紅光與近紅外線雷射劑量在口腔醫學上的應用: 光生物調節作用之功率密度分析及光型分布在光動力治療系統上的設計

Dosimetry of red and near-infrared laser in stomatology: Exact dose analysis of photobiomodulation and optical profile analysis of photodynamic therapy

蘇傳宗(Chuan-Tsung Su)

指導教授 ： 陳中明

共同指導教授 ： 吳季華(Jih-Huah Wu)

國立臺灣大學/工學院/醫學工程學研究所/博士(2021年)

https://doi.org/10.6342/NTU202102567

摘要

光生物調節作用 (Photobiomodulation, PBM) 已廣泛應用於體內與體外之臨床實務應用。而 PBM 在皮膚上的光學特性及應用已有多年的研究探討，但是PBM在真實皮膚下的劑量及穿透深度探討甚少，也缺乏直接證據。另一方面，抗菌光動力療法 (Antimicrobial photodynamic therapy, aPDT) 已被廣泛用於牙周疾病的治療，牙周疾病影響了全球 20% 至 50% 的人口，同時也構成全球的健康挑戰。然而雷射光型在 aPDT 體外研究的抗菌功效仍需進一步釐清。本論文研究包含 PBM 在牙齦上的定量分析及雷射光源均勻性在 aPDT的重要性探討。本論文發展出非侵入式感測裝置來偵測 PBM 穿透口輪匝肌到牙齦上的真實劑量，其劑量可被準確量測且定義出來。當PBM應用於皮膚下的目標組織時，正確的劑量計算有助於增加臨床上的整體性評估。在aPDT的應用中，本論文發展出低成本的aPDT系統應用在放線共生聚集桿菌和變異鏈球菌並可達到 98% 及 91% 的抗菌效果。研究結果顯示雷射光型的均勻性對於細菌存活率具關鍵的重要性。根據我們研究的結果，牙醫師可正確計算牙齦的照射劑量及有效評估體外抗菌的最佳照射參數。本研究結果預期可擴大 PBM 及 aPDT 的臨床應用並做為光生物刺激研究之重要參考。

關鍵字

光生物調節作用 ； 光動力療法 ； 牙周疾病 ； 抗菌功效 ； 雷射光型

並列摘要

Photobiomodulation (PBM) has been widely applied in vivo and in vitro studies. The optical characteristics of PBM on skin and applications have been studied for many years. However, the real penetration depth and evidence of light dose in the human skin were limited. On the other hand, antimicrobial photodynamic therapy (aPDT) has been widely utilized for the treatment of periodontal disease. Periodontal disease affects 20–50% of population worldwide, posing a global health challenge. However, the effect of laser profile on the antibacterial efficacy of aPDT remains to be established. In this work, the quantitative analysis of PBM on the attached gingiva and laser profile of aPDT in cellular assays were studied. A non-invasive sensing system was used to measure the real irradiance of PBM on the attached gingiva. And the dose of PBM can be defined and conducted precisely. The exact light dose calculation is helpful for the evaluation of clinical outcome, especially when the target lies beneath the skin. In aPDT applications, a low cost aPDT system provided antimicrobial efficacy of 98% and 91% for Actinobacillus actinomycetemcomitans and Streptococcus mutans, respectively. The results of the study highlighted the importance of laser profile as a key parameter that determines the survival rate of bacteria at the edge of the culture plate. Thus, the dose of aPDT at the margin of optical profile is important for antibacterial activity in vitro evaluation. Based on our results, the optimal dose of PBM and aPDT can be exactly calculation for stomatology by dentist. Further, the results of this study can be expanded to the clinical application as an important reference for PBM and aPDT.

並列關鍵字

photobiomodulation ； antimicrobial photodynamic therapy ； periodontal disease ； antibacterial efficacy ； laser profile

參考文獻

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