Evaluation of antibacterial photodynamic therapy effects on human dental pulp cell cultures

Abstract

The antibacterial photodynamic therapy (aPDT) has been used in dentistry against oral microorganisms because of its excellent biocide effect. However, for carious lesions applications, there is little evidence that this therapy is safe for the pulp tissue. This study evaluates the effects of an aPDT protocol on human pulp cells in vitro. Pulp cells isolated from dental pulp were exposed to an aPDT protocol associating methylene blue (MB) at concentrations of 0.0125, 0.025 and 0.050mg/ml and red laser irradiation using a continuous-wave indium-gallium-aluminum-phosphide (InGaAlP) diode laser (λ=660nm, 40mW, 2.4J, 60J/cm(2) for 1min). Pre-irradiation time was 5min for each MB concentration. Cell viability was determined by MTT assay and activity of alkaline phosphatase was assessed by BCIP-NBT assay. Type of aPDT-induced cell death was assessed by flow cytometry. Data was statistically compared (ANOVA followed by Tukey' or Bonferroni's post hoc tests). aPDT was able to kill pulp cells in a dye concentration-dependent manner. The cellular viability was significantly reduced when used MB at 0.025 or 0.050mg/ml concentrations (p<0.0001). At these concentrations, aPDT-induced cell death occurred mostly by necrosis. Alkaline phosphatase activity was significantly reduced in all experimental groups (p<0.001). Pulp cells showed suitable viability when MB at 0.0125mg/ml was exposed to laser irradiation. aPDT with MB at 0.0125mg/ml may represent a low-risk therapy for restorative dentistry applications. aPDT protocol using concentrations above 0.025mg/ml of MB associating red laser irradiation may be harmful for dental pulp cells.