Effects of experimental bleaching gels containing co-doped titanium dioxide and niobium pentoxide combined with violet light.

OBJECTIVES: The objective of the study is to evaluate the bleaching potential of 6% hydrogen peroxide (6% HP) gels containing NF_TiO2 or Nb2O5 irradiated with a violet LED light and the effects on enamel mineral content and surface morphology. METHODS: Particles were synthesized, and experimental gels were chemically analyzed by preliminary and accelerated stability tests, pH, and HP decomposition rate. Bovine enamel blocks were treated with 6% HP gels containing (n = 10): 5% NF_TiO2, 5% Nb2O5, 2.5% NF_TiO2 + 2.5% Nb2O5 or without particles (6% HP), irradiated or not with LED, and the control was treated with 35% HP. Color (∆E00) and whitening index (∆WID) variations, surface microhardness (SH), average roughness (∆Ra), Ca-P concentration (EDS), and enamel morphology (SEM) were assessed. Bleaching was performed in 3 sessions of 30 min and 7-day intervals. Data were submitted to two- (pH, decomposition rate, ∆E00, and ∆WID) or three-way ANOVA and Bonferroni (SH), Kruskal-Wallis (∆Ra), and Dunnet tests (α = 0.05). RESULTS: No changes in the gel's color, odor, or translucency were observed. The pH (6 to 6.5) remained stable over time, and light irradiation boosted the HP decomposition rate. NF_TiO2 and Nb2O5-containing gels displayed higher ∆E00 and ΔWID when light-irradiated (p < 0.05). Nb2O5 and Nb2O5 + NF_TiO2 decreased enamel SH (p < 0.05), but no SH changes were found among groups (p > 0.05). No differences among groups were noted in ∆Ra, Ca-P content, and enamel morphology after treatments (p > 0.05). CONCLUSION: Experimental light-irradiated 6% HP gels containing NF_TiO2 or Nb2O5 were chemically stable and exhibited bleaching potential comparable with 35% HP. CLINICAL RELEVANCE: Low-concentrated HP gels containing NF_TiO2 or Nb2O5 and light-irradiated stand as a possible alternative to in-office bleaching.

Antimicrobial photodynamic therapy mediated by methylene blue-loaded polymeric micelles against Streptococcus mutans and Candida albicans biofilms.

BACKGROUND: Streptococcus mutans and Candida albicans can colonize the teeth, the oral cavity as biofilm and can cause oral infections. Thus, strategies to prevent and control oral biofilms are requested. The present study aims the development and characterization of methylene blue (MB)-loaded polymeric micelles for antimicrobial photodynamic therapy (aPDT) against Streptococcus mutans and Candida albicans biofilms METHODS: MB-loaded polymeric micelles were produced and characterized by particle size, polydispersity index, morphology, zeta potential, stability, MB release profile, and antimicrobial effect against S. mutans and C. albicans biofilms. RESULTS: MB-loaded polymeric micelles showed a reduced particle size, moderate polydisperse profile, spherical and neutral shape, which demonstrated to be promising features to allow micelles penetration into biofilms. Antimicrobial effect against bacterial and yeast biofilms was demonstrated once MB was irradiated by light under 660 nm (aPDT). Furthermore, MB-loaded polymeric micelles showed significant inhibition of S. mutans and C. albicans biofilms. Furthermore, the treatment with MB-micelles incubated with high pre-incubation times (15 and 30 min) were more effective than 5 min. It can be explained by the time required for this nanosystem to penetrate the innermost layer of biofilms and release MB for aPDT. CONCLUSION: MB-loaded polymeric micelles can effectively decrease the bacteria and yeast viability and it may cause positive impacts in the clinical practice. Thus, the developed formulation showed potential in the treatment to remove oral biofilms, but clinical studies are needed to confirm its potential.

Antimicrobial photodynamic therapy as an adjunctive treatment to ultrasound for the dentin caries-like lesion removal.

OBJECTIVE: To evaluate in vitro the efficacy of ultrasound device to remove caries-like dentin and the curcumin-mediated antimicrobial photodynamic therapy (aPDT) to decontaminate the affected dentin. METHODS: Bovine dentin specimens (n = 173) of 4 × 4 × 2 mm were first submitted to Knoop surface microhardness to standardize the specimens (29 ± 3 KHN). Artificial caries lesion was induced by Streptococcus mutans strain by biological model for 7 days. Infected dentin was removed (1 min) with the following techniques: dentin excavator, bur at low-speed rotation and ultrasound device. After that, aPDT application was performed using blue LED under 460 nm. Polarized light microscopy (PLM), removal rate (n = 10), cross-sectional microhardness (n = 10), colony forming units per milliliter (CFU) (n = 9) and confocal laser microscopy (CM) (n = 2) were performed. ANOVA with Welch correction, post-hoc Games-Howell and two-way ANOVA followed by Tukey's post-hoc tests were used. RESULTS: PLM confirmed the caries lesion formation with a depth of ∼147.9 µm. Groups treated with ultrasound showed lower removal rate (p = 0.001). Regardless of the treatment, the microhardness values increased as function of depth (p ≤ 0.05). Carbide bur showed the highest microhardness value, followed by ultrasound and excavator. CFU and CM showed a significant reduction in S. mutans after aPDT application. CONCLUSION: Ultrasound was efficient, since it removed infected dentin, preserving the affected dentin and aPDT can be used as a complementary therapy to decontaminate the affected dentin. CLINICAL SIGNIFICANCE: Ultrasound device may help the clinician to remove dentin caries-like lesions since it is a conservative technique and provided the removal of infected dentin, preserving the affected dentin. aPDT application may be used as a complimentary technique to promote antibacterial effect and possibly minimize the risk of secondary caries.

Effect of curcumin-encapsulated Pluronic® F-127 over duo-species biofilm of Streptococcus mutans and Candida albicans.

To assess the effect of curcumin-encapsulated Pluronic® F-127 (Cur-Plu) during antimicrobial photodynamic therapy (aPDT) over duo-species biofilm of Streptococcus mutans and Candida albicans. Thermal analysis, optical absorption, and fluorescence spectroscopy were evaluated. Minimum inhibitory concentration (MIC) and minimum bactericidal/fungal concentration were obtained. The biofilms were cultured for 48 h at 37 °C and treated according to the groups: P + M + L + (photosensitizer encapsulated with Pluronic® F-127 + light); P + D + L + (photosensitizer incorporated in 1% DMSO + light); P - M + L + (no Pluronic® F-127 + light); P - D + L + (1% DMSO + light); P - L + (Milli-Q water + light); P + M + L - (photosensitizer encapsulated with Pluronic® F-127 no light); P + D + L - (photosensitizer in 1% DMSO, no light); P - M + L - (Pluronic® F-127 no light); P - D + L - (1% DMSO, no light); P - L - (Milli-Q water, no light; negative control group); CHX (0.2% chlorhexidine, positive control group); and NYS (Nystatin). Dark incubation of 5 min was used. The groups that received aPDT were irradiated by blue LED (460 nm, 15 J/cm2). Cell viability of the biofilms was performed by colony-forming units (CFU/mL) and confocal microscopy. Two-way ANOVA followed by Tukey's post hoc test was used at a significance level of 5%. P + D + L + and P + M + L + groups exhibited better log-reduction for both Candida albicans and Streptococcus mutans biofilms than P - M + L + , P - L + , and P - D + L + experimental groups. Furthermore, P + M + L + and P + D + L + showed greater reduction for Candida albicans than for Streptococcus mutans. aPDT mediated by Cur-Plu can be a potential strategy for biofilm control against duo-species biofilm of Streptococcus mutans and Candida albicans.

How can biophotonics help dentistry to avoid or minimize cross infection by SARS-CoV-2?

Biophotonics is defined as the combination of biology and photonics (the physical science of the light). It is a general term for all techniques that deal with the interaction between biological tissues/cells and photons (light). Biophotonics offers a great variety of techniques that can facilitate the early detection of diseases and promote innovative theragnostic approaches. As the COVID-19 infection can be transmitted due to the face-to-face communication, droplets and aerosol inhalation and the exposure to saliva, blood, and other body fluids, as well as the handling of sharp instruments, dental practices are at increased risk of infection. In this paper, a literature review was performed to explore the application of Biophotonics approaches in Dentistry focusing on the COVID-19 pandemic and how they can contribute to avoid or minimize the risks of infection in a dental setting. For this, search-related papers were retrieved from PubMED, Scielo, Google Schoolar, and American Dental Association and Centers for Disease Control and Prevention databases. The body of evidence currently available showed that Biophotonics approaches can reduce microorganism load, decontaminate surfaces, air, tissues, and minimize the generation of aerosol and virus spreading by minimally invasive, time-saving, and alternative techniques in general. However, each clinical situation must be individually evaluated regarding the benefits and drawbacks of these approaches, but always pursuing less-invasive and less aerosol-generating procedures, especially during the COVID-19 pandemic.

Curcumin-loaded Pluronic® F-127 Micelles as a Drug Delivery System for Curcumin-mediated Photodynamic Therapy for Oral Application.

Antimicrobial photodynamic therapy (aPDT) is promising for oral decontamination. Curcumin has been used as photosensitizer; however, the hydrophobic properties can negatively affect aPDT. This study evaluated the aPDT efficacy using Cur-loaded Pluronic® F-127 micelles against Streptococcus mutans and Candida albicans biofilms. Micelles characterization was performed by zeta potential, dynamic light scattering, transmission electron microscopy, absorption and fluorescence spectroscopy. Cur concentrations, cell viability by CFU mL-1 and confocal microscopy were determined. Data were analyzed by parametric and nonparametric tests under 5%. Cur-loaded Pluronic® F-127 exhibited spherical shape, suitable particle size (≤100 nm), adequate polydispersity index, best stability, lower photodegradation and autoaggregation compared to unloaded-Cur. Both microorganisms were sensitive to Cur-loaded Pluronic® F-127 micelles aPDT, with minimum inhibitory concentration (MIC) of 270 µm and 2.1093 µm for S. mutans and C. albicans suspended culture, respectively. Cur-loaded Pluronic® F-127 aPDT exhibited antibacterial/antifungal effect against the biofilms (~3 log10 reduction; P ≤ 0.05); however, similar to unloaded (P ≥ 0.05). Confocal images confirmed these results. Cur-loaded Pluronic® F-127 micelles exhibited good photo-chemical properties and may be a viable alternative to deliver Cur and to improve aPDT effect during the treatment of dental caries. Moreover, Pluronic® micelles can enhance the solubility, stability, permeability and control the release of Cur.

Current applications of drug delivery nanosystems associated with antimicrobial photodynamic therapy for oral infections.

The oral cavity is colonized by several species of microorganisms that can cause dental caries, periodontal diseases, candidiasis, endodontic infections, and, among other diseases related to the dental field. Conventional treatment consists of mechanical removal associated with systemic administration of antimicrobials, which can cause various side effects and microbial resistance. In this context, alternative therapies have been developed, including Antimicrobial Photodynamic Therapy (aPDT). For the improvement of therapy, the implementation of nanotechnology is very important to optimize the delivery system of the dyes or photosensitizers on biological targets. Besides, this combination provides a non-invasive treatment, better solubility and bioavailability, delivery to the target site, controlled release and protection against external and physical-chemical factors, low side effects, and, unlikely resistant species. Although, there are numerous researches on aPDT and nanotechnology, few review articles based on the combination of these three aspects: nanosystems, aPDT and oral infections are available. For this reason, this article aims to discuss the advances and advantages of this combination. Therefore, this article was divided into different types of nanosystems (organic and inorganic nanoparticles) associated with aPDT bringing a description of it is definitions, properties, and, applications in oral infections.