Antimicrobial Photodynamic Therapy (aPDT) for periodontal disease (PD) treatment has been studied for more than three decades, but there is no consensus among researchers about its role on PD control. PD is an oral infection linked with a variate of systemic diseases affecting mainly immunocompromised and elderly patients. The aim of this study is to evaluate aPDT for PD control and to analyze the periodontal microbiological profile regarding healthcare-associated infections (HAI). Six patients were enrolled in this study and the microbiological profile of 36 sites were evaluated in different moments: initial, after scaling and root planing, after aPDT and one-week post-treatment. aPDT was performed with 100μM water solution of methylene blue (MB), and a diode laser (100mW, 660nm, 90s per point, 9J). After periodontal therapy the pockets were irrigated with hydrogen peroxide (3%), washed with water, and MB was applied when no bleeding was detected. To collect the periodontal pocket content, a sterilized paper point was placed inside the pocket for 30s. The material was transferred to a vial with transport culture medium and sent to a microbiological facility to be analyzed blindly. The results showed the presence of pathogens linked with HAI as Acinetobacter baumannii, Candida albicans e Serratia marcescens immediately after therapy, but one week after treatment, none of them were detected and the periodontal index of all patients improved. This preliminary result point out that aPDT may not only improve periodontal clinical conditions, but also can diminish the systemic-health threat represented by this disease.
Ricardo Scarparo Navarro, Andréa Dias Neves Lago, Clarissa Calil Bonifácio, Fausto Medeiros Mendes, Patrícia Moreira de Freitas, Alessandra Baptista, Silvia Cristina Nunez, Adriana Bona Matos, José Carlos Imparato
The aim of this study was to evaluate the enamel demineralization around cavities prepared by Er,Cr:YSGG laser (2780 nm) and restored with different materials after an acid challenge. The human dental enamel samples were randomly divided in 12 groups (n=10): G1- high-speed drill (HD); G2- Er,Cr:YSGG laser L (3 W, 20 Hz, 53.05 J/cm2)(air 65% - water 55%); G3– L (4 W, 20 Hz, 70.74 J/cm2); G4– L (5 W, 20 Hz, 88.43 J/cm2). Each group was divided in subgroups: 1- glass ionomer cement (GIC), 2- resin modified GIC (RMGIC), 3- composite resin (C). Samples were submitted to an acid challenge (4.8 pH) for7 days. The calcium ion contend (ppm/mm2) from demineralizing solutions were analyzed by atomic emission spectrometry. ANOVA and LSD tests were performed (α=5%). The significant lower average values of calcium loss were observed on G2 + GIC, G2 + RMGIC, G1 + RMGIC (p<0.05); the significant higher values were observed on G1 + C, G4 +GIC, G4 + C (p<0.05). The composite resin showed higher calcium loss than RMGIC and GIC (p<0.05). The lased cavities using lower fluence (53.05J/cm2) showed significant reduced demineralization than higher fluences (70.74 and 88.43J/cm2) (p<0.05). Neither the techniques nor the restorative materials used were able to avoid the enamel demineralization. The findings of this in vitro study suggest that the Er,Cr:YSGG lased cavities restored with GIC or RMGIC or conventional drill cavities with RMGIC were effective on reducing the demineralization around restorations, showing an important potential in preventing secondary caries.
Diabetes Mellitus is a chronic disease that can lead to lower-limb ulceration. The photodynamic therapy (PDT) is based on light interaction with a photosensitizer capable to promote bacterial death and tissue repair acceleration. This study analyzed the effects of PDT in the repair of human diabetic ulcers, by means of microbiological assessment. The clinical study was composed of 12 patients of both sexes with diabetic ulcers in lower limbs that were divided into two groups, control group (n=6) and PDT group (n=6). All patients were treated with collagenase/chloramphenicol during the experimental period, in which 6 of them have received PDT with methylene blue dye (0.01%) associated with laser therapy (660 nm), dose of 6 J/cm2¨ and 30 mW laser power. PDT group received ten treatment sessions. Wounds were evaluated for micro-organisms analysis. It was found a reduction in the occurrence of Staphylococcus aureus in both groups, being that reduction more pronounced in the PDT group. Microbial count was performed on PDT group, showing a statistical difference reduction (p<0.05) when compared before and after the treatment. It is concluded that PDT seems to be effective in microbial reduction of human diabetic wounds, promoting acceleration and improvement of tissue repair quality.ty.
An endotracheal tube (ETT) is required for the management of critically ill, mechanically ventilated patients. Ventilatorassociated pneumonia (VAP) affects patients hospitalized in intensive care units; its risk of occurrence is 1% to up 3% for each day of mechanical ventilation. The polymicrobial nature of VAP is established with mixed bacterial-fungal biofilms colonizing the ETT. The microbial interaction enhances the microbial pathogenesis contributing to high indexes of morbidity/mortality. Antimicrobial Photodynamic Therapy (aPDT) could be a suitable therapy for decontamination of oral cavity and ETT at the same time, but the use of a fiber optics inside the ETT seems to not be appropriated since a cannula for secretion aspiration has to be introduced into the ETT to keep it´s lumen. The aim of this study is to proof the concept that an external light source from a LED is capable of reach all areas of the ETT. We use a commercial ETT, 60μM methylene blue (MB), and a 660nm diode laser and calculated the transmission coefficient of light in different situations as only tube, tube with biofilm and biofilm+MB. The results prove that is possible to transmit light through the tube even in the presence of MB and biofilm although a high attenuation of about 60% was measured depending on the tested condition.
The liver is responsible for several basic functions in human body how the syntheses of the most main proteins and degradation process of toxins, drugs and alcohols. In present days, the viral hepatitis C is one of the highest causes of chronic hepatic illness worldwide, affecting around 3% of the world population. The liver biopsy is considered the gold standard for diagnosing hepatic fibrosis; however, the biopsies may be questioned because of potential sampling error, morbidity, possible mortality and relatively high costs. Spectroscopy techniques such as Raman spectroscopy have been used for diagnosis of human tissues, with favorable results. Raman spectroscopy has been employed to distinguish normal from hepatic lesions through spectral features mainly of proteins, nucleic acids and lipids. In this study, eleven patients with diagnoses of chronic hepatitis C underwent hepatic biopsies having two hepatic fragments collected: one was scored through METAVIR system and the other one was submitted to near-infrared Raman spectroscopy using a dispersive spectrometer (830 nm wavelength, 300 mW laser power and 20 s exposure time). Five spectra were collected in each fragment and submitted to Principal Components Analysis (PCA). Results showed a good correlation between the Raman spectroscopy features and the stage of hepatic fibrosis and inflammation. PCA showed that samples with higher degree of fibrosis presented higher amount of protein features (collagen), whereas samples of higher degree of inflammation presented higher features of hemoglobin, in accordance to the expected evolution of the chronic hepatitis. It has been found an important biomarker for the beginning of hepatic lesion (quinone) with a spectral feature at 1595 cm-1.
The purpose of this study was to evaluate the morphological changes in cavities made by Er:YAG laser (2.94μm)(KaVo KEY 3)(LELO-FOUSP) and high-speed drill. Cavities were made on the buccal and lingual surfaces of 27 human molars (Banco de Dentes-FOUSP), using different laser parameters (n=3): G1-15Hz/160mJ enamel/ 6Hz/200mJ dentin; G2-15Hz/180mJ enamel/ 6Hz/200mJ dentin; G3-15Hz/160mJ enamel/ 6Hz/250mJ dentin; G4-15Hz/180mJ enamel/ 6Hz/250mJ dentin; G5-15Hz/180mJ enamel/ 10Hz/180mJ dentin; G6-15Hz/160mJ enamel/ 10Hz/180mJ dentin; G7-15Hz/160mJ enamel/ 10Hz/160mJ dentin; G8-15Hz/180mJ enamel/ 10Hz/160mJ dentin and G9-high-speed drill. Samples were fixed (2.5% glutaraldhyde, 12h, 4°C), dehydrated (25-100% ethanol), dried to a critical point and sputter-coated with gold for analysis under SEM. All laser parameters used showed no evidence of thermal damage and signs of burning and melting, Er:YAG laser ablated dental hard tissues, showing enamel prisms, like scales, dentin surface without smear layer and opened dentinal tubules. It was concluded that Er:YAG laser parameters were effective for ablation of hard tissues, promoting morphological changes in irradiated tissues, creating an irregular and microretentive morphological pattern.
The aim of this study was to evaluate the tensile strength of different adhesive systems to primary tooth dentin prepared by high-speed drill and Er:YAG laser (2.94μm). Buccal surfaces of 38 primary canines were ground and flattened with sand paper disks (#120-600 grit) and distributed into five groups (n=15): G1: diamond bur in high-speed drill (HD)+ 35% phosphoric acid (PA)+Single Bond (SB); G2: HD+self-etching One Up Bond F (OUB);G3: Er:YAG laser (KaVo 3- LELO-FOUSP)(4Hz, 80mJ, 25,72J/cm2) (L)+PA+SB, G4: L+SB, G5: L+OUB. The inverted truncated cone samples built with Z-100 composite resin after storage in water (37°C/24h) were submitted to tensile bond strength test on Mini Instron 4442 (0.5mm/min, 500N). The data were analyzed with ANOVA and Tukey Test (p<0.05). The mean (MPa) were: G1-3.18(±1.24); G2-1.79(±0.73); G3-3.17(±0.44); G4-8.29(±1.86); G5-7.11(±2.07). The data analyzed with ANOVA and Tukey Test showed that Laser associated with PA+SB, SB or OUB lead to increased bonding values when compared to HD+PA+SB and HD+OUB (p=0.000), L+SB showed higher values than L+PA+SB and L+OUB (p=0.0311). Er:YAG laser radiation promoted significant increase of bond strength of different adhesive systems evaluated in the dentin of primary teeth.
Various materials and techniques have been investigated in order to minimize or eliminate microleakage in composite restorations. The CO2 laser (10.6 micrometer) removes the smear layer and creates an irregular surface able to promote micromechanical retention for adhesive restorative materials. Forty Class V cavities were performed with high-speed drill in 20 extracted human molar and randomly divided into 4 different groups: Group 1 -- CO2 laser (3 W, 2 Hz, 50 ms) and after 37% phosphoric acid etching on dentin and enamel surface; Group 2 -- 37% phosphoric acid etching and after CO2 laser; Group 3 -- CO2 laser; Group 4 -- 37% phosphoric acid etching. The cavity restored with composite resin (Z-100) and thermally stressed (700 cycles, 5 - 55 degree Celsius). After the samples were impermeabilized, immersed in 50% silver nitrate solution for 8 hours and sectioned with Isomet saw. The teeth were exposed to Photoflood light (G.E.) for 5 minutes to reveal the dye. Leakage was observed under stereomicroscope and evaluated with scores. Results were analyzed with ANOVA (p greater than 1%) and Tukey's test (p equals 5%) and showed significant lower microleakage in the group treated only with CO2 laser and phosphoric acid etching alone (group 3 and 4) than groups treated with phosphoric acid and CO2 laser together (group 1 and 2).
The aim of this study was to evaluate microleakage of composite restorations submitted to marginal treatment. Class V preparations with walls located in enamel were performed at buccal and lingual surfaces of eighteen recently extracted, non-carious human premolars. Cavities were restored with composite resins and adhesive system. Samples were stored in distilled water for 48h and polished with Sof-Lex discs. Teeth were randomly divide in six groups: G1 - Control; G2 - marginal treatment with surface sealant; G3 - Nd:YAG 25 Hz, 80mJ, 2W; G4 - Nd:YAG 20Hz, 100mJ, 2W; G5 - Nd:YAG 30Hz, 60mJ, 1.8W; G6 - Nd:YAG 30Hz, 40mJ, 1.2W. Contact fiberoptic (300μm) pulsed (1.064 μm) Nd:YAG laser was used for 30sec, under air cooling. Teeth were impermeabilized, immersed in a dye (Rhodamine B) for 4h at 37°, and sectioned. Specimens were evaluated under light microscopy and evaluated with scores. Results were analyzed with Kruskal- Wallis test (p=0.05) and showed that there were significant differences between marginal treatments; there were no significant differences beaten groups 1, 2, 4 and 3, 5, 6; lower values of microleakage were at groups 3, 5, 6. Nd:YAG laser showed marginal sealing ability and decreased microleakage of composite resins restorations.
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