Evaluation of photobiomodulation in the salivary production of patients with hyposalivation induced by antihypertensive drugs - A blind, randomized, controlled clinical trial.

BACKGROUND: Arterial hypertension is a systemic condition that affects about 35% of the world population. The drugs that are used for its control can produce hyposalivation. This work evaluated the effect of photobiomodulation on salivary flow rate, salivary pH, total protein concentration, and calcium concentration in individuals using antihypertensive medications. MATERIAL AND METHODS: 41 subjects were randomly allocated in one of two groups: control (placebo) and photobiomodulation. The subjects had their salivary glands (20 sites) irradiated with a laser emitting at 808 nm, 4J/site once a week for 4 weeks and had their salivary flow measured before and after the whole treatment. RESULTS: The intragroup analysis (before and after treatment) shows a significant difference for both non-stimulated and stimulated salivary flow in the photobiomodulation group (p = 0.0007 and p = 0.0001, respectively). Comparing the placebo with the photobiomodulation group, significant differences were found for both non-stimulated (p = 0.0441) and stimulated salivary flow (p = 0.0441) after the treatment. No significant differences were found in pH, total protein concentration, calcium concentration. CONCLUSION: Despite the usage of drugs that influence the nervous system and typically result in a reduction of saliva production, photobiomodulation demonstrated a remarkable ability to enhance saliva production by a significant 75%.

Effects of amber LED on inflammatory and regulatory monocytes and lymphocytes.

The primary objective of the present study was to assess the impact of amber LED photobiomodulation (PBM) on human monocytes and lymphocytes that were polarized into proinflammatory and regulatory/reparative phenotypes. Human leukocytes were polarized with LPS or LPS + IL-4 for 2 h and irradiated after 2 and 6 h with amber LED (590 nm). Cell absorbance spectrum and gene and protein expression of IL-1ß, IL-6, IL-10, IL-17, TNF-α and IFNγ determined after 24 h. The results showed that irradiation did not significantly alter absorbance of non-polarized monocytes, whereas irradiated polarized monocytes presented reduction in absorbance in 625-850 nm region. Irradiated monocytes polarized with LPS + IL-4 presented reduction in absorbance in 600-725 nm region compared to non-irradiated group. Irradiated non-polarized lymphocytes presented absorbance peaks between 650 and 820 nm not seen in non-irradiated group. No difference was found in absorbance pattern of polarized lymphocytes after irradiation. Irradiation led to reduction in protein synthesis of IL-6 and TNFα in monocytes polarized to proinflammatory phenotype and increase in production of IL-17 in lymphocytes. Irradiation reduced production of IL-10 in monocytes and lymphocytes polarized to immunoregulatory phenotype. In conclusion, amber LED modulates light absorbance and expression of important cytokines in inflammatory/repair processes in monocytes and lymphocytes.

Evaluation of antimicrobial photodynamic therapy and minimal intervention associated with deproteinisation in permanent teeth with molar incisor hypomineralisation: study protocol for a clinical, controlled, blinded trial.

INTRODUCTION: Molar incisor hypomineralisation (MIH) is a qualitative defect of enamel development that occurs in the mineralisation phase. MIH affects one or more permanent molars and, occasionally, permanent incisors. The aim of the proposed study is to evaluate the clinical effect of antimicrobial photodynamic therapy (aPDT) on permanent teeth with MIH through decontamination and sensitivity control. METHODS AND ANALYSIS: Patients from 8 to 12 years of age with permanent molars will be randomly allocated to three groups. Group 1: selective chemical-mechanical removal of carious dentinal tissue around the walls of the cavity with Papacárie Duo and a curette followed by the application of aPDT and deproteinisation with Papacárie Duo; group 2: selective removal of carious dentinal tissue around the walls of the cavity with a curette, followed by the application of aPDT and deproteinisation with a 5% sodium hypochlorite solution; group 3: selective removal of carious dentinal tissue using a curette. The selected teeth must have a carious lesion in the dentin and posteruptive enamel breakdown on one or more surfaces with an indication for clinical restorative treatment. The teeth will subsequently be restored using a mixed technique with resin-modified glass ionomer cement and bulk-fill composite resin. The data will be submitted to descriptive statistical analysis. Associations with age and sex will be tested using either the χ2 test or Fisher's exact test. Pearson's correlation coefficients will be calculated to determine the strength of correlations between variables. Comparisons of the microbiological results (colony-forming units) will be performed using analysis of variance and the Kruskal-Wallis test. Kaplan-Meier survival analysis will be performed to assess the performance of the restorations. ETHICS AND DISSEMINATION: This protocol has been approved by the Human Research Ethics Committee of Nove de Julho University (certificate number: 61027522.0.0000.5511/approval date: 23 August 2022). The findings will be published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: NCT05443035.

The influence of growth medium on the photodynamic susceptibility of Aggregatibacter actinomycetemcomitans to antimicrobial blue light.

The aim of this study was to investigate whether antimicrobial blue light (aBL) can cause the death of Aggregatibacter actinomycetemcomitans (A.a) and to determine the influence of different culture media, specifically brain heart infusion and blood agar, on bacterial survival fraction. An LED emitting at 403 ± 15 nm, with a radiant power of 1W, irradiance of 588.2 mW/cm2, and an irradiation time of 0 min, 1 min, 5 min, 10 min, 30 min, and 60 min, was used. The plates were incubated in microaerophilic conditions at 37 °C for 48 h, and the colony-forming units were counted. The photosensitizers were investigated using spectroscopy and fluorescence microscopy. There was no significant difference between the culture media (p > 0.05). However, a statistical reduction in both media was observed at 30 min (1058 J/cm2) (p < 0.05). The findings of this study suggest that aBL has the potential to kill bacteria regardless of the culture media used. Light therapy could be a promising and cost-effective strategy for preventing periodontal disease when used in combination with mechanical plaque control.

Effect of Photobiomodulation Combined with Physiotherapy on Functional Performance in Children with Myelomeningo-Cele-Randomized, Blind, Clinical Trial.

BACKGROUND: This study aimed to evaluate the electrical activity of the rectus femoris, tibialis anterior, and lateral gastrocnemius muscles during the sit-to-stand task and functional mobility after a neurofunctional physiotherapy protocol associated with PBM. METHODS: Twenty-five children were randomly allocated to either Active PBM + physiotherapy (n = 13) or PBM sham + physiotherapy (n = 12). PBM was carried out with a LED device (850 nm, 25 J, 50 s per point and 200 mW) at four points over the area with absence of a spiny process. Both groups completed a twelve-week supervised program with two weekly 45-60 min sessions. Pre-training and post-training assessments involved the Pediatric Evaluation of Disability Inventory (PEDI). Muscle activity was assessed using portable electromyography (BTS Engineering) and the electrodes were positioned on the lateral gastrocnemius, anterior tibialis, and rectus femoris muscles. The RMS data were recorded and analyzed. RESULTS: After 24 sessions of the treatment protocol, improvements were found in the PEDI score. The participants presented greater independence in performing the tasks, requiring less assistance from their caregivers. More significant electrical activity was found in the three muscles evaluated between the rest period and execution of the sit-to-stand tasks, both in the more compromised or less compromised lower limbs. CONCLUSION: Neurofunctional physiotherapy with or without PBM improved functional mobility and electrical muscle activity in children with myelomeningocele.

Comparative study between photodynamic therapy and the use of probiotics in the reduction of halitosis in mouth breathing children: Study protocol for a randomized controlled clinical trial.

INTRODUCTION: Halitosis is a term that defines any odor or foul smell the emanates from the oral cavity, the origin of which may be local or systemic. One of the causes of local or oral halitosis is low salivary flow and dry mouth, which is also one of the complaints of individuals with the mouth-breathing habit. The aim of this study is to determine the effectiveness of antimicrobial photodynamic therapy (aPDT) and the use of probiotics for the treatment of halitosis in mouth-breathing children. METHODS: Fifty-two children between 7 and 12 years of age with a diagnosis of mouth breathing and halitosis determined through an interview and clinical examination will be selected. The participants will be divided into 4 groups: Group 1-treatment with brushing, dental floss and tongue scraper; Group 2-brushing, dental floss and aPDT applied to the dorsum and middle third of the tongue; Group 3-brushing, dental floss and probiotics; Group 4-brushing, dental floss, aPDT and probiotics. The use of a breath meter and microbiological analysis of the tongue coating will be performed before, immediately after treatment and 7 days after treatment. The quantitative analysis will involve counts of colony-forming bacteria per milliliter and real-time polymerase chain reaction. The normality of the data will be determined using the Shapiro-Wilk test. Parametric data will be submitted to analysis of variance and nonparametric data will be compared using the Kruskal-Wallis test. The results of each treatment in the different periods of the study will be compared using the Wilcoxon test. DISCUSSION: Due to the low level of evidence, studies are needed to determine whether treatment with aPDT using annatto as the photosensitizer and blue led as the light source is effective at diminishing halitosis in mouth-breathing children.

Antimicrobial Photodynamic Therapy in the Nasal Decolonization of Maintenance Hemodialysis Patients: A Pilot Randomized Trial.

RATIONALE & OBJECTIVE: Infections are an important cause of mortality among patients receiving maintenance hemodialysis. Staphylococcus aureus is a frequent etiological agent, and previous nasal colonization is a risk factor for infection. Repeated antimicrobial decolonization reduces infection in this population but can induce antibiotic resistance. We compared photodynamic therapy, a promising bactericidal treatment that does not induce resistance, to mupirocin treatment among nasal carriers of S aureus. STUDY DESIGN: Randomized controlled pilot study. SETTING & PARTICIPANTS: 34 patients receiving maintenance hemodialysis who had nasal carriage of S aureus. INTERVENTIONS: Patients were randomly assigned to decolonization with a single application of photodynamic therapy (wavelength of 660nm, 400mW/cm2, 300 seconds, methylene blue 0.01%) or with a topical mupirocin regimen (twice a day for 5 days). OUTCOME: Nasal swabs were collected at time 0 (when the carrier state was identified), directly after treatment completion, 1 month after treatment, and 3 months after treatment. Bacterial isolates were subjected to proteomic analysis to identify the species present, and antimicrobial susceptibility was characterized. RESULTS: All 17 participants randomized to photodynamic therapy and 13 of 17 (77%) randomized to mupirocin were adherent to treatment. Directly after treatment was completed, 12 participants receiving photodynamic therapy (71%) and 13 participants treated with mupirocin (77%) had cultures that were negative for S aureus (risk ratio, 0.92 [95% CI, 0.61-1.38]; P=0.9). Of the patients who had negative cultures directly after completion of photodynamic therapy, 67% were recolonized within 3 months. There were no adverse events in the photodynamic therapy group. LIMITATIONS: Testing was restricted to assessing nasal colonization; infectious complications were not assessed. CONCLUSIONS: Photodynamic therapy is a feasible approach to treating nasal carriage of S aureus. Future larger studies should be conducted to determine whether photodynamic therapy is equivalent to the standard of care with mupirocin. FUNDING: Government grant (National Council for Scientific and Technological Development process 3146682020-9). TRIAL REGISTRATION: Registered at ClinicalTrials.gov with study number NCT04047914.

Evaluation of different methods for the diagnosis of primary caries lesions: Study protocol for a randomized controlled clinical trial.

BACKGROUND: According to the World Health Organization (WHO), dental caries is considered one of the greatest pediatric health problems in the world, due to its high prevalence and incidence. Therefore, the early diagnosis of caries lesions is a fundamental procedure for planning treatment aimed at prevention, minimal intervention and promotion of oral health. The present study aims to evaluate, through a randomized and controlled clinical study, which is the best strategy for diagnosing primary caries lesions located in the interproximal region. MATERIALS AND METHODS: Eighty patients, aged between 4 and 10 years will be randomized and allocated into 2 groups for analysis and comparison of methods for diagnosing caries lesions. The following diagnostic methods will be analyzed and compared: visual clinical examination using ICDAS (International Caries Detection and Assessment System), the iTero Element 5D System (intraoral scanner with near infrared imaging (NIRI) technology) and bitewing radiography (BWX). All evaluations will be carried out by 02 examiners. Examiners will be trained and calibrated to use the visual and radiographic criteria and also to use the iTero 5D intraoral scanner, following the manufacturer's instructions. TRIAL REGISTRATION: NCT04900246 in ClinicalTrial.gov. First released in 05/11/2021 and last updated in 10/06/2021.

Simultaneous red and infrared light-emitting diodes reduced pain in individuals with temporomandibular disorder: a randomized, controlled, double-blind, clinical trial.

The aim of the present study was to evaluate the effects of photobiomodulation (PBM) with the simultaneous use of red and infrared LEDs on pain and mandibular range of motion in individuals with temporomandibular disorder (TMD). Eighteen participants were randomly allocated to an LED group or control group. The device had 18 red LEDs (660 nm) and 18 infrared LEDs (850 nm), with a total power irradiated of 126 mW and 75.6 J per point. The device was placed in the regions of the temporomandibular joint (TMJ) and masticatory muscles once per day three times per week for 2 weeks. Pain intensity was measured using the visual analog scale (VAS). Mandibular range of motion was determined using digital calipers and considering different conditions (unassisted opening without pain, maximum opening with and without assistance, right and left lateral movements, and protrusion). Evaluations were performed before treatment, immediately after the first LED irradiation session and at the end of six sessions. A significant reduction in pain intensity was found in the LED group at the end of treatment compared to the control group (p < 0.001) as well as in the comparison between the pretreatment and end of treatment evaluations (p < 0.001). Regarding mandibular movements, no statistically significant differences between the LED group and control group were found at the end of treatment for any of the conditions analyzed or in the comparison between the beginning and end of treatment with LED. Photobiomodulation using a cluster with red and infrared LEDs induced a reduction in pain in individuals with temporomandibular disorder but did not alter mandibular range of motion in these individuals. Trial registration number: NCT03696706; retrospectively registered (ClinicalTrials.gov).

Effect of photobiomodulation on fatigue in individuals with relapsing-remitting multiple sclerosis: a pilot study.

Multiple sclerosis is an autoimmune disease of the central nervous system characterized by inflammation and destruction of the myelin sheath. Fatigue is one of the main symptoms of this disease, with a negative impact on quality of life and few treatment options. Photobiomodulation is used for several inflammatory conditions and may be beneficial for the treatment of fatigue in individuals with multiple sclerosis. Conduct a pilot study to analyze the effect of photobiomodulation on fatigue in individuals with relapsing-remitting multiple sclerosis. The participants were recruited from the UNINOVE Integrated Health Clinic and randomly allocated to two groups: group 1, administration of photobiomodulation (808 nm, 36 J for 360 s) under the tongue and group 2, administration of photobiomodulation over the radial artery. Fatigue was measured using the Modified Fatigue Impact Scale (MFIS). No significant differences were found regarding the total MFIS score or subscale scores (p < 0.05, two-way ANOVA). Photobiomodulation with the parameters employed in the present study had no effect on fatigue in individuals with multiple sclerosis. ClinicalTrials.gov Identifier: NCT03360487.

Fotobiomodulação com LED induz melhora na funcionalidade da marcha em ratos após lesão nervosa periférica / Photobiomodulation with LED increased the gait functionality in rats submitted to peripheral nerve injury

Introdução: As lesões nervosas periféricas (LNP) podem resultar em distúrbios motores e sensoriais alterando a funcionalidade do membro afetado, porém pouco se conhece a respeito dos efeitos da fotobiomodulação (FBM) com diodo emissor de luz (LED). Objetivo: Analisar os efeitos do LED sobre a funcionalidade da marcha de ratos Wistar pós LNP. Metodologia: Ratos Wistar foram submetidos a LNP por esmagamento de ciático e analisados nos seguintes grupos experimentais: (1) Controle; (2) LNP; (3) LNP+ LED (780 nm, potência média 40 mW, exposição radiante, energia por ponto, 3,2 J sobre o nervo ciático (LEDn); (4) LNP+ LED em nervo e região do músculo envolvido (LEDnm) e (5) LNP+ LED apenas em região do músculo (LEDm). Após 7, 14, 21 e 28 dias foram realizadas as análises de marcha utilizando o Índice Funcional Ciático (IFC). Resultado: Após 7 dias, os grupos tratados com LED apresentaram uma melhora da marcha em relação ao grupo Lesão, sendo essa melhora mais pronunciada no grupo LEDn. Após 14 dias, os grupos LEDn e LEDnm apresentaram valores semelhantes ao grupo controle e após 21 e 28 dias o IFC não apresentou diferenças entre os grupos experimentais. Conclusão: O LED aumentou a funcionalidade da marcha avaliada pelo IFC após 1 e 2 semanas pós LNP, especialmente quando foi usado na região nervosa associada ou não à região muscular.

Introduction: Peripheral nerve injuries (PNI) can result in motor and sensory disturbances altering the functionality of the affected limb, however not much is known about the effects of photobiomodulation (PBM) with light emitting diode (LED). Objective: We aimed to analyze the effects of LED on the gait function of Wistar rats after PNI. Methodology: Wistar rats were submitted to PNI by sciatic crush and analyzed in the following experimental groups: (1) Control; (2) PNI; (3) PNI+ LED (780 nm, mean power 40 mW, radiant exposure, energy per spot, 3.2 J on the sciatic nerve) (LEDn); (4) LNP+ LED on nerve and involved muscle region (LEDnm) and (5) LNP+ LED only on muscle region (LEDm). After 7-, 14-, 21- and 28-days gait analyses were performed using the Sciatic Functional Index (SFI). Results: After 7 days, the groups treated with LED showed an improvement in gait compared to the PNI group, with this improvement being more pronounced in the LEDn group. After 14 days, the LEDn and LEDnm groups showed similar values to the control group and after 21 and 28 days the SFI did not show differences between the experimental groups. Conclusion: LED increased the gait functionality evaluated by SFI after 1 and 2 weeks post-PNI, especially when it was used in the nerve region associated or not with the muscle region.

Effect of antimicrobial photodynamic therapy with red led and methylene blue on the reduction of halitosis: controlled microbiological clinical trial.

To determine the effect of antimicrobial photodynamic therapy (aPDT) using a red light-emitting diode (LED) on the reduction of halitosis and microbiological levels in the tongue coating immediately after irradiation, 7, 14, and 30 days after treatment. Forty-five young adults diagnosed with halitosis were allocated to three groups: G1, aPDT with 0.005% methylene blue and red LED (660 nm, four irradiation points, 90 s per point, power of 400 mW, 36 J per point, radiant exposure of 95 J/cm2, continuous wave); G2, tongue scraping; and G3, tongue scraping and aPDT. Gas chromatography was performed before and immediately after treatment, as well as at the different follow-up times. Microbiological samples were collected at the same times from the dorsum of the tongue, and bacteria were quantified in the samples using real-time PCRq. The Wilcoxon test was used for the intragroup analyses, and the Kruskal-Wallis test was used for the intergroup analyses. In the intragroup analyses, differences were found before and immediately after treatment in all groups (p < 0.05). The effect was maintained after 7 days only in the tongue scraping group (p < 0.05). In the intergroup analysis, no statistically significant differences were found among the groups (p > 0.05). For the microbiological analyses, no statistically significant differences were found in the groups/bacteria that were analyzed (p > 0.05). aPDT using a red LED and 0.005% methylene blue caused an immediate reduction in halitosis, but the effect was not maintained after 7, 14, or 30 days. No reduction occurred in the number of bacteria investigated or the quantification of universal 16S rRNA. ClinicalTrials.gov Identifier: NCT03656419.

LED photobiomodulation therapy combined with biomaterial as a scaffold promotes better bone quality in the dental alveolus in an experimental extraction model.

A bone scaffold added to the dental alveolus immediately after an extraction avoids bone atrophy and deformity at the tooth loss site, enabling rehabilitation with implants. Photobiomodulation accelerates bone healing by stimulating blood flow, activating osteoblasts, diminishing osteoclastic activity, and improving the integration of the biomaterial with the bone tissue. The aim of the present study was to evaluate the effect of photobiomodulation with LED at a wavelength of 850 nm on bone quality in Wistar rats submitted to molar extraction with and without a bone graft using hydroxyapatite biomaterial (Straumann® Cerabone®). Forty-eight rats were distributed among five groups (n = 12): basal (no interventions); control (extraction) (basal and control were the same animal, but at different sides); LED (extraction + LED λ = 850 nm); biomaterial (extraction + biomaterial), and biomaterial + LED (extraction + biomaterial + LED λ = 850 nm). Euthanasia occurred at 15 and 30 days after the induction of the extraction. The ALP analysis revealed an improvement in bone formation in the control and biomaterial + LED groups at 15 days (p = 0.0086 and p = 0.0379, Bonferroni). Moreover, the LED group had better bone formation compared to the other groups at 30 days (p = 0.0007, Bonferroni). In the analysis of AcP, all groups had less resorption compared to the basal group. Bone volume increased in the biomaterial, biomaterial + LED, and basal groups in comparison to the control group at 15 days (p < 0.05, t-test). At 30 days, the basal group had greater volume compared to the control and LED groups (p < 0.05, t-test). LED combined with the biomaterial improved bone formation in the histological analysis and diminished bone degeneration (demonstrated by the reduction in AcP), promoting an increase in bone density and volume. LED may be an important therapy to combine with biomaterials to promote bone formation, along with the other known benefits of this therapy, such as the control of pain and the inflammatory process.

Effect of photobiomodulation combined with physical therapy on functional performance in children with myelomeningocele: A protocol randomized clinical blind study.

INTRODUCTION: Myelomeningocele is a severe type of spina bifida, resulting from improper closure of the neural tube. This condition drastically affects the structures of the spinal cord resulting in deficiencies. The combination of these deficiencies results in an overall decrease in mobility and functional participation amongst this population. Physiotherapy plays an essential role in rehabilitating people with MMC. The current literature shows that resources such as photobiomodulation (PBM) may support the rehabilitation of neurological conditions. The aim of the proposed study is to evaluate the effects of photobiomodulation (PBM) combined with physical therapy on functional performance in children with low lumbosacral myelomeningocele. MATERIALS AND METHODS: This is a protocol randomized clinical blind study, that will include 30 individuals of both sexes, aged between 5 to 8 years, diagnosed with low and sacral lumbar myelomeningocele and capable of performing the sit-to-stand task. The participants will be randomly assigned into two treatment groups: PBM + physiotherapeutic exercises and sham PBM + physiotherapeutic exercises. Irradiation will be carried out with light emitting diode (LED) at a wavelength of 850 nm, energy of 25 J per point, 50 seconds per point and a power of 200 mW. The same device will be used in the placebo group but will not emit light. Muscle activity will be assessed using a portable electromyograph (BTS Engineering) and the sit-to-stand task will be performed as a measure of functioning. Electrodes will be positioned on the lateral gastrocnemius, tibialis anterior and rectus femoris muscles. The Pediatric Evaluation of Disability Inventory will be used to assess functional independence. Quality of life will be assessed using the Child Health Questionnaire-Parent Form 50. Changes in participation will be assessed using the Participation and Environment Measure for Children and Youth. The data will be analyzed with the aid of GraphPad PRISM. DISCUSSION: The results of this study can contribute to a better understanding of the effectiveness of PBM on functioning and quality of life in children with myelomeningocele. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04425330.

Clinical evaluation of in-office tooth whitening with violet LED (405 nm): A double-blind randomized controlled clinical trial.

BACKGROUND: Although there is little evidence showing the effectiveness of violet LED on in-office tooth whitening, there are some studies which have reported satisfactory results. This double-blind randomized controlled clinical trial aimed to evaluate the effect of a violet light emission diode (LED) (405 nm) system, used in-office, on tooth whitening, sensitivity, use of medication after whitening and quality of life. METHODS: Eight patients were randomized into 4 groups (n = 20): G1 - violet LED, G2 - 35% carbamide peroxide (CP) and violet LED, G3 only CP 35% and G4 35% hydrogen peroxide (HP). The color was measured using a spectrophotometer at the following times: baseline, 15 and 180days. The colorimetric changes were analyzed using measurements from the CieLab System ΔE (ΔL, Δa and Δb) and the WID (Whiteness Index for Dentistry) for the 4 groups. Tooth sensitivity was recorded via a visual analog scale (VAS). Additionally, the Psychosocial Impact of Dental. Aesthetics Questionnaire (PIDAQ) was used to evaluate quality of life. RESULTS: For the analysis of ΔL, G4 and G2 presented more brightness than G1 and G3 (p<0.05), implying that G2 is at least as good as G4 (p>0.05). For measure of Δa, G4 presented better results, standing out from the other groups. (p<0.05). For Δb, both G4 and G2 showed a greater tendency for blue color than groups G1 and G3 (p <0.05). When analyzing ∆E at the 180-day follow up, G4 produced the highest ∆E, while G3 showed the lowest ∆E. The other 2 whitening groups produced intermediate ∆E values. For ∆W, G1 and G3 significantly differed from G2 and G3. When analyzing the 180-day follow up, G2 produced the highest ∆W, while G3 showed the lowest ∆W. The other two whitening treatments produced intermediate ∆W values. As for sensitivity, only G4 patients showed dental sensitivity within 24 h of the bleaching, with pain ceasing after 48 h. For G4, 33% of the patients needed to take analgesics within the first 24 h after the first 3 whitening sessions. For PIDAQ, there was no overall decrease in score over time for any of the groups and there was no difference between them (p>0.05). CONCLUSION: Our results showed that violet LED was not able to whiten teeth at the same intensity, when used alone, as it was when associated with 35% CP, contrary to our initial hypothesis. However, given that pain was not consistently reported in G2, one could suggest that treatment with LED + 35% CP is quite similar to that of 35% HP when used for tooth whitening, but with better pain outcomes. All treatments suggested an improvement in quality of life.Clinical Trial Registry: This trial is registered at ClinicalTrials.gov; the registration number is NCT03192852 https://clinicaltrials.gov/ct2/show/NCT03192852.

Comparative study between photodynamic therapy with urucum + Led and probiotics in halitosis reduction-protocol for a controlled clinical trial.

BACKGROUND: Halitosis is a term that defines any foul odor emanating from the oral cavity. The origin may be local or systemic. The aim of the proposed protocol is to determine whether treatment with antimicrobial photodynamic therapy (aPDT) and treatment with probiotics are effective at eliminating halitosis. MATERIALS AND METHODS: Eighty-eight patients, from 18 to 25 years old with a diagnosis of halitosis (H2S≥112 ppb, determined by gas chromatography) will be randomly allocated to four groups (n = 22) that will receive different treatments: Group 1 -treatment with teeth brushing, dental floss and tongue scraper; Group 2 -brushing, dental floss and aPDT; Group 3 -brushing, dental floss and probiotics; Group 4 -brushing, flossing, aPDT and probiotics. The results of the halimetry will be compared before, immediately after, seven days and thirty days after treatment. The microbiological analysis of the coated tongue will be performed at these same times. The normality of the data will be determined using the Shapiro-Wilk test. Data with normal distribution will be analyzed using analysis of variance (ANOVA). Non-parametric data will be analyzed using the Kruskal-Wallis test. The Wilcoxon test will be used to analyze the results of each treatment at the different evaluation periods. CLINICAL TRAIL REGISTRATION: NCT03996044.

Low-level laser or LED photobiomodulation on oral mucositis in pediatric patients under high doses of methotrexate: prospective, randomized, controlled trial.

PURPOSE: The objective of the present study was to compare the efficacy of photobiomodulation with low-level laser therapy (LLLT) or light-emitting diode therapy (LEDT) devices for the prevention and treatment of oral mucositis in pediatric patients diagnosed with acute lymphoblastic leukemia undergoing chemotherapy with high doses of methotrexate (MTX). METHODS: Eighty patients were randomly divided into two groups: LLLT and LEDT. Both protocols were applied with the same energy and radiant exposure. The protocols started in the beginning of high doses MTX and finished when the patients were discharged from the hospital or there was oral mucositis resolution. The oral mucositis was assessed during each session in accordance to the World Health Organization (WHO) score. The patients' self-assessed pain was scored on a visual analog scale (VAS). RESULTS: The incidence of oral mucositis was similar to LLLT and LEDT, 10% and 12.5%, respectively. Both groups required the same number of days to reach score of zero for mucositis and pain (p > 0. 05), and there was no significant difference in mean VAS between the groups. CONCLUSIONS: These findings suggest that LEDT has similar effects to LLLT to avoid and treat oral mucositis. Brazilian Clinical Trial Registry with #U1111-1221-5943.

Effects of photobiomodulation in salivary glands of chronic kidney disease patients on hemodialysis.

This randomized placebo-controlled trial evaluates the impact of photobiomodulation (PBMT) on the salivary flow and biochemistry of patients with chronic kidney disease (CKD) on hemodialysis. Forty-four patients on hemodialysis self-responded two questionnaires for oral health and salivary gland function perception. The subjects were evaluated for function of salivary glands and randomly allocated to two groups: PBMT group (three irradiations at 808 nm, 100 mW, 142 J/cm2, and 4 J per site); and placebo group. Patients were submitted to non-stimulated and stimulated sialometry and after the treatment at baseline and 14 days. Salivary volume and biochemical of the saliva were analyzed. At baseline, most subjects had self-perception of poor oral health (52.6%) and salivary dysfunction (63.1%). Clinical exam revealed that 47.3% of subjects presented dry mucosa. PBMT promoted increase of the non-stimulated (p = 0.027) and stimulated saliva (p = 0.014) and decrease of urea levels in both non-stimulated (p = 0.0001) and stimulated saliva (p = 0.0001). No alteration was detected in total proteins and calcium analysis. Patients with kidney disease can present alteration in flow, concentrations, and composition of saliva, affecting oral health, but our findings suggest that PBMT is effective to improve hyposalivation and urea levels in saliva of patients with CKD.

Evaluation of the efficacy of a commercially available regimen vs brushing alone on established plaque and gingivitis on adolescents: Study protocol for a randomized, controlled, blind clinical trial.

BACKGROUND: Dental biofilm accumulation and poor personal oral hygiene are known major risk factors for gingivitis and halitosis. However, it is not clear how studies compare the effectiveness of hygiene regimens, associated with outcomes centered on patients. METHODS: A randomized, blind, controlled clinical trial involving 58 participants aged from 12 to 17 years, who search the Department of Pediatric Dentistry of Universidade Metropolitana de Santos, will be conducted. Immediately, the volunteers will be inserted into Group 1 (commercially available hygiene regimen) or Group 2 (tooth brushing alone). In Group 1, participants will receive Colgate Total 12 toothpastes, Plax mouthwashes and Colgate Ultrasoft toothbrushes, while Group 2 will use Colgate Cavity Protection toothpastes and Colgate Ultrasoft toothbrushes. The interventions will be conducted in the periods of 1, 3, and 6 months after the baseline, when the evaluations will also be performed. Biofilm and halitosis indexes will be evaluated. Data regarding discomfort, satisfaction and the socioeconomic/individual characteristics will also be computed. DISCUSSION: Although toothbrushing has shown positive effects in decreasing biofilm and in gingival health, there is no comparison in the literature of different brushing regimens with halitosis measurement in adolescents. In addition, the effectiveness of these protocols would be confirmed from the acceptability of the volunteers.

Antimicrobial photodynamic therapy with Bixa orellana extract and blue LED in the reduction of halitosis-A randomized, controlled clinical trial.

BACKGROUND: This study aimed to evaluate the reduction of halitosis when using antimicrobial photodynamic therapy (aPDT) with Bixa orellana extract and blue light-emitting diode (LED). METHODS: Forty-four UNINOVE students or employees with a diagnosis of sulfide (H2S) ≥ 112 ppb in gas chromatography were selected. The patients were randomly divided in groups: Group 1 (n = 15): aPDT with annatto and LED; Group 2 (n = 14): tongue scraping; Group 3 (n = 15): tongue scraping and aPDT. For aPDT, a wasBixa orellana extract used in a concentration of 20 % w/v (Fórmula e Ação®, São Paulo, Brazil) on the tongue for 2 min, associated with a blue-violet LED (Valo Cordless Ultradent® Products, Inc., South Jordan, UT, USA) (395-480 nm). Six points were irradiated on the back of the tongue, at wavelength 395-480 nm for 20 s, energy of 9.6 J and radiant energy of 6.37 J/cm2 per point. The results were compared before, immediately after treatment and 7 days after. The Friedman test was used for the intragroup analysis and the Kruskal Wallis test for the intergroup analysis. RESULTS: In all groups, there was a difference between baseline and the value immediately after the treatment. In Groups 1 and 3, there was no difference between the baseline and the 7 days control. CONCLUSION: There was an immediate reduction of halitosis, but the reduction was not maintained after 7days.