Association of Papacarie Duo® and low-level laser in antimicrobial photodynamic therapy (aPDT).

Dental caries is a multifactorial, non-communicable disease. Effective treatment options for minimally invasive removal of carious tissue include Papacarie Duo® gel and antimicrobial photodynamic therapy (aPDT). aPDT involves a combination of a light source and photosensitizer. Given that Papacarie Duo® contains a percentage of blue dye, this study aims to explore the antimicrobial potential of Papacarie Duo® when associated with a light source against Streptococcus mutans strains. The chosen light source was a low-power diode laser (λ = 660 nm, E = 3 J, P = 100 mW, t = 30 s). To assess antimicrobial capacity, planktonic suspensions of Streptococcus mutans were plated on Brain Heart Infusion Agar (BHI) to observe the formation of inhibition halos. The studied groups included methylene blue (0.005%), Papacarie Duo®, distilled water (negative control), 2% chlorhexidine (positive control), Papacarie Duo® + laser, and methylene blue (0.005%) + laser. Following distribution onto plates, each group was incubated at 37 °C for 48 h under microaerophilic conditions. Inhibition halos were subsequently measured using a digital caliper. The results showed that chlorhexidine had the greatest antimicrobial effect followed by the group of irradiated methylene blue and irradiated Papacarie Duo®. All experimental groups demonstrated antimicrobial potential, excluding the negative control group. The study concludes that Papacarie Duo® exhibits antimicrobial properties when associated with a low-power diode laser.

Photobiomodulation therapy for hypersensitivity associated with molar-incisor hypomineralization: a case report.

Molar-incisor hypomineralization (MIH) is a qualitative defect of the dental enamel on permanent first molars and may be associated with permanent incisors. There is currently no defined therapeutic protocol for managing the hypersensitivity associated with this condition. The present case report describes the treatment of a patient with MIH and the impact on the patient's quality of life as assessed using the Child Perceptions Questionnaire for children aged 11 to 14 years (CPQ11-14). The maxillary central incisors, maxillary and mandibular first molars, and mandibular right canine of an 11-year-old girl were compromised by MIH. The long version of the CPQ11-14 was self-administered before treatment. Initially, the patient reported hypersensitivity of her maxillary right central incisor, maxillary and mandibular left first molars, and mandibular right canine when consuming cold food and beverages. This was confirmed by applying a jet of air to the teeth and asking the patient to report the level of sensitivity using the Wong-Baker FACES Pain Rating Scale. The patient reported that hypersensitivity was present every day or almost every day. Desensitizing treatment included 4 applications of photobiomodulation therapy (infrared diode laser) and 4 applications of fluoride varnish. After desensitization, the maxillary central incisors received direct composite resin restorations, while the maxillary left first molar, which had an amalgam restoration and recurrent caries, received a resin-modified glass ionomer cement restoration. At the conclusion of the treatment, the patient completed the CPQ11-14 again and reported less difficulty with consuming hot and cold foods and beverages, indicating that treatment had reduced hypersensitivity and its negative impact on her quality of life.

The Combination of Antimicrobial Photodynamic Therapy and Photobiomodulation Therapy for the Treatment of Palatal Ulcers: A Case Report.

Introduction: One of the unexpected side effects of the Haas type palatal expander is ulcers progressing to necrotic lesions in the palatal area due to poor hygiene. The use of antibiotic therapy is mandatory. However, long periods of healing/pain and the need for a systemic host response with the aid of metabolization, especially in children, are issues that should be taken into account in the management of this type of injury. Since phototherapy modalities (antimicrobial photodynamic therapy [aPDT] and photobiomodulation therapy [PBMT]) are able to enhance and accelerate the healing process and reduce the bacterial load, this case report aimed to describe the use of the above-mentioned therapies to treat palatal ulcers occurring during orthodontic expansion. Case Report: The patient, a 10-year-old boy, with a chief complaint of bleeding and continuous pain in the region of his expander was verified on a follow-up visit. After a dental examination, the expander was removed and two necrotic lesions which were in contact with the acrylic part of the tooth-tissue expander were found in the palatal region. The proposal was to use one aPDT session with methylene blue followed by 4 sessions of PBMT with a red laser diode. On the 5th day, reorganized tissue was verified, with the absence of bleeding, swelling, and pain. On the 20th day of follow-up, the area showed no signs of inflammation, healthy tissue without any pathological clinical symptoms, and complete wound healing. Conclusion: The concomitant use of PBMT and aPDT therapies may be considered feasible as an adjunct treatment to manage palatal ulcers resulting from the incorrect use of tooth-tissue types of expanders.

Efeito da terapia fotodinâmica antimicrobiana mediada por curcumina sobre Streptococcus Mutans / Effect of photodynamic antimicrobial chemotherapy mediated by curcumin on Streptococcus mutans

O trabalho investigou o potencial antimicrobiano fotodinâmico (PACT) mediado por um fotossensibilizador (FS) natural, curcumina (C), exposto a uma fonte de luz LED azul (L) aplicado sobre biofilme maduro de Streptococcus mutans (SM) formado sobre discos de hidroxiapatita e comparou esse potencial com biofilmes submetidos a imersão única com solução de clorexidina a 0.12% (CHX). Adicionalmente, verificou-se a eficácia de uma fonte de luz de amplo espectro (luz branca) de alta intensidade de potência na presença de C e azul de toluidina (T) a baixas concentrações expostos a um tempo extra curto de iluminação. Material e Método: Biofilmes de SM foram submetidos a tratamento com soluções de C e iluminadas com um LED azul (L) a 48 J/cm2 e 72 J/cm2 e a imersão em CHX. Adicionalmente, uma fonte de luz branca (42 J/cm2; 3410 mW/cm2) foi utilizada na presença de baixas concentrações de C e T por um período extra curto de iluminação sobre suspensões de SM. A eficácia das tratamentos foi realizada por meio da contagem de unidades formadoras de colônia (UFC/mg de biofilme seco e UFC/ml de suspensão) e análise morfológica dos biofilmes foram realizadas por meio de microscopia confocal a laser e microscopia eletrônica de varredura ambiental. Resultados: PACT (C a 2.5 mM e L a 48 J/cm2) apresentou a maior redução bacteriana substancial quando comparada a CHX. A luz branca apresentou fotossensibilização letal nos parâmetros utilizados. Conclusão: A utilização da curcumina, um corante natural e a luz branca, capaz de ativar FS em curtos períodos de tempo, são avanços nesse campo antimicrobiano alternativo.

Purpose: This work investigated the antimicrobial photodynamic potential (PACT) mediated by a natural photosensitizer (PS), curcumin (C), exposure to an source of blue LED (L) applied over a Streptoccocus mutans (SM) mature biofilm formed on hidroxiapatite discs and compared this potential with biofilms submitted to single immersion of chlorhexidine at 0.12% (CHX). Additionally, it was verified the efficacy of a broad visible spectrum light source (white light) of high potency intensity in the presence of C and toluidine blue (T) at low concentrations and exposure to an extra short illumination time. Materials: SM biofilms were submitted to a treatment with C solutions and exposure to a 48 J/cm2 e 72 J/cm2 of L and immersion in CHX. Furthermore, a white light source (42 J/cm2 ; 3410 mW/cm2 ) was used in the presence of low concentrations of C and T for an extra short period over SM suspensions. The efficacy of the treatments were performed by colony forming units counting (CFU/mg of dry biofilm and CFU/ml of suspension) and the morphological analysis of biofilms were performed using confocal laser scanning microscopy images and environmental scanning electron microscopy. Results: PACT (C at 2.5 mM and L at 48 J/cm2) presented a bacterial substantial reduction when compared with CHX treatment. The white light showed lethal photossensibilization in the utilized parameters. Conclusion: The use of curcumin, a natural compound and the white light, able to activate FS at shorts periods, are advance on this antimicrobial alternative field

Therapeutic effects of low-level laser therapy after premolar extraction in adolescents: a randomized double-blind clinical trial.

OBJECTIVE: The purpose of this study was to evaluate the effect of low-level laser therapy (LLLT) on wound healing process and pain levels after premolar extraction in adolescents. BACKGROUND DATA: The advantage of using LLLT in oral surgeries is the reduction of inflammation and postoperative discomfort; however, the optimal dosing parameters and treatment effects in surgical procedures are inconclusive. METHODS: A double-blind, randomized, controlled clinical trial was conducted with 14 patients who were to undergo surgical removal of premolars. Patients were randomly allocated to the LLLT (test) group and placebo (control) group. Patients in the test group received 5.1 J (60 J/cm(2)) of energy density of a gallium-aluminum-arsenide (GaAlAs) diode laser (wavelength, 830 nm; output power, 0.1 W) at three different points intraorally, 1 cm from the target tissue immediately and at 48 and 72 h after the surgical procedure. For patients in the placebo group, the laser device was applied to the same points without activating the hand piece. The wound healing process was evaluated by an independent examiner by visual inspection with the support of digital photographs at baseline and 2, 7, and 15 days postoperatively. Patients recorded the degree of pain using the visual analogue scale (VAS). RESULTS: Compared with the placebo group, the test group showed a lower intensity of pain, but this difference was not statistically significant at any time point. The wound healing process was similar in both groups. CONCLUSIONS: Within the limitations of this study, the LLLT parameters used neither increased the wound healing process nor significantly decreased pain intensity after premolar extraction in adolescents.