Novel indocyanine green mediated antimicrobial photodynamic therapy in the management of chronic periodontitis - A randomized controlled clinico-microbiological pilot study.

BACKGROUND: The use of scaling, root planing, antimicrobials, or antibiotics in the treatment of Chronic Periodontitis have proven beneficial in the past. The reduction in inflammatory markers and significant resolve in the clinical signs and symptoms and microbial loads evinced by a number of studies are a clear corroboration of the fact, but certain restraints utilizing these methods call for more effective ways of treating the disease. Later, lasers or photodynamic dyes used with the lasers like methylene blue or toluidine blue O have also not proven much efficacy and need further research. Hence the present pilot study is a step forward in this direction as it helps analyse the microbiological and clinical effects of indocyanine green antimicrobial photodynamic therapy an as adjunct to the non-surgical periodontal therapy in treating chronic periodontitis patients. MATERIALS AND METHODS: 30 patients diagnosed with generalized chronic periodontitis were treated with scaling and root planing alone - control sites; and indocyanine green antimicrobial photodynamic therapy in addition to scaling and root planing - experimental sites. 810 â€‹nm low level Gallium Aluminium Arsenide diode laser was used to activate the dye in the periodontal pockets of the experimental sites. Clinical parameters i.e. gingival index, plaque index, sulcus bleeding index, probing pocket depth and relative attachment level; and microbiological parameter i.e. the total viable anaerobic count were recorded at the inception and at 3- and 6-months post therapy. RESULTS: Experimental sites showed significantly greater amelioration in all inquired clinical parameters and microbiological parameter at the end of 3- and 6-months of therapy. CONCLUSION: While the gold standard scaling and root planing remains, clinicians may also contemplate using the indocyanine green mediated antimicrobial photodynamic therapy as an adjunct to it. Also, it is a safer, cost effective, less arduous, and patient friendly means of treating the disease.

Antimicrobial peptides: The miraculous biological molecules.

Antimicrobial peptides (AMPs) are biological molecules bridging the innate and acquired immune systems of the defense mechanism. They have been found to be effective against not only Gram-positive and -negative bacterial species but also fungi and viruses with their broad spectrum of activity. Among the various niches where they are found in the human body, in the oral cavity, the AMPs are secreted by the epithelial cells, defense cells, crevicular fluid, and in the salivary secretions and form the first line of defense against bacterial invasion. The present review gathers information from a number of literature reviews, systematic reviews articles, and original research work to come to a conclusion regarding the use of AMPs. AMPs are miraculous in that they either do not or develop resistance very slowly and hence are supposed to be great candidates for developing antibiotics. Their use in mouthwash formulations, topical applications, etc., as therapeutic modalities has found some success in the past but is still undergoing trials. In periodontal disease, their active role as biomarkers by the relative upregulations and downregulations during disease progression has also been recognized. The early recognition of these biomarker changes can help regulate the progression of periodontal diseases. They also control the development and progression of biofilm formation and might potentially contribute toward the development of therapeutic mimetics, probiotics, and antibiotics in the near future.