Phototoxic action of light emitting diode in the in vitro viability of Trichophyton rubrum.

BACKGROUND: Trichophyton rubrum is the most common agent of superficial mycosis of the skin and nails causing long lasting infections and high recurrence rates. Current treatment drawbacks involve topical medications not being able to reach the nail bed at therapeutic concentrations, systemic antifungal drugs failing to eradicate the fungus before the nails are renewed, severe side effects and selection of resistant fungal isolates. Photodynamic therapy (PDT) has been a promising alternative to conventional treatments. OBJECTIVES: This study evaluated the in vitro effectiveness of toluidine blue O (TBO) irradiated by Light emitting diode (LED) in the reduction of T. rubrum viability. METHODS: The fungal inoculums' was prepared and exposed to different TBO concentrations and energy densities of Light emitting diode for evaluate the T. rubrum sensibility to PDT and production effect fungicidal after photodynamic treatment. In addition, the profiles of the area and volume of the irradiated fungal suspensions were also investigated. RESULTS: A small reduction, in vitro, of fungal cells was observed after exposition to 100 µM toluidine blue O irradiated by 18 J/cm² Light emitting diode. Fungicidal effect occurred after 25 µM toluidine blue O irradiation by Light emitting diode with energy density of 72 J/cm². The analysis showed that the area and volume irradiated by the Light emitting diode were 52.2 mm² and 413.70 mm³, respectively. CONCLUSION: The results allowed to conclude that Photodynamic therapy using Light emitting diode under these experimental conditions is a possible alternative approach to inhibit in vitro T. rubrum and may be a promising new treatment for dermatophytosis caused by this fungus.

Cryptococcus gattii: in vitro susceptibility to photodynamic inactivation.

Cryptococus gattii is an emergent primary human pathogen that causes meningismus, papilledema, high intracranial pressure and focal involvement of the central nervous system in immunocompetent hosts. Prolonged antifungal therapy is the conventional treatment, but it is highly toxic, selects for resistant strains, contributes to therapy failure and has a poor prognosis. Photodynamic inactivation (PDI) offers a promising possibility for the alternative treatment of cryptococcosis. The aim of this study was to test the effectiveness of toluidine blue O (TBO) and light-emitting diode (LED) against C. gattii strains with distinct susceptibility profile to antifungal drugs (amphotericin B: 0.015-1.0 µg mL(-1); itraconazole: 0.015-2 µg mL(-1); fluconazole: 4-64 µg mL(-1)). Using 25 µM (6.76 µg mL(-1)) TBO and LED energy density of 54 J cm(-2) these fungal isolates presented variable susceptibility to PDI. The production of reactive oxygen species (ROS)/peroxynitrite was determined, and the catalase and peroxidase activities were measured. After PDI, high amounts of ROS/peroxynitrite are produced and higher catalase and peroxidase activities could be correlated with a lower susceptibility of C. gattii isolates to PDI. These results indicate that PDI could be an alternative to C. gattii growth inhibition, even of isolates less susceptible to classical antifungal drugs, also pointing to mechanisms related to their variable susceptibility behavior.

Phototoxic action of light emitting diode in the in vitro viability of Trichophyton rubrum / Ação fototóxica do diodo emissor de luz na viabilidade de Trichophyton rubrum in vitro

BACKGROUND: Trichophyton rubrum is the most common agent of superficial mycosis of the skin and nails causing long lasting infections and high recurrence rates. Current treatment drawbacks involve topical medications not being able to reach the nail bed at therapeutic concentrations, systemic antifungal drugs failing to eradicate the fungus before the nails are renewed, severe side effects and selection of resistant fungal isolates. Photodynamic therapy (PDT) has been a promising alternative to conventional treatments. OBJECTIVES: This study evaluated the in vitro effectiveness of toluidine blue O (TBO) irradiated by Light emitting diode (LED) in the reduction of T. rubrum viability. METHODS: The fungal inoculums' was prepared and exposed to different TBO concentrations and energy densities of Light emitting diode for evaluate the T. rubrum sensibility to PDT and production effect fungicidal after photodynamic treatment. In addition, the profiles of the area and volume of the irradiated fungal suspensions were also investigated. RESULTS: A small reduction, in vitro, of fungal cells was observed after exposition to 100 µM toluidine blue O irradiated by 18 J/cm² Light emitting diode. Fungicidal effect occurred after 25 µM toluidine blue O irradiation by Light emitting diode with energy density of 72 J/cm². The analysis showed that the area and volume irradiated by the Light emitting diode were 52.2 mm² and 413.70 mm³, respectively. CONCLUSION: The results allowed to conclude that Photodynamic therapy using Light emitting diode under these experimental conditions is a possible alternative approach to inhibit in vitro T. rubrum and may be a promising new treatment for dermatophytosis caused by this fungus.

FUNDAMENTOS: Trichophyton rubrum é o agente mais comum das micoses superficiais de pele e unhas causando infecções de longa duração e altas taxas de recidiva. As desvantagens do tratamento atual envolvem medicações tópicas as quais não são capazes de alcançar o leito ungueal em concentrações terapêuticas, antifúngicos sistêmicos que não erradicam o fungo antes das unhas serem renovadas, efeitos colaterais graves e seleção de isolados fúngicos resistentes. A terapia fotodinâmica tem sido uma alternativa promissora aos tratamentos convencionais. OBJETIVOS: Este estudo avaliou a eficácia, in vitro, de azul de orto-toluidina irradiado por diodo emissor de luz na redução da viabilidade de T. rubrum. MÉTODOS: O inóculo fúngico foi preparado e exposto a diferentes concentrações de azul de orto-toluidina e densidades de energia do diodo emissor de luz, para avaliar a sensibilidade de T. rubrum e o efeito fungicida, após terapia fotodinâmica. Além disso, os perfis da área e volume das suspensões fúngicas irradiados também foram investigados. RESULTADOS: Uma pequena redução, in vitro, de células fúngicas foi observada após a exposição a 100 mM azul de orto-toluidina irradiados por diodo emissor de luz a 18 J/cm². Efeito fungicida ocorreu após irradiação 25 µM orto-toluidina por diodo emissor de luz com densidade de energia de 72 J/cm². A análise mostrou que a área e o volume irradiados pelo diodo emissor de luz foram 52,2 mm² e 413,70 mm³, respectivamente. CONCLUSÕES: Os resultados permitiram concluir que a terapia fotodinâmica com diodo emissor de luz, nas condições experimentais é uma abordagem alternativa para inibir, in vitro, T. rubrum e pode ser um tratamento promissor para as dermatofitoses causadas por este fungo.

Cuidados odontológicos na paralisia supranuclear progressiva: relato de caso / Dental care in progressive supranuclear palsy: a case report

Este trabalho teve como objetivo relatar o tratamento de complicações bucais numa paciente hospitalizada com diagnóstico de paralisia supranuclear progressiva (PSP), causa mais comum de parkinsonismo degenerativo. A paciente fazia uso de vários medicamentos, tinha 70 anos de idade, sem acompanhamento odontológico durante a hospitalização, com edentulismo total na arcada superior e usuária de prótese parcial na região inferior, mas em função do quadro clínico sistêmico não fazia uso da mesma. No exame bucal, constatou-se uma lesão na mucosa e lábio superior em decorrência de trauma dos dentes inferiores. Planejou-se inicialmente o tratamento da lesão com laserterapia e exodontias dos dentes que provocaram a lesão traumática. Após a cicatrização da lesão, os dentes inferiores remanescentes foram extraídos. Os resultados obtidos da terapêutica aplicada foram eficazes na melhora clínica da paciente. Conclui-se, assim, que é marcante a necessidade de um cirurgião-dentista como membro permanente da equipe multidisciplinar para o tratamento dessa e de outras patologias, a fim de permitir melhor qualidade de vida aos pacientes.

This study aimed to report the treatment of oral complications in hospitalized patients diagnosed with progressive supranuclear palsy (PSP), the most common cause of degenerative parkinsonism. The patient was taking several medications, was 70 years old, without dental monitoring during hospitalization, with partial edentulism (without natural teeth in upper arch) and used a lower partial denture, but due to clinical history she was not using it. On examination, there was an oral mucosal damage and upper lip due to trauma of the lower teeth. It was planned to initially treat the lesion with laser therapy and extractions of teeth that caused the traumatic injury. After healing of the injury, the remaining lower teeth were extracted. The results of the treatment applied were effective in improving the clinical condition of the patient. This case report showed the need for a dentist as permanent member of the multidisciplinary team to treat this type and other conditions to allow better quality of life for patients.

Gengiva artificial: alternativa para solucionar os problemas estéticos da doença periodontal / Artificial gingival: alternative to solve the aesthetic problems of periodontal disease

O termo gengiva artificial, ou epítese, é usado para descrever a substituição da gengiva perdida por uma prótese removível. Atualmente, as reabilitações orais estéticas dispõem de inúmeros recursos para a substituição dessas estruturas, uma vez que a doença periodontal pode ocasionar perda das estruturas dentárias e exposição radicular, ocasionando recessões gengivais de vários graus. O presente artigo relata a utilização de gengiva artificial, como alternativa para a recuperação das estruturas de suporte perdidas, melhorando estética, fonética, suporte labial, higienização, devolvendo conforto e autoestima ao paciente.

Avaliaçäo quantitativa da drenagem do exsudato de bolsas periodontais supra-ósseas antes e após a aplicaçäo do raio laser Ga As 904nm: estudo em humanos / Quantitiative evaluation of exsudate drainage of suprabony periodontal pockets before and after the application of laser Ga As 904nm: study in humans

Os autores realizaram avaliaçäo eletrônica (Periotron) do volume de exsudato drenado de 30 bolsas periodontais, em humanos, antes e após a aplicaçäo da irradiaçäo Laser Ga As 904nm. Concluiram que esta drenagem aumentou consideravelmente depois da irradiaçäo. Sugerem que a laserterapia integre o elenco de técnicas constituintes dos procedimentos básicos na terapêutica periodontal