[논문]치아우식 예방을 위한 치아미백기의 활용 : 광역동 치료로서의 접근

박초아; 박호원; 이주현; 서현우; 이시영

doi:10.5933/jkapd.2020.47.1.70

[국내논문] 치아우식 예방을 위한 치아미백기의 활용 : 광역동 치료로서의 접근
Application of Teeth Whitening LED for Prevention of Dental Caries : Antimicrobial Photodynamic Therapy Approach 원문보기

大韓小兒齒科學會誌 = Journal of the Korean academy of pediatric dentistry, v.47 no.1, 2020년, pp.70 - 77

박초아 (강릉원주대학교 치과대학 소아치과학교실 및 구강과학연구소) , 박호원 (강릉원주대학교 치과대학 소아치과학교실 및 구강과학연구소) , 이주현 (강릉원주대학교 치과대학 소아치과학교실 및 구강과학연구소) , 서현우 (강릉원주대학교 치과대학 소아치과학교실 및 구강과학연구소) , 이시영 (강릉원주대학교 미생물학 및 면역학교실 및 구강과학연구소)

초록
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이 연구의 목적은 악궁 전반적으로 조사가 가능한 미백 LED를 이용하여 우식원성 Streptococcus mutans에 대한 광역동 치료의 효과를 알아보기 위한 in vitro 연구이다. S. mutans를 각각 두가지 다른 단계의 상태로 배양하였다. Planktonic 상태와 Hydroxyapatite disk와 CDC biofilm reactor를 5일간 사용하여 동적인 바이오필름 상태를 형성하였다. 20 μM 로 희석한 erythrosine을 5분간 전처리한후 가정용 미백기와 진료실 미백기를 사용하여 각 15분씩 광조사를 시행하였다. 실험 종료 후 각 실험군의 Colony Forming Unit를 측정하였으며 공초점 레이저 현미경를 이용하여 각 조건에 따른 광역동 치료 효과를 비교하였다. 실험 결과 S. mutans에 대한 aPDT효과는 control군과 비교시에 각각 플랑크토닉상태와 동적인 바이오필름 상태에서 모두 통계적으로 유의한 광역동 치료 효과가 나타났다(각각 p = 0.001, p = 0.002). 하지만 동적인 바이오필름 상태에서는 플랑크토닉 상태보다 광역동치료에 내성을 지녀 항미생물 효과가 떨어지는 양상이 관찰되었다. 진료실용 미백 LED와 가정용 미백LED는 유사한 항미생물 효과를 나타냈다. 구강악궁 전반적 조사가 가능한 미백용 LED는 우식의 원인이 되는 S. mutans 바이오필름에 유의한 광역동 치료의 효과를 나타냈으며, 이러한 결과는 치아 우식 예방으로의 광역동 치료의 임상적 적용 가능성을 제시한다.

Abstract ▼ AI-Helper

The present study is aimed to assess the effect of antimicrobial photodynamic therapy (aPDT) on Streptococcus mutans biofilm through teeth whitening light emitting diode (LED). Planktonic and dynamic biofilm state cultures of S. mutans were used. Erythrosine 20 μM/L was used as the photosensitizer. Irradiation was performed by exposing cultures to clinic and homecare whitening LEDs for 15 minutes. The viability was measured through Colony Forming Unit counts and confocal laser scanning microscopy. aPDT using whitening LEDs and erythrosine significantly decreased the CFU count of S. mutans compared to that in the control group. Dynamic biofilm group showed more resistant features to aPDT compared with planktonic state. Clinic and homecare whitening LED device showed similar antimicrobial effect. The whitening LED, which could irradiate the entire oral arch, showed a significant photodynamic effect on cariogenic S. mutans biofilm. aPDT mediated by erythrosine and LEDs used for teeth whitening exhibited promising antimicrobial activity.

주제어

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문제 정의

The objective of this in vitro study was to evaluate the antimicrobial effect of aPDT using whitening LED device on planktonic and biofilm cultures of S. mutans .

제안 방법

Analysis of the aPDT effect was performed in duplicate, and all procedures were independently repeated on different days. Data were analyzed using SPSS version 25.
It is due to the low energy of selected whitening LED and low concentration of photosensitizers. Further research designed to reduce irradiation time by increasing the light intensity or increasing the concentration of erythrosine is required.
HA disks were moved on to a glass slide and were examined with a LEICA TCS SP8 confocal microscope at 10× magnification, using an excitation laser (argon gas laser, 488 nm) and HyD detector (485/540 nm for detection of SYTO9 and 601/670 nm for detecting propidium iodide).
There are no previous reports of whitening devices being used as aPDT light delivery systems. Since oral biofilm management is mainly performed at home, this study was performed using both a homecare whitening device and a whitening device used in clinics. PDT with a useful light delivery source covering the entire dental arch might be a new option for the control of caries.
Additionally the application time of the homecare and clinical whitening LED devices was 15 minutes according to the manufacturer’s instruction. The experiment was designed on the assumption that the time spent on whitening could be spent on photodynamic therapy.

대상 데이터

Biofilms were cultured in a Center for Disease Control and Prevention (CDC) biofilm reactor (Fig. 1A). Hydroxyapatite (HA) disk was used to reproduce the surface of enamel for developing biofilms.
Streptococcus mutans ATCC 25175 strain was used in this study. The organism was inoculated into a brain heart infusion broth (BHI; Becton, Dickinson and Company, Sparks, MD, USA) and cultured at 37℃ for 18 hours in a 5% CO₂incubator.
1. Whitening LEDs used in this study. (A) Clinic whitening LED.

데이터처리

Kruskal-Wallis test was used for evaluating CFU/ mL data. Each group was compared by Mann-Whitney U test, and the p value was measured by the Bonferroni correction for post-hoc analysis. The level of significance was set at p < 0.

이론/모형

, Chicago, IL, USA). Kruskal-Wallis test was used for evaluating CFU/ mL data. Each group was compared by Mann-Whitney U test, and the p value was measured by the Bonferroni correction for post-hoc analysis.

성능/효과

In our study, aPDT groups showed 95% reduction in planktonic states, whereas in dynamic biofilm state, the reduction rate ranged from 53% to 61%.
In this study, both clinic whitening LED, and homecare LED exhibited a promising antimicrobial effect on the planktonic and biofilm states of S. mutans . The difference in the power density between homecare whitening LED and clinic whitening LED devices did not cause a difference in their antibacterial activity.

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