Acronym

L7-3186

Contract number

L7-3186

Department:

Department of Microbiology

Type of project

ARIS projects

Type of project

Aplikativni

Role

Lead

Duration

01.10.2021 - 30.09.2024

Total

1,38 FTE

Project manager at BF

Stopar David

Research activity

Problem. The incidences of biofilm related periodontal and peri-implant diseases are high. The weighted mean prevalence of peri-implant mucositis is 43 % and peri-implantitis 22 %, which implies that on average one out of five patients with dental implants is expected to suffer from severe peri-implant disease. The limited effectiveness of current treatment methods is due to hard-to-reach biofilm sites in the periodontal and peri-implant space and toxicity of effective antimicrobial agents to vital dental and implant tissues. The 3D geometry of periodontal and peri-implant space is complex and difficult to simulate. In the case of peri-implant diseases, additional factors that contribute to poor biofilm removal are macrotopography of implants (implant shape and threads) and implant microtopography (surface asperities across multiple scales) which protect microorganisms, facilitate microbial re-colonization and accelerate biofilm formation.

Current therapy strategies. Biofilm therapy for periodontal and peri-implant diseases include nonsurgical and surgical procedures. The nonsurgical procedures usually involve biofilm mechanical debridement of the tooth or implant surface using curettes, ultrasonic devices, air-abrasive devices, or lasers, with or without the adjunctive use of local antibiotics or antiseptics. The existent clinical, radiographic and microbiological data do not favor any decontamination approach and fail to show the influence of a particular decontamination protocol on surgical therapy.

Proposed solution. In the project we will apply new laser techniques and modalities developed in our laboratories to treat patients with severe periodontitis and peri-implantitis. The project will be divided into three work packages. First basic understanding of the effect of local geometry on photoacoustic, photodynamic, and photothermic induced hydrodynamic flow will be determined in manufactured 3D volumes. Second, the optimized laser parameters in constrained geometries will be used to examine the biofilm removal efficiency in vitro in hard to reach biofilm sites in manufactured 3D volumes. In the third work package the best in vitro laser parameters for biofilm removal will be used to treat patients with stage III periodontitis and peri-implantitis in a large randomized controlled clinical study. One of the partners in the project team (Fotona d.o.o.) develops and produces optoelectronic devices in particular laser technology and equipment for the dedicated dental use, which allows us to use flexible laser schemes and very efficient super short and ultrashort laser pulse technology in narrow geometries. The laser technology is based on photon induced photo-acoustic irrigant streaming with super short laser pulses (SSP) and shock wave enhanced emission photoacoustic streaming (SWEEPS). The two laser modalities proved to be very successful in endodontic tooth root canal biofilm removal, but have not been used yet in periodontal and implant therapy. The photoacoustic streaming with different laser modalities will be combined with different irrigants, and laser induced photodynamic and photothermal therapy.

 

Co-financing Organisation

  • Fotona d.o.o.
     

Abstract

In the proposed project we will apply new laser techniques and modalities developed in our laboratories to treat patients with severe periodontitis and peri-implantitis. To deliver this the project will be divided into three interrelated subprojects. First basic understanding of the effect of local geometry on photoacoustic, photodynamic, and photothermic induced hydrodynamic flow will be determined in manufactured 3D volumes that will mimic constricted geometries of periodontal and peri-implant space. Second, the optimized laser parameters in constrained geometries will be used to examine the biofilm removal efficiency in vitro in hard to reach biofilm sites. In the third subproject the best in vitro laser parameter setups for biofilm removal will be used to treat patients with stage III periodontitis and peri-implantitis in a large randomized controlled clinical study. One of the partners in the project team (Fotona d.o.o.) develops and produces optoelectronic devices in particular laser technology and equipment for the dedicated dental use. This will allow us to test flexible laser schemes and to use very efficient super short and ultrashort laser pulse technology to boost hydrodynamic streaming in constrained geometries of periodontal and peri-implant space. The proposed laser modalities proved to be very successful in endodontic tooth root canal biofilm removal, but have not been tested yet in periodontal and implant therapy. The photoacoustic streaming with different laser modalities will be combined with different irrigants, laser induced photodynamic, and photothermal therapy.

 

Researchers

  • University of Ljubljana, Biotechnical Faculty
  • University of Ljubljana, Faculty of Mechanical Engeeniring
  • University of Ljubljana, Faculty of Medicine
  • Fotona proizvodnaj optoelektronskih naprav d.o.o.
     

The phases of the project and their realization

The project will be divided into three work packages.

First basic understanding of the effect of local geometry on photoacoustic, photodynamic, and photothermic induced hydrodynamic flow will be determined in manufactured 3D volumes.

Second, the optimized laser parameters in constrained geometries will be used to examine the biofilm removal efficiency in vitro in hard to reach biofilm sites in manufactured 3D volumes.

In the third work stage the best in vitro laser parameters for biofilm removal will be used to treat patients with stage III periodontitis and peri-implantitis in a large randomized controlled clinical study