Combined Approaches for Photodynamic Inactivation Against Oral Biofilms

Biofilms are present in numerous oral infections and remain a pressing global public health concern. The human oral cavity hosts a complex microbiome consisting of bacteria, archaea, protozoa, fungi, and viruses. Oral biofilms represent one of the most complex biofilm systems in nature and are responsible for a variety of oral infections. These biofilms protect microorganisms from treatment and promote the expression of virulence factors, which exacerbate infections. To effectively combat biofilm-associated infections, early diagnosis and the discovery of novel treatments are essential. Antimicrobial photodynamic therapy (aPDT) is a promising tool for the inactivation of pathogens with varying resistance profiles; however, complete eradication of microorganisms in biofilms is rarely achieved. In this chapter, combined approaches utilizing aPDT against oral biofilms are explored through a literature review of in vitro and in vivo evidence. Overall, a synergistic effect between aPDT and other therapies has been observed in oral biofilms, resulting in enhanced microbial inactivation through chemical or mechanical means. This chapter highlights the most promising combination therapies currently under investigation for oral biofilms, with the aim of advancing future therapeutic innovations.