Advertisement

The effect of antimicrobial photodynamic therapy mediated by papain gel on infected dentin in primary teeth: a clinical trial with microbiological evaluation

  • Larissa Costa-Santos
  • Ana Carolina Costa da Mota
  • Renato Araujo Prates
  • Lara Jansiski Motta
  • Anna Carolina Ratto Tempestini Horliana
  • Zenildo Santos Silva-Junior
  • Raquel Agnelli Mesquita-Ferrari
  • Kristianne Porta Santos Fernandes
  • Sandra Kalil BussadoriEmail author
Original Article

Abstract

Purpose

Antimicrobial photodynamic therapy (aPDT) has been used for treatment of dental caries. Papacarie™ is a gel composed of papain and chloramine employed for the partial removal of carious tissue, effective against bacteria; however, some studies report that this antibacterial action is not quite so evident. The aim of this study is to evaluate the clinical effect of the substance PapaMBlue followed by laser irradiation on infected dentin in dental caries lesion in primary teeth.

Methods

Thirty-two primary molars with deep occlusal dental caries were selected and divided in two groups: G1—caries removal with a low-speed drill—and G2—application of aPDT with PapacarieMBlue. After treatment, all the teeth were restored with glass ionomer cement and followed up clinically and radiographically, with evaluations at 3, 6, and 12 months. Dentin samples before and after treatment were analyzed microbiologically.

Results

A reduction in the bacterial count was found in both groups and the inter-group difference was non-significant (p = 0.41022).

Conclusion

It is possible to conclude that there was a microbial reduction with the two treatments proposed; however, PapaMBlue is minimally invasive, maintains healthy tissue integrity, and is easy to use in Pediatric Dentistry and Public Health.

Trial registration

NCT02734420 on 10 March 2016

Keywords

Dental caries Antimicrobial photodynamic therapy Low-level laser therapy 

Notes

Acknowledgments

The authors gratefully thank FAPESP process number 2016/11711-3 Nove de Julho University for its technological support.

Compliance with ethical standards

This clinical trial received approval from the Human Research Ethics Committee of University Nove de Julho(certificate number: 391563) .

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from all individual participants included in the study.

References

  1. 1.
    Fejerskov O, Kidd E (2009) Dental caries: the disease and its clinical management. John Wiley & Sons, Blackwell, London.Google Scholar
  2. 2.
    Ericson D, Kidd E, McComb D, Mjor I, Noack MJ (2003) Minimally invasive dentistry—concepts and techniques in cariology. Oral Health Prev Dent 1(1):59–72PubMedGoogle Scholar
  3. 3.
    Bussadori S, Guedes C, Bachiega J, Santis T, Motta L (2011) Clinical and radiographic study of chemical-mechanical removal of caries using Papacarie: 24-month follow up. J Clin Pediatr Dent 35(3):251–254CrossRefGoogle Scholar
  4. 4.
    Frencken J, Makoni E, Sithole WA Traumatic restorative treatment and glass ionomer cement sealants in school oral health program in Zimbabwe. Evaluation After 1:428–436Google Scholar
  5. 5.
    Matsumoto SFB, Motta LJ, Alfaya TA, Guedes CC, Fernandes KPS, Bussadori SK (2013) Assessment of chemomechanical removal of carious lesions using Papacarie Duo™: randomized longitudinal clinical trial. Indian J Dent Res 24(4):488–492CrossRefGoogle Scholar
  6. 6.
    Anegundi RT, Patil SB, Tegginmani V, Shetty SD (2012) A comparative microbiological study to assess caries excavation by conventional rotary method and a chemo-mechanical method. Contemp Clin Dentist 3(4):388CrossRefGoogle Scholar
  7. 7.
    Kumar J, Nayak M, Prasad K, Gupta N (2012) A comparative study of the clinical efficiency of chemomechanical caries removal using Carisolv® and Papacarie®-A papain gel. Indian J Dent Res 23(5):697CrossRefGoogle Scholar
  8. 8.
    Camila de Almelda BG, Luz MA, Simionato MRL, Ramalho KM, Imparato JC, Pinheiro SL (2011) Clinical use of photodynamic antimicrobial chemotherapy for the treatment of deep carious lesions. J Biomed Opt 16(8):088003CrossRefGoogle Scholar
  9. 9.
    El-Tekeya M, El-Habashy L, Mokhles N, El-Kimary E (2012) Effectiveness of 2 chemomechanical caries removal methods on residual bacteria in dentin of primary teeth. Pediatr Dent 34(4):325–330PubMedGoogle Scholar
  10. 10.
    Bijle M, Patil S, Mumkekar SS, Arora N, Bhalla M, Murali K (2013) Awareness of dental surgeons in Pune and Mumbai, India, regarding chemomechanical caries removal system. J Contemp Dent Pract 1(14):1Google Scholar
  11. 11.
    Martins MD, Fernandes KPS, Motta LJ, Santos EM, Pavesi VCS, Bussadori SK (2009) Biocompatibility analysis of chemomechanical caries removal material Papacarie on cultured fibroblasts and subcutaneous tissue. J Dent Child 76(2):123–129Google Scholar
  12. 12.
    Kochhar GK, Srivastava N, Pandit I, Gugnani N, Gupta M (2011) An evaluation of different caries removal techniques in primary teeth: a comparitive clinical study. J Clin Pediatr Dent 36(1):5–10CrossRefGoogle Scholar
  13. 13.
    Bohari MR, Chunawalla YK, Ahmed BMN (2012) Clinical evaluation of caries removal in primary teethusing conventional, chemomechanical and lasertechnique: an in vivo study. J Contemp Dent Pract 13(1):40–47CrossRefGoogle Scholar
  14. 14.
    Jawa D, Singh S, Somani R, Jaidka S, Sirkar K, Jaidka R (2010) Comparative evaluation of the efficacy of chemomechanical caries removal agent (Papacarie) and conventional method of caries removal: an in vitro study. J Indian Soc Pedodont Prevent Dentist 28(2):73–77CrossRefGoogle Scholar
  15. 15.
    Bittencourt S, Pereira J, Rosa A, Oliveira K, Ghizoni J, Oliveira M (2010) Mineral content removal after Papacarie application in primary teeth: a quantitative analysis. J Clin Pediatr Dent 34(3):229–231CrossRefGoogle Scholar
  16. 16.
    Bussadori S, Guedes C, Hermida Bruno M, Ram D (2008) Chemo-mechanical removal of caries in an adolescent patient using a papain gel: case report. J Clin Pediatr Dent 32(3):177–180CrossRefGoogle Scholar
  17. 17.
    Beeley J, Yip H, Stevenson A (2001) Chemo-mechanical caries removal: a review of the techniques and latest developments. Nederlands Tijdschrift Voor Tandheelkunde 108(7):277–281PubMedGoogle Scholar
  18. 18.
    K-i T, Araki K, Mataki S, Kurosaki N (2003) Effects of chloramines and sodium hypochlorite on carious dentin. J Med Dent Sci 50(2):139–146Google Scholar
  19. 19.
    Walsh L (1994) Dental lasers: some basic principles. Postgrad Dent 4:26–29Google Scholar
  20. 20.
    Miserendino L, Pick RM (1995) Lasers in dentistry. Quintessence Pub Co, Michigan.Google Scholar
  21. 21.
    Goldman L, Goldman B, Lieu NV (1987) Current laser dentistry. Lasers Surg Med 6(6):559–562CrossRefGoogle Scholar
  22. 22.
    Wilson M (1993) Photolysis of oral bacteria and its potential use in the treatment of caries and periodontal disease. J Appl Bacteriol 75(4):299–306CrossRefGoogle Scholar
  23. 23.
    Wilson M (2004) Lethal photosensitisation of oral bacteria and its potential application in the photodynamic therapy of oral infections. Photochem Photobiol Sci 3(5):412–418CrossRefGoogle Scholar
  24. 24.
    Maisch T, Baier J, Franz B, Maier M, Landthaler M, Szeimies R-M, Bäumler W (2007) The role of singlet oxygen and oxygen concentration in photodynamic inactivation of bacteria. Proc Natl Acad Sci 104(17):7223–7228CrossRefGoogle Scholar
  25. 25.
    Wilson M, Dobson J, Harvey W (1992) Sensitization of oral bacteria to killing by low-power laser radiation. Curr Microbiol 25(2):77–81CrossRefGoogle Scholar
  26. 26.
    Hope C, Wilson M (2006) Induction of lethal photosensitization in biofilms using a confocal scanning laser as the excitation source. J Antimicrob Chemother 57(6):1227–1230CrossRefGoogle Scholar
  27. 27.
    Kömerik N, Nakanishi H, MacRobert A, Henderson B, Speight P, Wilson M (2003) In vivo killing of Porphyromonas gingivalis by toluidine blue-mediated photosensitization in an animal model. Antimicrob Agents Chemother 47(3):932–940CrossRefGoogle Scholar
  28. 28.
    Tuite EM, Kelly JM (1993) New trends in photobiology: photochemical interactions of methylene blue and analogues with DNA and other biological substrates. J Photochem Photobiol B Biol 21(2-3):103–124CrossRefGoogle Scholar
  29. 29.
    Pupo Y, Gomes GM, Santos EB, Chaves L, Michel MD, Kozlowski V Jr, Gomes O, Gomes JC (2010) Susceptibility of Candida albicans to photodynamic therapy using methylene blue and toluidine blue as photosensitizing dyes. Acta Odontol Latinoam 24(2):188–192Google Scholar
  30. 30.
    Souza RC, Junqueira JC, Rossoni RD, Pereira CA, Munin E, Jorge AO (2010) Comparison of the photodynamic fungicidal efficacy of methylene blue, toluidine blue, malachite green and low-power laser irradiation alone against Candida albicans. Lasers Med Sci 25(3):385–389CrossRefGoogle Scholar
  31. 31.
    Cieplik F, Buchalla W, Hellwig E, Al-Ahmad A, Hiller K-A, Maisch T, Karygianni L (2017) Antimicrobial photodynamic therapy as an adjunct for treatment of deep carious lesions—a systematic review. Photodiagn Photodyn Ther 18:54–62CrossRefGoogle Scholar
  32. 32.
    Ornellas PO, da Costa Fontes KBF, Antunes LS, Póvoa HCC, Küchler EC, Iorio NLP, Antunes LAA (2016) Effect of the antimicrobial photodynamic therapy on microorganism reduction in deep caries lesions: a systematic review and meta-analysis. J Biomed Opt 21(9):090901CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Larissa Costa-Santos
    • 1
  • Ana Carolina Costa da Mota
    • 1
  • Renato Araujo Prates
    • 1
  • Lara Jansiski Motta
    • 1
  • Anna Carolina Ratto Tempestini Horliana
    • 1
  • Zenildo Santos Silva-Junior
    • 1
  • Raquel Agnelli Mesquita-Ferrari
    • 1
  • Kristianne Porta Santos Fernandes
    • 1
  • Sandra Kalil Bussadori
    • 1
    Email author
  1. 1.Nove de Julho UniversitySão PauloBrazil

Personalised recommendations