A mechanistic approach for clinical translation of Photobiomodulation therapy in Peri-implantitis management
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ABSTRACTBackground: The success of dental implants has been a major milestone in clinical dentistry. However, a few issues with infections around the implants remain. The purpose of this research is to evaluate a molecular rationale for the use of low power laser treatments, termed Photobiomodulation Therapy, in management of Peri-Implantitis.Material and Methods: A randomized, single-blinded, interventional human clinical study in 22 subjects was proposed to the University at Buffalo Institutional Review Board and protocol #STUDY00000470 was approved. PBM therapy using a near-infrared (810 nm) diode laser at irradiance of 10 mW/cm2, 300 seconds for a total fluence (dose) 3 J/cm2. Both groups were subjected to routine, standard-of-care management including curettage, disinfection and bone-graft as necessary. Tissue samples were collected during curettage from both groups and processed for HBD-2 expression. Normal human oral fibroblast (HOF) were seeded in culture dishes and treated with LPS derived from Porphyromonas gingivalis (P Gingivalis) and PBM therapy was performed at varying doses. mRNA was collected after 24 hours and qRT-PCR for HBD-2 and GAPDH expression were performed and analyzed using the ddCT method.Results: The clinical study demonstrated an increased expression of HBD-2 expression in PBM treatment group compared to controls. In lab study, PBM treatments induced HBD-2 in infection mimicking scenario at an optimum dose of 50mW/cm2 for 120sec for total dose of 6 J/cm2. Conclusions: This study demonstrated the utility of assessing HBD-2 expression as a potential biomarker to optimize PBM treatment parameters in peri-implant disease management.