Photodynamic Therapy as Novel Treatment for Halitosis in Adolescents: A Case Series Study

Introduction: Halitosis is a common problem that affects a large portion of the population worldwide. The origin of this condition is oral in 90% of cases and systemic in 10% of cases. The foul odor is caused mainly by volatile sulfur compounds produced by Gram-negative bacteria. However, it has recently been found that anaerobic Gram-positive bacteria also produce hydrogen sulfide (H2S) in the presence of amino acids, such as cysteine. Light with and without the combination of chemical agents has been used to induce therapeutic and antimicrobial effects. In photodynamic therapy, the antimicrobial effect is confined to areas covered by the photosensitizing dye. The aim of the present case series study was to evaluate the antimicrobial effect of photodynamic therapy on halitosis in adolescents through the analysis of volatile sulfur compounds measured using a sulfide meter (Halimeter®).Methods: Five adolescents aged 14 to 16 years were evaluated using a sulfide meter before and one hour after photodynamic therapy, which involved the use of methylene blue 0.005% on the middle third and posterior thirds of the dorsum of the tongue and nine points of laser irradiation in the red band (660 nm) with an energy dose of 9 J, power output of 100 mW and 90-seconds exposure time.Results: A 31.8% reduction in the concentration of volatile sulfur compounds was found in the comparison of the initial and final readings. The statistically significant reduction (p = 0.0091) led to an absence of halitosis following treatment (mean: 58.2 ppb).Conclusion: Photodynamic therapy seems to be effective on reduction the concentration of volatile sulfur compounds.Considering the positive effects of photodynamic therapy in this case series, further studies involving microbiological analyses should be conducted to allow comparisons of the results

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.National Institutes of Health (U.S.) (Grant R01AI050875

Concepts and Principles of Photodynamic Therapy as an Alternative Antifungal Discovery Platform

Opportunistic fungal pathogens may cause superficial or serious invasive infections, especially in immunocompromised and debilitated patients. Invasive mycoses represent an exponentially growing threat for human health due to a combination of slow diagnosis and the existence of relatively few classes of available and effective antifungal drugs. Therefore systemic fungal infections result in high attributable mortality. There is an urgent need to pursue and deploy novel and effective alternative antifungal countermeasures. Photodynamic therapy (PDT) was established as a successful modality for malignancies and age-related macular degeneration but photodynamic inactivation has only recently been intensively investigated as an alternative antimicrobial discovery and development platform. The concept of photodynamic inactivation requires microbial exposure to either exogenous or endogenous photosensitizer molecules, followed by visible light energy, typically wavelengths in the red/near infrared region that cause the excitation of the photosensitizers resulting in the production of singlet oxygen and other reactive oxygen species that react with intracellular components, and consequently produce cell inactivation and death. Antifungal PDT is an area of increasing interest, as research is advancing (i) to identify the photochemical and photophysical mechanisms involved in photoinactivation; (ii) to develop potent and clinically compatible photosensitizers; (iii) to understand how photoinactivation is affected by key microbial phenotypic elements multidrug resistance and efflux, virulence and pathogenesis determinants, and formation of biofilms; (iv) to explore novel photosensitizer delivery platforms; and (v) to identify photoinactivation applications beyond the clinical setting such as environmental disinfectants

Effects of two different decellularization routes on the mechanical properties of decellularized lungs

Considering the limited number of available lung donors, lung bioengineering using whole lung scaffolds has been proposed as an alternative approach to obtain lungs suitable for transplantation. However, some decellularization protocols can cause alterations on the structure, composition, or mechanical properties of the lung extracellular matrix. Therefore, the aim of this study was to compare the acellular lung mechanical properties when using two different routes through the trachea and pulmonary artery for the decellularization process. This study was performed by using the lungs excised from 30 healthy male C57BL/6 mice, which were divided into 3 groups: tracheal decellularization (TDG), perfusion decellularization (PDG), and control groups (CG). Both decellularized groups were subjected to decellularization protocol with a solution of 1% sodium dodecyl sulfate. The behaviour of mechanical properties of the acellular lungs was measured after decellularization process. Static (Est) and dynamic (Edyn) elastances were obtained by the end-inspiratory occlusion method. TDG and PDG showed reduced Est and Edyn elastances after lung decellularization. Scanning electron microscopy showed no structural changes after lung decellularization of the TDG and PDG. In conclusion, was demonstrated that there is no significant difference in the behaviour of mechanical properties and extracellular matrix of the decellularized lungs by using two different routes through the trachea and pulmonary artery

Evaluation of the photodynamic antimicrobial therapy on pathogenic yeasts

Este trabalho tem por objetivo investigar o comportamento da terapia fotodinâmica (PDT) em leveduras patogênicas. Tem sido proposto que a PDT pode inativar células microbianas e, um grande número de fotossensibilizadores e fontes de irradiação são reportados em diferentes parâmetros. Para melhor entendimento dos processos fotodinâmicos, a taxa de fluência, fluência e tempo de irradiação foram estudadas, bem como fluências iguais em parâmetros diferentes foram comparadas entre si. O papel da concentração de azul de metileno e do transporte desta droga pela membrana fúngica foram investigados. Diferentes cepas de Cryptococcus neoformans foram comparadas frente à ação fotodinâmica com fotossensibilizadores distintos. Após esta etapa, atividades metabólicas de processo de morte microbiana e produção de melanina foram avaliadas quanto a sua interferência na inativação fúngica. Por fim, um modelo de criptococose foi desenvolvido para avaliação in vivo da ação fotodinâmica. Foi observado que parâmetros de irradiação influenciam substancialmente os resultados da PDT em leveduras e que, fluências iguais em diferentes tempos de irradiação podem apresentar resultados diferentes. Em conclusão, a fluência não deve ser utilizada como parâmetro único para comparação dos resultados de fotoinativação de leveduras. Além disso, o transporte de azul de metileno pela membrana fúngica pode influenciar os efeitos da PDT. A ação fotodinâmica depende do sítio de ligação do fotossensibilizador na célula e não somente da quantidade de moléculas no interior do microrganismo. É importante ressaltar que características intrínsecas de cada cepa podem influenciar diretamente os efeitos da PDT. As células morrem geralmente por processo não lítico, e quando utilizada in vivo, a PDT mostrou-se capaz de reduzir a recuperação de células viáveis.This study aimed to investigate the photodynamic therapy (PDT) behavior on pathogenic yeasts. It has been proposed in literature that PDT is able to inactivate microbial cells, and a number of photosensitizer (FS) agents and irradiation sources were reported with different parameters. The role of fluence rate, as well as fluence and irradiation time was studied to achieve a deep understanding of this subject and to compare equivalent fluences under dissimilar irradiation parameters. Methylene blue concentration and its transport through yeast membrane were also focused. Cryptococcus neoformans strains that present particular metabolic characteristics were used to investigate photosensitizers and their ability to inactivate yeast. Furthermore, the role of PDT in microbial death process and inhibition of killing effects by melanin production were analyzed. Thereafter, an in vivo model of cryptococcosis was developed to evaluate photodynamic effect. The main point of our results was that light parameters play an important role on yeast inactivation and the same fluence under different irradiation parameters present dissimilar quantity of cell death. In conclusion, fluence per se should not be used as the only parameter to compare photoinactivation effects on yeast cells. In addition, MB transport thought yeast membrane can change PDT effects, as well as the photosensitizer preferential bind site inside the cell. The quantity of PS uptake, under specific conditions, does not seem to present a direct relation with cell inactivation. In addition, microbial strain characteristics can directly interfere on PDT results and cells appear to be killed by an apoptotic-like effect. Finally, PDT can kill C. neoformans in vivo and reduces its recover from infected site

Low-Level Laser Therapy in Burning Mouth Syndrome Patients: A Pilot Study

Objective: The aim of this study was to investigate the effect of low-level laser therapy (LLLT) on the treatment of burning mouth syndrome (BMS). In addition, the laser effect was compared on the different affected oral sites. Materials and Methods: Eleven subjects with a total of 25 sites (tongue, lower lip, upper lip, and palate) affected by a burning sensation were selected. The affected areas were irradiated once a week for three consecutive weeks with an infrared laser (lambda = 790 nm). The probe was kept in contact with the tissue, and the mucosal surface was scanned during the irradiation. The exposure time was calculated based on the fluence of 6 J/cm(2), the output power of 120 mW, and the area to be treated. Burning intensity was recorded through a visual analog scale before and after the treatment and at the 6-week follow-up. The percentage of the improvement in symptoms was also obtained. Results: Burning intensity at the end of the laser therapy was statistically lower than at the beginning (p < 0.01). Patients reported an 80.4% reduction in the intensity of symptoms after laser treatment. There was no statistical difference between the end of the treatment and the 6-week follow-up, except for the tongue site. Conclusion: Under the investigated parameters, infrared LLLT proved to be a valuable alternative for BMS treatment, providing a significant and lasting reduction in symptoms.FAPESP (Fundacao de Amparo a Pesquisa do Estado de Sao Paulo)[06/55860-0]CNPq-Brazil (Conselho Nacional de Pesquisa e Desenvolvimento

Influence of Ultrapulsed CO2 Laser, before Application of Different Types of Fluoride, on the Increase of Microhardness of Enamel In Vitro

Objective. To evaluate the influence of ultrapulsed CO2 laser in combination with commercial fluoride products in order to verify the increase of microhardness of artificial enamel caries lesions. Materials and Methods. Bovine enamel specimens were prepared, and artificial enamel caries lesions were created. Teeth were randomly divided into 5 groups (n=10): treated with laser (L), laser + neutral fluoride gel 2% (LNF), laser + acidulated phosphate fluoride gel 1.23% (LAFG), laser + acidulated fluoride mousse 1.23% (LAFM), and laser + fluoride varnish 5% (LFV). Microhardness was evaluated at baseline, after caries induction, after CO2 laser irradiation + fluoride treatment in the 1st week, and after fluoride treatment at 3rd and 5th week. Results. There was a decrease in microhardness in all groups after artificial enamel caries lesion formation; no increase in microhardness was found in the first and third weeks in all groups (p > 0.05). In the fifth week, an increase in microhardness occurred in all groups (p < 0.05). Conclusion. Although CO2 laser irradiation in combination with different commercial fluoride products was capable of increasing microhardness on enamel caries lesions in bovine tooth enamel it is necessary to confirm these results by testing the isolated effect of fluoride on enamel surface microhardness. Also, although microhardness was higher in the fluoride varnish group than in the other groups in the fifth week it is not possible to discard the best effect of fluoride varnish treatment on absence of artifacts that may occur with the other fluoride treatments. Clinical Relevance. In order to prove that CO2 laser may contribute to an increase in microhardness when applied to enamel lesions in combination with different commercial fluoride products it is necessary to conduct additional studies. Also, higher microhardness of fluoride varnish group should be carefully considered

El Diario de Pontevedra : periódico liberal: Ano XXXIV Número 9883 - 1917 marzo 27

Considering the limited number of available lung donors, lung bioengineering using whole lung scaffolds has been proposed as an alternative approach to obtain lungs suitable for transplantation. However, some decellularization protocols can cause alterations on the structure, composition, or mechanical properties of the lung extracellular matrix. Therefore, the aim of this study was to compare the acellular lung mechanical properties when using two different routes through the trachea and pulmonary artery for the decellularization process. This study was performed by using the lungs excised from 30 healthy male C57BL/6 mice, which were divided into 3 groups: tracheal decellularization (TDG), perfusion decellularization (PDG), and control groups (CG). Both decellularized groups were subjected to decellularization protocol with a solution of 1% sodium dodecyl sulfate. The behaviour of mechanical properties of the acellular lungs was measured after decellularization process. Static (Est) and dynamic (Edyn) elastances were obtained by the end-inspiratory occlusion method. TDG and PDG showed reduced Est and Edyn elastances after lung decellularization. Scanning electron microscopy showed no structural changes after lung decellularization of the TDG and PDG. In conclusion, was demonstrated that there is no significant difference in the behaviour of mechanical properties and extracellular matrix of the decellularized lungs by using two different routes through the trachea and pulmonary artery