A randomized clinical trial evaluating Photodithazine-mediated Antimicrobial Photodynamic Therapy as a treatment for Denture stomatitis

Abstract

Objective: This randomized clinical trial assessed antimicrobial Photodynamic Therapy (aPDT) mediated by Photodithazine (PDZ) to treat patients with denture stomatitis (DS). Methodologies: Patients with DS were randomly assigned to the groups: aPDT (n = 30) and nystatin (NYS, n = 35). aPDT patients received 6 aPDT sessions, three times a week for 15 days, which involved PDZ (200 mg/L) topical application (20 min) on the palate and upper denture, followed by LED illumination (660 nm, 50 J/cm²). NYS patients were instructed to rinse one dropper of this medication for one minute, four times a day, for 15 days. Microbiological collections of dentures and palates were performed and cultured on blood agar and CHROMAgar Candida. Microbial viability was determined, and photographs of the palates were taken for clinical evaluation. Data were analyzed by Repeated Measure Linear Model and Bonferroni (p ≤ 0.05). Results: aPDT was more effective to reduce the total microbiota than NYS. At the end of the treatments, aPDT reduced 1.98 from the palate and 1.91 log10 from the denture, while NYS reduced 0.05 and 0.17 log10, respectively. Moreover, aPDT was as effective as NYS to reduce Candida. Reductions of 0.68 and 0.77 log10 were observed in the palate and denture of aPDT group, while reductions of 0.57 and 1.43 log10 were achieved in the NYS group, respectively. Regarding to oral lesion, 53.3 and 54.2 % of the patients from aPDT and NYS groups had clinical improvement. However, the recurrence of DS was observed in both groups. Conclusion: PDZ-mediated aPDT is a promising treatment for DS.