Bactericidal effects of different laser wavelengths on periodontopathic germs in photodynamic therapy.

This study was an attempt to clarify whether the bactericidal effects of photodynamic therapy (PDT) are wavelength or dose-dependent. We also attempted to create an optimised protocol for a light-based bactericidal modality to eliminate periodontal pathogens. Cultures of Actinobacillus actinomycetemcomitans, Fusobacterium nucleatum, Porphromonas gingivalis, Prevotella intermedia, and Streptococcus sanguis, were exposed to a He-Ne laser (632.8 nm) with a 30 mW power output, a 100 mW diode laser at 665 nm, or a 100 mW diode laser at 830 nm, in the presence or absence of methylene blue (MB) as a photosensitiser. A control group was also used with exposure to MB alone without laser exposure. The cultures were analysed by viable counts. The results indicated that exposure to the 100 mW laser light could eliminate up to 40% of bacteria on average. In particular, the most effective killing occurred with exposure to laser light in combination with the MB photosensitiser. The results of kinetic studies indicated that the best PDT response rate was achieved with a 60 s (energy density 21.2 J/cm(2)) exposure to the 665 nm wavelength diode laser in the presence photosensitiser. In this condition, approximately 95% of A. actinomycetemcomitans and F. nucleatum, and 99-100% of the black-pigmented bacteria ( P. gingivalis and P. intermedia) and S. sanguis were eliminated. These results showed that both wavelength and energy density are important factors, and that a low power laser of optimal wavelength and dosage, in combination with an appropriate photosensitiser, is a practical bactericidal modality. We concluded that using a diode laser of proper power and wavelength to deliver 60 s of irradiation could be a useful adjunct with mechanical debridement in the prevention of the re-colonisation of subgingival lesions by pathogenic microorganisms.