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

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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.

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Data availability

Data will be made available on request.

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Funding

The work was supported by the Brazilian National Council for Scientific and Technological Development (CNPq), the Coordination for the Improvement of Higher Education Personnel (CAPES), and the Postgraduate Program in Dental Sciences of the Federal University of Rio Grande do Norte, Brazil.

Author information

Authors and Affiliations

  1. Postgraduate Program in Dental Sciences, Department of Dentistry, Federal University of Rio Grande Do Norte, Av. Salgado Filho, 1787, Lagoa Nova, Natal, RN, 59056-000, Brazil

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

Authors
  1. Maurília Raquel de Souto Medeiros
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  2. Caio César da Silva Barros
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  3. Ana Cláudia de Macedo Andrade
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  5. Éricka Janine Dantas da Silveira
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Contributions

The draft of the manuscript was written by Maurília Raquel de Souto Medeiros, Caio César da Silva Barros, and Ana Cláudia de Macedo Andrade. The clinical intervention, collection of biological material, and data collection were performed by Maurília Raquel de Souto Medeiros. Material preparation and microbiological assay were performed by Caio César da Silva Barros and Ana Cláudia de Macedo Andrade. Kenio Costa de Lima performed the data analysis and interpretation. Éricka Janine Dantas da Silveira contributed to the study’s conception and design. All authors reviewed and approved the final manuscript.

Corresponding author

Correspondence to Éricka Janine Dantas da Silveira.

Ethics declarations

Ethical approval

All procedures performed in studies involving human participants followed the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Ethics Committee of the Federal University of Rio Grande do Norte (Approval No. 3,300,838 – CAAE: 08005419.8.5537). This study was approved by the Brazilian Registry of Clinical Trials (ReBEC) (Approval No. RBR-8w8599).

Informed consent

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

Conflict of interest

The authors declare no competing interests.

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de Souto Medeiros, M.R., da Silva Barros, C.C., de Macedo Andrade, A.C. et al. Antimicrobial photodynamic therapy in the treatment of oral erythematous candidiasis: a controlled and randomized clinical trial. Clin Oral Invest 27, 6471–6482 (2023). https://doi.org/10.1007/s00784-023-05252-3

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