The Finnish oral care innovation Lumoral is of great interest to the academic world, and several new Lumoral studies have been launched in recent months. Koite Health Ltd’s Clinical Project Manager Mikko Kylmänen shares his thoughts on the latest Lumoral clinical studies in this article.

In November 2023, we started a Lumoral study in Lund, Sweden, focusing on fixed orthodontic appliances. This Koite Health sponsor study is a randomized clinical trial involving 40 young subjects. The measurements of the study are performed by dentist and doctor of odontology Ann-Marie Roos Jansåker, specialized in periodontology, in collaboration with specialist dentist Katja Elses. The clinical measurements will be made blinded, so that the investigator does not know whether a participant is using Lumoral or not. 

In January-February 2024, three new academic randomized Lumoral studies will start:

HEALTHIER: The study evaluates the effectiveness of Lumoral in the treatment of peri-implantitis. The study is conducted at a private clinic, Södertandläkarna, in Stockholm, Sweden, and a total of 80 subjects will participate.

LumOsteo: The study investigates the effect of Lumoral on the prevention of complications related to implant installation. The study is conducted at Hammaslääkärit Eteläranta 10 dental clinic in Helsinki, Finland, and a total of 40 subjects will participate.

Tartu University Dental Student Crossover Plaque Study: The study compares two different oral hygiene practices and their impact on oral health. The study is conducted in Tartu, Estonia, and has two test groups. Half of the participants will use Lumoral at the beginning, and after a break of two weeks, the groups switch: one half uses Lumoral, the other does not. This provides comparison results at both group and individual level. The study participants are healthy young adults.

On the innovation front, Lumoral studies have received approval for one thousand recruitable subjects, which indicates that researchers in the field are interested in this new approach to oral care. In 2024, the majority of Lumoral studies will be conducted by academic research groups, which is most encouraging.

- Studies with the Lumoral method open up new possibilities for the development of oral care. Our company is proud to promote health and well-being through innovative solutions. We continue to work closely with the research community and look forward to potential applications of Lumoral in the future," says Mikko Kylmänen, Research Manager at Koite Health Oy.

- It is great to see how much interest researchers are showing in Lumoral studies. In 2024, a large part of the Lumoral studies will be conducted by academic research groups, he continues.

For more information on the Lumoral studies and their effects, visit www.lumoralpro.com.

(This article is based on the writing of dentist Viktoria Ljutkina, published in the largest dental medicine periodical in Estonia, Ajakiri Hambaarst. Ljutkina works as a dentist at Läänemere Hambakliinikus dental clinic in Tallinn.)

Periodontitis is a common disease affecting an estimated 20–50% of the population. This severe oral condition originates in the gum tissue, and if left untreated, the inflammatory process spreads deeper, leading to tooth loss (1). Periodontitis is a multifactorial disease primarily caused by bacterial colonization in the oral cavity (2). Many risk factors, such as diabetes and smoking, contribute to the development of periodontitis and influence its prognosis.

The goal of periodontitis treatment is to eliminate factors promoting inflammation in the oral cavity and support the patient's immune system. Fundamental to gum disease treatment is meticulous oral hygiene, preventing the formation of new dental calculus and reducing the number of bacteria in the oral cavity, thereby promoting periodontitis healing (3). The effects of Antimicrobial Photodynamic Therapy (aPDT) on oral diseases, including periodontitis and peri-implantitis, have been extensively studied, with substantial clinical evidence supporting its effectiveness.

The Lumoral oral care method, developed by Finnish scientists, is based on dual-light antibacterial therapy that can be administered at home. Lumoral's effects have been scientifically proven in various clinical studies. Regular use of Lumoral prevents tooth decay and significantly reduces the count of periodontal bacteria in the mouth (4).

Lumoral treatment relies on the administration of dual-light therapy through the Lumoral oral device – near-infrared light and antibacterial blue light. The near-infrared light has a wavelength of 810 nm, penetrating tissues up to 10 cm deep. Antibacterial blue light, with a wavelength of 410 nm, acts on inflammation-causing bacteria, slowing down their growth. When porphyrin molecules in the bacteria are exposed to specific wavelengths of light, they produce reactive oxygen species, which, in turn, kill the bacteria.

Lumoral is effective against harmful bacteria in the mouth

The Lumoral method includes a light source and a mouthwash. The photosensitive indocyanine green molecule in the Lumorinse mouthwash, in combination with the light source, achieves the desired therapeutic outcome. Indocyanine green (ICG) is water-soluble and highly light-absorbing. The dual light reacts with the ICG photosensitizer, generating reactive oxygen species (ROS) and heat, initiating a series of photochemical and biological processes that destroy the bacterial cell membrane, thereby damaging the bacterial cell structure.

The body's immune cells use a similar method to protect against harmful pathogens. Pathogenic bacteria contain porphyrin and flavin molecules with photosensitive properties. Therefore, Lumoral mainly affects pathogenic bacteria.

The Lumoral method has proven to be highly effective against harmful bacteria, with no development of bacterial resistance even with repeated use (5). The largest European study on periodontitis demonstrates significant improvement in treatment outcomes when dental calculus is regularly removed from the mouth. Lumoral has been shown to help users achieve better oral hygiene, even after using the most modern and efficient electric toothbrushes, which can leave plaque on teeth. The study also indicates that Lumoral aids in achieving better oral hygiene.

In support of brushing and flossing

Lumoral does not replace the need for mechanical brushing and cleaning between teeth but helps further improve oral hygiene. Effectively, Lumoral can remove bacteria from the surfaces of teeth and even from the gumline, where access with a toothbrush may be challenging.

aPDT treatment has proven to be significantly more effective and better tolerated than commonly used chlorhexidine mouthwashes. Home use of Lumoral reduces gum inflammation and enhances oral hygiene. Effective oral hygiene also enhances the efficiency of periodontal treatment (6).

Periodontal treatment and improvement of oral hygiene are considered the gold standard in periodontitis treatment. However, some patients may not respond positively to treatment due to risk factors and/or systemic diseases.

Smoking is considered a major risk factor for gum diseases, negatively impacting both the course of the disease and treatment outcomes. Nicotine in tobacco products hinders the oral cavity's defense mechanisms, impedes the healing of periodontal tissues, and adversely affects tissue blood circulation. Changes in the oral microbiome also occur due to smoking, promoting the development of advanced periodontitis and poorer healing after treatment. Finding effective treatment for smoking patients with periodontitis is crucial because managing periodontitis based on the aforementioned biological processes poses a significant challenge for physicians (7).

Independent Lumoral study shows efficacy

I decided to try the Lumoral method at Läänemere Hambakliinikus dental clinic to improve oral hygiene in patients with periodontitis. Twelve smoking patients with generalized periodontitis at stage III, grade B, and without other chronic diseases were selected for the clinical study. Half of the patients received Lumoral photodynamic therapy 2–3 times a week for six months (recommended dose after periodontal treatment twice daily for four weeks). The remaining patients received traditional periodontal treatment only. The general treatment strategy was similar for all patients, including comprehensive diagnostics (periodontal condition, radiological diagnostics, anamnesis), non-surgical periodontal treatment, and periodontal follow-ups at two weeks, three months, and six months. During the control visits, patients' dental calculus was stained to check oral hygiene.

I noticed that patients using Lumoral in addition to traditional treatment showed better results in periodontal treatment outcomes (pocket depths, tooth mobility, BOP, VIP, SUP) and oral hygiene compared to those not using Lumoral as an oral hygiene aid. Based on my clinical experience, we can conclude that using the Lumoral method improves patients' oral hygiene and leads to more positive treatment outcomes. It is essential to use the device correctly and regularly following the dentist's recommendations.

References:

Petersen, P. E., Baehni, P. C. Periodontal health and global public health. Periodontol 2000. 2012 Oct; 60 (1): 7–14.

Bartold, P. M., Van Dyke, T. E. Periodontitis: a host-mediated disruption of microbial homeostasis. Unlearning learned concepts. Periodontol 2000. 2013 Jun; 62 (1): 203–17.

Greenstein, G. Research, Science and Therapy Committee of the American Academy of Periodontology. The Role of supra- and subgingival irrigation in the treatment of periodontal diseases. J Periodontol. 2005; 76: 2015–27.

Villafuerte, K. R., Martinez, C. J. H., Vieira, L. H. P., Nobre, A. V. Benefits of antimicrobial photodynamic therapy as an adjunct to non-surgical periodontal treatment in smokers with periodontitis: a systematic review and meta-analysis. Medicina 2023, 59 (4): 684.

Lähteenmäki, H., Pätilä, T., Räisänen, I. T., Kankuri, E., Tervahartiala, T., Sorsa, T. Repeated Homeapplied dual-light antibacterial photodynamis therapy can reduce

Finnish health technology company Koite Health Oy has signed a distribution accord in March with Medshop OÜ, an Estonian distributor of premium quality dentistry products such as implantology and teeth whitening systems. Following the agreement, Medshop will offer Lumoral® – the latest technology for improved oral health self-care – to oral health professionals in Estonia as well as to the consumer market through its newly opened website.

Medshop was established in 2016 by two dentists – Mihhail Botšinski and Konstantin Loginov – who were looking for new premium-quality products for their own dental clinic in Estonia. 

– Our first partner was Medentis Medical GmbH, a German manufacturer of ICX Implantology systems. Now we have several partners worldwide, says Mari-Liis Järvesalu, CEO of Medshop.    

Medshop distributes high-quality products to dental clinics all over Estonia. These include BlancOne LED teeth whitening systems, Japanese Tokuyama Dental products, Danish Vela Medical dental chairs, and many other high-end brands. 

– Medishop is a fast-growing company, and our mission is to offer the best quality products for a fair price and quick delivery time. This year we opened a webshop for consumers who want to buy oral hygiene homecare products that have been recommended by their dentist, Järvesalu says. 

Järvesalu sees Lumoral as an interesting new product in the dentistry field that fits well with the company’s existing product portfolio.

– We wanted to represent Lumoral because it is something new and innovative. Our idea is to offer our customers interesting new products and technologies.  

Järvesalu has used the Lumoral method herself in addition to regular brushing and flossing and is happy with its results – a perfectly clean mouth with minimal effort.

– In general, we do not sell products without testing or without believing in them fully ourselves. Antibacterial PDT technology is a scientifically confirmed and well-known method used in the field of dentistry, so this was all clear to us how the Lumoral system works.

What does Mari-Liis Järvesalu expect the ongoing collaboration with Koite Health to bring her business and its customers?

– The most important thing in a partnership is trust and reliability. This means that if you have any questions regarding a product, it is important that you receive quick answers and support from the producer side.  We as distributors must give professional and quick support ourselves to our customers.  For us to be able to do this, we must receive good service from our producer. With Koite Health we are happy with our partnership, Järvesalu says.

Despite the relatively small population of Estonia – around 1.1. million – the number of dentists in the country per 1, 000 inhabitants is above the European average. According to Järvesalu, there is one dentist per 1,149 inhabitants in Estonia and about 450 dental clinics in the country. Moreover, clinical results show that every other Estonian has some sort of gum disease in their mouth. 

– We will sell the Lumoral product on our webshop and offer it to dental clinics.  Lumoral is especially beneficial to patients who have periodontitis, peri-implantitis, halitosis, and other gum problems that are caused by bacteria.      

– In terms of exact sales number, it is hard to estimate because Lumoral is a completely new and unique product in the Estonian market. It all depends on how fast we attract the users who need the product the most, Järvesalu concludes.