Viabilidade da utilização da terapia fotodinâmica no tratamento da estomatite protética. Estudos in vitro
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Data
2009-07-24
Autores
Mima, Ewerton Garcia de Oliveira [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
Estes estudos in vivo tiveram como objetivos: 1 – avaliar a efetividade da terapia fotodinâmica (PDT) na inativação de Candida albicans em um modelo murino de candidose bucal; 2 – comparar a eficácia clínica e microbiológica da PDT com a da terapia antifúngica tópica (nistatina suspensão oral) no tratamento da estomatite protética, assim como identificar e determinar a prevalência das espécies de Candida dessa patologia. Na primeira investigação, camundongos foram imunossuprimidos com injeções subcutâneas de prednisolona. Tetraciclina foi fornecida na água de beber para promover alteração da microbiota bucal dos camundongos. Os animais foram sedados com injeção de cloridrato de clorpromazina e um swab oral embebido em uma suspensão de C. albicans (107 UFC/mL) foi esfregado na cavidade bucal dos animais. Quatro dias após a inoculação, a PDT foi realizada no dorso lingual utilizando administração tópica de Photogem® a 400, 500 ou 1000 mg/L e, após 30 minutos, iluminação com 305 J/cm² de luz de LED a 455 ou 630 nm. Posteriormente, a quantidade de fungos viáveis foi determinada (UFC/mL) e analisada pelos testes de ANOVA e Holm- Sidak (P < 0,05). Os camundongos foram sacrificados, e as línguas foram removidas e processadas para avaliação histológica de presença de fungos e reação inflamatória. No estudo clínico, pacientes (n = 40) foram aleatoriamente atribuídos a um dos seguintes grupos de 20 indivíduos cada; grupo NYS: pacientes receberam tratamento tópico com nistatina (100.000 UI) quatro vezes ao dia por 15 dias e; grupo PDT: prótese total superior e o palato dos pacientes foram borrifados pelo Photogem® a 500 mg/L e, após 30 minutos de incubação, iluminado por luz de LED a 455 nm (37,5 e 122 J/cm2, respectivamente) três vezes por semana durante 15 dias. Culturas micológicas de amostras das próteses e das mucosas palatinas e fotografias...
These in vivo studies evaluated 1 – the effectiveness of photodynamic therapy (PDT) on the inactivation of Candida albicans in a murine model of oral candidosis; 2 – compared the clinical and mycological efficacy of PDT with that of topical antifungal therapy (nystatin oral suspension) for the treatment of denture stomatitis (DS) as well as to identify and determine the prevalence of Candida species in DS. In the first investigation, mice were immunosupressed with subcutaneous injections of prednisolone. Tetracycline hydrochloride on drinking water was managed to change the oral microflora. They were kept in a sedative state after injection of chlorpromazine chloride and a suspension of C. albicans (107 CFU/mL) was swabbed in the oral cavity. Four days after oral infection, PDT was performed on the dorsum of the tongue using a topical administration of Photogem® at 400, 500 or 1000 mg/L and, after 30 minutes, illumination with 305 J/cm² of LED light at 455 or 630 nm. Then, the number of surviving yeast was determined (CFU/mL) and analyzed by ANOVA and Holm- Sidak tests (P < 0.05). Animals were sacrificed, the tongues surgically removed and processed for histological evaluation of yeast presence and inflammatory reaction. In the clinical trial, patients (n = 40) were randomly assigned to one of two groups of 20 subjects each; NYS group: patients received topical treatment with nystatin (100,000 IU) four times daily for 15 days; PDT group: maxillary denture and palate of patients were sprayed with 500 mg/L of Photogem® and, after 30 min of incubation, illuminated by LED light at 455 nm (37.5 and 122 J/cm2, respectively) three times a week for 15 days. Mycological cultures taken from dentures and palates and standard photographs of the palates were performed at baseline (day 0), at the end of the treatment (day 15) and at the follow-up (days 30, 60 and 90 after the beginning... (Complete abstract click electronic access below)
These in vivo studies evaluated 1 – the effectiveness of photodynamic therapy (PDT) on the inactivation of Candida albicans in a murine model of oral candidosis; 2 – compared the clinical and mycological efficacy of PDT with that of topical antifungal therapy (nystatin oral suspension) for the treatment of denture stomatitis (DS) as well as to identify and determine the prevalence of Candida species in DS. In the first investigation, mice were immunosupressed with subcutaneous injections of prednisolone. Tetracycline hydrochloride on drinking water was managed to change the oral microflora. They were kept in a sedative state after injection of chlorpromazine chloride and a suspension of C. albicans (107 CFU/mL) was swabbed in the oral cavity. Four days after oral infection, PDT was performed on the dorsum of the tongue using a topical administration of Photogem® at 400, 500 or 1000 mg/L and, after 30 minutes, illumination with 305 J/cm² of LED light at 455 or 630 nm. Then, the number of surviving yeast was determined (CFU/mL) and analyzed by ANOVA and Holm- Sidak tests (P < 0.05). Animals were sacrificed, the tongues surgically removed and processed for histological evaluation of yeast presence and inflammatory reaction. In the clinical trial, patients (n = 40) were randomly assigned to one of two groups of 20 subjects each; NYS group: patients received topical treatment with nystatin (100,000 IU) four times daily for 15 days; PDT group: maxillary denture and palate of patients were sprayed with 500 mg/L of Photogem® and, after 30 min of incubation, illuminated by LED light at 455 nm (37.5 and 122 J/cm2, respectively) three times a week for 15 days. Mycological cultures taken from dentures and palates and standard photographs of the palates were performed at baseline (day 0), at the end of the treatment (day 15) and at the follow-up (days 30, 60 and 90 after the beginning... (Complete abstract click electronic access below)
Descrição
Palavras-chave
Fotoquimioterapia, Candidiase bucal, Estomatite sob prótese, Nistatina, Photochemotherapy, Candida, Oral candidiasis, Denture stomatitis, Nystatin
Como citar
MIMA, Ewerton Garcia de Oliveira. Viabilidade da utilização da terapia fotodinâmica no tratamento da estomatite protética. Estudos in vitro. 2009. 155 f. Tese (doutorado) - Universidade Estadual Paulista, Faculdade de Odontologia de Araraquara, 2009.