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18.09.2023 | Research

Antimicrobial photodynamic therapy in the treatment of oral erythematous candidiasis: a controlled and randomized clinical trial

verfasst von: Maurília Raquel de Souto Medeiros, Caio César da Silva Barros, Ana Cláudia de Macedo Andrade, Kenio Costa de Lima, Éricka Janine Dantas da Silveira

Erschienen in: Clinical Oral Investigations | Ausgabe 11/2023

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Abstract

Objective

To analyze the clinical and microbiological efficacy of antimicrobial photodynamic therapy (aPDT) in patients with erythematous candidiasis (EC).

Methods

This study was a controlled and randomized clinical trial in patients diagnosed with EC, who were allocated into a control group (CG) and experimental group (EG) treated with nystatin oral suspension and aPDT with methylene blue 0.1%, respectively. A clinical index was used to classify the EC lesions from mild to severe and assess the treatment efficacy. Microbiological samples were collected before and after aPDT session and analyzed by counting colony-forming units (CFUs) of Candida and Staphylococcus sp.

Results

A total of 41 patients (CG (n = 18); EG (n = 23)) were analyzed in our research. Of these, 16 (94.1%) of the CG and 16 (84.2%) of the EG exhibited complete remission of the lesions. Regarding the degree of the lesion, it was observed that the severe lesions were more difficult to present remission, while all the mild and moderate lesions showed complete regression (p = 0.001). The microbiological analysis showed that Candida albicans and Staphylococcus sp. were the most prevalent microorganisms, and the aPDT group showed a decrease in CFUs of these microorganisms after the first aPDT session (p < 0.05).

Conclusions

aPDT proved to be a clinically and microbiologically effective therapy for treating EC.

Trial registration

Registered at ClinicalTrials.gov; Set 12th, 2019; No. RBR-8w8599.

Clinical relevance

aPDT is a promising alternative treatment since it presents satisfactory results and does not cause damage to oral tissues or develop resistance to the treatment.

Nur mit Berechtigung zugänglich

Reinhardt LC, Nascente PS, Ribeiro JS, Lund RG (2018) A single-center 18-year experience with oral candidiasis in Brazil: a retrospective study of 1,534 cases. Braz Oral Res 32:92–101. https://doi.org/10.1590/1807-3107bor-2018.vol32.0092CrossRef

Lewis MOA, Williams DW (2017) Diagnosis and management of oral candidosis. Br Dent J 223:675–681. https://doi.org/10.1038/sj.bdj.2017.886CrossRefPubMed

Millsop JW, Fazel N (2016) Oral candidiasis. Clin Dermatol 34:487–494. https://doi.org/10.1016/j.clindermatol.2016.02.022CrossRefPubMed

Nishimaki F, Yamada SI, Sakurai A, Hayashi K, Kurita H (2019) Relationship between the quantity of oral Candida and systemic condition/diseases of the host: oral Candida increases with advancing age and anemia. Mycopathologia 184:251–260. https://doi.org/10.1007/s11046-019-00326-xCrossRefPubMed

Vipulanandan G, Herrera M, Wiederhold NP, Li X, Mintz J, Wickes BL, Kadosh D (2018) Dynamics of mixed–Candida species biofilms in response to antifungals. J Dent Res 97:91–98CrossRefPubMed

Nittayananta W (2016) Oral fungi in HIV: challenges in antifungal therapies. Oral Dis 22:107–113. https://doi.org/10.1111/odi.12394CrossRefPubMed

Tay LY, Jorge JH, Herrera DR, Campanha NH, Gomes BP, Santos FA (2014) Evaluation of different treatment methods against denture stomatitis: a randomized clinical study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 118:72–77. https://doi.org/10.1016/j.oooo.2014.03.017CrossRef

Emami E, Kabawat M, Rompre PH, Feine JS (2014) Linking evidence to treatment for denture stomatitis: a meta-analysis of randomized controlled trials. J Dent 42:99–106. https://doi.org/10.1016/j.jdent.2013.11.021CrossRefPubMed

Chanda W, Joseph TP, Wang W, Padhiar AA, Zhang M (2017) The potential management of oral candidiasis using anti-biofilm therapies. Med Hypotheses 106:15–18. https://doi.org/10.1016/j.mehy.2017.06.029CrossRefPubMed

10.

Gursoy H, Ozcakir-Tomruk C, Tanalp J (2013) Photodynamic therapy in dentistry: a literature review. Clin Oral Investig 17:1113–1125. https://doi.org/10.1007/s00784-012-0845-7CrossRefPubMed

11.

Carrera ET, Corbi SCT, Marcontonio RAC et al (2016) The application of antimicrobial photodynamic therapy (aPDT) in dentistry: a critical review. Laser Phys 26:1–14. https://doi.org/10.1088/1054-660X/26/12/123001CrossRef

12.

Ziental D, Mlynarczyk DT, Czarczynska-Goslinska B, Lewandowsk K, Sobotta L (2021) Photosensitizers mediated photodynamic inactivation against fungi. Nanomaterials 11:2883–2942CrossRefPubMedPubMedCentral

13.

Hu X, Huang YY, Wang Y, Wang X, Hamblin MR (2018) Antimicrobial photodynamic therapy to control clinically relevant biofilm infections. Front Microbiol 9:1–24. https://doi.org/10.3389/fmicb.2018.01299CrossRef

14.

Darabpour E, Kashef N, Mashayekhan S (2016) Chitosan nanoparticles enhance the efficiency of methylene blue-mediated antimicrobial photodynamic inactivation of bacterial biofilms: an in vitro study. Photodiagnosis Photodyn Ther 14:211–217. https://doi.org/10.1016/j.pdpdt.2016.04.009CrossRefPubMed

15.

Senna AM et al (2018) Photodynamic inactivation of Candida ssp. on denture stomatitis. A clinical trial involving palatal mucosa and prosthesis disinfection. Photodiagnosis Photodyn Ther 22:212–216. https://doi.org/10.1016/j.pdpdt.2018.04.008CrossRefPubMed

16.

Alves F et al (2020) A randomized clinical trial evaluating photodithazine-mediated antimicrobial photodynamic therapy as a treatment for denture stomatitis. Photodiagnosis Photodyn Ther 32:102041. https://doi.org/10.1016/j.pdpdt.2020.102041CrossRefPubMed

17.

Javed F, Samaranayake LP, Romanos GE (2014) Treatment of oral fungal infections using antimicrobial photodynamic therapy: a systematic review of currently available evidence. Photochem Photobiol Sci 13:726–734. https://doi.org/10.1039/c3pp50426cCrossRefPubMed

18.

Mima EG et al (2012) Comparison of photodynamic therapy versus conventional antifungal therapy for the treatment of denture stomatitis: a randomized clinical trial. Clin Microbiol Infect 18:E380–E388. https://doi.org/10.1111/j.1469-0691.2012.03933.xCrossRefPubMed

19.

Pandis N, Chung B, Scherer RW et al (2017) CONSORT 2010 statement: extension checklist for reporting within person randomized trials. BMJ j2835. https://doi.org/10.1136/bmj.j2835

20.

Yan Z, Liu X, Liu Y et al (2016) The efficacy and safety of miconazole nitratemuco adhesive tablets versus itraconazole capsules in the treatment of oral candidiasis: an open-label, randomized, multicenter trial. PLoS ONE 11:1–12. https://doi.org/10.1371/journal.pone.0167880CrossRef

21.

Carmello JC et al (2016) Treatment of oral candidiasis using photodithazine-mediated photodynamic therapy – mediated photodynamic therapy in vivo. PLoS ONE 11:1–18. https://doi.org/10.1371/journal.pone.0156947CrossRef

22.

Lynge Pedersen AM et al (2015) Oral mucosal lesions in older people: relation to salivary secretion, systemic diseases and medications. Oral Dis 2:721–729. https://doi.org/10.1111/odi.12337CrossRef

23.

Lyu X et al (2016) Efficacy of nystatin for the treatment of oral candidiasis: a systematic review and meta-analysis. Drug Des Devel Ther 10:1161–1171. https://doi.org/10.2147/DDDT.S100795CrossRefPubMedPubMedCentral

24.

Morse JD et al (2018) Denture-associated biofilm infection in three-dimensional oral mucosal tissue models. J Med Microbiol 67:364–375CrossRefPubMedPubMedCentral

25.

Garcia-Cuesta C, Sarrion-Pérez MG, Bagán JV (2014) Current treatment of oral candidiasis: a literature review. J Clin Exp Dent 6:e576–e582. https://doi.org/10.4317/jced.51798CrossRefPubMedPubMedCentral

26.

Quindós G et al (2019) Therapeutic tools for oral candidiasis: current and new antifungal drugs. Med Oral Patol Oral Cir Bucal 24:e172–e180. https://doi.org/10.4317/medoral.22978CrossRefPubMedPubMedCentral

27.

Bhattacharya S, Sae-Tia S, Fries BC (2020) Candidiasis and mechanisms of antifungal resistance. Antibiotics (Basel) 9:312–331. https://doi.org/10.3390/antibiotics9060312CrossRefPubMed

28.

Cieplik F, Deng D, Crielaard W, Buchalla W, Hellwig E et al (2018) Antimicrobial photodynamic therapy – what we know and what we don’t. Crit Rev Microbiol 44:571–589. https://doi.org/10.1080/1040841X.2018.1467876CrossRefPubMed

29.

Sardi JC et al (2013) Candida species: current epidemiology, pathogenicity, biofilm formation, natural antifungal products and new therapeutic options. J Med Microbiol 62:10–24. https://doi.org/10.1099/jmm.0.045054-0CrossRefPubMed

30.

Al-Aali et al (2023) Efficacy of adjunct photodynamic therapy on Candida growth and oral health quality of life in denture stomatitis patients with type 2 diabetes mellitus wearing implant-retained overdentures: a randomized clinical study. Photodiagnosis Photodyn Ther 42:103630. https://doi.org/10.1016/j.pdpdt.2023.103630CrossRefPubMed

31.

Preissner S et al (2016) Adjuvant antifungal therapy using tissue tolerable plasma on oral mucosa and removable dentures in oral candidiasis patients: a randomized double-blinded split-mouth pilot study. Mycosis 59:467–475. https://doi.org/10.1111/myc.12495CrossRef

32.

Scorzoni L et al (2013) Antifungal efficacy during Candida krusei infection in non-conventional models correlates with the yeast in vitro susceptibility profile. PLoS One 8:e660047. https://doi.org/10.1371/journal.pone.0060047CrossRef

33.

Brunke S, Hube B (2013) Two unlike cousins: Candida albicans and C. glabrata infection strategies. Cell Microbiol 15:701–708. https://doi.org/10.1111/cmi.12091CrossRefPubMedPubMedCentral

34.

Sousa AS et al (2016) Photodynamic inactivation of Candida albicans biofilm: influence of the radiant energy and photosensitizer charge. Photodiagnosis Photodyn Ther 14:111–114. https://doi.org/10.1016/j.pdpdt.2016.03.004CrossRefPubMed

35.

Paz-Cristobal MP et al (2014) Photodynamic fungicidal efficacy of hypericin and dimethyl methylene blue against azole-resistant Candida albicans strains. Mycosis 57:35–42. https://doi.org/10.1111/myc.12099CrossRef

36.

Dovigo LN et al (2011) Fungicidal effect of photodynamic therapy against fluconazole resistant Candida albicans and Candida glabrata. Mycoses 54:123–130. https://doi.org/10.1111/j.1439-0507.2009.01769.xCrossRefPubMed

37.

Shirtlif ME, Peters BM, Jabra-Rizk MA (2009) Cross-kingdom interactions: Candida albicans and bacteria. FEMS Microbiol Lett 299:1–8. https://doi.org/10.1111/j.1574-6968.2009.01668.xCrossRef

38.

Ponde NO, Lorta L, Ramage G, Naglik JR, Richardson JP (2021) Candida albicans biofilms and polymicrobial interactions. Crit Rev Microbiol 47:91–111. https://doi.org/10.1080/1040841X.2020.1843400CrossRefPubMedPubMedCentral

39.

Gleiznys A, Zdanavičienė E, Žilinskas J (2015) Candida albicans importance to denture wearers. A literature review. Stomatologija 17:54–66PubMed

Titel: Antimicrobial photodynamic therapy in the treatment of oral erythematous candidiasis: a controlled and randomized clinical trial
verfasst von: Maurília Raquel de Souto Medeiros
Caio César da Silva Barros
Ana Cláudia de Macedo Andrade
Kenio Costa de Lima
Éricka Janine Dantas da Silveira
Publikationsdatum: 18.09.2023
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Oral Investigations / Ausgabe 11/2023
Print ISSN: 1432-6981
Elektronische ISSN: 1436-3771
DOI: https://doi.org/10.1007/s00784-023-05252-3

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Antimicrobial photodynamic therapy in the treatment of oral erythematous candidiasis: a controlled and randomized clinical trial