Use Of Antimicrobial Photodynamic Therapy Research Articles

The effectiveness of antimicrobial photodynamic therapy on catheter infection model

Background/AimThis experimental study aimed to examine the effectiveness of transdermal antimicrobial photodynamic therapy (APDT) with and without antimicrobial lock therapy (ALT), on catheter biofilms. MethodsS. epidermidis and C. orthopsilosis biofilms were formed within peripheral venous catheters positioned in the marginal ear veins of New Zealand white rabbits. Biofilm formation was confirmed with scanning electron microscopy in two catheters. 24 catheters with staphylococcal biofilms and 24 with fungal biofilms were treated with APDT, ALT or “APDT plus ALT” for five days. Six catheters were separated as controls. APDT was applied with a red colored LED lamp and methylene blue as the photosensitizer. Vancomycin lock solutions were used as ALT for staphylococcal biofilms and amphotericin B for fungal biofilms. The effect of treatment procedures was evaluated by intraluminal biofilm viability testing based on spectrophotometric evaluation, and a quantitative (OD) value was obtained for each catheter. ResultsThe mean OD values obtained by 600 nm spectrophotometric reading at 24 h (biofilm viability) after “ALT”, “APDT” and “ALT plus APDT” procedures were 0.363, 0.151 and 0.128 for S. epidermidis and 0.092, 0.104 and 0.227 for C. orthopsilosis, respectively. All these OD values obtained after treatment procedures were lower than controls for both S. epidermidis (OD: 0,802) and C. orthopsilosis (OD: 0,315), although there were large fluctuations in our results. ConclusionsOur results suggest that transdermal APDT may be an effective method for treating staphylococcal and candida biofilms formed within intravenous catheters in our rabbit ear model. The combined use of APDT and ALT might be beneficial in these staphylococcal biofilms.

The adjunctive use of antimicrobial photodynamic therapy, light-emitting-diode photobiomodulation and ozone therapy in regenerative treatment of stage III/IV grade C periodontitis: a randomized controlled clinical trial

ObjectivesTo assess the short-term efficacy of multiple sessions of antimicrobial photodynamic therapy (aPDT), light-emitting-diode (LED) photobiomodulation, and topical ozone therapy applications following surgical regenerative treatments on clinical parameters, patient-centered outcomes, and mRNA expression levels of VEGF, IL-6, RunX2, Nell-1, and osterix in gingival crevicular fluid samples in patients with stage III/IV, grade C periodontitis.Materials and methodsForty-eight systemically healthy patients were assigned into four groups to receive adjunctive modalities with regenerative periodontal surgical treatment. A 970 ± 15 nm diode laser plus indocyanine-green for aPDT group, a 626 nm LED for photobiomodulation group, and topical gaseous ozone were applied at 0, 1, 3, and 7 postoperative days and compared to control group. The clinical periodontal parameters, early wound healing index (EHI), and postoperative patients’ morbidity were evaluated. The mRNA levels of biomarkers were assessed by real-time polymerase chain reaction.ResultsNo significant difference in the clinical parameters except gingival recession (GR) was identified among the groups. For group-by-time interactions, plaque index (PI) and probing pocket depths (PD) showed significant differences (p = 0.034; p = 0.022). In sites with initial PD > 7 mm, significant differences were observed between control and photobiomodulation groups in PD (p = 0.011), between control and aPDT, and control and photobiomodulation groups in CAL at 6-month follow-up (p = 0.007; p = 0.022). The relative osterix mRNA levels showed a statistically significant difference among the treatment groups (p = 0.014).ConclusionsThe additional applications of aPDT and LED after regenerative treatment of stage III/IV grade C periodontitis exhibited a more pronounced beneficial effect on clinical outcomes in deep periodontal pockets.

Antimicrobial photodynamic therapy in the nonsurgical treatment of periodontitis in patients with HIV infection: a systematic review and meta-analysis.

The aim of this systematic review and meta-analysis (SRM) was to evaluate the effectiveness of the adjunctive use of antimicrobial photodynamic therapy (aPDT) in non-surgical periodontal treatment (NSPT) in subjects with Human Immunodeficiency Virus (HIV) and periodontitis. This SRM was registered in PROSPERO (CRD42023410180) and followed the guidelines of PRISMA 2020. Searches were performed in different electronic databases. Risk of bias was performed using the Cochrane Risk of Bias tool (RoB 2.0) for randomized clinical trials (RCT). Meta-analysis was performed using Rev Man software. The mean difference (MD) measure of effect was calculated, the random effect model was applied with a 95% confidence interval, and heterogeneity was tested by the I2 index. The certainty of the evidence was rated using GRADE. A total of 1118 records were screened, and four studies were included. There was a greater reduction in the microbial load of periodontopathogens after NSPT with aPDT. Meta-analysis showed that probing depth (post 3 and 6 months) and clinical attachment loss (post 6 months) were lower for the aPDT-treated group than the NSPT alone: MD -0.39 [-0.74; -0.05], p = 0.02; MD -0.70 [-0.99; -0.41], p < 0.0001; MD -0.84 [-1,34; -0.34], p = 0.0001, respectively. Overall, the studies had a low risk of bias and, the certainty of evidence was rated as moderate. It is suggested that aPDT is a promising adjuvant therapy, showing efficacy in the reduction of the microbial load and in some clinical parameters of individuals with periodontitis and HIV.

Extracts of Trichocline sinuata (Asteraceae) as natural sensitizers in the photodynamic inactivation of Candida albicans.

Despite significant progress in the development of phototherapy drugs, it is widely recognized that natural products remain the primary source of new photoactive compounds. Exploring uncharted flora in the east-central region of Argentina may offer a vast array of opportunities to isolate new photoactive molecules or plant extracts with high potential for use in antimicrobial photodynamic therapy (aPDT) against Candida albicans. To assess the photofungicidal potential of T. sinuata ("contrayerba") against C. albicans, the extracts underwent spectroscopic and chromatographic analysis, resulting in the identification of furanocoumarin metabolites with similar spectrophotometric properties in all extracts. The extract profiles were created using UHPLC-DAD, and seven furanocoumarins (FCs) were detected. The highest photoinactivation against C. albicans was observed for dicholormethanic extracts (MFC = 62.5 μg/mL), equal to xanthotoxin employed as a positive control. Furthermore, we determine that photochemical mechanisms dependent on oxygen (type I and type II processes) and mechanisms independent of oxygen (photoadduct formation) are involved in the death of these yeasts. These results support the use of native plants of the east-central region of Argentina as potent sensitizers for aPDT and suggest that they can replace xanthotoxin in treating superficial yeast infections of the skin.

Effect of antimicrobial photodynamic therapy on the treatment of peri-implantitis: narrative review

Background and Objective: The greatest challenge of implantology is the maintenance of dental implants, with peri-implantitis being the main cause of implant loss. Studies highlight the importance of dental biofilm control, reduction of the inflammatory process in the peri-implant mucosa and decontamination of the implant surface, as well as the need for surgical intervention. Recently, low-level laser therapy (LLLT) has been introduced in different dental specialties, especially those related to oral mucosa lesions and the treatment of periodontal disease. The combination of LLLT and a photosensitizer dye promotes antimicrobial activity (aPDT) and may be used as a noninvasive treatment of peri-implantitis. The objective of this study was to conduct a literature review on the use of antimicrobial photodynamic therapy (aPDT) in the treatment of peri-implantitis.

The in vitro photocytotoxicity of photosensitizer encapsulated by nanovehicles comprising biomimetic phospholipids.

Photosensitizers (PSs) for use in antimicrobial photodynamic therapy (aPDT) are often characterized by poor solubility and a tendency to aggregate in aqueous environments. Mixed nanomicellar drug delivery systems based on Pluronics block copolymers and biomimetic phospholipids (Colalipids) may enhance the efficiency of photosensitizers. The aim of the present work was to explore a mixed nano-micellar drug delivery composed of Pluronic P123 and three different biomimetic phospholipids (Colalipids). Interactions between the PSs and P123/ Colalipids assemblies were studied at micromolar concentration by means of UV-Vis absorption spectrometry and by photon correlation spectroscopy. The prepared nanocarriers efficiently solubilized model PS precluding its aggregation in aqueous media. P123/Colalipid assemblies formed small, positively charged micelles that efficiently delivered PS to fungal cells leading to cell death following exposure to blue light in vitro. It was found that mixed micelles based on short and medium chain phospholipids caused higher fungal cell reduction as compared to their long chain counterpart. The clinically relevant, CA2 strain was more resistant to aPDT in vitro treatment, as compared to model ATCC strain. However the treatment with optimized formulation caused 6 log CFU reduction of cell survival in CA2 cultures upon light activation.

Adjunctive use of antimicrobial photodynamic therapy in the surgical treatment of periapical lesions: A case series

BackgroundAntimicrobial photodynamic therapy (aPDT) is used in endodontics to improve orthograde root canal disinfection as an adjunct to standard treatments. Conversely, evidence concerning the application of aPDT in retrograde endodontic surgery is limited. Thus, the aim of the present study was to provide additional data regarding the use of aPDT in the surgical endodontic treatment of periapical lesions. MethodsA total of 25 consecutive patients presenting teeth with periapical radiolucency eventually associated with clinical signs and symptoms of apical periodontitis were included. Following access flap completion, osteotomy, mechanical debridement, root apical third resection, and preparation of the root-end cavity, aPDT was applied to decontaminate the surgical site using phenothiazine chloride dye at a concentration of 10 mg/mL and irradiation with a hand-held 100-mW diode laser with a wavelength of 660 ± 10 nm. At the latest follow-up visit, healing was evaluated as successful, uncertain, or failure according to well-established clinical and radiological criteria. ResultsOverall, 31 periapical lesions were treated with aPDT. Healing proceeded uneventfully. The mean follow-up time was 36.19 months, with times ranging from 12 to 85 months. A total of 25 (80.65%) cases were classified as successful, 5 (16.13%) as uncertain, and only one (3.22%) as failure. Irrespective of the treatment outcome, all treated teeth were still functional, with no symptoms reported by the patients. ConclusionaPDT as an adjunctive treatment modality in the surgical endodontic treatment of periapical lesions showed promising medium-term results associated with preservation of all diseased teeth.

The use of antimicrobial photodynamic therapy in the successful management of a nonsurgical complex type II Dens Invaginatus

Because of its complex root canal morphology, dens invaginatus (DI) is a developmental anomaly that represents an endodontic challenge to complete cleaning, shaping, and disinfecting the root canal system. The present case report describes the use of antimicrobial photodynamic therapy as an adjunctive treatment in the successful management of nonsurgical complex type II DI in a left maxillary lateral incisor with thin and fragile dentin walls associated with periradicular lesion.

Efficacy of Adjunctive Antimicrobial Photodynamic Therapy to Mechanical Debridement in the Treatment of Peri-implantitis or Peri-implant Mucositis in Smokers: A Systematic Review and Meta-analysis.

This systematic review and meta-analysis aimed to determine whether adjunctive use of antimicrobial photodynamic therapy (a-PDT) in peri-implant diseases improves clinical outcomes in smokers. An electronic search was performed in MEDLINE (through PubMed), Scopus, Cochrane Library, Embase, Web of Science and Google Scholar. The primary outcome measures were bleeding on probing (BOP) and pocket depth (PD). Plaque index (PI) was the secondary outcome. Four RCTs, (188 participants) comprised of 118 cigarette smokers, 38 E-cig smokers and 32 water pipe smokers with follow-up periods ranged from 6 weeks to 6 months were recruited. All trials applied diode laser in one session with wavelengths ranged from 660 to 670 nm. There was a significant difference between mechanical debridement (MD)+a-PDT and MD alone groups in PD (WMD = -1.26 mm, 95% CI: -2.19 to -0.32, P = 0.01) and PI (WMD = -10.60%, 95% CI: -14.46 to -6.74, P < 0.001) at 3-month follow-up. However, a great amount of heterogeneity was observed (PD: χ2 = 199.19, I2 = 98%, P < 0.001 and PI: χ2 = 25.63, I2 = 84.4%, P < 0.001). Due to methodological heterogeneity and small number of studies, this systematic review was unable to reach conclusive evidence in regards of adjunctive a-PDT efficacy in improving clinical parameters in smokers.

Use of antimicrobial photodynamic therapy in the treatment of medication-related osteonecrosis of the jaw

Medication-related osteonecrosis of the jaw (MRONJ) is a debilitating complication associated with antiresorptive agents, in which treatment can be quite challenging. This study aimed to report two cases of cancer patients with MRONJ treated in a complementary manner by antimicrobial photodynamic therapy (aPDT). Both patients were male, 84 and 82 years old, respectively, and had a diagnosis of prostate adenocarcinoma and bone metastasis, treated with intravenous injections of bisphosphonates. The dental history for both was toothache, followed by extraction of dental elements that culminated with the appearance of necrotic bone in the mandibular region, which was confirmed with imaging exams and histopathological reports. The treatment protocol for both cases consisted of performing the aPDT once a week, associated with the use of 10 volumes hydrogen peroxide and 0.12% chlorhexidine digluconate for continuous use after oral brushing and amoxicillin with clavulanate three times a day for 7 days. The patient in case 1 performed 27 sessions, responded well to treatment, however, due to complications of the underlying neoplasm, he died without complete resolution of the osteonecrosis. In case 2, 32 sessions were carried out, with a good evolution of the symptoms. The patient is being followed up for 14 months, with no need for surgical intervention to date. Based on the reported cases and the literature survey, it can be concluded that aPDT can be an effective alternative in cases of MRONJ. The patients in the study in question showed success and control of the clinical picture.

Attenuation of Aggregatibacter actinomycetemcomitans virulence using curcumin-decorated nanophytosomes-mediated photo-sonoantimicrobial chemotherapy

This study aimed to focus on the simultaneous use of antimicrobial photodynamic therapy (aPDT) and sonodynamic antimicrobial chemotherapy (SACT), which is called photo-sonodynamic antimicrobial chemotherapy (PSACT) to attenuate the virulence of Aggregatibacter actinomycetemcomitans. Following the synthesis of Curcumin-decorated nanophytosomes (Cur-NPhs) as a novel photo-sonosensitizer, its particle size, polydispersity, ζ-potential surface morphology, physical stability, drug release, and entrapment efficiency were determined. In the Cur-NPhs-PSACT, the antimicrobial activities of Cur-NPhs against A. actinomycetemcomitans were investigated using cell viability, biofilm killing/degradation, metabolic activity, expression of quorum-sensing-associated qseB and qseC genes, and biofilm-associated rcpA gene under blue laser irradiation plus ultrasonic waves. Characterization tests showed the presence of a sphere-shaped vesicle and the self-closed structure of Cur-NPhs, resulting in a high drug-loading content and encapsulation efficiency. However, the antimicrobial effect of Cur-NPhs-PSACT was dose-dependent, PSACT using the high concentrations of Cur-NPhs (50 × 10–4 g/L) showed significant reductions (P < 0.05) in cell viability (13.6 log10 CFU/mL), biofilm killing/degradation (65%), metabolic activity (89.6%,), and mRNA levels of virulence determinant genes (qseB; 9.8-fold, qseC; 10.2-fold, and recA; 10.2-fold). This study concludes that the Cur-NPhs-PSACT had antimicrobial activities against A. actinomycetemcomitans by downregulating the expression of virulence genes, and may attenuate this bacterium that decreases periodontal disease severity in patients.

Antimicrobial photodynamic therapy can be an effective adjuvant for surgical wound healing in cattle.

Rumenostomy is a useful procedure commonly performed in cattle for medical treatment of domestic ruminants with forestomach diseases. Methylene blue (MB)-mediated antimicrobial photodynamic therapy (APDT) has been broadly investigated to treat infected wounds. The aim of the study was to evaluate the effectiveness of MB-mediated APDT (MB-APDT) combined with chlorhexidine and zinc oxide ointment on wound healing process after rumenostomy. Fourteen Nelore bulls were subjected to rumenostomy procedure. Animals were randomly divided into MB-APDT (MB associated with a red diode laser performed immediately after surgery and repeated on days 3, 5, 7 and 10) and control groups. Daily care included topical cleaning with chlorhexidine 2% followed by topical zinc oxide ointment. Animals were followed-up until the 28th day. Wounds presented a better post-surgical profile in MB-APDT group when it was compared with the control group. In MB-APDT group, it was also possible to observe less pain on palpation of wounds borders, less edema and inflammatory exudate. Additionally, animals from MB-APDT group were faster discharged from the cattle care facility. Our results support the use of MB-APDT for the post-surgical management of rumenostomy. This pilot study ratifies the use of APDT in cattle and also suggests that it could be performed for other surgical procedures as a complementary approach or an alternative for topical administration of antibiotics.

Efficacy of antimicrobial photodynamic therapy (aPDT) for nonsurgical treatment of periodontal disease: a systematic review.

Although the standard treatment for periodontal disease is based on scaling and root planing (SRP), the use of antimicrobial photodynamic therapy (aPDT) has been studied as a complement to obtain better clinical results. The purpose of this study was to evaluate the effect of aPDT as adjuncts to SRP, compared with SRP alone, on clinical parameters of chronic periodontal patients. Only randomized controlled trials with at least 3-month follow-ups, of SRP alone and in association with aPDT, were included. The MEDLINE (PubMed), Google Scholar, and LILACS databases were searched for articles published up to July 2020. Random-effects meta-analyses were conducted for clinical attachment level (CAL) and probing pocket depth (PPD) change after treatment. Of 141 potentially relevant papers, 22 were included. The association between SRP and aPDT promoted a significant CAL gain and PPD reduction. Periodontal treatment was partially improved by aPDT, and a favorable effect of indocyanine green-mediated aPDT was observed, and high concentrations of phenothiazine chloride presented clinical improvement as well.

Use of Antimicrobial Photodynamic Therapy as an Adjunct in the Treatment of Peri-Implantitis: A Prospective Study with 24 Months Follow up

Introduction: Despite the long-term predictability of Osseointegrated implants, biologic, biomechanical and esthetic complication can occur in a small percentage of cases. With increasing use of dental implants for rehabilitation of missing teeth there is increase in cases of peri-implantitis. Use of photodynamic therapy has showed promising results for management of peri-implantitis. Materials and methods: Sixteen patients of peri-implantitis were selected and randomly assigned to test or control group. Readings were taken at baseline, 6 weeks, 6 months, and 24 months for Probing Pocket Depth (PPD), and Bleeding on Probing (BOP). Control group patients were treated with periodontal therapy whereas test group patients were given photodynamic therapy additionally. Result: 64% reduction in PPD was observed in test group whereas BOP and suppuration were absent. Significant reduction in PPD was seen in control group as well. After 24 months test group had average pocket depth of 2 mm and control group 3 mm. Conclusion: Use of photodynamic therapy added therapeutic benefit to conventional management and should be considered as a part of peri-implantitis management therapy.

A clinico-microbiological and biochemical study evaluating the adjunctive use of antimicrobial photodynamic therapy and local drug delivery of 1.2 % simvastatin gel compared to scaling and root planing alone.

To evaluate and compare the efficacy of antimicrobial Photodynamic therapy (aPDT), Local Drug Delivery (LDD) of 1.2 % Simvastatin gel as an adjunct to scaling and root planning (SRP) and SRP alone in the treatment of Periodontitis using clinical, microbiological and biochemical parameters. A total of 33 test sites in 11 Grade A Stage II periodontitis patients were randomly divided into three groups: GROUP I: Treated by SRP alone (SRP group); GROUP II: Treated by SRP followed by aPDT (aPDT group); GROUP III: Treated by SRP followed by single subgingival application of 1.2 % simvastatin gel (SMV group). Clinical parameters including API, PBI, PPD and RAL were assessed. Quantification of Porphyromonas gingivalis was evaluated by RT -PCR technique and estimation of RANKL levels was checked by ELISA. All assessments were done at baseline and 3 months RESULTS: All three groups showed significant reduction in the scores of clinical parameters, P. gingivalis DNA copy numbers and GCF RANKL levels at 3 months post therapy compared to baseline (p < 0.05). On comparison between the three groups, the results were non significant for all parameters both at baseline and at 3 months post therapy (p > 0.05). However slightly greater reduction was seen in the mean scores of PPD and RAL in the SMV Group and in P. gingivalis DNA copy numbers and GCF RANKL levels in aPDT group compared to the other groups although statistically non significant. A significant positive correlation(p < 0.05) was observed between P. gingivalis DNA copy numbers and PPD scores in SMV group and a significant negative correlation(p < 0.05) was observed between P. gingivalis DNA copy numbers and API & PBI scores in SRP group at 3 months follow up. aPDT, 1.2 % SMV local drug delivery as adjunct to SRP and SRP alone are effective in improving clinical parameters, reducing P. gingivalis DNA copy numbers and GCF RANKL levels. The superiority of one over another modality of treatment could not be established in this short term study.

Use of antimicrobial photodynamic therapy in the treatment of chronic tonsillitis

An effective method for treatment of chronic tonsillitis has been developed. It is based on combined (sequential) exposure of the tonsils to laser radiation of violet (405 nm wavelength) and red (650 wavelength) spectral regions at a power density of 25 mW/cm 2 for 3 minutes for each amygdala for 7 days. It was shown that laser therapy according to the above method has positive anti-inflammatory, decongestant and antimicrobial effects. Moreover, the antimicrobial effect of laser radiation is due to the excitation of endogenous porphyrin and flavin photosensitizers, localized mainly in pathogenic microflora. The high efficiency of generation of singlet oxygen by these compounds is capable of realizing the bactericidal action of light without introducing exogenous photosensitizers.

Efficacy and safety of photodynamic therapy with RLP068 for diabetic foot ulcers: a review of the literature and clinical experience.

This article is the second part of a literature review concerning diabetic foot ulcers (DFUs) and the use of antimicrobial photodynamic therapy (PDT). PDT involves the topical application of a photosensitiser into the tissue, followed by illumination that induces the formation of reactive oxygen species (ROS). PDT provides bacterial inactivation and promotes wound healing, and it can be used to manage the infection and microbial colonisation of DFUs. It has pivotal advantages in comparison with chemotherapeutics, such as no potential to induce resistance, and a wide spectrum of activity. Tetracationic Zn(II) phthalocyanine derivatives have been developed for PDT. Among these, we would like to focus on RLP068, whose antimicrobial activity has been widely demonstrated in preclinical studies and in a clinical trial. This article reports previously published evidence and presents four unpublished clinical cases of DFUs treated in the real-life setting with PDT.

Is the Use of Antimicrobial Photodynamic Therapy or Systemic Antibiotics More Effective in Improving Periodontal Health When Used in Conjunction with Localised Non-Surgical Periodontal Therapy? A Systematic Review

Periodontal disease can be treated in several ways. This paper reviewed whether antimicrobial photodynamic therapy (aPDT) in addition to scaling and root planing (SRP) produces improved clinical results over systemic antibiotics (ABs) in conjunction with SRP in adults with periodontitis. Studies were searched using the following electronic databases: MEDLINE, the Cochrane Database of Systematic Reviews, and the Web of Science Core Collection up to and including November 2018. Four randomized controlled trials (RCTs) were reviewed to maximise the reliability of the evidence. All participants suffered from either chronic or aggressive periodontitis and each study contained SRP as an adjunct to ABs or aPDT. To determine whether groups showed improvement after treatment, the outcome parameters chosen were probing depth (PD), clinical attachment level (CAL), and bleeding on probing (BOP). Despite finding significant improvements in all groups, the differences among groups were not consistently statistically significant. The lack of homogeneity in the results among these studies indicates that it was not possible to determine a conclusion about whether aPDT or AB as an adjunct to SRP provides better improvements in periodontitis as measured by PD, CAL, and BOP. Further studies with more similar study designs are required before firm conclusions can be deduced.

The benefits of antimicrobial photodynamic therapy with RLP068 in the management of diabetic foot ulcers.

This article is the first part of a literature review concerning diabetic foot ulcers and the use of antimicrobial photodynamic therapy (PDT). Diabetic foot ulcers are associated with high morbidity, mortality, and healthcare costs. Natural healing is often delayed by microbial infection or colonisation, which might lead to serious complications, such as amputation. Furthermore, antibiotic treatment could have limited success because of the development of bacterial resistance and severely limited drug delivery to the ulcer due to vascular damage. PDT has antimicrobial effects and has been used to reduce the total and pathogenic microbial load in diabetic ulcers without inducing bacterial resistance. It is safe and can be used to improve outcomes. A clinical trial demonstrated that PDT with RLP068 reduced the microbial load of diabetic ulcers in 62 patients. This article reports previously published evidence and presents four, unpublished, clinical cases treated in the real-life setting.

Adjunctive application of antimicrobial photodynamic therapy in the prevention of medication-related osteonecrosis of the jaw following dentoalveolar surgery: A case series.

Medication-related osteonecrosis of the jaw (MRONJ) is a debilitating complication strongly associated to antiresorptive agents. The present study aimed to describe the use of antimicrobial photodynamic therapy (aPDT) in the prevention of MRONJ. The sample consisted of 11 non-oncologic osteoporotic subjects in therapy with non-intravenous antiresorptive agents, requiring tooth extractions and/or implant removal. After minimally invasive surgical extractions, each alveolar socket was debrided and bony edges were smoothened. At this point, aPDT was performed using methylene blue-based phenothiazine chloride dye irradiated with a hand-held 100 mW diode laser with a wavelength of 660 ± 10 nm. Flaps were sutured to achieve first intention closure. Soft tissue healing was promoted with weekly applications of low-level laser therapy for 6 weeks. Recall visits were scheduled weekly for the first two months and monthly thereafter up to 6 months. At the 6-month appointment, healing was assessed clinically and radiographically. A total of 62 surgical extractions were performed in both jaws, including 51 natural elements and 11 dental implants. No intraoperative complications were observed. Immediate post-operative period was generally uneventful except for mild pain and ecchymosis that occurred rarely and resolved spontaneously. Healing proceeded uneventfully, with no clinical or radiological prodromal manifestations of MRONJ up to the latest follow-up visit. aPDT might constitute a promising preventive treatment to reduce the risk of MRONJ in non-oncologic osteoporotic patients treated with non-intravenous antiresorptive agents that underwent dentoalveolar surgery.