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      Antimicrobial photodynamic therapy: An overview

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          Abstract

          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.

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          Most cited references45

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          Definition of type I and type II photosensitized oxidation.

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            Photodynamic therapeutics: basic principles and clinical applications.

            Photodynamic therapy (PDT) is a promising new treatment for cancer that has been recently accepted in the clinic. PDT involves the localization of a light-sensitive drug (photosensitizer) in the target tissue prior to illumination using an appropriate wavelength. Cytotoxic agents generated upon illumination trigger a cascade of biochemical responses that inactivate cancer cells either directly or through the induction of vascular stasis. These treatments are better tolerated as they destroy diseased tissue while leaving normal tissue intact. The haematoporphyrin derivative, Photofrin(R), has been approved in a number of European and Asian countries, as well as in North America. To enhance the potential of PDT and explore its application for other conditions, second-generation photosensitizers are being rigorously investigated.
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              Photophysical and photobiological processes in the photodynamic therapy of tumours.

              Photodynamic therapy (PDT) is an innovative and attractive modality for the treatment of small and superficial tumours. PDT, as a multimodality treatment procedure, requires both a selective photosensitizer and a powerful light source which matches the absorption spectrum of the photosensitizer. Quadra Logic's Photofrin, a purified haematoporphyrin derivative, is so far the only sensitizer approved for phase III and IV clinical trials. The major drawbacks of this product are the lack of chemical homogeneity and stability, skin phototoxicity, unfavourable physicochemical properties and low selectivity with regard to uptake and retention by tumour vs. normal cells. Second-generation photosensitizers, including the phthalocyanines, show an increased photodynamic efficiency in the treatment of animal tumours and reduced phototoxic side effects. At the time of writing of this article, there were more than half a dozen new sensitizers in or about to start clinical trials. Most available data suggest a common mechanism of action. Following excitation of photosensitizers to long-lived excited singlet and/ or triplet states, the tumour is destroyed either by reactive singlet oxygen species (type II mechanism) and/or radical products (type I mechanism) generated in an energy transfer reaction. The major biological targets of the radicals produced and of singlet oxygen are well known today. Nucleic acids, enzymes and cellular membranes are rapidly attacked and cause the release of a wide variety of pathophysiologically highly reactive products, such as prostaglandins, thromboxanes and leukotrienes. Activation of the complement system and infiltration of immunologically active blood cells into the tumorous region enhance the damaging effect of these aggressive intermediates and ultimately initiate tumour necrosis. The purpose of this review article is to summarize the up-to-date knowledge on the mechanisms responsible for the induction of tumour necrotic reactions.
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                Author and article information

                Journal
                J Indian Soc Periodontol
                JISP
                Journal of Indian Society of Periodontology
                Medknow Publications & Media Pvt Ltd (India )
                0972-124X
                0975-1580
                Oct-Dec 2011
                : 15
                : 4
                : 323-327
                Affiliations
                [1] Department of Conservative Dentistry, Sree Mookambika Institute of Dental Sciences, Kulasekharam, K.K. Dist, India
                [1 ] Department of Periodontics, Sree Mookambika Institute of Dental Sciences, Kulasekharam, K.K. Dist, India
                [2 ] Department of Orthodontics, GDC, Kottayam, India
                [3 ] PG, Department of Prosthodontics, SMIDS, Kulasekharam, Kerala, India
                Author notes
                Address for correspondence: Dr. Elizabeth Koshi, Department of Periodontics, Sree Mookambika Institute of Dental Sciences, Kulasekharam, Kanyakumari, Tamil Nadu - 629 161, India. E-mail: elizabethkoshi_dr@ 123456yahoo.com
                Article
                JISP-15-323
                10.4103/0972-124X.92563
                3283927
                22368354
                e11f5879-07b0-484e-9358-189910e9372c
                Copyright: © Journal of Indian Society of Periodontology

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 January 2011
                : 29 November 2011
                Categories
                Review Article

                Dentistry
                peri-implantitis,endodontic disinfection,periodontits,antimicrobial photodynamic therapy,gingivitis

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