Antimicrobial photodynamic therapy on teeth with molar incisor hypomineralization-controlled clinical trial

Letícia Diniz Santos Vieira, Marco Aurelio Benini Paschoal, Pamella de Barros Motta, Elza Padilha Ferri, Caroline Diniz Pagani Vieira Ribeiro, Lourdes Aparecida Martins Dos Santos-Pinto, Lara Jansiski Motta, Marcela Letícia Leal Gonçalves, Anna Carolina Ratto Tempestini Horliana, Kristianne Porta Santos Fernandes, Raquel Agnelli Mesquita Ferrari, Alexandre Melo Deana, Sandra Kalil Bussadori, Letícia Diniz Santos Vieira, Marco Aurelio Benini Paschoal, Pamella de Barros Motta, Elza Padilha Ferri, Caroline Diniz Pagani Vieira Ribeiro, Lourdes Aparecida Martins Dos Santos-Pinto, Lara Jansiski Motta, Marcela Letícia Leal Gonçalves, Anna Carolina Ratto Tempestini Horliana, Kristianne Porta Santos Fernandes, Raquel Agnelli Mesquita Ferrari, Alexandre Melo Deana, Sandra Kalil Bussadori

Abstract

Background: Molar incisor hypomineralization (MIH) is a change in the formation of dental enamel of systemic origin that affects at least one of the first 4 permanent molars and usually affects incisors. During the eruption, the affected surfaces tend to fracture, exposing the dentin, which causes excessive sensitivity in addition to making the region very susceptible to the appearance of carious lesions. The objective of this research will be to evaluate the clinical effect of antimicrobial photodynamic therapy (aPDT) in permanent teeth with severe and sensitive MIH.

Methods: The methodology will be based on the selection of patients from 6 to 12 years of age with permanent molar teeth, randomly divided in 2 groups. The selected teeth should have MIH on the occlusal surface, indicated for clinical restorative treatment. In Group 1, aPDT will be applied for the treatment of infected dentin. Afterward, the teeth will be restored with high viscosity glass ionomer cement. In Group 2, the removal of the softened dentin around the side walls of the cavity with sharp dentine curettes and posterior restoration with high viscosity glass ionomer cement will be performed. All patients will have clinical and radiographic follow-up with a time interval of 6 and 12 months. The data obtained will be submitted to descriptive statistical analysis to evaluate the association of categorical variables. Chi-square test and Fisher exact test will be applied, to analyze the correlation between the continuous variables, Pearson correlation test will be applied. For the analysis of dentin density in the scanned radiographic images and the microbiological results for colony-forming units, ANOVA and Kruskal-Wallis will be applied.

Discussion: Often in the presence of severe MIH, the presence of dentin sensitivity is also associated with caries lesion, making it even more necessary to respect the principles of minimal intervention.

Trial registration: NCT03904641.

Conflict of interest statement

The authors have no conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Schedule of enrolment, interventions, and assessments of the present study.
https://www.ncbi.nlm.nih.gov/pmc/articles/instance/6775381/bin/medi-98-e17355-g003.jpg

References

    1. Fejerskov O, Kidd E. Dental Caries: the disease and its clinical treatment 1st edition Sao SUGA, S Enamel hypomineralization viewed from the pattern of progressive mineralization of human and monkey developing enamel. Adv Dent Res 1989;3:188–98.
    1. Weerheijm KL. Molar incisor hypomineralization (MIH): clinical presentation, aetiology and management. Dent Update 2004;31:9–12.
    1. Basso AP. Hipomineralização molar-incisivo &61; Molar incisor hypomineralization. Rev Odonto Ciência 2007;22:371–6.
    1. Weerheijm KL, Jalevik B, Alaluusua S. Molar incisor hypomineralisation. Caries Res 2001;35:390–1.
    1. Jalevik B. Prevalence and diagnosis of molar-incisor-hypomineralisation (MIH): a systematic review. Eur Archs Paediatr Dent 2010;11:59–64.
    1. Cabral RN, Nyvad B, Soviero VLVM, et al. Reliability and validity of a new classification of MIH based on severity. Clin Oral Investig 2019;[Epub ahead of print].
    1. Fernandes AS, Mesquita P, Vinhas L. Hipomineralizacão incisivo-molar: uma revisão da literatura. Rev Portuguesa Estomatol Medicina Dentária Cirurgia Maxilofac 2012;5:258–62.
    1. Fayle SA. Molar incisor hypomineralisation: restorative management. Eur J Paediatr Dent 2003;2:121–6.
    1. Ericson D. Minimally invasive dentistry. Oral Health Prev Dent 2003;2:91–2.
    1. Bussadori SK, Guedes CC, Bachiega JC, et al. Clinical and radiographic study of chemical-mechanical removal of caries using Papacárie: 24-month follow up. J Clin Pediatr Dent 2011;35:251–4.
    1. Frencken JE, Makoni E, Sithole WD. Atraumatic restorative treatment and glassionomer cement sealants in school oral health programme in Zimbabwe: evaluation after 1 year. Caries Res 1996;30:428–36.
    1. Matsumoto SF, Motta LJ, Alfaya TA, et al. Assessment of chemomechanical removal of carious lesions using Papacarie Duo™: randomized longitudinal clinical trial. Indian J Dent Res 2013;24:488.
    1. Anegundi RT, Patil SB, Tegginmani V, et al. A comparative microbiological study to assess caries excavation by conventional rotary method and a chemo-mechanical method. Contemp Clin Dent 2012;3:388–92.
    1. Kumar J, Nayak M, Prasad KL, et al. A comparative study of the clinical efficiency of chemomechanical caries removal using Carisolv and Papacarie—a papain gel. Indian J Dent Res 2012;23:697.
    1. Guglielmi C de A, Simionato MR, Ramalho KM, et al. Clinical use of photodynamic antimicrobial chemotherapy for the treatment of deep carious lesions. J Biomed Opt 2011;16:088003.
    1. Banerjee A, Frencken JE, Schwendicke F, et al. Contemporary operative caries management: consensus recommendations on minimally invasive caries removal. Br Dent J 2017;223:215.
    1. Innes NPT, Frencken JE, Bjørndal L, et al. Managing carious lesions: consensus recommendations on terminology. Adv Dent Res 2016;28:49–57.
    1. El-Tekeya M, El-Habashy L, Mokhles N, et al. Effectiveness of 2 chemomechanical caries removal methods on residual bacteria in dentin of primary teeth. Pediatr Dent 2012;34:325–30.
    1. Bijle MN, Patil S, Mumkekar SS, et al. Awareness of dental surgeons in Pune and Mumbai, India, regarding chemomechanical caries removal system. J Contemp Dent Pract 2013;14:96–9.
    1. Martins MD, Fernandes KP, Motta LJ, et al. Biocompatibility analysis of chemomechanical caries removal material Papacarie on cultured fibroblasts and subcutaneous tissue. J Dent Child (Chic) 2009;76:123–9.
    1. Bittencourt ST, Pereira JR, Rosa AW, et al. Mineral content removal after Papacarie application in primary teeth: a quantitative analysis. J Clin Pediatr Dent 2010;34:229–31.
    1. Bussadori SK, Guedes CC, Hermida BML, et al. Chemo-mechanical removal of caries in an adolescent patient using a papain gel: case report. J Clin Pediatr Dent 2008;32:177–80.
    1. Kochhar GK, Srivastava N, Pandit IK, et al. An evaluation of different caries removal techniques in primary teeth: a comparative clinical study. J Clin Pediatr Dent 2011;36:5–10.
    1. Tonami K, Araki K, Mataki S, et al. Effects of cloramines and sodium hypoclorite on carious dentin. J Med Dent Sci 2003;50:139–46.
    1. Cury JA, Tenuta LMA. Enamel remineralization: controlling the caries disease or treanting the early caries lesions? Braz Oral Res 2009;23(SpecIss 1):23–30.
    1. Silva ZS, JR, Huang YY, De Freitas LF, et al. Papain gel containing methylene blue for simultaneous caries removal and antimicrobial photoinactivation against Streptococcus mutans biofilms. Sci Rep 2016;6:33270.
    1. Beeley JA, Yip HK, Stevenson AG. Chemomechanical caries removal: a review of the techniques and latest developments. Br Dent J 2000;188:427–30.
    1. Costa-Santos L, Silva-Júnior ZS, Sfalcin RA, et al. The effect of antimicrobial photodynamic therapy on infected dentin in primary teeth: a randomized controlled clinical trial protocol. Medicine 2019;98:15.
    1. Walsh LJ. Dental lasers: some basic principles. Postgrad Dent 1994;4:26–9.
    1. Meserendio LJ, Pick Robert M. Lasers in dentistry Chicago: quintessence, 1995. J Am Dent Assoc 1995;126:1354–6.
    1. Goldman L, Goldman B, Van Lieu N. Current laser dentistry. Lasers Surg Med 1987;6:559–62.
    1. Wilson M. Photolysis of oral bacteria and its potential use in the treatment of caries and periodontal disease. J Appl Bacteriol 1993;75:299–306.
    1. Wilson M. Lethal photosensitization of oral bacteria and its potential application in the photodynamic therapy or oral infections. J Photochem Photobiol 2004;3:412–8.
    1. Maisch T, Baier J, Franz B, et al. The role of singlet oxygen and oxygen concentration in photodynamic inactivation of bacteria. PNAS 2007;104:7223–8.
    1. Garcez AS, Souza FR, Núñez SC, et al. Terapia Fotodinâmica em Odontologia – Laser de Baixa Potência para Redução Bacteriana. Revista APCD 2003;7:223–6.
    1. Mota ACC, Leal CRL, Olivan S, et al. Case report of photodynamic therapy in the treatment of dental caries on primary teeth. J Lasers Med Sci 2016;7:131–3.
    1. Wilson M, Dobson J, Harvey W. Sensitization of oral bacteria to killing by low-power laser radiation. Curr Microbiol 1992;25:77–81.
    1. Jensen MP, Karoly P, Braver S. The measurement of clinical pain intensity: a comparison of six methods. Pain 1986;27:117–26.
    1. Correa FN, Rocha Rde O, Rodrigues Filho LE, et al. Chemical versus conventional caries removal techniques in primary teeth: a microhardness study. J Clin Pediatr Dent 2007;31:187–92.
    1. Oliveira EF, Carminatti G, Fontanella V, et al. The monitoring of deep caries lesions after incomplete dentine caries removal: results after 14-18 month. Clin Oral Invest 2006;10:134–9.
    1. Hebling J, Giro EM, Costa CAS. Human pulp response after an adhesive system application in deep cavities. J Dent 1999;27:557–64.
    1. Reddy MS, Jeffcoat MK. Digital subtraction radiography. Dent Clin Of North Am 1993;37:553–65.
    1. Hope CK, Wilson M. Induction of lethal photosensitization in biofilms using a confocal scanning laser as the excitation source. J Antimicrob Chemother 2006;57:1227–30.
    1. Gröndahl H-G. A digital subtraction technique for dental radiography. Oral Surg Oral Medic Oral Path 1983;55:96–102.

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren