Indocyanine Green-Assisted and LED-Light-Activated Antibacterial Photodynamic Therapy Reduces Dental Plaque

Sakari Nikinmaa, Niina Moilanen, Timo Sorsa, Juha Rantala, Heikki Alapulli, Anja Kotiranta, Petri Auvinen, Esko Kankuri, Jukka H Meurman, Tommi Pätilä, Sakari Nikinmaa, Niina Moilanen, Timo Sorsa, Juha Rantala, Heikki Alapulli, Anja Kotiranta, Petri Auvinen, Esko Kankuri, Jukka H Meurman, Tommi Pätilä

Abstract

Aim: This study aimed to determine the feasibility and first efficacy of indocyanine green (ICG)-assisted antimicrobial photodynamictherapy (aPDT) as activated using LED light to the dental plaque.

Methods: Fifteen healthy adults were assigned to this four-day randomized study. After rinsing with ICG, 100 J/cm2 of 810 nm LED light was applied to the aPDT-treatment area. Plaque area and gingival crevicular fluid (GCF) matrix metalloproteinase-8 (MMP-8) were measured, and plaque bacteriomes before and after the study were analyzed using 16S rRNA sequencing.

Results: aPDT administration was preformed successfully and plaque-specifically with the combination of ICG and the applicator. Total plaque area and endpoint MMP-8 levels were reduced on the aPDT-treatment side. aPDT reduced Streptococcus, Acinetobacteria, Capnocytophaga, and Rothia bacteria species in plaques.

Conclusion: ICG-assisted aPDT reduces plaque forming bacteria and exerts anti-inflammatory and anti-proteolytic effects.

Keywords: antibacterial photodynamic therapy; dental plaque; gingivitis.

Conflict of interest statement

Tommi Pätilä is a stock owner and founder of Koite Health Oy, a company specialized in providing photodynamic therapy. He is a co-inventor of US20210030874A1, WO2021023915A1, WO2020193870A1, and WO2019234308A1. Sakari Nikinmaa is a stock owner and founder of Koite Health Oy, a company specialized in providing photodynamic therapy. He is a co-inventor of patents WO2020084199A1, US20210030874A1, WO2021023915A1, WO2020193870A1, and WO2019234308A1. Juha Rantala is a stock owner and founder of Koite Health Oy, a company specialized in providing photodynamic therapy. He is a co-inventor of patents WO2020084199A1, US20210030874A1, WO2021023915A1, WO2020193870A1, and WO2019234308A1. Timo Sorsa is an inventor of U.S. Patents 5652223, 5736341, 5866432, and 6143476 and co-inventor of U.S. Patent 20170023571A1.

Figures

Figure 1
Figure 1
(A) LED light applicator; and (B) study workflow. 16S, bacteriome 16S rRNA sequencing; CGF cervical gingival fluid; aPDT, antimicrobial photodynamic therapy. (C,D) Selective indocyanine green (ICG) localization to the dental plaque. Daylight (C,D) near-infrared light images after ICG mouth rinse. Representative images at Day 2, when the teeth had been without cleaning for a single day. * premolar one and ** premolar two.
Figure 2
Figure 2
Dental plaque formation: (A) plaque areas (62.7% of total premolar dental area) on the control side in the last imaging session (premolar one (*) and premolar two (**)); (B) plaque areas (33.8% of total premolar dental area) on the treatment side at the same time point; and (C) plaque areas at the end of study after four days of aPDT application. Paired measurements demonstrated significantly less plaque formation on the treated side compared to control side.
Figure 3
Figure 3
(A) Matrix metalloproteinase-8 (MMP-8) concentrations at indicated days and sides in samples from gingival pockets. aPDT effect on MMP-8 secretion significantly lower on the aPDT-treated side than on the control side after the last application of aPDT at end-of-study; and (B) analysis of bacteriome using 16S rRNA sequencing. This figure shows the diversity of bacteria within the plaque samples from the treatment and control premolars at the start of the treatment at baseline and at the end of the study period. At the end of treatment, a significant reduction in the relative proportion of Streptococcus, Actinomyces, and Rothia bacteria species was identified, and a relative increase in the Neisseria, Haemophilus, and Leptotrichia bacteria species was seen between treated and control side. * p < 0.05, ** p < 0.01, *** p < 0.001.

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