EVALUATION AND COMPARISON OF THE EFFECT OF INDOCYANINE GREEN, PHOTOTHERMAL THERAPY AND PHOTODYNAMIC THERAPY ON TITANIUM ADHERENT BIOFILM OF PORPHYROMONAS GINGIVALIS - AN IN VITRO STUDY

Dr. Rashika V., *Dr. Neelamma A. Shetti and Dr. Shaik Shahanaz

ABSTRACT

Introduction: Peri-implantitis is an oral disease that is known to cause inflammation around osseointegrated implants and its supporting structures due to the presence of plaque (dental biofilm). It is caused by the accumulation of dental plaque which is a structurally and functionally well-organized biofilm that normally maintains a homeostatic relationship with the human host. A disturbance in this balance causes a microbial shift from commensal to pathogenic periodontal pathogens that mark the beginning of the peri-implant disease. The frontline treatment for peri-implant diseases includes scaling and root planning (SRP) that effectively removes the plaque and restores it to a healthy state and the use of antimicrobial agents such as Chlorhexidine that are often used as an adjunct to SRP to aid and maintain the healthy state of tissues. However, these antimicrobial agents have side effects such as alteration of taste, discoloration of teeth and development of antimicrobial resistance. The conventional treatment doesn’t eliminate the biofilm completely due to the complex structure of the implant. Hence, there has been a shift in research towards new non- invasive technique as LASER. However, the laser may cause some detrimental thermal effects on the surrounding periodontal tissues that lead to potential and unexpected side effects. Recently, an alternative approach named antimicrobial photodynamic therapy (aPDT) has been developed for the decontamination of implant surfaces. In dentistry, the application of PDT is growing rapidly. The purpose of the current study is to assess and compare the antimicrobial activity of Indocyanine green, Photothermal therapy and Photodynamic therapy on the titanium adherent biofilm of Porphyromonas gingivalis. Aim: To assess and compare the antimicrobial activity of Indocyanine green, Photothermal therapy and Photodynamic therapy on titanium adherent biofilm of Porphyromonas gingivalis. Materials and Methods: This is an experimental in-vitro microbial study. 120 pre-sterilized titanium of 8mm and thickness of 2mm was obtained and the disc were inoculated with strain of porphyromonas gingivalis and kept in anaerobic chamber for 48 hours. The inoculated disc was randomly allocated into four groups. Group 1: control group; group 2: photosensitizer (Test group 1); group 3: Photothermal therapy (Test group 2); group 4: Photodynamic therapy (Test group 3). The dye used was Indocyanine green dye. Diode laser was used with 940 nm at 0.1 power watt at 5J/cm2 for 30-40 sec. The data were entered in Excel and analyzed statistically using the SPSS software version. Inter group comparisons was done by One way ANOVA. Pairwise Comparison of four groups was also carried out using LSD post hoc test. All statistical tests were performed at a significance level of 5% (p<0.05). Results and Conclusion: In test groups there was a significant reduction in P. gingivalis colony count in ICG, PTT and PDT group. The maximum reduction in P.gingivalis bacterial colony count was noted with PDT (Mean ±SD is 20.7±2.7 ×10⁴) while minimum reduction was noted in ICG group (Mean±SD is 51 ± 2.6 ×10⁴). Photothermal therapy also showed reduction in P.gingivalis bacterial colony count with 34.3 ± 4.2×10⁴) Therefore, it is described that Photodynamic therapy (PDT) showed maximum reduction in P. gingivalis bacterial colony count when compared to other treatment protocol and shows there is statistically significant result of P value <0.001

Keywords: Implant, Indocyanine green, Laser, Peri-implantitis, Photodynamic therapy.