point on the occlusal plane of the tooth determined by measurements on 3D models), the presence of gingival hypertrophy (with a free gingival margin of at least 1 mm occlusal to the enamel-cement junction), the plaque index (PI), the sulcus bleeding index (SBI) and the subjective pain sensation using the visual analogue scale (VAS) were monitored. In the experimental PBM group (N = 14), the rate of movement with the FOA was statistically significantly higher at both 1 week of placement (0.5 mm [95%CI: 0.4-0.8]) and 4 weeks (1.1 mm [95%CI: 0.8-1.4]) than in the placebo group (N = 18), where the values were (0.4 mm [95%CI: 0.2-0.5]) at 1 week and (0.6 mm [95%CI: 0.4-0.9]) at 4 weeks. A lower incidence of gingival hypertrophy was observed in the PBM group (21.4%) than in the placebo group (55.6%) after 4 weeks (Mann-Whitney U-test, p < 0.05). PBM with LED accelerated orthodontic tooth movement during the levelling and alignment phase and reduced the incidence of gingival hypertrophy.

Adjunctive photochemical therapy for management of inflammatory peri-implant diseases: A systematic review and meta-analysis

This study aimed to systematically review the data on interventions involving adjunctive photochemical therapy in treating peri-implant mucositis (PIM) and peri-implantitis (PI). The electronic search was conducted through six databases in October 2023, seeking studies relying on any kind of adjunctive photochemical therapy in treating inflammatory peri-implant diseases (PIDs). To showcase the effect size, mean differences along with 95% confidence intervals were utilized. Forty-seven studies were deemed eligible for qualitative synthesis, 14 of which were included in the meta-analysis. Low-level light therapy and photodynamic therapy led to enhanced improvements in clinical and radiographic indices, such as bone level (BL), bleeding on probing (BoP), clinical attachment level (CAL), and probing depth (PD), during the 3-month follow-up. However, the differences in efficacy between treatments incorporating adjunctive photochemical therapy and those relying solely on mechanical debridement, considered the gold standard, lessened over extended follow-up periods of 6, 9, and 12 months. Significant differences were observed when comparing the treatment outcomes following adjunctive photochemical therapy between obese and smoker patients with healthy subjects. Incorporating adjunctive photochemical therapy for PID treatment might improve clinical and radiographic parameters in a short-term follow-up of 3 months, but longer-term benefits appear comparable to routine treatments.

Enhanced Photothermal Tumor Ablation Using Polypyrrole-Gold Nanocomposites Activated by Polarized Polychromatic Low-Energy Light: An In Vivo Study

Photothermal therapy (PTT) offers a minimally invasive approach for cancer treatment, using light energy to selectively heat and destroy cancer cells. Success in PTT depends on efficient, stable, and biocompatible photothermal agents. This study investigates polypyrrole@gold nanocomposites (PPy@Au NCs) as photothermal agents combined with polarized polychromatic low-energy light (PPLEL) to target tumors and limit disease progression. In vivo experiments on Ehrlich carcinoma-bearing female Swiss albino mice demonstrated that PPy@Au NCs selectively accumulated in tumor tissue and, when activated by PPLEL, generated sufficient heat for effective tumor ablation. This approach enhanced treatment efficacy and presented a cost-effective solution due to the affordability of both the nanocomposite and light source. Histopathological analysis confirmed significant tumor reduction, suggesting that this synergistic combination offers a promising cancer treatment strategy. Findings support further research and potential clinical applications in photothermal cancer therapy.

Use of quantum hyperlight technology in photobiomodulation on stem cells: an experimental in vitro study

Human umbilical cord matrix Wharton's jelly mesenchymal stem cells (WJ-MSCs) are commonly utilized in regenerative medicine due to their therapeutic benefits. However, the microenvironmental stress present in patients with hyperglycemia can significantly reduce mesenchymal stem cell (MSC) viability under high-glucose conditions in the body, ultimately reducing their therapeutic effectiveness. Enhancing the survival rate of MSCs following cell transplantation remains a crucial challenge. This study investigates whether Quantum Hyperlight (QHL) can counteract the detrimental effects of high glucose (HG), thereby improving MSC survival, proliferation, and mitochondrial function. We aimed to evaluate the effect of QHL on cellular viability, proliferation, and mitochondrial activity in WJ-MSCs exposed to HG. MSCs were cultured in a medium containing normal glucose (NG) (1 g/L) and HG (4.5 g/L). MSCs in the HG medium were exposed to QHL for 90 s or 180 s with an energy density of 2.4 Joules/cm2/minute and an average power density of 40 mW/cm2. Then, proliferating cell nuclear antigen (PCNA), MTT assays, and Mitotracker Green staining were performed to evaluate cell viability and proliferation. The viability of MSCs was significantly increased in the QHL-treated groups (84% in QHL-90 s and 86% in QHL-180 s) compared to the untreated HG group (65%, p < 0.001). PCNA expression in QHL-90 s and QHL-180 s groups showed significant increases (p < 0.001) compared to the untreated HG group. MitoTracker staining intensity was significantly higher in the QHL-treated groups compared to the untreated HG group (p < 0.001). The HG environment reduced viability, proliferation, and mitochondrial staining. In the context of the NG environment, MSCs exhibited notable differences. However, the viability, proliferation, and mitochondrial staining rates of MSCs were significantly higher in the HG conditions when treated with QHL compared to the group that did not receive QHL. This study introduces QHL as a novel approach to enhance the therapeutic potential of WJ-MSCs under HG conditions, demonstrating its ability to improve cellular viability, proliferation, and mitochondrial activity. This study highlights its potential as a pretreatment to improve clinical outcomes in regenerative medicine.

Oral Fluid Biomarkers for Peri-Implantitis: A Scoping Review

Peri-implantitis, a prevalent complication in dental implant therapy, poses a significant threat to long-term implant success. The identification of reliable biomarkers for the early detection and monitoring of peri-implantitis is crucial for timely intervention and improved treatment outcomes. Salivary and peri-implant sulcular fluid (PISF) biomarkers have become promising diagnostic tools in the field of implant dentistry. This scoping review aims to explore current studies in the literature on salivary and PISF biomarkers for peri-implantitis. A systematic search was conducted on 2 databases (PubMed and Scopus) to identify relevant studies published up to January 2023. A total of 86 articles were included, which underwent data extraction and analysis. Several biomarkers have been investigated in salivary and PISF samples for association with peri-implantitis. Investigations included a wide range of biomarkers, including inflammatory markers, matrix metalloproteinases and bone loss markers. The findings suggested that certain salivary and PISF biomarkers demonstrated potential in distinguishing healthy peri-implant conditions from peri-implantitis. Elevated levels of proinflammatory cytokines, such as interleukin-1β (IL-1β) and interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-α), and matrix metalloproteinases, have been consistently associated with peri-implantitis. Additionally, alterations in bone loss markers have shown potential as indicators of disease progression and treatment response. In conclusion, this scoping review provides an overview of current knowledge on salivary and PISF biomarkers for peri-implantitis. The identified biomarkers are promising as noninvasive diagnostic tools for early detection, monitoring, and personalised management of peri-implantitis. Future studies should focus on establishing standardised protocols and conducting well-designed clinical trials to validate the diagnostic accuracy and clinical relevance of these biomarkers.

The Efficacy of Ten Different Adjunctive Measures in Patients with Nonsurgically Treated Peri-Implant Disease: A Network Meta-Analysis of Randomized Controlled Trials

Objective: This study aimed to evaluate the impact of 10 adjunctive measures on non-surgical therapy outcomes for peri-implant disease. Methods: We formulated the study question and keywords following the Population, Intervention, Comparator, Outcome framework. Randomized controlled trials were identified through searches in PubMed, Embase, the Cochrane Library, and the Web of Science. Two researchers assessed the quality of included literature according to the Cochrane Risk of Bias Assessment Tool. Data analysis and ranking were performed using Stata 15.0 software. Results: This study, involving 51 pieces of literature and 2660 samples, conducted a network meta-analysis (NMA), which revealed that photodynamic therapy (PDT) significantly reduced probing pocket depth values in patients with peri-implant mucositis (SUCRA = 96.3%) and peri-implantitis (SUCRA = 96.7%). In addition, it showed an improvement in bleeding on probing (BOP) values for peri-implantitis (SUCRA = 91.6%). Furthermore, diode lasers improved BOP values for peri-implant mucositis (SUCRA = 76.5%). Conclusions: According to the NMA results and the surface under the cumulative ranking curve (SUCRA), PDT and diode laser outperform other adjuncts in peri-implant disease.

Consensus Report of the Technical-Scientific Associations of Italian Dental Hygienists and the Academy of Advanced Technologies in Oral Hygiene Sciences on the Non-Surgical Treatment of Peri-Implant Disease

BACKGROUND

The recent publication of the new classification of periodontal and peri-implant disease has given clear indications on the parameters to be taken into consideration to correctly diagnose the different phases of these diseases. To date, however, there are no equally clear indications on the treatments to be implemented to solve these diseases. The objective of this Consensus Report is to provide guidance for the non-surgical management of peri-implant mucositis and peri-implantitis. For the drafting of the consensus, the most recent scientific literature was analysed.

MATERIALS AND METHODS

A group of 15 expert Italian dental hygienists were selected by the Italian technical-scientific societies (AIDI, UNID and ATASIO) and, starting from the literature review, they formulated indications according to the GRADE method (Grading of Recommendations, Assessment, Development, and Evaluation, a tool for rating the quality of evidence, used to draw up systematic reviews and clinical guidelines) on the treatment of peri-implant mucositis, peri-implantitis and on management of the various implanting surfaces.

CONCLUSIONS

in accordance with the international literature, non-surgical therapy alone can resolve peri-implant mucositis, but not peri-implantitis. Several adjunctive therapies have been considered and some appear to be helpful in managing inflammation.