Chlorin-e6-mediated antimicrobial photodynamic therapy enhanced by nanoemulsion and antimicrobial peptide for the treatment of periodontitis

Abstract

Scaling and Root Planing (SRP) is the treatment of choice for non-surgical management of Periodontal Disease (PD). Nevertheless, this usual intervention might show limitations or insufficient outcomes when used as a unique therapy in certain clinical cases. Thus, alternative therapies have been investigated to overcome SRP deficiencies that may be related to the limited access to the root surface, presence of periodontopathogens in the deeper periodontal pockets and the ability of some bacteria to invade adjacent tissues. Among current alternative therapies, antimicrobial photodynamic therapy (aPDT) and antimicrobial peptides have been suggested as promising adjuvant treatments. The general aim of the present study is investigating the optimization of chlorin-e6 (Ce6) in aPDT and its effect as an adjuvant therapy in the treatment of periodontitis. The specific objectives of the study are: preliminary study - characterizing the Ce6 nanoemulsion in the presence of antimicrobial peptide (LL-37) and evaluating its photochemical activity; in vitro study - investigating the effect of the combination (Ce6 + LL-37) to eliminate multispecies biofilm of bacteria related to PD; randomized clinical trial - evaluating the clinical, immunological, and microbiological benefits of multiple applications of adjunctive Ce6-aPDT to conventional non-surgical therapy in the treatment of residual periodontal pockets. (AU)