Department of Pediatric Dentistry and Orthodontics, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
Laser Biospectroscopy Laboratory, Prokhorov General Physics Institute of the Russian Academy of Sciences, Moscow, Russia.
Front Public Health. 2023 Jan 30;11:961066. doi: 10.3389/fpubh.2023.961066. eCollection 2023.
Dental diseases occur in children with cerebral palsy three times higher than in healthy children. Low values of the unstimulated salivation rate (<0.3 ml per minute), pH and buffer capacity, changes in enzyme activity and sialic acid concentration, as well as increased saliva osmolarity and total protein concentration, which indicates impaired hydration, are the factors in the development of a gingiva disease in case of cerebral palsy. This leads to increased bacterial agglutination and the formation of acquired pellicle and biofilm, leading to the formation of dental plaque. There is a tendency toward an increase in the concentration of hemoglobin and a decrease in the degree of hemoglobin oxygenation, as well as an increase in the generation of reactive oxygen and nitrogen species. Photodynamic therapy (PDT) with the use of photosensitizer methylene blue improves blood circulation and the degree of oxygenation in periodontal tissues, as well as eliminates a bacterial biofilm. Analysis of back diffuse reflection spectra makes it possible to conduct non-invasive monitoring determine tissue areas with a low level of hemoglobin oxygenation for precision photodynamic exposure.
To improve the effectiveness of phototheranostics methods using, namely PDT with simultaneous optical-spectral control, for the treatment of gingivitis in children with complex dental and somatic status (cerebral palsy).
The study involved 15 children (6-18 y.o.) with various forms of cerebral palsy, in particular, spastic diplegia and atonic-astatic form and with gingivitis. The degree of hemoglobin oxygenation was measured in tissues before PDT and on the 12th day. PDT was performed using laser radiation (λ = 660 nm) with a power density of 150 mW/cm with a five-minute application of 0.01% MB. The total light dose was 45 ± 15 J/cm. For statistical evaluation of the results, a paired Student's t-test was used.
The paper presents the results of phototheranostics using methylene blue in children with cerebral palsy. An increase in the level of hemoglobin oxygenation from 50 to 67% ( < 0.001) and a decrease in blood volume in the microcirculatory bed of periodontal tissues were shown.
Photodynamic therapy methods with application of methylene blue make it possible to assess the state of the gingival mucosa tissue diseases objectively in real time, and to provide effective targeted therapy for gingivitis in children with cerebral palsy. There is a prospect that they can become widely used clinical methods.
脑瘫儿童患口腔疾病的几率比健康儿童高 3 倍。未刺激唾液分泌率（<0.3 毫升/分钟）、pH 值和缓冲能力低、酶活性和唾液酸浓度改变、唾液渗透压和总蛋白浓度增加等因素，表明水合作用受损，这些都是脑瘫患者发生牙龈疾病的因素。这导致细菌聚集增加，获得性黏膜和生物膜形成，导致牙菌斑形成。血红蛋白浓度呈上升趋势，血红蛋白氧合程度下降，活性氧和氮物质生成增加。使用光敏剂亚甲蓝的光动力疗法（PDT）可改善牙周组织的血液循环和氧合程度，并消除细菌生物膜。背反射漫散光光谱分析可实现非侵入性监测，确定血红蛋白氧合水平低的组织区域，从而进行精确的光动力暴露。
改善使用光热疗法方法的效果，即同时进行光光谱控制的 PDT，用于治疗具有复杂牙齿和躯体状况（脑瘫）的儿童的牙龈炎。
该研究涉及 15 名（6-18 岁）患有各种形式脑瘫的儿童，特别是痉挛性双侧瘫和弛缓性-震颤性瘫痪，以及患有牙龈炎。在 PDT 之前和第 12 天测量组织中的血红蛋白氧合程度。使用激光辐射（λ=660nm）进行 PDT，功率密度为 150mW/cm，应用 0.01%MB 五分钟。总光剂量为 45±15J/cm。为了对结果进行统计评估，使用配对学生 t 检验。
本文介绍了在脑瘫儿童中使用亚甲蓝进行光热治疗的结果。血红蛋白氧合水平从 50%增加到 67%（<0.001），牙周组织微循环床中的血液体积减少。
应用亚甲蓝的光动力疗法方法可实时客观评估牙龈黏膜组织疾病的状态，并为脑瘫儿童的牙龈炎提供有效靶向治疗。这些方法有望成为广泛应用的临床方法。
