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.

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.

Photodynamic therapy for endodontic treatment of primary teeth: A randomized controlled clinical trial.

OBJECTIVES: This study aimed to evaluate the reduction in bacterial load following conventional endodontic treatment with and without antimicrobial photodynamic therapy (a-PDT) in primary teeth. METHODS: Thirty primary anterior teeth with a diagnosis of pulp necrosis were selected. Patients were randomly allocated to two groups as follows: Group I, patients undergoing conventional root canal therapy (n = 15) and Group II, patients undergoing conventional root canal therapy combined with antimicrobial PDT (n = 15). For PDT, methylene blue, at a concentration of 0.005 %, was used as the photosensitizing agent, which was applied to the interior of the canal with a sterile paper cone for 3 min, followed by the administration of laser light for 40 s (wavelength: 660 nm, energy density: 4 J/cm², power: 100 mW), delivered in direct contact at the entrance to the root canal. Two microbiological samples of the intra-canal content were taken (one before and one immediately after treatment in both groups) using paper cones. Clinical follow-up involved the investigation of fistulas and mobility and was performed 1- and 3 months after treatment. Data were statistically analyzed. RESULTS: The reduction in bacterial load was 93 % in Group I and 99 % in Group II, with no statistically significant difference. CONCLUSIONS: Conventional treatment combined with antimicrobial PDT with parameters used in this study proved effective but presented equal efficacious capability to conventional endodontic treatment alone. CLINICAL SIGNIFICANCE: The use of PDT has been studied in endodontic treatment protocols in permanent teeth. However, clinical trials in deciduous teeth are necessary for establishing the effectiveness and parameters of this application. The present study analyzes the results of PDT in the endodontic treatment of deciduous teeth.

Photodynamic therapy with Bixa orellana extract and LED for the reduction of halitosis: study protocol for a randomized, microbiological and clinical trial.

BACKGROUND: Halitosis is an unpleasant breath odour that can interfere with the professional life, social life and quality of life of people who suffer from it. A modality of treatment that has been increasing in dentistry is antimicrobial photodynamic therapy (aPDT). Bixa orellana, popularly known as "urucum" is a plant native to Brazil. The seeds are used to produce a dye that is largely used in the food, textile, paint and cosmetic industries. The aim of this study is to verify whether aPDT with Bixa orellana extract and blue light-emitting diodes (LEDs) is effective in reducing halitosis. This method will also be compared with tongue scraping, the most commonly used conventional method for tongue coating removal, and the association of both methods will be evaluated. METHODS/DESIGN: A randomized clinical trial will be conducted at the dental clinic of the Universidade Nove de Julho. Thirty-nine patients will be divided by block randomization into three groups (n = 13) according to the treatment to be performed. In Group 1, tongue scraping will be performed by the same operator in all patients for analysis of the immediate results. Patients will also be instructed on how to use the scraper at home. Group 2 will be treated with aPDT with Bixa orellana extract and the LED light curing device: Valo Cordless Ultradent®. Six points in the tongue dorsum with a distance of 1 cm between them will be irradiated. The apparatus will be pre-calibrated at wavelength 395-480 nm for 20 s and 9.6 J per point. In Group 3, patients will be submitted to the tongue scraping procedure, as well as to the previously explained aPDT. Oral air collection with the Oral Chroma™ and microbiological collections of the tongue coating shall be done before, immediately after and 7 days after treatment for comparison. DISCUSSION: Halitosis treatment is a topic that still needs attention. The results of this trial could support decision-making by clinicians regarding aPDT using blue LEDs for treating halitosis on a daily basis, as most dentists already have this light source in their offices. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03346460 . Registered on 17 November 2017.

Antimicrobial Photodynamic Therapy as a Co-adjuvant in Endodontic Treatment of Deciduous Teeth: Case Series.

To assure the success of endodontic treatment, the root canal must be completely decontaminated. Thus, some methods have been researched in an attempt to effectively eliminate microorganisms from the interior of the root canal system. Among them is conventional endodontic therapy in conjunction with photodynamic therapy (PDT). Five anterior deciduous teeth were treated endodontically with the conventional technique and PDT. For PDT, 0.005% methylene blue was used as a photosensitizer and a 660 nm laser. After the conventional endodontic therapy, the photosensitizer was applied inside the root canal, 3 min of pre-irradiation time, and then, the laser was applied for 40s with an energy of 4J. Afterward, the canal was irrigated with saline solution and the sealing material of the root canal was placed. The microbiological analysis of the samples was collected before and after the treatments were performed. Observing the results obtained in this case series, which showed a bacterial reduction from 37.57% to 100%, and the clear difficulty in the success of endodontic treatment of deciduous teeth, antimicrobial photodynamic therapy can be considered an alternative of easy application that does not generate microbial resistance, to act as a support in the decontamination of the root canals.

Effect of photodynamic therapy in the reduction of halitosis in patients with multiple sclerosis: clinical trial.

Smell and odours play a vital role in social interaction. Halitosis is a social problem that affects one third of the population, causing a negative impact on the quality of life. There is little knowledge on the prevalence and management of halitosis in multiple sclerosis (MS) patients. The present study aims to evaluate the presence of halitosis in patients with MS when compared to a control group, and also evaluate treatment of the problem with antimicrobial photodynamic therapy (aPDT). This is a case-control clinical study in which 60 patients were evaluated: 30 MS patients in treatment at the Specialties Clinic School of Medicine, and 30 healthy patients, matched in age and gender for the control group. Data was collected on the duration of the disease as well as the degree of disability and medication use in the MS group. For all patients, halitosis was assessed with Oral Chroma™. Individuals with halitosis underwent treatment with tongue scraping and aPDT. The photosensitizer was methylene blue (0.005%) and a THERAPY XT-EC® laser (660 nm, 9 J, 100 mW for 90 s per point, 320 J cm-2, 3537 mW cm-2) was used. Six points 1 cm apart from each other were irradiated in the tongue dorsum. There was a positive correlation between the disability and disease duration. No parameter was correlated with halitosis. Patients with MS have higher levels of SH2 compounds when compared to the control group (p = 0.003, Mann-Whitney), but after aPDT both groups significantly reduced the levels to under the halitosis threshold. The aPDT scraping treatment was effective in the immediate reduction of halitosis in both groups.

Case Report of Photodynamic Therapy in the Treatment of Dental Caries on Primary Teeth.

INTRODUCTION: The partial removal of dental caries aiming to maintain the integrity of the pulp has been considered the therapy of choice in the treatment of deep carious lesions, as long as certain principles of diagnosis are respected. Dentists are always looking for techniques to remove the decayed tissue with biosafety, what provides more comfort to the patient especially when it comes to children. Photodynamic therapy (PDT) is an antimicrobial treatment. PapacárieMblue is a modification of the regular Papacárie, with a photosensitizer added to it. CASE REPORT: PapacárieMblue was used in a patient who had deep carious lesions in a primary molar. After 5 minutes of application, the soft and infected tissues were removed from the side walls of the cavity and, after, PDT was held in the pulp wall with red laser (660 nm), energy of 30 J, output power of 100 mW and 5 minutes of exposure time. This caused a reduction in the amount of dental tissue removed, what favored the prognosis of the dental element. After a period of 3 months, a control of the case was done and we discovered that the tooth that received the PDT was not painful and the x-ray showed an absence of lesions in the furcation. CONCLUSION: PDT with PapacárieMblue has been effective in the removal of a deep carious lesion that had a risk of pulp exposure.

Choosing between intraoral or extraoral, red or infrared laser irradiation after impacted third molar extraction.

BACKGROUND AND OBJECTIVE: Swelling and trismus are complications experienced by nearly all subjects after undergoing oral surgery for the removal of impacted teeth. The main purpose of this paper was to compare the effects of photobiomodulation therapy (PBMT) at two different wavelengths applied intra-orally and extra-orally on facial swelling and trismus in the postoperative period following the extraction of impacted mandibular third molars. STUDY DESIGN/MATERIALS AND METHODS: Sixty subjects were randomly divided into five groups, taking into account the type of laser therapy applied after surgery (intraoral or extraoral irradiation with 660 nm laser; intraoral or extraoral irradiation with 808 nm; and sham irradiation). Two and seven days after the surgery, two blinded evaluators measured the subjects' faces (swelling), and mouth opening (trismus). RESULTS: There was a statistically significant interaction between the irradiation site and wavelength (swelling and trismus were smaller if the red laser was applied intra-orally or if infrared laser was applied extra-orally). The intra-group analyses showed that 808 nm laser applied extra-orally favored reductions in postoperative facial swelling and trismus, although the inter-group comparisons revealed no statistically significant differences. CONCLUSION: Besides energy parameters, the combination of irradiation site and wavelength drive the results of phototherapy after the removal of impacted teeth. Lasers Surg. Med. 48:511-518, 2016. © 2016 Wiley Periodicals, Inc.

Evaluation of Effective Transmission of Light Through Alveolar Bone: A Preliminary Study.

Introduction: The aim of the present study was to determine the effective transmission of 660 and 780 nm lasers through mandibular and maxillary alveolar bones in the buccal-lingual/ palatal direction. Methods: The laser probe was positioned in direct contact with the surface of the anterior, middle and posterior regions of each bone (5 dried maxillae and 5 mandibles) and the power meter was positioned on the bone wall opposite to the radiated wall for the measure of the remaining energy passing through the bone tissue. Ten measurements were performed with each laser at each irradiated point. Results: Transmitted power was significantly higher in bones irradiated with 780 nm laser. Tendencies toward greater average power transmitted in the anterior region of both bones at both wavelengths were also observed. Conclusion: Dosimetry and the choice of light source may be adjusted according to the anatomic region of the alveolar bone to be treated.

Immediate results of photodynamic therapy for the treatment of halitosis in adolescents: a randomized, controlled, clinical trial.

UNLABELLED: Light with or without chemical agents has been used to induce therapeutic and antimicrobial effects. With photodynamic therapy, the antimicrobial effect is confined to areas covered by a photosensitive dye and irradiated with light. The aim of the present study was to evaluate the effect of photodynamic therapy for the treatment of halitosis in adolescents through the analysis of volatile sulfur compounds, especially sulfide. A controlled, clinical trial was conducted with 45 adolescents randomly allocated to three groups: group 1, photodynamic therapy administered to the dorsum of the tongue; group 2, treatment with a tongue scraper; and group 3, treatment with a tongue scraper combined with photodynamic therapy. The diagnosis of halitosis was performed using gas chromatography before and after treatment. Comparisons were made using the Kruskal-Wallis test followed by the Student-Newman-Keuls test, with the level of significance set at 5 % (p < 0.05). After treatment, a statistically significant reduction in halitosis was found in all groups (p < 0.001). The greatest reduction in total sulfides (median = 0) occurred with the combination of tongue scraper and photodynamic therapy. The present study describes a novel option for the treatment of halitosis in adolescents with an immediate effect that does not involve the mechanical aggression of the lingual papillae that occurs with conventional treatment. TRIAL REGISTRATION: Photodynamic Therapy in Adolescents Halitosis ( https://clinicaltrials.gov/ct2/show/NCT02007993?term=NCT02007993&rank=1 )Number: NCT02007993FUNDING:FAPESPNumber: 2013/13032-8.

Does the hybrid light source (LED/laser) influence temperature variation on the enamel surface during 35% hydrogen peroxide bleaching? A randomized clinical trial.

OBJECTIVE: The present study investigated how a hybrid light source (LED/laser) influences temperature variation on the enamel surfaces during 35% hydrogen peroxide (HP) bleaching. Effects on the whitening effectiveness and tooth sensitivity were analyzed. METHOD AND MATERIALS: Twenty-two volunteers were randomly assigned to two different treatments in a split-mouth experimental model: group 1 (control), 35% HP; group 2 (experimental), 35% HP + LED/laser. Color evaluation was performed before treatment, and 7 and 14 days after completion of bleaching, using a color shade scale. Tooth sensitivity was assessed using a visual analog scale (VAS; before, immediately, and 24 hours after bleaching). During the bleaching treatment, thermocouple channels positioned on the tooth surfaces recorded the temperature. Data on color and temperature changes were subjected to statistical analysis (α = 5%). Tooth sensitivity data were evaluated descriptively. RESULTS: Groups 1 and 2 showed mean temperatures (± standard deviation) of 30.7 ± 1.2 °C and 34.1 ± 1.3 °C, respectively. It was found that there were statistically significant differences between the groups, with group 2 showing higher mean variation (P < .0001). The highest temperature variation occurred for group 2, with an increase of 5.3 °C at the enamel surface. The color change results showed no differences in bleaching between the two treatment groups (P = .177). The variation of the average temperature during the treatments was not statistically associated with color variation (P = .079). Immediately after bleaching, it was found that 36.4% of the subjects in group 2 had mild to moderate sensitivity. In group 1, 45.5% showed moderate sensitivity. In both groups, the sensitivity ceased within 24 hours. CONCLUSION: Hybrid light source (LED/ laser) influences temperature variation on the enamel surface during 35% HP bleaching and is not related to greater tooth sensitivity.

Evaluation of the effectiveness of photodynamic therapy for the endodontic treatment of primary teeth: study protocol for a randomized controlled clinical trial.

BACKGROUND: The elimination of pathogenic microorganisms from the root canal system is one of the major steps required for successful endodontic treatment. The aim of the proposed study is to conduct a randomized, controlled, clinical trial for the clinical and radiographic evaluation of the effectiveness of photodynamic therapy during the endodontic treatment of primary teeth. METHODS: Thirty primary anterior teeth in children aged 3 to 6 years old will be randomly divided into 2 groups: a control group, which will receive conventional treatment, and an experimental group, which will be subjected to photodynamic therapy. Microbiological evaluations will be performed before and after endodontic treatment. Moreover, clinical and radiographic evaluations will be performed on the day of treatment as well as 1, 3 and 6 months after treatment. Comparisons will be made of the two study groups. The data will be tabulated and presented in a descriptive, analytical fashion. Depending on the distribution (normal or non-normal), either the t test, ANOVA or the Mann-Whitney test will be used for analysis of the variables. The Wilcoxon test will be used for comparisons before and after treatment. P values<0.05 (95% significance level) will be considered indicative of statistically significant differences. DISCUSSION: As successful endodontic treatment is directly related to intra-canal bacterial disinfection and considering the difficult task of endodontic treatment in primary teeth, often due to difficulties in controlling young children, the internal anatomy of root canals and root resorption, the alternative of using PDT is a painless,easy-to-administer method that does not lead to microbial resistance and can assist in the achievement of successful endodontic treatment in primary teeth by eliminating the pain children can experience due to retreatment as well as premature tooth loss. TRIAL REGISTRATION: The protocol for this study was registered with Clinical Trials number NCT02485210 on 30 july 2015.

Effect of low-intensity laser treatment on pain after extraction of impacted mandibular third molars: a randomised, controlled, clinical trial.

Extraction of impacted third molars is painful, so we have evaluated whether low-intensity laser could reduce the pain. Sixty patients were randomly allocated to five groups that were treated with laser immediately after extraction. Postoperative pain was evaluated after two and seven days. The Shapiro-Wilk test was used to assess whether the distribution was normal, and as it was skewed, the Kruskal-Wallis test, ANOVA and the Student-Newman-Keuls test for multiple comparisons were used to compare the groups. The Wilcoxon test was used for comparisons of pain (measured by visual analogue scale (VAS) and numerical rating scale (NRS) 101 between the second and seventh postoperative days). Probabilities of less than 0.05 were accepted as significant. We conclude that a single session of low intensity laser had no significant effect on the amount of pain under the conditions investigated.