Photodynamic Therapy with Aminolevulinic Acid Enhances the Cellular Activity of Cells Cultured on Porcine Acellular Dermal Matrix Membranes Used in Periodontology

Abstract

This study aims to test a photodynamic protocol based on a gel containing aminolevulinic acid followed by red-LED (ALAD-PDT) irradiation on human gingival fibroblasts (hGFs) and osteoblasts (hOBs) cultured on a porcine acellular dermal matrix membrane (PADMM). In the previous literature, ALAD-PDT showed solid antibacterial activity and proliferative induction on HGFs cultured on plates and HOBs cultured on a cortical lamina. PADMMs are used in dentistry and periodontology to treat gingival recessions and to increase the tissue thickness in the case of a thin biotype without the risks or postoperative discomfort associated with connective tissue grafts. However, one of the possible complications in this type of surgery is represented by bacterial invasion and membrane exposition during the healing period. We hypothesized that the addition of ALAD-PDT to PADMMs could enhance more rapid healing and decrease the risks connected with bacterial invasion. In periodontal surgery, PADMMs are inserted after a full-thickness flap elevation between the bone and the flap. Consequently, all procedures were performed in parallel on hOBs and hGFs obtained by dental patients. The group control (CTRL) was represented by the unexposed cells cultured on the membranes, group LED (PDT) were the cells subjected to 7 min of red LED irradiation, and ALAD-PDT were the cells subjected to 45 min of ALAD incubation and then to 7 min of red LED irradiation. After treatments, all groups were analyzed for MTT assay and subjected to histological examination at 3 and 7 days and to the SEM observations at 3, 7, and 14 days. Different bone mineralization assays were performed to quantify the effects of ALAD-PDT on hOBs: ALP activity, ALP gene expression, osteocalcin, and alizarin red. The effects of ALAD-PDT on hGFs were evaluated by quantifying collagen 1, fibronectin, and MMP-8. Results showed that ALAD-PDT promoted cellular induction, forming a dense cellular network on hOBs and hGFs, and the assays performed showed statistically significantly higher values for ALAD-PDT with respect to LED alone and CTRLs. In conclusion, ALAD-PDT could represent a promising aid for enhancing the healing of gingival tissues after PADMM applications.

Evaluation of Oromucosal Natural Gum-Based Emulgels as Novel Strategy for Photodynamic Therapy of Oral Premalignant Lesions

“…In the present study, the focus was on developing oromucosal ALA-loaded delivery platforms for PDT treatment of precancerous diseases. Despite several research data aimed at evaluating topical ALA-loaded systems in a form of gel composition [27][28][29], to our knowledge this is the first study which has shown the potential of emulgels comprised of natural gums as PDT option for oromucosal application. Prepared formulations displayed off-white color, smooth consistency and the drug content was found uniform and within acceptable limits of 90-110% (Table 3) [30].…”

Photodynamic Therapy with Tolonium Chloride and a Diode Laser (635 nm) in the Non-Surgical Management of Periodontitis: A Clinical Study

“…Local factors, such as deep periodontal pockets (>5 mm), and anatomical challenges, like fissures, concavities, and furcation involvement, hinder effective debridement, leading to sub-optimal outcomes of periodontitis treatment [ 10 , 11 , 12 ]. To address these limitations associated with non-surgical mechanical debridement, additional approaches have been proposed to complement, but not replace, the standard of care [ 13 , 14 , 15 , 16 , 17 , 18 ]. These approaches primarily focus on enhancing the bactericidal effect and promoting periodontium repair.…”

“…These approaches primarily focus on enhancing the bactericidal effect and promoting periodontium repair. One such approach introduced in the management of periodontal diseases is photodynamic therapy (PDT) also referred to as antimicrobial photodynamic therapy [ 13 , 14 , 15 , 16 , 17 , 18 ].…”