Antimicrobial Photodynamic Therapy in the Treatment of Oral Erythematous Candidiasis: a Controlled and Randomized Clinical Trial

Overview

Journal Clin Oral Investig

Specialty Dentistry

Date 2023 Sep 17

PMID 37718381

Authors

Maurilia Raquel de Souto Medeiros

Caio Cesar da Silva Barros

Ana Claudia de Macedo Andrade

Kenio Costa de Lima

Ericka Janine Dantas da Silveira

Affiliations

Soon will be listed here.

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.

Citing Articles

Anticandidal effect of multiple sessions of erythrosine and potassium iodide-mediated photodynamic therapy.

Pitaksanurat P, Mayeah N, Saithong P, Pimha S, Sirikarn P, Damrongrungruang T J Oral Microbiol. 2024; 16(1):2369357.

PMID: 38903483 PMC: 11188948. DOI: 10.1080/20002297.2024.2369357.

References

Lewis M, Williams D . Diagnosis and management of oral candidosis. Br Dent J. 2017; 223(9):675-681. DOI: 10.1038/sj.bdj.2017.886. View

Millsop J, Fazel N . Oral candidiasis. Clin Dermatol. 2016; 34(4):487-94. DOI: 10.1016/j.clindermatol.2016.02.022. View

Nishimaki F, Yamada S, Kawamoto M, Sakurai A, Hayashi K, Kurita H . Relationship Between the Quantity of Oral Candida and Systemic Condition/Diseases of the Host: Oral Candida Increases with Advancing Age and Anemia. Mycopathologia. 2019; 184(2):251-260. DOI: 10.1007/s11046-019-00326-x. View

Vipulanandan G, Herrera M, Wiederhold N, Li X, Mintz J, Wickes B . Dynamics of Mixed- Candida Species Biofilms in Response to Antifungals. J Dent Res. 2017; 97(1):91-98. PMC: 5755808. DOI: 10.1177/0022034517729351. View

Nittayananta W . Oral fungi in HIV: challenges in antifungal therapies. Oral Dis. 2016; 22 Suppl 1:107-13. DOI: 10.1111/odi.12394. View

Emami E, Kabawat M, Rompre P, Feine J . Linking evidence to treatment for denture stomatitis: a meta-analysis of randomized controlled trials. J Dent. 2013; 42(2):99-106. DOI: 10.1016/j.jdent.2013.11.021. View

Chanda W, Joseph T, Wang W, Padhiar A, Zhong M . The potential management of oral candidiasis using anti-biofilm therapies. Med Hypotheses. 2017; 106:15-18. DOI: 10.1016/j.mehy.2017.06.029. View

Gursoy H, Ozcakir-Tomruk C, Tanalp J, Yilmaz S . Photodynamic therapy in dentistry: a literature review. Clin Oral Investig. 2012; 17(4):1113-25. DOI: 10.1007/s00784-012-0845-7. View

Ziental D, Mlynarczyk D, Czarczynska-Goslinska B, Lewandowski K, Sobotta L . Photosensitizers Mediated Photodynamic Inactivation against Fungi. Nanomaterials (Basel). 2021; 11(11). PMC: 8621466. DOI: 10.3390/nano11112883. View

10.

Darabpour E, Kashef N, Mashayekhan S . Chitosan nanoparticles enhance the efficiency of methylene blue-mediated antimicrobial photodynamic inactivation of bacterial biofilms: An in vitro study. Photodiagnosis Photodyn Ther. 2016; 14:211-7. DOI: 10.1016/j.pdpdt.2016.04.009. View

11.

de Senna A, Vieira M, Machado-de-Sena R, Bertolin A, Nunez S, Ribeiro M . Photodynamic inactivation of Candida ssp. on denture stomatitis. A clinical trial involving palatal mucosa and prosthesis disinfection. Photodiagnosis Photodyn Ther. 2018; 22:212-216. DOI: 10.1016/j.pdpdt.2018.04.008. View

12.

Alves F, Carmello J, Alonso G, Mima E, Bagnato V, Pavarina A . A randomized clinical trial evaluating Photodithazine-mediated Antimicrobial Photodynamic Therapy as a treatment for Denture stomatitis. Photodiagnosis Photodyn Ther. 2020; 32:102041. DOI: 10.1016/j.pdpdt.2020.102041. View

13.

Javed F, Samaranayake L, Romanos G . Treatment of oral fungal infections using antimicrobial photodynamic therapy: a systematic review of currently available evidence. Photochem Photobiol Sci. 2014; 13(5):726-34. DOI: 10.1039/c3pp50426c. View

14.

Mima E, Vergani C, Machado A, Massucato E, Colombo A, Bagnato V . Comparison of Photodynamic Therapy versus conventional antifungal therapy for the treatment of denture stomatitis: a randomized clinical trial. Clin Microbiol Infect. 2012; 18(10):E380-8. DOI: 10.1111/j.1469-0691.2012.03933.x. View

15.

Lyu X, Zhao C, Yan Z, Hua H . Efficacy of nystatin for the treatment of oral candidiasis: a systematic review and meta-analysis. Drug Des Devel Ther. 2016; 10:1161-71. PMC: 4801147. DOI: 10.2147/DDDT.S100795. View

16.

Morse D, Wilson M, Wei X, A O Lewis M, Bradshaw D, Murdoch C . Denture-associated biofilm infection in three-dimensional oral mucosal tissue models. J Med Microbiol. 2018; 67(3):364-375. PMC: 5882079. DOI: 10.1099/jmm.0.000677. View

17.

Garcia-Cuesta C, Sarrion-Perez M, Bagan J . Current treatment of oral candidiasis: A literature review. J Clin Exp Dent. 2015; 6(5):e576-82. PMC: 4312689. DOI: 10.4317/jced.51798. View

18.

Quindos G, Gil-Alonso S, Marcos-Arias C, Sevillano E, Mateo E, Jauregizar N . Therapeutic tools for oral candidiasis: Current and new antifungal drugs. Med Oral Patol Oral Cir Bucal. 2019; 24(2):e172-e180. PMC: 6441600. DOI: 10.4317/medoral.22978. View

19.

Bhattacharya S, Sae-Tia S, Fries B . and Mechanisms of Antifungal Resistance. Antibiotics (Basel). 2020; 9(6). PMC: 7345657. DOI: 10.3390/antibiotics9060312. View

20.

Cieplik F, Deng D, Crielaard W, Buchalla W, Hellwig E, Al-Ahmad A . Antimicrobial photodynamic therapy - what we know and what we don't. Crit Rev Microbiol. 2018; 44(5):571-589. DOI: 10.1080/1040841X.2018.1467876. View