Avaliação microbiológica in vivo de lesões de cárie profundas tratadas pela terapia fotodinâmica / In vivo microbiological analisys of deep carious lesions treated by photodynamic therapy

AUTOR(ES)

Camila de Almeida Brandao Guglielmi

DATA DE PUBLICAÇÃO

2009

RESUMO

The traditional treatment of dentinal caries lesions has been based on the mechanical removal of all demineralized dentine, using hand or rotatory instruments. As an alternative to removal of the cariogenic organisms by drilling, the purpose of this study was to eliminate them through photosensitization promoted by irradiation with a low power laser associated with a specific dye. If bacteria in carious lesion could be eliminated, demineralized tissue could be retained and pulpal exposure could be avoided, particularly in case of deep carious lesions. Photodynamic therapy involves the use of photoactive dye that is activated by irradiation with light of an adequate wavelength causing the generation of cytotoxic species, such as singlet oxygen and free radicals. In order to evaluate in vivo the effectiveness of the therapy, remaining carious dentine of deep cavitated lesions on permanent molars (n=26) were treated with 0.01% methylene blue dye and irradiated with a low power diode laser (= 660 nm) for 90 seconds. Samples of dentine from pulpal wall were collected with a micropunch immediately before and after the therapy and kept in VGMA III transport medium for microbiological analysis. Samples were then cultured in Brucella blood agar, Mitis Salivarius Bacitracin agar and Rogosa agar plates to determine the total viable, S. mutans and Lactobacillus spp. counts, respectively. After incubation, the number of colony-forming units was counted and the percentage of microbial reduction was calculated for each group of bacteria studied. Wilcoxon and Mann-Whitney tests showed that there was a statistically significant reduction (p<0,0001) of the dentin microflora after photodynamic therapy for the total of viable bacteria (76.03%), S. mutans (78.07%) and Lactobacillus spp. (78.0%) and that there was no statistic differences for its efficiency between groups (p>0,05). Photodynamic antimicrobial therapy can be considered an effective technique to kill bacteria present in dentine from deep carious lesions.

ASSUNTO(S)

fotoquimioterapia bactérias dental caries photochemotherapy cárie dentária bacteria

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