title: Comparison of antibacterial effect of photodynamic therapy using indocyanine green (Emundo) with 2% metronidazole and 2% chlorhexidine gel on Porphyromonas gingivalis (an in-vitro study).
abstract: BACKGROUND
  The treatment of periodontal disease focuses on eradication or suppression of the pathogenic microbiota within the periodontal pocket. There are some mechanical and chemical ways, and recently antimicrobial photodynamic therapy to eliminate the bacteria. The aim of this in vitro study was to compare the effects of 2% chlorhexidine gel, 2% metronidazole in Orabase, antimicrobial photodynamic therapy with Emundo solution and Emundo solution on P. gingivalis.
  
  
  METHODS
  The antibacterial activities of 2% CHX gel, 2% Metronidazole in Orabase, Emundo+Laser (an infra-red laser diode of 810nm, 300mW, continuous mode radiation, 30s and energy density of 11.5J/cm2), and Emundo against P. gingivalis was tested in vitro using two different methods; (1) Counting CFU/mL and (2) agar diffusion test (ADT). Data of CFU/mL were analyzed using one way ANOVA and Post hoc Tukey test (p<0.05). Data obtained from ADT test were analyzed using Kruskal-Wallis.
  
  
  RESULTS
  The percentage of colony-forming units reduction was (99.75, 99.98) in Metronidazole, (99.66, 99.85) in CHX, and (96.68, 96.68) in Laser+Emundo (96.68, 96.68) groups after 24 and 48h, respectively. The amount of bacterial reduction in terms of log10 CFU/mL was decreased in the Metronidazole, CHX, Laser+Emundo and, Emundo groups, respectively after 48h (p<0.05). The inhibition zone radius was decreased in CHX, Metronidazole and, Laser+Emundo, respectively (p<0.05).
  
  
  CONCLUSIONS
  It can be concluded that within the limitations of this in-vitro study, although photodynamic therapy with Emundo reduced the amount of P. gingivalis significantly, the use of metronidazole 2% in Orabase performed better in terms of reducing the amount of the bacteria. Also, the antibacterial effect of 2% CHX gel on P. gingivalis was significantly more than photodynamic therapy with Emundo.
authors.affiliation: Periodontology Department, Dental Faculty - Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Fekrazad
authors.affiliation: Department of Endodontics, Faculty of Dentistry, Shiraz Branch, Islamic Azad University, Shiraz, Iran. Electronic address: kasra.karamifar@gmail.com.
authors.forename: Kasra
authors.initials: K
authors.lastname: Karamifar
authors.affiliation: Department of Microbiology, Laser Research Center, Dental Research Center, Dentistry Research Institute, School of Medicine, Tehran University of Medical Sciences, Iran.
authors.forename: Abbas
authors.initials: A
authors.lastname: Bahador
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002470:Cell Survival / Q000187:drug effects / Q000502:physiology / Q000528:radiation effects; D002710:Chlorhexidine / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004307:Dose-Response Relationship, Radiation; D004359:Drug Therapy, Combination / Q000379:methods; D005782:Gels / Q000008:administration & dosage; D006801:Humans; D007208:Indocyanine Green / Q000008:administration & dosage*; D008027:Light; D008795:Metronidazole / Q000008:administration & dosage*; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000008:administration & dosage; D016966:Porphyromonas gingivalis / Q000187:drug effects* / Q000502:physiology / Q000528:radiation effects*
chemical_list: D000900:Anti-Bacterial Agents; D005782:Gels; D017319:Photosensitizing Agents; D008795:Metronidazole; D007208:Indocyanine Green; D002710:Chlorhexidine
keywords: Antimicrobial photodynamic therapy; Chlorhexidine; Emundo; Metronidazole; Orabase; Porphyromonas gingivalis