Journal of Indian Society of Periodontology
Journal of Indian Society of Periodontology
Home | About JISP | Search | Accepted articles | Online Early | Current Issue | Archives | Instructions | SubmissionSubscribeLogin 
Users Online: 1837  Home Print this page Email this page Small font size Default font size Increase font sizeWide layoutNarrow layoutFull screen layout

   Table of Contents    
Year : 2011  |  Volume : 15  |  Issue : 4  |  Page : 323-327  

Antimicrobial photodynamic therapy: An overview

1 Department of Conservative Dentistry, Sree Mookambika Institute of Dental Sciences, Kulasekharam, K.K. Dist, India
2 Department of Periodontics, Sree Mookambika Institute of Dental Sciences, Kulasekharam, K.K. Dist, India
3 Department of Orthodontics, GDC, Kottayam, India
4 PG, Department of Prosthodontics, SMIDS, Kulasekharam, Kerala, India

Date of Submission26-Jan-2011
Date of Acceptance29-Nov-2011
Date of Web Publication2-Feb-2012

Correspondence Address:
Elizabeth Koshi
Department of Periodontics, Sree Mookambika Institute of Dental Sciences, Kulasekharam, Kanyakumari, Tamil Nadu 629 161
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-124X.92563

Rights and Permissions

Inflammatory periodontal disease caused by dental plaque is characterized by the clinical signs of inflammation and loss of periodontal tissue support. The mechanical removal of this biofilm and adjunctive use of antibacterial disinfectants and antibiotics have been the conventional methods of periodontal therapy. But the removal of plaque and the reduction in the number of infectious organisms can be impaired in sites with difficult access. The possibility of development of resistance to antibiotics by the target organism has led to the development of a new antimicrobial concept with fewer complications. Photodynamic therapy (PDT) involves the use of low power lasers with appropriate wavelength to kill micro organisms treated with a photosensitizer drug. PDT could be a useful adjunct to mechanical as well as antibiotics in eliminating periopathogenic bacteria.

Keywords: Antimicrobial photodynamic therapy, endodontic disinfection, gingivitis, periodontits, peri-implantitis

How to cite this article:
Rajesh S, Koshi E, Philip K, Mohan A. Antimicrobial photodynamic therapy: An overview. J Indian Soc Periodontol 2011;15:323-7

How to cite this URL:
Rajesh S, Koshi E, Philip K, Mohan A. Antimicrobial photodynamic therapy: An overview. J Indian Soc Periodontol [serial online] 2011 [cited 2021 Aug 4];15:323-7. Available from:

   Introduction Top

Periodontal disease results from inflammation of the supporting structure of the teeth and in response to chronic infection caused by various periodontopathic bacteria. In the treatment of periodontally involved teeth, current concepts are based on mechanical scaling and root planing to remove bacterial deposits, calculus, and cementum contaminated by bacteria and endotoxins. [1],[2] However, removal of plaque and the reduction of the number of infectious cells can be impaired in sites with difficult access by mechanical scaling and root planing. Some therapeutic alternatives, such as systemic and local antibiotics, have been used in cases not responding to conventional treatments, although this therapy brings undesirable side effects and development of bacterial drug resistance. [3],[4]

Photodynamic therapy (PDT) has emerged in recent years as a non- invasive therapeutic modality for the treatment of various infections by bacteria, fungi, and viruses. [5] This therapy is defined as an oxygen-dependent photochemical reaction that occurs upon light - mediated activation of a photosensitizing compound leading to the generation of cytotoxic reactive oxygen species, predominantly singlet oxygen. [6] PDT can be applied topically into a periodontal pocket avoiding overdoses and side effects associated with the systemic antimicrobial agent administration. It also minimizes the occurrence of bacterial resistance. [7],[8]

Photodynamic antimicrobial chemotherapy represents an alternate antibacterial, antifungal, and antiviral treatment against drug - resistant organisms. [9] Applications of PDT in dentistry are growing rapidly. They are also used in the treatment of oral cancer, bacterial and fungal infections, and in the photodynamic diagnosis of the malignant transformation of oral lesions. [10] This review is aimed to discuss the role of PDT in periodontal and endodontic therapy.

Historical perspective of photodynamic therapy

The origin of light as a therapy in medicine and surgery are traced from antiquity to the modern day. Phototherapy began in ancient Greece, Egypt, and India, but disappeared for many centuries, only being rediscovered by the Western civilization at the beginning of the 20 th century. [11] The use of contemporary photodynamic therapy was first reported by the Danish physician, Niels Finsen. He successfully demonstrated photodynamic therapy by employing heat - filtered light from a carbon - arc lamp (The Finsen Lamp) in the treatment of a tubercular condition of the skin known as Lupus Vulgaris. [11]

The concept of cell death induced by the interaction of light and chemicals was first reported by Osar Raab, a medical student working with Professor Herman Von Tappeiner in Munich. During the course of his study on the effects of acridine on paramecia cultures, he discovered that the combination of acridine red and light had a lethal effect on infusoria, a species of paramecium. [12] Subsequent work in the laboratory of Von Tappeiner coined the term "Photodynamic action" and showed that oxygen was essential. Much later, Thomas Dougherty and Co-workers at Roswell Park cancer institute, Buffalo, New York, clinically tested PDT. In 1978, they published striking results in which they treated 113 cutaneous or subcutaneous malignant tumors and observed a total or partial resolution of 111 tumors. The active photosensitizer used in this clinical PDT trial was called Hematoporphyrin Derivative. It was John Toth, who renamed it as PDT. [13]

PDT was approved by the Food and Drug Administration in 1999 to treat pre-cancerous skin lesions of the face or scalp. [14] PDT has emerged in recent years as a new non - invasive therapeutic option.

Mechanism of action

PDT involves three components: Light, a photosensitizer, and oxygen. The photosensitizer is administered to the patient, and upon irradiation with light of a specific wavelength, the photosensitizer undergoes a transition from a low energy ground state to an excited singlet state. Subsequently, the photosensitizer may decay back to its ground state with the emission of fluorescence or may undergo a transition to a higher energy triplet state. [15] The triplet state photosensitizer can react with biomolecules in two different pathways - type I and II. [16]

Type I reaction involves electron - transfer reactions between the excited state of the photosensitizer and an organic substrate molecule of the cells, producing free radicals. These free radical species are generally highly reactive and interact with endogenous molecular oxygen to produce highly reactive oxygen species, such as superoxide, hydroxyl radicals, and hydrogen peroxide, which are harmful to cell membrane integrity, causing irreparable biological damage. [1],[17]

In type II reaction, the triplet state photosensitizer reacts with oxygen to produce an electronically excited and highly reactive state of oxygen, known as singlet oxygen ( 1 O 2 ) which can interact with a large number of biological substrates inducing oxidative damage on the cell membrane and cell wall. Microorganisms that are killed by singlet oxygen include viruses, bacteria, and fungi. Singlet oxygen has a short lifetime in biological systems and a very short radius of action (0.02 mm). Hence, the reaction takes place within a limited space, leading to a localized response; thus making it ideal for application to localized sites without affecting distant cells or organs. Thus, the type II reaction is accepted as the major pathway in microbial cell damage. [17],[18]

Light source

PDT requires a sources of light to activate the photosensitizer by exposure to low power visible light at a specific wavelength. Most photosensitizers are activated by red light between 630 and 700 nm, corresponding to a light penetration depth from 0.5 cm to 1.5 cm. [19],[20] This limits the depth of necrosis. The total light dose, dose rates, and the depth of destruction vary with each tissue treated and photosensitizer used. [20],[21] Currently, the light source applied in photodynamic therapy are those of helium - neon lasers (633 nm), gallium - aluminum - arsenide diode lasers (630-690, 830 or 906 nm), and argon laser (488-514 nm), the wavelength of which range from visible light to the blue of argon lasers, or from the red of helium-neon laser to the infra red area of diode lasers. [22],[23] Recently, non laser light source, such as light - emitting diodes (LED), has been used as new light activators in PDT. LED devices are more compact, portable, and cost effective compared to traditional lasers. [1]


An optimal photosensitizer must possess photo-physical, chemical, and biological characteristics. Most of the sensitizers used for medical purposes belong to the following basic structure.

  1. Tricyclic dyes with different meso-atoms E.g.: Acridine orange, proflavine, riboflavin, methylene blue, fluorescein, and erythrosin.
  2. Tetrapyrroles. E.g.: Porphyrins and derivatives, chlorophyll, phylloerythrin, and phthalocyanines.
  3. Furocoumarins. E.g.: Psoralen and its methoxy-derivatives, xanthotoxin, and bergaptene. [24]

Photofrin and hematophyrin derivatives are referred to as first generation sensitizers. Second generation photosensitizers include 5-aminolevulinic acid (ALA), benzoporphyrin derivative, texaphyrin, and temoporfin (mTHPC). These photosensitizers have greater capability to generate singlet oxygen. Topical ALA have been used to treat pre-cancer conditions, and basal and squamous cell carcinoma of skin. [25],[26]

In antimicrobial PDT, photosensitizers used are toluidine blue O and methylene blue. Both have similar chemical and physicochemical characteristics. Toluidine blue O is a solution that is blue - violet in color. It stains granules within mast cells and proteoglycans/glycosaminoglycans within connective tissues. Methylene blue is a redox indicator that is blue in an oxidizing environment and becomes colorless upon reduction. Methylene blue combined with light has been reported to be beneficial in killing the influenza virus, Helicobacter pylori, and C. albicans. [27],[28] Methylene blue and toluidine blue O are very effective photosensitizing agents for the inactivation of both gram-positive and gram-negative periodontopathic bacteria. Tetracyclines used as antibiotics in periodontal diseases are also effective photosensitizers producing singlet oxygen. [29]

Application of photodynamic therapy in dentistry

Antimicrobial PDT can be considered as an adjunctive to conventional mechanical therapy. The liquid photosensitizer placed directly in the periodontal pocket can easily access the whole root surface before activation by the laser light through an optical fiber placed directly in the pocket. [30] As a result of the technical simplicity and the effective bacterial killing, the application of PDT in the treatment of periodontal diseases has been studied extensively.

Antimicrobial PDT not only kills the bacteria, but may also lead to the detoxification of endotoxins such as lipopolysaccharide. These lipopolysaccharides treated by PDT do not stimulate the production of pro-inflammatory cytokines by mononuclear cells. Thus, PDT inactivate endotoxins by decreasing their biological activity. [31]

It has been demonstrated that bacteria associated with periodontal disease can be killed through photosensitization with toulidine blue O by irradiating with helium - neon soft laser. [23] Data from an in vitro study indicated that PDT could kill bacteria organized in a biofilm. [32] In an animal study, it was found that PDT was useful in reducing the redness, bleeding on probing, and  Porphyromonas gingivalis Scientific Name Search ls. [33]

A randomized controlled clinical study compared the effects of PDT alone without sub gingival SRP to sub gingival SRP in subject with aggressive periodontitis. At three months following the therapy, both treatment yielded comparable outcomes in terms of reduction of bleeding on probing and probing depth (PD), gains in clinical attachment level (CAL), thus suggesting a potential clinical benefits of PDT. [34]

Christodoulides et al. evaluated the clinical and microbiologic effects of the adjunctive use of PDT to non - surgical periodontal treatment. Twenty four subjects with chronic periodontitis were randomly treated with scaling and root planing followed by a single episode of PDT. The additional application of a single episode of PDT to scaling and root planing failed to result an additional improvement in terms of pocket depth reduction and clinical attachment level gain, but it resulted in a significant reduction in bleeding scores compared to scaling and root planing alone. [35]

Bhatia et al. demonstrated that the optimal concentration of toluidine blue O to kill P. gingivalis was 12.5 mg/ml with helium-neon laser irradiations. This was caused by the disruption of outer membrane proteins of these bacteria. [36],[37] Chan and Lai showed that the presence of methylene blue at the wavelength of 632.8 nm (helium-neon laser) and 665 and 830 nm (diode laser) has a high bactericidal effect on periodontal pathogens. [38]

Yilmaz et al. randomly assigned a total of 10 patients to receive repeated application of scaling and root planing with photodynamic therapy the other groups were receiving only scaling and root planing, photodynamic therapy, and oral hygiene instructions. Methylene blue served as the photosensitizer and was used as a mouth rinse. Significant clinical and microbiological improvement was seen within groups receiving scaling and root planing with photodynamic therapy and the scaling and root planing alone. However, improvement in groups receiving photodynamic therapy alone, as well as those receiving only oral hygiene instructions, did not reach significant levels. The reduced effectiveness of PDT may be the due the application of PDT from the external surface of the gingiva. [39] Several studies have demonstrated bactericidal and detoxification effects on high-level lasers on contaminated dental implant surfaces. High-level lasers have been used successfully in the surgical management of peri - implantitis. [40] In an in vitro study, Hass et al. examined the efficacy of PDT in killing bacteria associated with peri - implantitis which adhered to titanium plates with different surface characteristics. Scanning electron microscopic analysis showed that antimicrobial photodynamic therapy led to bacterial cell destruction without damaging the titanium surface. [40] Similar antimicrobial results were obtained by Shibli et al. who reported that PDT could reduce the bacterial count of P. intermedia, P. nigrescens, Fusobacterium spp. in ligature induced peri - implantitis of dogs. [41]

On interpreting the data from the various controlled clinical studies, it becomes obvious that in patients with chronic periodontitis, aggressive periodontitis and peri implantitis, the adjunctive use of PDT to scaling and root planing may result in greater clinical attachment level gains, reduction in bleeding on probing and probing pocket depths. PDT has advantage such as reducing the treatment time, no need for anesthesia, destruction of bacteria, inactivation of endotoxins, and unlikely development of resistance by the target bacteria and no damage to the adjacent host tissues. [24]

In operative dentistry, it is proved that the antimicrobial photodynamic therapy technique is effective for the treatment and prevention of dental caries. [42] Endodontic failures are caused by the proliferation of residual bacteria that are left behind within the root canal due to the complexity of the root canal system that makes complete debridement with instrumentation and irrigation alone almost impossible. Antimicrobial photodynamic therapy has been reported to be effective as an adjunct to conventional endodontic disinfection treatment to destroy the bacteria that remain even after irrigation with sodium hypo chlorite. [43]

Soukos et al. conducted a study to investigate the effect of PDT on endodontic pathogens in planktonic phase as well as on Enterococcus faecalis biofilms in experimentally infected root canals of extracted teeth. Strains of microorganisms were sensitized with methylene blue (25 mg/ml) for five minutes followed by exposure to red light of 665 nm with an energy florescence of 30 J/cm 2 . Methylene blue fully eliminated all bacterial species with the exception of E. faecalis (53% killed). The same concentration of methylene blue in combination with red light (222 J/cm 2 ) was able to eliminate 97% of E. faecalis biofilm bacteria in root canals using an optical fiber with multiple cylindrical diffusers that uniformly distributed light at 360°. Hence, PDT may be developed as an adjunctive procedure to kill residual bacteria in the root canal system after standard endodontic treatment. [44]

The study by Garcez et al. reported the antimicrobial effect of PDT combined with endodontic treatment in patients with necrotic pulp infected with microflora resistant to a previous antibiotic therapy. The use of PDT added to conventional endodontic treatment leads to a further major reduction of microbial load. PDT is an efficient treatment to kill multi-drug resistant microorganisms. [45]

Adverse effects

The risk and side effects of antimicrobial PDT are basically classified into two categories.

  1. Relates to the effect of light energy.
  2. Relates to the photosensitizer and the photo chemical reaction. [1]

The potential inadvertent irradiation of the patients eyes must be strictly avoided during treatment, even though the laser power employed is very low. The use of protective glasses by the patient, the operator and the assistant is recommended. During treatment with high level lasers, thermogenesis occurs as a result of the interaction of the laser with the tissues. PDT as a low level therapy, using a diode laser with short irradiation time, does not produce any thermal changes within the gingival tissues and root surfaces. With regard to photosensitizers and photochemical reactions, it is important to apply antimicrobial photodynamic therapy to stain and kill selectively the targeted bacteria without adversely affecting the surrounding periodontal tissues. [1],[37]

Perspectives and future directions

The numerous studies cited in this review indicate that PDT appears to be most efficient for treatment of localized and superficial infections. Thus, infections in the oral cavity such as mucosal and endodontic infections, periodontal diseases, caries, and peri - implantitis are potential targets. PDT will not replace antimicrobial chemotherapy, but may improve the treatment of oral infections, accelerating and lowering the cost of the treatment. Development of new photosensitizers, more efficient light delivery systems, and further studies are required to establish the optimum treatment parameters.

   Conclusion Top

Antimicrobial PDT seems to be a unique and interesting therapeutic approach towards periodontal and endodontic therapy. The numerous in vitro studies have clearly demonstrated the effective and efficient bactericidal effect of PDT. However, the superior effects of the adjunctive use of PDT have not been demonstrated clinically or in vivo in either periodontal or endodontic therapy. There is a great need to develop an evidence based approach to the use of PDT for the treatment of periodontitis, peri-implantitis, and endodontic therapy. It would be prudent to say that there is an insufficient evidence to suggest that PDT is superior to the traditional modalities of periodontal and endodontic therapy. Further, randomized long term clinical studies and meta analyses are necessary to demonstrate the beneficial effect of antimicrobial photodynamic therapy, and in comparison with conventional methods. Antimicrobial photodynamic therapy may hold promise as a substitute for currently available chemotherapy in the treatment of periodontal and peri - implant diseases, and in endodontic therapy.

   References Top

1.Takasaki AA, Aoki A, Mizutani K, Schwarz F, Sculean A, Wang CY, et al. Application of antimicrobial photodynamic therapy in periodontal and peri-implant diseases Periodontol 2000 2009;51:109-40.  Back to cited text no. 1
2.Polson AM, Frederick GT, Ladenheim S, Hanes PJ. The production of a root surface smear layer by instrumentation and its removal by citric acid. J Periodontol 1984;55;443-6.  Back to cited text no. 2
3.Van Winkelhoff AJ, Rams TE, Slots J. Systemic antibiotic therapy in periodontics. Periodontol 2000 1996;10:45-78.  Back to cited text no. 3
4.Lopez NJ, Gamonal JA, Martinez B. Repeated metronidazole and amoxicillin treatment of periodontitis. A follow-up study. J Periodontol 2000;71:79-89.  Back to cited text no. 4
5.Kornman KS, Page RC, Tonetti MS. The host response to the microbial challenge in periodontitis: Assembling the players. Periodontol 2000 1997;14:33-53.  Back to cited text no. 5
6.Ochsner M. Photophysical and Photobiological processes in the photodynamic therapy of tumors J Photochem Photobiol B 1997;39:1-18.  Back to cited text no. 6
7.Hamblin MR, Hasan T. Photodynamic therapy: A new antimicrobial approach to infectious diseases? Photochem Photobiol Sci 2004;3:436-50.  Back to cited text no. 7
8.Wainwright M. Photodynamic antimicrobial chemotherapy. J Antimicrob Chemother 2004;48:2173-8.  Back to cited text no. 8
9.Wainwright M. Photodynamic antimicrobial chemotherapy (PACT). J Antimicrob Chemother 1998;42:13-28.  Back to cited text no. 9
10.Sharwani A, Jerjes W, Salih V, MacRobert AJ. Fluorescence Spectroscopy combined with 5 - aminolevulinic acid - induced protoporphyrin IX fluorescence in detecting oral premalignancy J Photochem Photobiol B 2006;83:27-33.  Back to cited text no. 10
11.Deniell MD, Hill JS. A history of Photodynamic therapy. Aust N Z J Surg 1991;61:340-8.  Back to cited text no. 11
12.Raab O. The effect of fluorescent agents on infusoria (in German). Z Biol 1900;39:524-6.  Back to cited text no. 12
13.Dougherlg TJ, Marcus SL. Photodynamic therapy. Eur J Cancer 1992;28:1734-42.  Back to cited text no. 13
14.Lui H, Anderson RR. Photodynamic therapy in dermatology: Shedding a different light on Skin disease. Arch Dermatol 1992;128:1631-6.  Back to cited text no. 14
15.Ochsner M. Photodynamic therapy in squamous cell carcinoma. J Photochem Photobial B 2001;52:42-8.  Back to cited text no. 15
16.Foote CS. Definition of type I and type II photosensitized oxidation. Photochem Photobiol 1991;54:659.  Back to cited text no. 16
17.Sharman WM, Allen CM, Van Lier JE. Photodynamic therapeutics: Basic principles and clinical applications. Drug Discov Today 1999;4:507-17.  Back to cited text no. 17
18.Moan J, Berg K. The photodegradation of porphyrins in cells can be used to estimate the lifetime of singlet oxygen. Photochem Photobiol 1991;53:549-53.  Back to cited text no. 18
19.Salva KA. Photodynamic therapy: Unapproved uses, dosages or indications. Clin Dermatol 2002;20:571-81.  Back to cited text no. 19
20.Grant WE, Hopper C, Speight PM, Bown SG. Photodynamic therapy, an effective, but non-selective treatment for superficial cancers of the oral cavity. Int J Cancer 1997;71:937-42.  Back to cited text no. 20
21.Biel MA. Photodynamic therapy in head and neck cancer. Curr Oncol Rep 2002;4:87-96.  Back to cited text no. 21
22.Juzeniene A, Juzenas P, Ma LW, Iani V, Moan J. Effectiveness of different light Sources for 5 - aminolevulinic acid photodynamic therapy. Lasers Med Sci 2004;19:139-49.  Back to cited text no. 22
23.Dobson J, Wilson M. Sensitization of oral bacteria in biofilms to killing by light from a low- power laser. Arch Oral Biol 1992;37:883-7.  Back to cited text no. 23
24.Malik R, Manocha A, Suresh DK. Photodynamic therapy - A strategic review. Indian J Dent Res 2010;21:285-91.  Back to cited text no. 24
[PUBMED]  Medknow Journal  
25.Allison RR, Cuenca RE, Downie GH, Brodish B, Sibate CH. Clinical photodynamic therapy of head and neck cancers - A review of applications and outcomes. Photodiagn Photodyn Ther 2005;2:205-22.  Back to cited text no. 25
26.Allison RR, Bagnato VS, Cuenca R, Downie GH, Sibata CH. The future of photodynamic therapy in Oncology. Future Oncol 2006;2:53-71.  Back to cited text no. 26
27.Lambrecht B, Mohr H, Knuver - Hopf J, Schmitt H. Photoinactivation of viruses in human fresh plasma by phenothiazine dyes in Combination with visible light. Vox Sang 1991;60:207-13.  Back to cited text no. 27
28.Millson CE, Wilson M, Macrobert AJ, Bedwell J, Brown SG. The killing of helicobacter pylori by low-power laser light in the presence of a photosensitizer. J Med Microbiol 1996;44:245-52.  Back to cited text no. 28
29.Miskoski S, Sanchez E, Garavano M, Lopez M, Soltermann AT, Garcia NA. Singlet Molecular oxygen - mediated photo - oxidation of tetracyclines kinetics, mechanism and microbiological implications. J Photochem Phtobiol B - Biol 1998;43:164-71.  Back to cited text no. 29
30.Andersen R, Loebel N, Hammond D, Wilson M. Treatment of periodontal diseases by photodisinfection compared to scaling and root planing. J Clin Dent 2007;18:34-8.  Back to cited text no. 30
31.Komerik N, Wilson M, Poole S. The effect of photodynamic action on two virulence factors of gram - negative bacteria. Photochem Photobiol 2000;72:676-80.  Back to cited text no. 31
32.Soukos NS, Mulholland SE, Socransky SS, Doukas AG. Photodestruction of human dental plaque bacteria. Enhancement of the photodynamic effect by photochemical waves in an oral biofilm model. Lasers Surg Med 2003;33:161-8.  Back to cited text no. 32
33.Sigusch BW, Pfitzner A, Albrecht V, Glockmann E. Efficacy of photodynamic therapy on inflammatory signs and two selected periodontopathogenic species in a beagle dog model. J Periodontol 2005;76:1100-5.  Back to cited text no. 33
34.De Oliveira RR, Schwartz - Filho HO, Novaes AB, Taba M Jr. Antimicrobial photodynamic therapy in the non - surgical treatment of aggressive periodontitis. A preliminary randomized controlled clinical study. J Periodontol 2007;78:965-73.  Back to cited text no. 34
35.Christodoulides N, Nikolidakis D, Chondros P, Becker J, Schwarz F, Rössler R, et al. Photodynamic Therapy as an adjunct to non - surgical periodontal treatment A Randomized controlled clinical trial. J Periodontol 2008;79:1638-44.  Back to cited text no. 35
36.Bhatti M, MacRobert A, Meghji S, Henderson B, Wilson M. Effect of dosimetric and physiologic factors on the lethal photosensitization of porphyromonas gingivalis in vitro. Photochem Photobiol 1997;65:1026-31.  Back to cited text no. 36
37.Bhatti M, MacRobert A, Meghji S, Henderson B, Wilson M. A Study of the update of Toluidine Blue O by porphyromonas gingivalis and the mechanism of lethal photosensitization. Photochem Photobiol 1998;68:370-6.  Back to cited text no. 37
38.Chan Y, Lai CH. Bactericidal effects of different laser wavelengths on periodontopathic germs in photodynamic therapy. Laser Med Sci 2003;18:51-5.  Back to cited text no. 38
39.Yilmaz S, Kuru I, Kuru L, Noyan U, Argun D, Kadir T. Effect of gallium arsenide diode laser on human periodontal diseases; a microbiological and clinical study. Lasers Surg Med 2002;30:60-6.  Back to cited text no. 39
40.Hass R, Dortbudak O, Mensdorff - Pouilly N, Mailath G. Elimination of bacteria on different implant surfaces through photosensitization and soft laser. An in vitro study. Clin Oral Implants Res 1997;8:249-54.  Back to cited text no. 40
41.Shibli JA, Martins MC, Theodoro LH, Lotufo RF, Garcia VG, Marcantonio EJ. Lethal photosensitization in microbiological treatment of ligature-induced peri - implantitis: A preliminary study in dogs. J Oral Sci 2003;45:17-23.  Back to cited text no. 41
42.Kalka K, Merk H. Photodynamic therapy in dermatology J. Am Acad Dermatol 2000;42:389-413.  Back to cited text no. 42
43.Fimple JL, Fontana CR, Foschi F, Ruggiero K, Song X, Pagonis TC, et al. Photodynamic treatment of endodontic polymicrobial infection in vitro. J Endod 2008;34:728-34.  Back to cited text no. 43
44.Soukos NS, Chen PS, Morris JT, Ruggiero K, Abernethy AD, Som S, et al. Photodynamic therapy for endodontic disinfection. J Endod 2006;32:979-84.  Back to cited text no. 44
45.Garcez AS, Nuñez SC, Hamblim MR, Suzuki H, Ribeiro MS. Photodynamic therapy associated with conventional Endodontic treatment in patients with antibiotic-resistant micro flora a preliminary report. J Endodontics 2010;36:1463-6.  Back to cited text no. 45

This article has been cited by
1 Photodynamic and Nail Penetration Enhancing Effects of Novel Multifunctional Photosensitizers Designed for The Treatment of Onychomycosis
Threes Smijs,ZoŽ Dame,Ellen de Haas,Jan-Bonne Aans,Stan Pavel,Henricus Sterenborg
Photochemistry and Photobiology. 2014; 90(1): 189
[Pubmed] | [DOI]
2 Antimicrobial Photodynamic Therapy and Dental Plaque: A Systematic Review of the Literature
G. C. Santin,D. S. B. Oliveira,R. Galo,M. C. Borsatto,S. A. M. Corona
The Scientific World Journal. 2014; 2014: 1
[Pubmed] | [DOI]
3 Analysis of photodynamic antimicrobial chemotherapy (PACT) action with Chloro-Aluminum Phthalocyanine (Pc-CLAL) on Pseudomonas aeruginosa (Gram -) and Staphylococcus aureus (Gram +) microorganisms [An√°lise da a√ß√£o da quimioterapia fotodin√Ęmica antimicrobiana (PACT) com Ftalocianina cloro-alum√≠nio (FC-CLAL) sobre os microrganismos Pseudomonas aeruginosa (Gram -) e Staphylococcus aureus (Gram +)]
Bastos, J.L.N. and Nitschke, M. and Parizotto, N.A.
Revista Brasileira de Engenharia Biomedica. 2013; 29(2): 175-183
4 Control of optical transmittance of fat tissue slices at NIR photodynamic action mediated by indocyanine green
Yanina, I.Y., Doubrovsky, V.A., Tuchin, V.V.
Progress in Biomedical Optics and Imaging - Proceedings of SPIE 8699. 2013;
5 Photoelimination of Streptococcus mutans with two methods of photodynamic and photothermal therapy
Reza Fekrazad,Farzaneh Khoei,Neda Hakimiha,Abbas Bahador
Photodiagnosis and Photodynamic Therapy. 2013;
[Pubmed] | [DOI]


    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

  In this article

 Article Access Statistics
    PDF Downloaded1476    
    Comments [Add]    
    Cited by others 5    

Recommend this journal