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Nunes GP, de Oliveira Alves R, Ragghianti MHF, Martins TP, Dos Reis Prado AH, Nunes LP, Poli MCF, Silva ANA, Benetti F. Antimicrobial photodynamic therapy in the nonsurgical treatment of periodontitis in patients with HIV infection: a systematic review and meta-analysis. Lasers Med Sci 2024; 39:155. [PMID: 38865020 DOI: 10.1007/s10103-024-04087-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 05/15/2024] [Indexed: 06/13/2024]
Abstract
The aim of this systematic review and meta-analysis (SRM) was to evaluate the effectiveness of the adjunctive use of antimicrobial photodynamic therapy (aPDT) in non-surgical periodontal treatment (NSPT) in subjects with Human Immunodeficiency Virus (HIV) and periodontitis. This SRM was registered in PROSPERO (CRD42023410180) and followed the guidelines of PRISMA 2020. Searches were performed in different electronic databases. Risk of bias was performed using the Cochrane Risk of Bias tool (RoB 2.0) for randomized clinical trials (RCT). Meta-analysis was performed using Rev Man software. The mean difference (MD) measure of effect was calculated, the random effect model was applied with a 95% confidence interval, and heterogeneity was tested by the I2 index. The certainty of the evidence was rated using GRADE. A total of 1118 records were screened, and four studies were included. There was a greater reduction in the microbial load of periodontopathogens after NSPT with aPDT. Meta-analysis showed that probing depth (post 3 and 6 months) and clinical attachment loss (post 6 months) were lower for the aPDT-treated group than the NSPT alone: MD -0.39 [-0.74; -0.05], p = 0.02; MD -0.70 [-0.99; -0.41], p < 0.0001; MD -0.84 [-1,34; -0.34], p = 0.0001, respectively. Overall, the studies had a low risk of bias and, the certainty of evidence was rated as moderate. It is suggested that aPDT is a promising adjuvant therapy, showing efficacy in the reduction of the microbial load and in some clinical parameters of individuals with periodontitis and HIV.
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Affiliation(s)
- Gabriel Pereira Nunes
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil.
| | - Renata de Oliveira Alves
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Matheus Henrique Faccioli Ragghianti
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Tamires Passadori Martins
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Alexandre Henrique Dos Reis Prado
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
| | - Larissa Pereira Nunes
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Maria Clara Faria Poli
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University (UNESP), Rua José Bonifácio 1193, Araçatuba, SP, 16015-050, Brazil
| | - Arles Naisa Amaral Silva
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Francine Benetti
- Department of Restorative Dentistry, School of Dentistry, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil
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Nunes LP, Nunes GP, Ferrisse TM, Strazzi-Sahyon HB, Dezan-Júnior E, Cintra LTA, Sivieri-Araujo G. A systematic review and meta-analysis on the effects of phototherapy on postoperative pain in conventional endodontic reintervention. Clin Oral Investig 2024; 28:232. [PMID: 38556608 DOI: 10.1007/s00784-024-05623-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 03/17/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES This systematic review and meta-analysis (SRM) aimed to evaluate the efficacy of laser phototherapy (LPT) on the reduction in postoperative pain (PP) of endodontic origin after conventional/non-surgical reintervention of root canals. METHODS This SRM was registered with PROSPERO (CRD42021243500) and followed the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Meta-analysis was conducted using R software with the "META" package, the mean difference (MD) measure of effect was calculated, and the fixed effect model was applied with a 95% confidence interval (CI). The Cochrane collaboration scale was used to assess the risk of bias and the GRADE tool to assess the quality of evidence. RESULTS Initially, 1028 articles were found, and five articles were included. Most studies were classified as "low" risk of bias. Of the five clinical studies, four showed a significant decrease in PP after endodontic reintervention in the LPT groups compared to the control group, especially in the first four days after the intervention. In symptomatic teeth with multiple roots, LPT led to less PP at 24 h (MD -0.52 [-1.03; -0.02] p = .04). However, no significant difference between the groups was found at 48 and 72 h (p > .05). The certainty of the evidence was classified as low. CONCLUSION Despite the limitations of this SRM, LPT was shown to be a promising alternative for reducing and controlling PP in conventional endodontic reintervention. CLINICAL SIGNIFICANCE The use of LPT in endodontic reintervention may be a safe and promising alternative to clinically efficacious agent for use in the management of PP in this procedure.
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Affiliation(s)
- Larissa Pereira Nunes
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio, Araçatuba, SP, Brazil
| | - Gabriel Pereira Nunes
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio, Araçatuba, SP, Brazil.
| | - Túlio Morandin Ferrisse
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Henrico Badaoui Strazzi-Sahyon
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Eloi Dezan-Júnior
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio, Araçatuba, SP, Brazil
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio, Araçatuba, SP, Brazil
| | - Gustavo Sivieri-Araujo
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Rua José Bonifácio, Araçatuba, SP, Brazil
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Cintra LTA, Cantiga-Silva C, Banci HA, Faria FD, da Silva Machado NE, Cardoso CDBM, de Oliveira PHC, Estrela LRDA, Sivieri-Araujo G, Berbert FLCV, Garcia AJA, Leonardo RDT. Influence of photoactivation on tissue response to different dyes used in photodynamic therapy and laser ablation therapy. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY. B, BIOLOGY 2024; 251:112843. [PMID: 38262341 DOI: 10.1016/j.jphotobiol.2024.112843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/27/2023] [Accepted: 01/08/2024] [Indexed: 01/25/2024]
Abstract
Laser ablation therapy (LA) uses Indocyanine Green dye (ICG) which efficiently absorbs laser energy and the increased temperature results in an instantaneous flame that chars tissue and microbes. Photodynamic therapy (PDT) uses different dyes that are activated by light to kill bacteria. This study evaluated the biocompatibility of the dye Curcumin (CUR), Methylene Blue (MB), and Indocyanine Green (ICG) before and after laser activation (ACT). Polyethylene tubes containing one of the dyes were implanted in the subcutaneous tissue of 32 rats (4 tubes per rat) which were divided into 8 groups: C - control (saline solution); C + ACT (Red Laser 660 nm); CUR; CUR + ACT (480 nm blue LED); MB; MB + ACT (Red Laser 660 nm); ICG; ICG + ACT (810 nm Infrared Laser). After 7 and 30 days (n = 8/time), the rats were euthanized and the tubes with the surrounding tissue were removed and processed for histological analysis of inflammation using H&E stain, and collagen fiber maturation using picrosirius red (PSR). A two-way analysis of variance statistical test was applied (p < 0.05). At 7 days, regardless of laser activation, the CUR group showed a greater inflammatory infiltrate compared to the ICG and control groups, and the MB group had a greater inflammation only in relation to the control (p < 0.05). At 30 days, CUR and MB groups showed a greater inflammatory infiltrate than the control (p < 0.05). ICG group was equal to the control in both periods, regardless of the laser activation (p > 0.05). Laser activation induced the proliferation of collagen immature fibers at 7 days, regardless of the dye (p < 0.05). The CUR group showed a lower percentage of immature and mature fibers at 7 days, compared to ICG and control (p < 0.05) and, at 30 days, compared to control (p < 0.05). Regardless of laser activation, the ICG showed the results of collagen maturation closest to the control (p > 0.05). It was concluded that all dyes are biocompatible and that laser activation did not interfere with biocompatibility. In addition, the maturity of collagen was adequate before and after the laser activation. These results demonstrate that the clinical use of dyes is safe even when activated with a laser.
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Affiliation(s)
- Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil.
| | - Cristiane Cantiga-Silva
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Henrique Augusto Banci
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Flávio Duarte Faria
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | - Nathália Evelyn da Silva Machado
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | | | | | | | - Gustavo Sivieri-Araujo
- Department of Preventive and Restorative Dentistry, São Paulo State University (UNESP), School of Dentistry, Araçatuba, SP, Brazil
| | | | | | - Renato de Toledo Leonardo
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
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Vieira SM, Mima EGDO, Honório HM, Moher D, Drugowick LMH, Stabili MRG, Dovigo LN. A protocol for an overview of systematic reviews to map photodynamic inactivation evidence in different dental specialties. Photochem Photobiol Sci 2024; 23:387-394. [PMID: 38341812 DOI: 10.1007/s43630-023-00523-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 12/13/2023] [Indexed: 02/13/2024]
Abstract
This is a protocol for an overview to summarize the findings of Systematic Reviews (SR) dealing with Photodynamic Inactivation (PDI) for control of oral diseases. Specific variables of oral infectious will be considered as outcomes, according to dental specialty. Cochrane Database of Systematic Reviews (CDSR), MEDLINE, LILACS, Embase, and Epistemonikos will be searched, as well as reference lists. A search strategy was developed for each database using only terms related to the intervention (PDI) aiming to maximize sensitivity. After checking for duplicate entries, selection of reviews will be performed in a two-stage technique: two authors will independently screening titles and abstracts, and then full texts will be assessed for inclusion/exclusion criteria. Any disagreement will be resolved through discussion and/or consultation with a third reviewer. Data will be extracted following the recommendations in Chapter V of Cochrane Handbook and using an electronic pre-specified form. The evaluation of the methodological quality and risk of bias (RoB) of the SR included will be carried out using the AMSTAR 2 and ROBIS. Narrative summaries of relevant results from the individual SR will be carried out and displayed in tables and figures. A specific summary will focus on PDI parameters and study designs, such as the type and concentration of photosensitizer, pre-irradiation time, irradiation dosimetry, and infection or microbiological models, to identify the PDI protocols with clinical potential. We will summarize the quantitative results of the SRs narratively.
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Affiliation(s)
- Sâmmea Martins Vieira
- Department of Social Dentistry, School of Dentistry, São Paulo State University (UNESP), Rua Humaitá 1680, Araraquara, SP, CEP 14801-903, Brazil
| | - Ewerton Garcia de Oliveira Mima
- Department of Dental Materials and Prosthodontics, School of Dentistry, São Paulo State University (UNESP), Araraquara, SP, Brazil
| | - Heitor Marques Honório
- Department of Pediatric Dentistry, Orthodontics and Collective Health, School of Dentistry, University of São Paulo (USP), Bauru, SP, Brazil
| | - David Moher
- Ottawa Hospital Research Institute, Centre for Journalology, Ottawa, Canada
| | - Lara Maria Herrera Drugowick
- State University of Campinas (UNICAMP), Institute of Mathematics, Statistics and Scientific Computing, Campinas, SP, Brazil
| | | | - Lívia Nordi Dovigo
- Department of Social Dentistry, School of Dentistry, São Paulo State University (UNESP), Rua Humaitá 1680, Araraquara, SP, CEP 14801-903, Brazil.
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Pažin B, Lauc T, Bago I. Effect of photodynamic therapy on the healing of periapical lesions after root canal retreatment: 1-year follow up randomized clinical trial. Photodiagnosis Photodyn Ther 2024; 45:103907. [PMID: 38013016 DOI: 10.1016/j.pdpdt.2023.103907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 11/22/2023] [Accepted: 11/22/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND The aim of this randomized clinical trial was to evaluate the effects of photodynamic therapy (PDT) after traditional activated final irrigation protocol (ultrasonically activated irrigation, UAI) on periapical lesion healing after single-visit root canal retreatment. METHODS We included 36 patients with asymptomatic chronic apical periodontitis with periapical lesions larger than 5 mm and teeth sensitive to percussion and palpation, who had previous root canal treatment. All patients who signed informed consent underwent cone-beam computed tomography (CBCT) to determine and calculate the preoperative volume of the periapical lesion. Patients were randomly distributed into two groups according to the final disinfection protocol: Group 1; UAI (NaOCl, EDTA, and NaOCl), Group 2; UAI + PDT. All patients underwent single-visit root canal retreatment using rotary instrumentation and standardized irrigation (3 %NaOCl) by the same endodontist. The root canals were filled with epoxy resin-based sealer and single-cone gutta-percha, followed by control radiography. After one year, a new CBCT scan of the teeth was performed to calculate the reduction in the initial periapical lesion as a measure of periapical healing. For the statistical analysis, the chi-square test variants, Fisher's exact test and the Fisher-Freeman-Halton test were used at the level of significance set at 5 %. RESULTS There were no significant differences between the groups in terms of age, sex, preoperative and postoperative lesion volume (p > 0.05), and reduction of periapical lesion volume (median, 86.98 % for UAI and 79.72 % for UAI+PDT) (p = 0.970). Additional use of PDT after UAI did not contribute to the healing of periapical lesions. CONCLUSION The UAI and UAI+PDT protocols had equal effects on healing of periapical lesion.
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Affiliation(s)
- Boris Pažin
- Department of Endodontics, Oral Patology and Periodontology, Dental Polyclinic Zagreb, Croatia
| | | | - Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb 10 000, Croatia.
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Heyder M, Reise M, Burchardt J, Guellmar A, Beck J, Schulze-Späte U, Sigusch B, Kranz S. Photodynamic Suppression of Enterococcus Faecalis in Infected Root Canals with Indocyanine Green, Trolox TM and Near-Infrared Light. Pharmaceutics 2023; 15:2572. [PMID: 38004551 PMCID: PMC10674481 DOI: 10.3390/pharmaceutics15112572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/16/2023] [Accepted: 10/29/2023] [Indexed: 11/26/2023] Open
Abstract
Recently, our group showed that additional supplementation of Trolox™ (vitamin E analogue) can significantly enhance the antimicrobial photodynamic effect of the photosensitizer Indocyanine green (ICG). Up to now, the combined effect has not yet been investigated on Enterococcus faecalis in dental root canals. In the present in vitro study, eighty human root canals were inoculated with E. faecalis and subsequently subjected to antimicrobial Photodynamic Therapy (aPDT) using ICG (250, 500, 1000 µg/mL) and near-infrared laser light (NIR, 808 nm, 100 Jcm-2). Trolox™ at concentrations of 6 mM was additionally applied. As a positive control, irrigation with 3% NaOCl was used. After aPDT, root canals were manually enlarged and the collected dentin debris was subjected to microbial culture analysis. Bacterial invasion into the dentinal tubules was verified for a distance of 300 µm. aPDT caused significant suppression of E. faecalis up to a maximum of 2.9 log counts (ICG 250 µg/mL). Additional application of TroloxTM resulted in increased antibacterial activity for aPDT with ICG 500 µg/mL. The efficiency of aPDT was comparable to NaOCl-irrigation inside the dentinal tubules. In conclusion, ICG significantly suppressed E. faecalis. Additional application of TroloxTM showed only minor enhancement. Future studies should also address the effects of TroloxTM on other photodynamic systems.
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Affiliation(s)
| | | | | | | | | | | | | | - Stefan Kranz
- Department of Conservative Dentistry and Periodontology, University Hospital Jena, An der Alten Post 4, 07743 Jena, Germany; (M.H.); (M.R.); (J.B.); (A.G.); (J.B.); (U.S.-S.); (B.S.)
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Alaqeel SM, Moussa IM, Altinawi A, Almozainy M, Hashem M. Antibacterial effectiveness of photo-sonodynamic treatment by methylene blue-incorporated poly(D, L-lactide-co-glycolide) acid nanoparticles to disinfect root canals. Photodiagnosis Photodyn Ther 2023; 43:103692. [PMID: 37419191 DOI: 10.1016/j.pdpdt.2023.103692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 06/30/2023] [Accepted: 07/05/2023] [Indexed: 07/09/2023]
Abstract
AIM This in-vitro investigation aimed to assess the antibacterial effectiveness of photo-sonodynamic treatment using methylene blue (MTB)-incorporated poly(D, L-Lactide-Co-Glycolide) acid (PLGA)-nanoparticles for the disinfection of root canals. METHODS The synthesis of PLGA nanoparticles was achieved using a solvent displacement technique. The morphological and spectral characterization of the formulated PLGA nanoparticles were carried out using scanning electron microscopy (SEM) and Transformed-Fourier infrared spectroscopy (TFIR), respectively. One hundred human premolar teeth were sterilized and then their root canals were infected with Enterococcus faecalis (E. faecalis). Later, the bacterial viability evaluation of the following 5 research groups was conducted: (a) G-1: specimens treated with a diode laser; (b) G-2: specimens treated with antimicrobial photodynamic therapy (aPDT) and 50 µg/mL of MTB-incorporated PLGA nanoparticles; (c) G-3: specimens treated with ultrasound (US); (d) G-4: specimens treated with US and 50 µg/mL of MTB-incorporated PLGA nanoparticles; and (e) G-5: control group consisting of specimens that did not undergo any treatment. RESULTS Under SEM, the nanoparticles exhibited a uniform spherical shape and were around 100 nm. The formulated nanoparticles' size was validated through zeta potential analysis utilizing dynamic light scattering (DLS). The TFIR images of both PLGA nanoparticles and MTB-incorporated PLGA nanoparticles exhibited absorption bands ranging from around 1000 to 1200/cm and nearly from 1500 to 1750/cm. The G-5 samples (control group) demonstrated the greatest viability against E. faecalis, followed by G-3 (US-conditions specimens), G-1 (diode laser-conditioned specimens), G-2 (aPDT + MTB-incorporated PLGA-nanoparticles-conditioned specimens), and G-5 (US + MTB-incorporated PLGA-nanoparticles-conditioned specimens). Significant statistical differences (p < 0.05) were observed among all research groups, including both the experimental groups and control group. CONCLUSION The combination of US via MTB-incorporated PLGA nanoparticles exhibited the most effective eradication of E. faecalis, suggestive of a promising therapeutic modality against E. faecalis for disinfecting root canals with complex and challenging anatomy.
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Affiliation(s)
- Samer M Alaqeel
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, 11433, Saudi Arabia
| | - Ihab M Moussa
- Dental Biomaterials Department, College of Dentistry, King Saud University, Riyadh, 11433, Saudi Arabia
| | - Amir Altinawi
- Biomedical Technology Department, College of Applied Medical Sciences, King Saud University, Riyadh, 11433, Saudi Arabia
| | - Mayyadah Almozainy
- Restorative Dental Science Department, College of Dentistry, King Saud University, Riyadh, 11433, Saudi Arabia
| | - Mohamed Hashem
- Dental Health Department, College of Applied Medical Sciences, King Saud University, Riyadh, 11433, Saudi Arabia.
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Asnaashari M, Veshveshadi O, Aslani F, Hakimiha N. Evaluation the antibacterial efficacy of sodium hypochlorite in combination with two different photodynamic therapy protocols against Enterococcus Faecalis in Infected root canals: An in-vitro experiment. Photodiagnosis Photodyn Ther 2023; 43:103722. [PMID: 37487810 DOI: 10.1016/j.pdpdt.2023.103722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/16/2023] [Accepted: 07/21/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Photodynamic therapy (PDT) is an antimicrobial approach that can be used as an adjunctive safe technique for root canal disinfection. In this study, we aimed to evaluate the antibacterial efficacy of PDT with indocyanine green and toluidine blue in combination with sodium hypochlorite (NaOCl) in compared with NaOCl alone against Enterococcus faecalis in infected root canals. METHODS Sixty five root canals of sound human premolars were collected. First, the teeth were sterilized, then 60 root canals were inoculated with the E. faecalis, and 5 samples served as negative control remained uncontaminated. The contaminated root canals were randomly assigned into 4 experimental groups (n=15): (1) NaOCl, (2) NaOCl+ PDT-1 (toluidine blue + 630nm LED), (3) NaOCl+ PDT-2 (indocyanine green + 808nm diode laser), and (4): positive control (no treatment). Then, the colony-forming units (CFU/mL) of E. faecalis were calculated in all the groups. Moreover, 5 samples from each group were examined under a scanning electron microscope. The data were analyzed by independent T-test and the Mann-Whitney U test at the significance level of 0.05. RESULTS The CFU count was significantly lower in the indocyanine green-PDT group in comparison with other groups (p˂0.05). The mean of CFU in the positive control group was significantly higher than the other groups (p˂0.05). No significant difference was detected between NaOCl and toluidine blue -PDT group (p=1.00). CONCLUSION Indocyanine green- PDT improved the antibacterial effects of NaOCl against E. faecalis, while toluidine blue - mediated PDT had no significant additional effect on NaOCl.
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Affiliation(s)
- Mohammad Asnaashari
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Endodontic Department, Dental school, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | - Neda Hakimiha
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Sologova D, Petukhova M, Podoplelova P, Davletshin D, Firsova A, Grishin A, Grin M, Suvorov N, Vasil’ev Y, Dydykin S, Rysanova E, Shchelkova V, Tarasenko S, Diachkova E. Effectiveness of Photodynamic Therapy as Antiseptic Measure for Oral Cavity and Pharynx: A Systematic Review. Dent J (Basel) 2023; 11:192. [PMID: 37623288 PMCID: PMC10453266 DOI: 10.3390/dj11080192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/31/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND The complex traditional treatment of inflammation diseases in oral cavity includes the prescription of antibiotic and antiseptic therapy. This systematic review aims to evaluate the effect of photodynamic therapy as a part of management of inflammatory diseases in oral cavity; Methods: The study is presented in accordance with the preferred reporting points for systematic reviews and meta-analyses (PRISMA). This systematic review was conducted using electronic databases such as Medline PubMed, Scopus and the Cochrane Central Register of Controlled Trials. All the studies in this systematic review, were randomized, the risk of bias 2 (ROB 2) were assessed; Results: Considering the inclusion and exclusion criteria, we included 10 randomized clinical trials, published up to 2023 investigating the application of photodynamic therapy as a part of management of inflammatory diseases in oral cavity. The diode laser was used in the oral cavity in the zone of inflammatory process (gingivitis, mucositis, periimplantitis, marginal periodontitis, abscess, periostitis, osteomyelitis etc.) in nine studies or in the zone before surgical procedures in one study; Conclusion: Based on the results of clinical studies, it can be stated that photodynamic therapy shows good results for operations performed in the oral cavity and pharynx.
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Affiliation(s)
- Diana Sologova
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia; (M.P.); (P.P.); (D.D.); (A.F.); (S.T.); (E.D.)
| | - Marina Petukhova
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia; (M.P.); (P.P.); (D.D.); (A.F.); (S.T.); (E.D.)
| | - Polina Podoplelova
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia; (M.P.); (P.P.); (D.D.); (A.F.); (S.T.); (E.D.)
| | - Dinislam Davletshin
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia; (M.P.); (P.P.); (D.D.); (A.F.); (S.T.); (E.D.)
| | - Anna Firsova
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia; (M.P.); (P.P.); (D.D.); (A.F.); (S.T.); (E.D.)
| | - Andrey Grishin
- Maxillofacial Surgery Department, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Street 8\2, 119991 Moscow, Russia;
| | - Mikhail Grin
- Department of Chemistry and Technology of Biologically Active Compounds, Medicinal and Organic Chemistry, Institute of Fine Chemical Technologies, MIREA-Russian Technological University, 86 Vernadsky Avenue, 119571 Moscow, Russia; (M.G.); (N.S.)
| | - Nikita Suvorov
- Department of Chemistry and Technology of Biologically Active Compounds, Medicinal and Organic Chemistry, Institute of Fine Chemical Technologies, MIREA-Russian Technological University, 86 Vernadsky Avenue, 119571 Moscow, Russia; (M.G.); (N.S.)
| | - Yuriy Vasil’ev
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Street bldg. 8\2, 119435 Moscow, Russia; (Y.V.); (S.D.)
| | - Sergey Dydykin
- Department of Operative Surgery and Topographic Anatomy, I.M. Sechenov First Moscow State Medical University (Sechenov University), Trubetskaya Street bldg. 8\2, 119435 Moscow, Russia; (Y.V.); (S.D.)
| | - Elena Rysanova
- Moscow Regional Research and Clinical Institute, Street Schepkina 61/2, 129110 Moscow, Russia; (E.R.); (V.S.)
| | - Victoria Shchelkova
- Moscow Regional Research and Clinical Institute, Street Schepkina 61/2, 129110 Moscow, Russia; (E.R.); (V.S.)
| | - Svetlana Tarasenko
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia; (M.P.); (P.P.); (D.D.); (A.F.); (S.T.); (E.D.)
| | - Ekaterina Diachkova
- Department of Oral Surgery of the Institute of Dentistry, I.M. Sechenov First Moscow State Medical University (Sechenov University), 119048 Moscow, Russia; (M.P.); (P.P.); (D.D.); (A.F.); (S.T.); (E.D.)
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10
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Chalub LO, Nunes GP, Strazzi-Sahyon HB, Ferrisse TM, Dos Santos PH, Gomes-Filho JE, Cintra LTA, Sivieri-Araujo G. Antimicrobial effectiveness of ultrasonic irrigation in root canal treatment: a systematic review of randomized clinical trials and meta-analysis. Clin Oral Investig 2023; 27:1343-1361. [PMID: 36757461 DOI: 10.1007/s00784-023-04897-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 02/01/2023] [Indexed: 02/10/2023]
Abstract
OBJECTIVE The objective of this systematic review and meta-analysis (SRM) was to answer the question as to whether the use of ultrasonic irrigation (UI) results in better antimicrobial activity in root canal disinfection compared to conventional irrigation (CI). METHODS A literature search was performed in the main scientific databases, carried out until October 2021. The eligibility criteria were randomized clinical trials (RCTs). Two meta-analyses were conducted using R software with the "META" package. The mean difference (MD) and odds ratio (OR) measure of effect were calculated. The fixed effect model was applied with a 95% confidence interval. The Cochrane collaboration scale was used to assess risk of bias and the GRADE tool to assess the quality of evidence. RESULTS A total of 1782 records were screened, and 12 studies meeting the criteria were included in this review. A low risk of bias was observed for most domains, except allocation concealment that was considered unclear. The certainty of evidence was classified as moderate in the OR meta-analyses and low in the MD meta-analyses. Ultrasonic irrigation resulted in a better antimicrobial effect in both meta-analyses, MD 1.42 [1.60; 1.23] p < 0.0001, I2 = 80%; and OR 3.86 [1.98; 7.53] p< 0.0001, I2 = 28.7%. CONCLUSION Within the limitations of this SRM, UI presented better antimicrobial efficacy than CI. CLINICAL RELEVANCE UI should be used by clinicians as it promotes better antimicrobial efficacy in patients undergoing endodontic treatment.
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Affiliation(s)
- Lucas Orbolato Chalub
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, 1193 José Bonifácio Street, Araçatuba, SP, 16015-050, Brazil
| | - Gabriel Pereira Nunes
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, 1193 José Bonifácio Street, Araçatuba, SP, 16015-050, Brazil
| | - Henrico Badaoui Strazzi-Sahyon
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, 1193 José Bonifácio Street, Araçatuba, SP, 16015-050, Brazil
| | - Túlio Morandin Ferrisse
- Oral Medicine, Department of Diagnosis and Surgery, Araraquara School of Dentistry, São Paulo State University - UNESP, 1680 Humaitá Street, Araraquara, SP, 14801-385, Brazil
| | - Paulo Henrique Dos Santos
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, 1193 José Bonifácio Street, Araçatuba, SP, 16015-050, Brazil
| | - João Eduardo Gomes-Filho
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, 1193 José Bonifácio Street, Araçatuba, SP, 16015-050, Brazil
| | - Luciano Tavares Angelo Cintra
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, 1193 José Bonifácio Street, Araçatuba, SP, 16015-050, Brazil
| | - Gustavo Sivieri-Araujo
- Department of Preventive and Restorative Dentistry, Araçatuba School of Dentistry, São Paulo State University - UNESP, 1193 José Bonifácio Street, Araçatuba, SP, 16015-050, Brazil.
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Efficacy of 5% Aminolaevulinic Acid and Red Light on Enterococcus faecalis in Infected Root Canals. Gels 2023; 9:gels9020125. [PMID: 36826295 PMCID: PMC9957220 DOI: 10.3390/gels9020125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 01/25/2023] [Accepted: 01/31/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND In this ex vivo study, the aim was to evaluate the effects of ALAD and red light on Enterococcus faecalis in infected root canals using a special intracanal fiber. METHODS A total of 70 extracted, single-rooted teeth were used. The teeth were decoronated at the length of the roots to approximately 15 mm and then instrumented. The apical foramen was sealed by composite resin, and the root canals were infected with a pure culture of E. faecalis ATCC 29212 for eight days at 37 °C. Following the contamination period, the roots were divided into seven groups, including the positive and negative control groups, and treated as follows: ALAD 45 min; red light activation 7 min; ALAD 45 min and red-light activation 7 min; sodium hypochlorite 2.5% 15 min; sodium hypochlorite 1% 15 min. The samples were taken by three sterile paper points, transferred to tubes containing 1 mL of PBS, and immediately processed for the number of colony-forming units and the cell viability by using live/dead. RESULTS The best treatment is obtained with 2.5% NaOCl. Except for ALAD + red light vs. 1% NaOCl, a statistically significant difference is recorded for all treatments. The combination of 2.5% NaOCl and ALAD + 7 min irradiation produces an evident killing effect on the E. faecalis cells. On the other hand, 1% NaOCl is ineffective for the viability action, with 25% of dead cells stained in red. CONCLUSIONS This ex vivo study shows that ALAD gel with light irradiation is an efficacious protocol that exerts a potent antibacterial activity against E. faecalis in infected root canals.
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12
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Effect of antimicrobial photodynamic therapy on the reduction of bacteria and virulence factors in teeth with primary endodontic infection. Photodiagnosis Photodyn Ther 2023; 41:103292. [PMID: 36681260 DOI: 10.1016/j.pdpdt.2023.103292] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/08/2023] [Accepted: 01/13/2023] [Indexed: 01/20/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of supplemental photodynamic therapy for improving the bacterial removal and the levels of lipopolysaccharide (LPS) and lipoteichoic acid (LTA) by conducting a clinical trial. METHODOLOGY Twenty-four root canals with pulp necrosis and periapical lesion were selected and randomly divided into conventional group using endodontic treatment with chemo-mechanical preparation (CMP) alone (n = 12) and a group using antimicrobial photodynamic therapy (aPDT) after CMP (n = 12). The samples were collected before and after CMP (conventional group) and after photodynamic therapy (aPDT group). A photosensitizer (0.005% methylene blue) was applied to the root canal for 3 minutes after CMP, whereas aPDT was performed by using a red laser with a power of 30Mw and energy density of 9J/cm2 for 90 s per root canal. Culture technique was performed to determine the bacterial colony forming units. LPS and LTA levels were quantified by using limulus amoebocyte lysate (LAL) assay and enzyme-linked immunosorbent assay (ELISA), respectively. RESULTS All samples showed growth of viable bacteria on Fastidious Anaerobe Agar (FAA), with an average of 5.19 × 105 CFU/ mL. CMP was effective in decreasing viable bacteria (p < 0.05), whereas there was a significant decrease (p < 0.05) in the samples treated with aPDT compared to those submitted to CMP. LPS and LTA were detected in all initial samples, with mean values of 20.561 EU/mL and 430.91 pg/mL, respectively. Both CMP and aPDT groups significantly decreased the levels of LPS and LTA (p < 0.05), with a statistical difference between the groups regarding aPDT (p < 0.05). CONCLUSION Photodynamic therapy as an adjunct to CMP proved to be effective in improving root canal disinfection and reducing the LPS and LTA levels in teeth with primary endodontic infection.
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Banci HA, Strazzi-Sahyon HB, Bento VAA, Sayeg JMC, Bachega MDO, Pellizzer EP, Sivieri-Araujo G. Influence of antimicrobial photodynamic therapy on the bond strength of endodontic sealers to intraradicular dentin: A systematic review and meta-analysis. Photodiagnosis Photodyn Ther 2022; 41:103270. [PMID: 36596331 DOI: 10.1016/j.pdpdt.2022.103270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/17/2022] [Accepted: 12/30/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND The objective of this systematic review and meta-analysis (SRMA) was to investigate the influence of antimicrobial photodynamic therapy (aPDT) on the bond strength of endodontic sealers to intraradicular dentin. METHODS This SRMA followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and was registered in the International Prospective Registry of Systematic Reviews (PROSPERO) (CRD42022319856). A population, intervention, control, and outcome (PICO) question was formulated: "Does antimicrobial photodynamic therapy decrease the bond strength of root canal sealers?". A literature search was performed in PubMed/MEDLINE, Embase, Web of Science, Scopus, Cochrane Library, and ProQuest databases until July 2022. Joanna Briggs Institute Critical Assessment Guidelines for Quasi-Experimental Studies were used for quality assessment. The meta-analysis was based on the inverse variance (IV) method (p<0.05). RESULTS Out of an initial 345 articles, 8 in vitro studies were included, published between 2013 and 2022. The studies were qualitatively analyzed; two studies showed a positive effect, two studies a negative effect, and the other studies showed no effect on bond strength of endodontic sealers to intraradicular dentin. Seven of the studies were included in the SRMA, which indicated that there was no significant difference in bond strength when using aPDT (P = 0.90; MD: -0.03; 95% CI: -0.46 to -0.41). There was a high level of evidence for each meta-analysis outcome. CONCLUSION It can be concluded that the use of aPDT as a method of root canal disinfection does not negatively influence the bond strength of endodontic sealers in the root canal.
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Affiliation(s)
- Henrique Augusto Banci
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Henrico Badaoui Strazzi-Sahyon
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Victor Augusto Alves Bento
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - João Mateus Cavalaro Sayeg
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Mariana de Oliveira Bachega
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Eduardo Piza Pellizzer
- Department of Dental Materials and Prosthodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil
| | - Gustavo Sivieri-Araujo
- Department of Preventive and Restorative Dentistry, Discipline of Endodontics, Araçatuba School of Dentistry, São Paulo State University - UNESP, Araçatuba, SP, Brazil.
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Ferrisse TM, Dias LM, de Oliveira AB, Jordão CC, Mima EGDO, Pavarina AC. Efficacy of Antimicrobial Photodynamic Therapy Mediated by Photosensitizers Conjugated with Inorganic Nanoparticles: Systematic Review and Meta-Analysis. Pharmaceutics 2022; 14:2050. [PMID: 36297486 PMCID: PMC9612113 DOI: 10.3390/pharmaceutics14102050] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/09/2022] [Accepted: 09/11/2022] [Indexed: 09/29/2023] Open
Abstract
Antimicrobial photodynamic therapy (aPDT) is a method that does not seem to promote antimicrobial resistance. Photosensitizers (PS) conjugated with inorganic nanoparticles for the drug-delivery system have the purpose of enhancing the efficacy of aPDT. The present study was to perform a systematic review and meta-analysis of the efficacy of aPDT mediated by PS conjugated with inorganic nanoparticles. The PubMed, Scopus, Web of Science, Science Direct, Cochrane Library, SciELO, and Lilacs databases were searched. OHAT Rob toll was used to assess the risk of bias. A random effect model with an odds ratio (OR) and effect measure was used. Fourteen articles were able to be included in the present review. The most frequent microorganisms evaluated were Staphylococcus aureus and Escherichia coli, and metallic and silica nanoparticles were the most common drug-delivery systems associated with PS. Articles showed biases related to blinding. Significant results were found in aPDT mediated by PS conjugated with inorganic nanoparticles for overall reduction of microorganism cultured in suspension (OR = 0.19 [0.07; 0.67]/p-value = 0.0019), E. coli (OR = 0.08 [0.01; 0.52]/p-value = 0.0081), and for Gram-negative bacteria (OR = 0.12 [0.02; 0.56/p-value = 0.0071). This association approach significantly improved the efficacy in the reduction of microbial cells. However, additional blinding studies evaluating the efficacy of this therapy over microorganisms cultured in biofilm are required.
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Affiliation(s)
- Túlio Morandin Ferrisse
- Department of Dental Materials and Prosthodontics, School of Dentistry at Araraquara, Universidade Estadual Paulista (UNESP), Araraquara 14801-903, SP, Brazil
| | - Luana Mendonça Dias
- Department of Dental Materials and Prosthodontics, School of Dentistry at Araraquara, Universidade Estadual Paulista (UNESP), Araraquara 14801-903, SP, Brazil
| | - Analú Barros de Oliveira
- Department of Morphology, Pediatric Dentistry and Orthodontic, School of Dentistry, São Paulo State University (UNESP), Araraquara 14801-903, SP, Brazil
| | - Cláudia Carolina Jordão
- Department of Dental Materials and Prosthodontics, School of Dentistry at Araraquara, Universidade Estadual Paulista (UNESP), Araraquara 14801-903, SP, Brazil
| | - Ewerton Garcia de Oliveira Mima
- Department of Dental Materials and Prosthodontics, School of Dentistry at Araraquara, Universidade Estadual Paulista (UNESP), Araraquara 14801-903, SP, Brazil
| | - Ana Claudia Pavarina
- Department of Dental Materials and Prosthodontics, School of Dentistry at Araraquara, Universidade Estadual Paulista (UNESP), Araraquara 14801-903, SP, Brazil
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