Authored by Hassan A Al-Shamahy*
Abstract
Background: Chronic gingivitis is a common disease, especially among adult patients who often develop periodontal pocket and the occurrence gradual loss of the periodontal attachment. A wide range of microorganisms is known to be associated with periodontal disease, including Porphyromonas gingivalis (Pg) and Aggregatibacter actinomycetemcomitans (Aa).
Objectives: Therefore, a study was conducted to determine the effect of phototoxicity of visible blue light (vBL) on Aa and Pg Clinical isolates from chronic periodentitis patients, and to study their antibiotic sensitivity against selected antibiotics. Methods: The test was carried out on 15 strains of Aa and 15 strains of Pg isolated from pockets of chronic periodentitis patients aged between 30-50 years old with pocket depths of 5-6mm. Bacteria cultured, isolated, identified by standard bacteriological methods, and then exposed to visible blue light for different periods of time. After bacterial cultures were exposed to light, bacterial killing rates were calculated from a colony forming unit (CFU) after 48 hours of anaerobic incubation.
Results: There was a decrease in CFU for both microorganisms and the result is increased with the increase of exposure to vBL, from zero, 20, 40 and 60 secs.
Conclusion: There was a phototoxic effect of visible blue light emitted by a light therapy device against anaerobic gingival pathogens and exposure to blue light is effective in reducing gum pathogens. It is recommended to use an adjuvant external optical enhancer and to expose pathogens to visible light for clinical antimicrobial treatment.
Keywords:
Blue light; CFU; Anaerobic periodontal pathogenIntroduction
PVL is a toxin produced by Staphylococcus aureus. It induces soft tissue breakdown and necrosis increasing the virulence of the associated microorganism. It is commonly associated with cutaneous abscesses and carbuncles however it can cause complications such as bacteraemia, septic arthritis and necrotizing pneumonia. This case reports discusses a clinical scenario where a patient attended to a maxillofacial unit with an infection to his lip, which was found to be PVL positive.The result of vBL in the 400-450nm range has been reported in a number of studies as it has been effective as a topical treatment for eczema and psoriasis and is assumed to help inhibit the immune response [1-3]. Studies have also shown improvement in facial acne when exposed to LED emissions at 414nm [4,5]. A combination of red and blue light exposure is used in clinical dermatological treatments [6,7]. Creators such as Philips are currently developing devices and technologies that emit a blue visible spectrum for use in the treatment of skin diseases [8-10]. The presence of blue light has also been reported in a number of studies that have been effective in killing bacteria associated with periodontal disease, such as Pg and Aa [11-13] Periodontal disease, also known as gum disease, is a group of inflammatory conditions that affect the tissues surrounding the teeth [14]. The disease start as acute tenderness of the gum tissue and untreated cases can develop to form dental pockets, and finally tooth death [14]. Wide group of microorganisms have been associated with periodontal disease, out of which Pg and Aa. Treatment of periodontal disease has long involved non-surgical cleaning of the gums under a procedure called “root surface instrumentation” (RSI), which causes mechanical disruption of the bacterial biofilms below the gums. It makes it difficult to completely remove bacterial deposits and biofilms from the root surface by mechanical methods [15]. Also, there have been many treatment options available to support the effectiveness of the instrumentation, such as the use of local antibiotics and antimicrobials-photodynamic therapy [16].
One of the problems that address the use of chemical agents is the failure to maintain therapeutic concentrations at the target site and the disruption of oral microflora [17]. Thus, photodynamic therapy (PTD) was introduced to open a new course in the treatment of periodontal disease without hindering the above obstacles and problems. An innovative non-antibiotic approach, the blue light antimicrobial in the spectrum of 400-470nm demonstrated its intrinsic antimicrobial properties resulting from the presence of endogenous photosynthetic chromophores in pathogenic microbes. Microbes are expected to be less able to develop resistance to blue light than conventional antibiotics, due to the multi-target properties of blue light (aBL) [11]. In addition, it is well accepted that aBL is less harmful to host cells than UVC irradiation. [12,13]. The objectives of this study were to determine the phototoxic effect of visible blue light on Pg and Aa isolates of chronic gingivitis patients, and to study their antibiotic sensitivity against selected antibiotics.
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