Comparative in vitro study among the effects of different laser and LED irradiation protocols and conventional chlorhexidine treatment for deactivation of bacterial lipopolysaccharide adherent to titanium surface.

OBJECTIVE AND BACKGROUND The present in vitro study was designed to evaluate and compare the efficacy of: 1) different dental laser devices used in photoablative (PA) mode, namely commercial CO(2), Er:YAG, and Nd:YAG lasers and a prototype diode laser (wavelength = 810  nm); 2) prototype low-energy laser diode or light-emitting diode (LED) (wavelength = 630  nm), used in photodynamic (PD) mode together with the photoactivated agent methylene blue; and 3) chlorhexidine, used as reference drug, to reduce the activation of macrophages by lipopolysaccharide (LPS), a major pro-inflammatory gram-negative bacterial endotoxin, adherent to titanium surface. METHODS RAW 264-7 macrophages were cultured on titanium discs, cut from commercial dental implants and precoated with Porphyromonas gingivalis LPS. Before cell seeding, the discs were treated or not with the noted lasers and LED in PA and PD modes, or with chlorhexidine. The release of nitric oxide (NO), assumed to be a marker of macrophage inflammatory activation, in the conditioned medium was related to cell viability, evaluated by the MTS assay and ultrastructural analysis. RESULTS PA laser irradiation of the LPS-coated discs with Er:YAG, Nd:YAG, CO(2,) and diode (810  nm) significantly reduced NO production, with a maximal inhibition achieved by Nd:YAG and diode (810  nm). Similar effects were also obtained by PD treatment with diode laser and LED (630  nm) and methylene blue. Notably, both treatments were superior to chlorhexidine in terms of efficiency/toxicity ratio. CONCLUSIONS These findings suggest that laser and LED irradiation are capable of effectively reducing the inflammatory response to LPS adherent to titanium surface, a notion that may have clinical relevance.