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.

Effects of photobiomodulation on interleukin-10 and nitrites in individuals with relapsing-remitting multiple sclerosis - Randomized clinical trial.

OBJECTIVE: Investigate the effects of photobiomodulation (PBM) on the expression of IL-10 and nitrites in individuals with Relapsing-Remitting multiple sclerosis (MS), as these biomarkers play a fundamental role in the physiopathology of the disease. The modulation of IL-10 and nitrites through treatment with PBM may be a novel treatment modality for MS. METHODS: A randomized, uncontrolled, clinical trial was conducted involving 14 individuals with a diagnosis of Relapsing-Remitting MS and a score of up to 6.0 on the Expanded Disability Status Scale (EDSS). THE PARTICIPANTS WERE RANDOMIZED TO TWO GROUPS: Group 1 -PBM in the sublingual region; Group 2 -PBM over the radial artery. Irradiation was administered with a wavelength of 808 nm and output power of 100 mW for 360 seconds twice a week, totaling 24 sessions. Peripheral blood was analyzed for the determination of serum levels of IL-10 and nitrites. RESULTS: After treatment with PBM, the expression of IL-10 increased in both the sublingual group (pre-treatment: 2.8 ± 1.4 pg/ml; post-treatment: 8.3 ± 2.4 pg/ml) and the radial artery group (pre-treatment: 2.7 pg/ml ± 1.4; post-treatment: 11.7 ± 3.8 pg/ml). In contrast, nitrite levels were not modulated in the sublingual group (pre-treatment: 65 ± 50 nmol/mg protein; post-treatment: 51 ± 42 nmol/mg protein) or the radial artery group (pre-treatment: 51 ± 16 nmol/mg protein; post-treatment: 42 ± 7 nmol/mg protein). CONCLUSION: Treatment with PBM positively modulated the expression of IL-10 but had no effect on nitrite levels. Further studies should be conducted with a larger sample and a control group, as PBM may be a promising complementary treatment for the management of MS. This trial is registered at ClinicalTrials.gov. Identifier: NCT03360487.

"Efficacy of photodynamic therapy on the treatment of herpes labialis: A systematic review".

OBJECTIVE: We conducted a systematic review to evaluate the efficacy of PDT in the management of recurrent herpes labialis (RHL). STUDY DESIGN: systematic review. METHODS: This study was reported according to the PRISMA checklist and we performed a literature search on five databases. RESULTS: The search revealed that there are no published clinical trials addressing PDT on RHL, therefore we conducted a review of case reports and five studies were included for qualitative review. The number of treated patients varied from 2 to 6 in each article. Most studies used methylene blue as a photosensitizer, while one used 5-aminolevulinic acid. For light irradiation, most studies used laser and one used a red light from halogen lamp. Patients' follow-up varied from 24 h to 12 months. All articles reported good outcomes with resolution of disease and no recurrences. Only one study reported adverse effects during treatment (burning and pain). CONCLUSION: The results of this review suggest that PDT could be an effective treatment for herpes labialis. However, due to very few case reports and heterogeneity among protocols, there is a call for well-designed randomized clinical trials to confirm the efficacy of this therapy and to establish standardized protocols. The review protocol was registered at the International Prospective Register of Systematic Reviews (PROSPERO) under number CRD CRD42018108973.

Papain gel containing methylene blue for simultaneous caries removal and antimicrobial photoinactivation against Streptococcus mutans biofilms.

This study intended to evaluate the effects of a papain-gel with a red-light absorbing pigment (methylene blue - MB) to mediate photodynamic therapy (PDT) against Streptococcus mutans biofilms. The PapaMBlue was compared with free MB to generate reactive oxygen species using fluorescence probes (SOSG and HPF). PDT (660-nm light) was carried out against S. mutans biofilms grown on either plastic dishes or on collagen membrane and assayed by CFU, live-dead staining using confocal microscopy, transmission electron microscopy and H&E staining for collagen films. Cytotoxicity and subcellular localization was studied in human fibroblasts. Sponges of bioabsorbable type I collagen membrane were exposed to papain based gel, irradiated with laser and analyzed about their integrity by ATR-FTIR. The PapaMBlue produced higher amounts of singlet oxygen and hydroxyl radicals than free MB, possibly due to better disaggregation of the dye in solution. The PapaMBlue antimicrobial effects on biofilms proved to be capable of reducing the S. mutans. Both MTT and PrestoBlue assays showed higher cell viability and metabolism scores in fibroblasts treated with PapaMBlue and MB, possibly due to stimulation of mitochondrial activity and that collagen triple helix is unaffected. The PapaMBlue is equally effective as MB in destroying S. mutans biofilms growing on plastic or collagen without affecting fibroblasts.

Effect of low-level laser therapy on adolescents with temporomandibular disorder: a blind randomized controlled pilot study.

PURPOSE: The aim of this pilot study was to evaluate the effect of low-level laser therapy on pain, mandibular movements, and occlusal contacts in adolescents and young adults with temporomandibular disorder. MATERIALS AND METHODS: Individuals aged 14 to 23 years were evaluated. The Research Diagnostic Criteria for Temporomandibular Disorders were used for the diagnosis of temporomandibular disorders. Pain was assessed with a visual analog scale. Occlusal contacts were recorded using the T-Scan III program (Tekscan, Boston, MA). The participants were randomly allocated to 2 groups: active or placebo laser treatment. The laser parameters were as follows: wavelength of 780 nm, energy density of 33.5 J/cm(2), power of 50 mW, power density of 1.67 W/cm(2), and 20-second exposure time. The Kolmogorov-Smirnov test was used to determine the normality of the data distribution. The paired t test was used for the comparisons of the pretreatment and post-treatment results. The SPSS program for Windows (version 15.0; SPSS, Chicago, IL) was used for all analyses, with the level of significance set at 5% (P < .05). RESULTS: No statistically significant differences between groups were found for the right and left anterior temporal muscles (P = .3801 and P = .5595, respectively), superior masseter muscles (P = .087 and P = .1969, respectively), medial masseter muscles (P = .2241 and P = .076, respectively), or inferior masseter muscles (P = .5589 and P = .3268, respectively) after treatment. CONCLUSIONS: No statistically significant differences were found regarding pain, mandibular range of motion, or the distribution of occlusal contacts after treatment with low-level laser therapy. These preliminary results need to be verified in a larger sample of patients to confirm the lack of response to low-level laser therapy.

Effect of low-level laser therapy on the post-surgical inflammatory process after third molar removal: study protocol for a double-blind randomized controlled trial.

BACKGROUND: Low-level laser therapy (LLLT) has been shown to modulate the inflammatory process without adverse effects , by reducing pain and swelling and promoting the repair of damaged tissues. Because pain, swelling and muscle spasm are complications found in virtually all patients following oral surgery for the removal of impacted teeth, this model has been widely used to evaluate the effects of LLLT on the inflammatory process involving bone and, connective tissue and the muscles involved in mastication. METHODS/DESIGN: After meeting the eligibility criteria, 60 patients treated at a Specialty Dental Center for the removal of impacted lower third molars will be randomly divided into five groups according to the type of laser therapy used at the end of surgery (intraoral irradiation with 660 nm laser; extraoral irradiation with 660 nm laser; intraoral irradiation with 808 nm laser; extraoral irradiation with 808 nm laser and no irradiation). To ensure that patients are blinded to the type of treatment they are receiving, the hand piece of the laser apparatus will be applied both intraorally and extraorally to all participants, but the device will be turned on only at the appropriate time, as determined by the randomization process. At 2 and 7 days after surgery, the patients will be evaluated by three blinded evaluators who will measure of swelling, mouth opening (muscle spasm evaluation) and pain (using two different pain scales). The 14-item Oral Health Impact Profile (OHIP-14) will be used to assess QOL. All data will be analyzed with respect to the normality of distribution using the Shapiro-Wilk test. Statistically significant differences between the experimental groups will be determined using analysis of variance, followed by a suitable post hoc test, when necessary. The significance level will be set at α = 0.05. DISCUSSION: The lack of standardization in studies with regard to the samples, methods and LLLT parameters complicates the determination of the actual effect of laser therapy on this model. The present study aims to provide a randomized, controlled, double-blind trial to compare four different LLLT parameters in relation to the outcomes of pain, swelling and muscle spasm following surgery for the extraction of impacted third molars and evaluate the effects os surgery on patients' quality os life (QOL). TRIAL REGISTRATION: Brazilian Registry of Clinical Trials - Rebec (RBR-6XSB5H).