Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/doi/10.1590/1807-2577.20260016
Revista de Odontologia da UNESP
Original Article

Antimicrobial photodynamic therapy in the treatment of experimentally induced dental alveolitis in animals

Terapia fotodinâmica antimicrobiana no tratamento de alveolite experimentalmente induzida em animais

Valdir Gouveia GARCIA; Wilson LOPES JÚNIOR; Letícia Helena THEODORO

http://dx.doi.org/10.1590/1807-2577.20260016 Rev. odontol. UNESP, vol.55, e20260016, 2026
PDF
Downloads: 0
Views: 13

Abstract

Introduction: Alveolar repair in infected areas still lacks further studies, especially regarding adjuvant or alternative therapies.

Objective: This study aimed to histologically analyze the repair process in infected wounds after tooth extraction treated with photobiomodulation (PBM) therapy alone or in combination with a photosensitizer (PS) in antimicrobial photodynamic therapy (aPDT).

Material and method: Forty-eight rats underwent extraction of the right upper incisor and subsequently received experimental alveolitis induction. They were then randomly divided into 4 groups (n=12) that received the following treatments: Control group (C), no intra- or extra-alveolar treatment; PS group, alveolar irrigation with methylene blue photosensitizer (MB, 100 µg/mL); PBM group, the alveoli were subjected to PBM therapy mediated with a low-power laser (685nm, 0.05W, 240s, 12J); aPDT Group: The treatment was similar to that of the PS group, with a pre-irradiation time of 60 seconds, followed immediately by laser irradiation, under conditions similar to those of the PBM group. The animals were euthanized post-operatively on days 7, 15, 21, and 28.

Result: The wounds in group C showed a delay in the chronology of alveolar repair, PS group showed an improved initial inflammatory response compared to the control group. The animals treated with PBM and aPDT showed faster bone repair than those in group C.

Conclusion: It is concluded that there was a delay in the alveolar repair process; that the isolated use of the PS minimized the alveolitis deleterious effects on bone repair; those photonic therapies benefited alveolar repair, especially when aPDT was used.

Keywords

Dry socket; low-level light therapy; photochemotherapy; bone regeneration; rats

Resumo

Introdução: A reparação alveolar em áreas infectadas ainda carece de estudos adicionais, especialmente no que diz respeito a terapias adjuvantes ou alternativas.

Objetivo: Este estudo teve como objetivo analisar histologicamente o processo de reparação em feridas infectadas após extração dentária tratadas com terapia de fotobiomodulação (FBM) isoladamente ou em combinação com um fotossensibilizador (FS) na terapia fotodinâmica antimicrobiana (aPDT).

Material e método: Quarenta e oito ratos foram submetidos à extração do incisivo superior direito e após, receberam a indução da alveolite experimental. A seguir, foram aleatoriamente divididos em 4 grupos (n=12) que receberam os seguintes tratamentos: Grupo controle (C), sem tratamento intra ou extra-alveolar; Grupo FS, irrigação alveolar com azul de metileno (100 µg/mL); Grupo FBM, os alvéolos foram submetidos à irradiação com laser de baixa potência (685nm, 0,05W, 240s, 12J); Grupo aPDT: O tratamento foi semelhante ao do grupo FS, com um tempo de pré-irradiação de 60 segundos, seguido imediatamente da irradiação com laser, em condições semelhantes às do grupo FBM. Os animais foram eutanasiados no pós-operatório nos dias 7, 15, 21 e 28. Foram realizadas análises descritivas do processo do reparo alveolar em três locais.

Resultado: As feridas do grupo C apresentaram atraso na cronologia da reparação alveolar. O grupo FS apresentou uma melhor resposta inflamatória inicial em comparação ao grupo controle. Os animais tratados com FBM e aPDT apresentaram reparação óssea mais acelerada do que os do grupo C.

Conclusão: Conclui-se que houve atraso do processo de reparação alveolar; que o uso isolado do FS minimizou os efeitos deletérios da alveolite sobre o reparo ósseo; que as terapias fotônicas beneficiaram o reparo alveolar, principalmente quando a aPDT foi utilizada.

Palavras-chave

Alveolite seca; terapia por luz de baixa intensidade; fotoquimioterapia; regeneração óssea; ratos

References

1 Blum IR. Contemporary views on dry socket (alveolar osteitis): a clinical appraisal of standardization, etiopathogenesis and management: a critical review. Int J Oral Maxillofac Surg. 2002 Jun;31(3):309-17. https://doi.org/10.1054/ijom.2002.0263. PMid:12190139.

2 Kolokythas A, Olech E, Miloro M. Alveolar osteitis: a comprehensive review of concepts and controversies. Int J Dent. 2010;2010:249073. https://doi.org/10.1155/2010/249073. PMid:20652078.

3 Rosa A, Pujia AM, Arcuri C. Investigation of alveolar osteitis and the effectiveness of laser treatment: a unified Meta-analysis and review of the literature. BMC Oral Health. 2024;24(1):700. https://doi.org/10.1186/s12903-024-04461-w. PMid:38886713.

4 Bowe DC, Rogers S, Stassen LF. The management of dry socket/alveolar osteitis. J Ir Dent Assoc. 2011;57(6):305-10. PMid:22338284.

5 Eshghpour M, Rezaei NM, Nejat A. Effect of menstrual cycle on frequency of alveolar osteitis in women undergoing surgical removal of mandibular third molar: a single-blind randomized clinical trial. J Oral Maxillofac Surg. 2013 Sep;71(9):1484-9. https://doi.org/10.1016/j.joms.2013.05.004. PMid:23866782.

6 Daly B, Sharif MO, Newton T, Jones K, Worthington HV. Local interventions for the management of alveolar osteitis (dry socket). Cochrane Database Syst Rev. 2012 Dec;12:CD006968. https://doi.org/10.1002/14651858.CD006968.pub2. PMid:23235637.

7 Eshghpour M, Ahrari F, Najjarkar NT, Khajavi MA. Comparison of the effect of low level laser therapy with alvogyl on the management of alveolar osteitis. Med Oral Patol Oral Cir Bucal. 2015 May;20(3):e386-92. https://doi.org/10.4317/medoral.20375. PMid:25662557.

8 Taberner-Vallverdú M, Nazir M, Sanchez-Garces MA, Gay-Escoda C. Efficacy of different methods used for dry socket management: a systematic review. Med Oral Patol Oral Cir Bucal. 2015 Sep;20(5):e633-9. https://doi.org/10.4317/medoral.20589. PMid:26116842.

9 Ramos E, Santamaria J, Santamaria G, Barbier L, Arteagoitia I. Do systemic antibiotics prevent dry socket and infection after third molar extraction? A systematic review and meta-analysis. Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Oct;122(4):403-25. https://doi.org/10.1016/j.oooo.2016.04.016. PMid:27499028.

10 Daly BJ, Sharif MO, Jones K, Worthington HV, Beattie A. Local interventions for the management of alveolar osteitis (dry socket). Cochrane Database Syst Rev. 2022 Sep;9(9):CD006968. https://doi.org/10.1002/14651858.CD006968.pub3. PMid:36156769.

11 Laforgia A, Inchingolo AD, Riccaldo L, Avantario P, Buongiorno S, Malcangi G, et al. The use of Platelet-Rich Fibrin (PRF) in the management of dry socket: a systematic review. Int J Mol Sci. 2024 Sep;25(18):10069. https://doi.org/10.3390/ijms251810069. PMid:39337554.

12 Camps-Font O, Sábado-Bundó H, Toledano-Serrabona J, Valmaseda-de-la-Rosa N, Figueiredo R, Valmaseda-Castellón E. Antibiotic prophylaxis in the prevention of dry socket and surgical site infection after lower third molar extraction: a network meta-analysis. Int J Oral Maxillofac Implants. 2024 Jan;53(1):57-67. https://doi.org/10.1016/j.ijom.2023.08.001. PMid:37612199.

13 Minervini G, Franco R, Martelli M, Hafedh S, Maddalena Marrapodi M, Di Blasio M, et al. Low-level laser treatment’s ability to reduce dry socket pain. Acta Odontol Scand. 2024 Nov;83:631-41. https://doi.org/10.2340/aos.v83.42261. PMid:39530606.

14 Supachawaroj N, Kerdmanee K, Limsitthichaikoon S. Lidocaine-loaded thermoresponsive gel for accelerated wound healing in dry socket and oral wounds. Gels. 2024 Nov;10(11):739. https://doi.org/10.3390/gels10110739. PMid:39590095.

15 Çırak E, Özyurt A, Peker T, Ömeroğlu S, Güngör MN. Comparative evaluation of various low-level laser therapies on bone healing following tooth extraction: An experimental animal study. J Craniomaxillofac Surg. 2018 Jul;46(7):1147-52. https://doi.org/10.1016/j.jcms.2018.05.012. PMid:29805068.

16 Ribeiro LNS, Figueiredo FAT, Silva Mira PC, Arnez MFM, Matsumoto MAN, Menezes LM, et al. Low-level laser therapy (LLLT) improves alveolar bone healing in rats. Lasers Med Sci. 2022 Mar;37(2):961-9. https://doi.org/10.1007/s10103-021-03340-y. PMid:34002343.

17 Gururaj SB, Shankar SM, Parveen F, Chidambar CK, Bhushan K, Prabhudev CM. Assessment of healing and pain response at mandibular third molar extraction sites with and without pre- and postoperative photobiomodulation at red and near-infrared wavelengths: a clinical study. J Pharm Bioallied Sci. 2022 Jul;14(Suppl 1):S470-4. https://doi.org/10.4103/jpbs.jpbs_675_21. PMid:36110661.

18 Hadad H, Santos AFP, Jesus LK, Poli PP, Mariano RC, Theodoro LH, et al. Photobiomodulation therapy improves postoperative pain and edema in third molar surgeries: a randomized, comparative, double-blind, and prospective clinical trial. J Oral Maxillofac Surg. 2022 Jan;80(1):37.e1-12. https://doi.org/10.1016/j.joms.2021.08.267. PMid:34656515.

19 Sampaio Camargo P, Stoppelaar JD. The preservation of dental plaque samples in liquid nitrogen. Caries Res. 1976;(10):148.

20 Ahn H, Kang SG, Yoon SI, Ko HJ, Kim PH, Hong EJ, et al. Methylene blue inhibits NLRP3, NLRC4, AIM2, and non-canonical inflammasome activation. Sci Rep. 2017 Sep;7(1):12409. https://doi.org/10.1038/s41598-017-12635-6. PMid:28963531.

21 Zheng J, Li Q. Methylene blue regulates inflammatory response in osteoarthritis by noncoding long chain RNA CILinc02. J Cell Biochem. 2019 Mar;120(3):3331-8. https://doi.org/10.1002/jcb.27602. PMid:30548658.

22 Xiong ZM, O’Donovan M, Sun L, Choi JY, Ren M, Cao K. Anti-aging potentials of methylene blue for human skin longevity. Sci Rep. 2017;7(1):2475. https://doi.org/10.1038/s41598-017-02419-3. PMid:28559565.

23 Qiu L, Chen W, Wang J, Deng X, Liu H, Qiu J. Phenothiazines enhance antibacterial activity of macrophage by inducing ROS and autophagy. Front Immunol. 2025 Nov;16:1712724. https://doi.org/10.3389/fimmu.2025.1712724. PMid:41394842.

24 Garcia VG, Carvalho PSP, Oliveira JAGP. Ação da radiação Laser na reparação de feridas de extração dental infectadas: estudo histológico em ratos. RGO. 1995;43(4):191-4.

25 Lubart R, Eichler M, Lavi R, Friedman H, Shainberg A. Low-energy laser irradiation promotes cellular redox activity. Photomed Laser Surg. 2005 Feb;23(1):3-9. https://doi.org/10.1089/pho.2005.23.3. PMid:15782024.

26 Xu Y, Lin Y, Gao S, Shen J. Study on mechanism of release oxygen by photo-excited hemoglobin in low-level laser therapy. Lasers Med Sci. 2018;33(1):135-9. https://doi.org/10.1007/s10103-017-2363-y. PMid:29067617.

27 Rico-Holgado S, Ortiz-Díez G, Martín-Espada MC, Fernández-Pérez C, Baquero-Artigao MR, Suárez-Redondo M. Effect of low-level laser therapy on bacterial counts of contaminated traumatic wounds in dogs. J Lasers Med Sci. 2021 Dec;12(1):e78. https://doi.org/10.34172/jlms.2021.78. PMid:35155163.

28 Kubota J. Effects of diode laser therapy on blood flow in axial pattern flaps in the rat model. Lasers Med Sci. 2002;17(3):146-53. https://doi.org/10.1007/s101030200024. PMid:12181629.

29 Colombo F, Valença A No, Sousa AP, Marchionni AM, Pinheiro AL, Reis SR. Effect of low-level laser therapy (lambda660 nm) on angiogenesis in wound healing: a immunohistochemical study in a rodent model. Braz Dent J. 2013;24(4):308-12. https://doi.org/10.1590/0103-6440201301867. PMid:24173246.

30 Usumez A, Cengiz B, Oztuzcu S, Demir T, Aras MH, Gutknecht N. Effects of laser irradiation at different wavelengths (660, 810, 980, and 1064 nm) on mucositis in an animal model of wound healing. Lasers Med Sci. 2014 Nov;29(6):1807-13. https://doi.org/10.1007/s10103-013-1336-z. PMid:23636299.

31 Wainwright M. Princípios básicos da terapia fotodinâmica na infecção. In: Garcia VG, Theodoro LH, editors. Lasers em odontologia: uma visão clínica baseada em evidências científicas. São Paulo: Santos Publicações Ltda; 2021.

32 Neugebauer J, Jozsa M, Kübler A. Antimicrobial photodynamic therapy for prevention of alveolar ostitis and post-extraction pain. Mund Kiefer Gesichtschir. 2004 Nov;8(6):350-5. https://doi.org/10.1007/s10006-004-0572-6. PMid:15583924.

33 Theodoro LH, Pires JR, Fernandes LA, Gualberto EC Jr, Longo M, Almeida JM, et al. Effect of antimicrobial photodynamic therapy on periodontally infected tooth sockets in rats. Lasers Med Sci. 2015 Feb;30(2):677-83. https://doi.org/10.1007/s10103-013-1400-8. PMid:23912780.
 

Submitted date:
04/17/2026

Accepted date:
07/06/2026

6a85ec09a95395435c1ff1d4 rou Articles
Links & Downloads
1807-2577 (Electronic)
Rev. odontol. UNESP ©2026 All rights reserved for this website content. Articles follow their own licenses.

Rev. odontol. UNESP

Share this page
Page Sections