Liquid crystal precursor system as a vehicle for curcumin-mediated photodynamic inactivation of oral biofilms.

Curcumin has great potential as a photosensitizer, but it has low solubility in aqueous solutions. This study reports the antimicrobial efficacy of photodynamic inactivation (PDI) mediated by a curcumin-loaded liquid crystal precursor (LCP) on in situ dental biofilms. Thirty volunteers used intraoral devices containing enamel samples for 48 hours for biofilm formation. The samples were then removed from the device and treated either with LCP with 160 µM of curcumin plus illumination at 18 J/cm2 (C + L+ group) or with LCP without curcumin in the dark (C - L - group). Following this, the biofilm from the samples was plated for quantifying the viable colonies at 37°C for 48 hours. Specific and nonspecific media were used for the presumptive isolation of Streptococcus mutans, Lactobacillus species/aciduric microorganisms, Candida species, and total microbiota. The C + L+ group showed a highly significant (P < .001) reduction in the log10 (colony forming units/mL) values as compared to the C - L - group for all culture media. Hierarchical linear regression indicated that there may be predictors at individual volunteer level explaining the difference in the PDI efficacy among different individuals (P = .001). The LCP system retained curcumin and released it slowly and continuously, thus protecting the drug from photodegradation. LCP with curcumin is considered effective for the photoinactivation of dental biofilms, but the PDI efficacy may differ based on the host's individual characteristics.

Photodynamic potential of curcumin in bioadhesive formulations: Optical characteristics and antimicrobial effect against biofilms.

BACKGROUND: Although Curcumin (CUR) has great potential as a photosensitizer, the low solubility in water impairs its clinical performance in photodynamic inactivation (PDI). This study sought to establish an effective antimicrobial protocol for PDI using CUR in three different bioadhesive formulations. METHODS: A CUR-loaded chitosan hydrogel with a poloxamer (CUR-CHIH), a CUR-loaded liquid crystal precursor system (CUR-LCP), a CUR-loaded microemulsion (CUR-ME), and CUR in dimethylsulfoxide (DMSO) solution (CUR-S; control formulation) were tested against in vitro and in situ oral biofilms. The optical properties of each formulation were evaluated. RESULTS: All of the formulations exhibited lower absorbance than CUR-S; however, the CUR-LCP curve bore the highest resemblance. The CUR present in all formulations was completely degraded after 15 min of illumination. In vitro experiments showed that CUR-S was the only formulation able to significantly reduce biofilm viability of Candida albicans and Lactobacillus casei when compared to the negative control (no PDI); the amount of reduction obtained was 1.8 and 3.7 log (CFU/mL) for C. albicans and L. casei, respectively. There was a significant reduction on the viability of Streptococcus mutans biofilms when CUR-S and CUR-LCP were applied (approximately 3.5 and 1.6 log [CFU/mL], respectively). In situ testing showed antimicrobial efficacy against S. mutans and general microorganisms. CONCLUSIONS: Although the evaluated protocols has not been effective to all of the evaluated microorganisms, PDI showed potential against dental biofilms and evidence that the phototoxic effects of CUR have a high relation with the type of formulation in which it is loaded.

Curcumin-mediated Photodynamic Therapy for the treatment of oral infections-A review.

BACKGROUND: Recent evidences show the promising applications of Curcumin (CUR) against different diseases, including some of the main oral pathologies. The objective of this review paper was to catalog articles that investigated the photodynamic effect of CUR for oral diseases in the last 15 years. METHODS: The establishment of defined criteria for data collection was proposed and a total of 173 articles were identified, but only 26 were eligible for full text reading. Their main findings were critically reviewed to provide a state-of-the-art overview of the use of CUR in Dentistry. RESULTS: Antimicrobial potential of CUR was the subject of the majority of the articles. CUR showed great potential for photodynamic action against oral bacteria, fungi, and strains resistant to conventional drugs. Some authors indicated the efficacy of CUR-mediated Photodynamic Therapy to reduce tumor cells while others observed low cytotoxicity in mammalian cells and healthy oral mucosa. However, CUR solubility and stability is still a problem for the photodynamic technique, and to overcome these drawbacks, biocompatible vehicles need to be better explored. CONCLUSIONS: Investigations have used different CUR concentrations and formulations, as well as different light parameters. This fact, together with the lack of in vivo studies, clearly shows that clinical protocols have not been established yet. Investigations are necessary in order to establish the best concentrations and safe vehicles to be used for this technique.

Potential of curcumin-mediated photodynamic inactivation to reduce oral colonization.

OBJECTIVE: The present study assessed the susceptibility of salivary pathogens to photodynamic inactivation (PDI), mediated by a water-soluble mixture of curcuminoids (CRM) and LED light. METHODS: A 10mL sample of unstimulated saliva was collected from volunteers. The inoculum was prepared using 9mL of saline and 1mL of saliva. Inoculum suspensions were divided into 14 groups and treated according to the description below. Groups that received the PDI treatment (light for 1min or 5min and 1.5g/L or 3.0g/L of CRM concentration) were called C1.5L1.8, C1.5L9.0, C3.0L1.8, C3.0L9.0. To evaluate the CRM decontamination alone, the C1.5/1,C1.5/5,C3.0/1 and C3.0/5 groups were assessed. Likewise, light alone was evaluated through the L1.8 and L9.0 groups. Chlorhexidine at 0.12% (CLX) for 1 or 5min was used for the positive control groups (CLX1 and CLX5, respectively); saline was used for 1 or 5min (CTR1, CTR5, respectively) for the negative control groups. After the tests, serial dilutions were performed, and the resulting samples were plated on blood agar in microaerophilic conditions. The number of colony forming units (CFU/mL) was determined and log10-transformed. Data were analyzed using a One-way Analysis of Variance with Welch correction, followed by the Games Howell's test (α=0.05). Log reduction (LR) measure for antimicrobial efficacy was also calculated using data from the CTR5 as untreated samples. RESULTS: The CHX5 showed the best antimicrobial result, followed by the CLX1. The antimicrobial effect of CRM was more pronounced when associated with light (PDI), but significantly lower than the CLX5 effect. The C3.0L9.0 protocol showed similar results to the CLX1. CONCLUSION: The results show that PDI with CRM at the studied concentrations is as effective for oral decontamination in clinical dental care conditions as the CLX at 0.12% for 1min.

Reliability of the agar based method to assess the production of degradative enzymes in clinical isolates of Candida albicans.

The aim of this study was to establish a reproducible protocol using the methodology of hyaline zones around the colonies on specific agar plates for phospholipase and proteinase production. This was an in vitro double-blind experiment, in which the dependent variables were the enzymatic activity measurements (Pz) for the production of phospholipase (Pz-ph) and the production of secreted aspartyl proteinases (Pz-sap). Three independent variables give rise to different measurement protocols. All measurements were carried out at two different moments by four examiners (E1, E2, E3, and E4). The minimum sample size was 30 Candida albicans clinical isolates. Specific agar plates for phospholipase and SAPs production were prepared according the literature. The intra-and inter-examiner reproducibility for each protocol was estimated using the Intraclass Correlation Coefficient (ICC) and its confidence interval (95% CI). Based on the results obtained for both phospholipase and SAPs, there appears to be no consensus on the protocol chosen for each particular examiner. Measuring the colonies in triplicate may be the main factor associated with the increase in measurement accuracy and should therefore take precedence over measuring only one colony. When only one examiner is responsible for taking measurements, a standard protocol should be put in place and the statistical calibration of this researcher should be done prior to data collection. However, if two or more researchers are involved in the assessment of agar plates, our results suggest that the protocols using software to undertake plate reading is preferred.

Anterior restorations in bleached teeth: difficulty establishing the color after bleaching.

It is becoming more common for patients to look for cosmetic procedures in dental offices. The search for lost or desired esthetics by patients is increasingly frequent and the professional must be able to meet this demand. To do this, dentists not only need to return the tooth back to its normal functioning state but also promote esthetic excellence. In this context, the association of cosmetic procedures, such as teeth whitening and restorative procedures, such as direct adhesive restorations is very common. The composite resins employed nowadays allow the reproduction of various optical properties of natural teeth. With these composite resins, it is possible to reproduce features such as translucency, opacity and specific features of the dental element, to bring back the esthetic harmony of the smile. This article reports a clinical case demonstrating the placement, in a stratified manner, of composite resins in bleached teeth, as well as the reproduction of optical and natural aspects of the teeth. In order to achieve esthetic and functional success of the restored procedure, it is important to be familiar with the new techniques and new materials in the market and above all, we must know when and where to use them.