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Rubilar-Huenchuman M, Ortega-Villanueva C, González IA, Palavecino CE. The Effect of Photodynamic Therapy on Enterococcus spp. and Its Application in Dentistry: A Scoping Review. Pharmaceutics 2024; 16:825. [PMID: 38931945 PMCID: PMC11207625 DOI: 10.3390/pharmaceutics16060825] [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: 05/13/2024] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024] Open
Abstract
Enterococci spp. are Gram-positive bacteria that cause mild to severe infections, many associated with the oral cavity, such as periapical infections and healthcare-associated infections (HAIs). Many of these infections become serious diseases that are difficult to resolve, specifically when multidrug-resistant (MDR) strains cause them. In recent years, the number of MDR strains of Enterococcus spp. has increased significantly. This increased prevalence of MDR strains produces significant pressure to generate more antimicrobial therapies, but there is a decline in the production of new antibiotics, driving the development of complementary therapies, such as photodynamic therapy (PDT). PDT combines a photosensitizer agent (PS), light, and oxygen to cause photooxidative stress in bacterial cells. PDT can eradicate Enterococcus spp. contaminations, improve the classic cleaning processes, and eradicate the bacteria in dental pieces. PDT's effectiveness can be improved with nanoparticles that function as carriers. Our work aims to describe the advances in PDT against Enterococcus spp. as a complement to antibiotic therapy, focusing on infections by Enterococcus faecium and Enterococcus faecalis, dental hygiene, and using nanoparticles to improve the antimicrobial effect. A systematic bibliographic search without a meta-analysis was conducted on various databases, using inclusion and exclusion criteria to identify the most relevant research. Of the 193 non-redundant articles found, 65 were selected for a systematic review, from which a summary table was created and a manual description was made. Photodynamic therapy for treating E. faecium and E. faecalis is a widely studied area, with promising results concerning bactericidal effectiveness and reductions in biofilm formation, particularly in regard to dental hygiene. Because most of the studies were conducted in vitro or ex vivo, the results indicated that there were not sufficient data to initiate clinical trials for safety and efficacy studies on humans.
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Affiliation(s)
- Mariaignacia Rubilar-Huenchuman
- Laboratorio de Microbiología Celular, Facultad de Medicina y Ciencias de la Salud, Universidad Central de Chile, Lord Cochrane 418, Santiago 8330546, Chile; (M.R.-H.); (C.O.-V.)
| | - Camilo Ortega-Villanueva
- Laboratorio de Microbiología Celular, Facultad de Medicina y Ciencias de la Salud, Universidad Central de Chile, Lord Cochrane 418, Santiago 8330546, Chile; (M.R.-H.); (C.O.-V.)
| | - Iván A. González
- Departamento de Química, Facultad de Ciencias Naturales, Matemática y del Medio Ambiente, Universidad Tecnológica Metropolitana, Las Palmeras 3360, Ñuñoa, Santiago 7800003, Chile;
| | - Christian Erick Palavecino
- Laboratorio de Microbiología Celular, Facultad de Medicina y Ciencias de la Salud, Universidad Central de Chile, Lord Cochrane 418, Santiago 8330546, Chile; (M.R.-H.); (C.O.-V.)
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Liu H, Yu Y, Dong A, Elsabahy M, Yang Y, Gao H. Emerging strategies for combating Fusobacterium nucleatum in colorectal cancer treatment: Systematic review, improvements and future challenges. EXPLORATION (BEIJING, CHINA) 2024; 4:20230092. [PMID: 38854496 PMCID: PMC10867388 DOI: 10.1002/exp.20230092] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 11/16/2023] [Indexed: 06/11/2024]
Abstract
Colorectal cancer (CRC) is generally characterized by a high prevalence of Fusobacterium nucleatum (F. nucleatum), a spindle-shaped, Gram-negative anaerobe pathogen derived from the oral cavity. This tumor-resident microorganism has been closely correlated with the occurrence, progression, chemoresistance and immunosuppressive microenvironment of CRC. Furthermore, F. nucleatum can specifically colonize CRC tissues through adhesion on its surface, forming biofilms that are highly resistant to commonly used antibiotics. Accordingly, it is crucial to develop efficacious non-antibiotic approaches to eradicate F. nucleatum and its biofilms for CRC treatment. In recent years, various antimicrobial strategies, such as natural extracts, inorganic chemicals, organic chemicals, polymers, inorganic-organic hybrid materials, bacteriophages, probiotics, and vaccines, have been proposed to combat F. nucleatum and F. nucleatum biofilms. This review summarizes the latest advancements in anti-F. nucleatum research, elucidates the antimicrobial mechanisms employed by these systems, and discusses the benefits and drawbacks of each antimicrobial technology. Additionally, this review also provides an outlook on the antimicrobial specificity, potential clinical implications, challenges, and future improvements of these antimicrobial strategies in the treatment of CRC.
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Affiliation(s)
- Hongyu Liu
- State Key Laboratory of Separation Membranes and Membrane ProcessesSchool of Materials Science and EngineeringTiangong UniversityTianjinP. R. China
| | - Yunjian Yu
- State Key Laboratory of Separation Membranes and Membrane ProcessesSchool of Materials Science and EngineeringTiangong UniversityTianjinP. R. China
| | - Alideertu Dong
- College of Chemistry and Chemical EngineeringInner Mongolia UniversityHohhotP. R. China
| | - Mahmoud Elsabahy
- Department of PharmaceuticsFaculty of PharmacyAssiut UniversityAssiutEgypt
| | - Ying‐Wei Yang
- International Joint Research Laboratory of Nano‐Micro Architecture ChemistryCollege of ChemistryJilin UniversityChangchunP. R. China
| | - Hui Gao
- State Key Laboratory of Separation Membranes and Membrane ProcessesSchool of Materials Science and EngineeringTiangong UniversityTianjinP. R. China
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Afrasiabi S, Entezari S, Etemadi A, Chiniforush N. The influence of different mode of power density during antimicrobial photodynamic therapy for photokilling of Streptococcus mutans. Photodiagnosis Photodyn Ther 2023; 44:103770. [PMID: 37640204 DOI: 10.1016/j.pdpdt.2023.103770] [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: 07/05/2023] [Revised: 08/21/2023] [Accepted: 08/25/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the inactivation potency of riboflavin and curcumin plus blue diode laser against Streptococcus mutans with different power densities. MATERIALS AND METHODS In this in vitro study, standard-strain S. mutans was exposed to curcumin and riboflavin plus blue diode laser with different power densities (0.4-1.0 W/cm2) as well as chlorhexidine (CHX). The colony forming units (CFUs)/mL was calculated. Data were analyzed by one-way ANOVA. RESULTS Antibacterial analysis indicated that the blue diode laser irradiation with curcumin and riboflavin provided a satisfactory reduction of the S. mutans level. In addition, S. mutans was more affected by curcumin + blue diode laser when the power density was set to 1.0 W/cm2 (P < 0.0001). Meanwhile, bacterial suspensions treated with CHX showed maximum colony number reduction, compared with the control (P < 0.0001). CONCLUSION This study showed the blue diode laser along with curcumin had strong bactericidal effect on S. mutans, and this effect improved by increasing the power density.
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Affiliation(s)
- Shima Afrasiabi
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sarvin Entezari
- Dentist, Faculty of Dentistry, Tehran Medical Sciences. Islamic Azad University, Tehran, Iran
| | - Ardavan Etemadi
- Department of Periodontics, Faculty of Dentistry, Tehran Medical Sciences, Islamic Azad University, Laser Research Center of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Nasim Chiniforush
- Laser Research Center of Dentistry, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Aghili SS, Jahangirnia A, Alam M, Oskouei AB, Golkar M, Badkoobeh A, Abbasi K, Mohammadikhah M, Karami S, Soufdoost RS, Namanloo RA, Talebi S, Amookhteh S, Hemmat M, Sadeghi S. The effect of photodynamic therapy in controlling the oral biofilm: A comprehensive overview. J Basic Microbiol 2023; 63:1319-1347. [PMID: 37726220 DOI: 10.1002/jobm.202300400] [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: 07/14/2023] [Revised: 08/16/2023] [Accepted: 08/26/2023] [Indexed: 09/21/2023]
Abstract
Several resistance mechanisms are involved in dental caries, including oral biofilms. An accumulation of bacteria on the surface of teeth is called plaque. Periodontitis and gingivitis are caused by dental plaque. In this review article, we aimed to review the studies associated with the application of photodynamic therapy (PDT) to prevent and treat various microbial biofilm-caused oral diseases in recent decades. There are several studies published in PubMed that have described antimicrobial photodynamic therapy (APDT) effects on microorganisms. Several in vitro and in vivo studies have demonstrated the potential of APDT for treating endodontic, periodontal, and mucosal infections caused by bacteria as biofilms. Reactive oxygen species (ROS) are activated in the presence of oxygen by integrating a nontoxic photosensitizer (PS) with appropriate wavelength visible light. By causing irreversible damage to microorganisms, ROS induces some biological and photochemical events. Testing several wavelengths has been conducted to identify potential PS for APDT. A standard protocol is not yet available, and the current review summarizes findings from dental studies on APDT.
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Affiliation(s)
- Seyedeh Sara Aghili
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mostafa Alam
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Asal Bagherzadeh Oskouei
- Dental Research Center, Research Institute of Dental Sciences, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohsen Golkar
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ashkan Badkoobeh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Qom University of Medical Sciences, Qom, Iran
| | - Kamyar Abbasi
- Department of Prosthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Meysam Mohammadikhah
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
| | | | | | | | - Sahar Talebi
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Samira Amookhteh
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Hemmat
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sima Sadeghi
- Student Research Committee, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
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Damrongrungruang T, Panutyothin N, Kongjun S, Thanabat K, Ratha J. Combined bisdemethoxycurcumin and potassium iodide-mediated antimicrobial photodynamic therapy. Heliyon 2023; 9:e17490. [PMID: 37455953 PMCID: PMC10345248 DOI: 10.1016/j.heliyon.2023.e17490] [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: 02/22/2023] [Revised: 06/12/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
Antimicrobial photodynamic therapy is emerging as a promising way to treat infections with minimal side effects. Typically, a single photosensitizer used in photodynamic therapy is capable of generating only one type of reactive oxygen species, which may have inadequate capability to eradicate certain types of microbes, especially Candida species. Thus, the use of combined photosensitizers is examined as a means of achieving superior antimicrobial results. We postulate that bisdemethoxycurcumin, a type I reactive oxygen species generator, combined with potassium iodide, an antimicrobial iodide molecule, might exhibit superior antimicrobial effects compared to a single photosensitizer-mediated photodynamic therapy. The effects of bisdemethoxycurcumin + potassium iodide + dental blue light on Candida albicans reduction were examined. Candida biofilms were treated with 20, 40 or 80 μM bisdemethoxycurcumin, 100 mM potassium iodide or a combination of these species for 20 min before irradiation with a dental blue light (90 J/cm2). The negative and positive controls were phosphate buffer saline and nystatin at 1 : 100,000 units/ml, respectively. Candidal numbers were quantified at 0, 1, 6 and 24 h. Hydroxyl radicals were spectrophotometrically measured using 2-[6-(4'amino phynoxyl-3H-xanthen-3-on-9-yl)] benzoic acid or APF probe-mediated fluorescence intensity (Varioskan) at 490/515 nm (excitation/emission). Candidal counts and hydroxyl radical comparisons were performed using the Kruskal-Wallis test and one-way ANOVA, respectively. Correlations between candidal numbers and hydroxyl radical levels were done with a Pearson correlation test. Forty μM bisdemethoxycurcumin+100 mM KI could provide a 3.5 log10 CFU/ml reduction after 6 h. Bisdemethoxycurcumin alone generated OH levels that were strongly correlated with candidal reduction. In conclusion, 40 μM bisdemethoxycurcumin+100 mM KI could reduce C. albicans biofilm.
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Affiliation(s)
- Teerasak Damrongrungruang
- Division of Oral Diagnosis, Department of Oral Biomedical Science, Faculty of Dentistry, Khon Kaen University, 40002, Thailand
- Melatonin Research Program, The Research and Academic Affairs, Khon Kaen University, 40002, Thailand
| | - Nichapat Panutyothin
- Division of Oral Diagnosis, Department of Oral Biomedical Science, Faculty of Dentistry, Khon Kaen University, 40002, Thailand
| | - Sirapakorn Kongjun
- Division of Oral Diagnosis, Department of Oral Biomedical Science, Faculty of Dentistry, Khon Kaen University, 40002, Thailand
| | - Kittapak Thanabat
- Division of Oral Diagnosis, Department of Oral Biomedical Science, Faculty of Dentistry, Khon Kaen University, 40002, Thailand
| | - Juthamat Ratha
- Melatonin Research Program, The Research and Academic Affairs, Khon Kaen University, 40002, Thailand
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Minhaco VMTR, Maquera Huacho PM, Mancim Imbriani MJ, Tonon CC, Chorilli M, Rastelli ANDS, Spolidorio DMP. Improving antimicrobial activity against endodontic biofilm after exposure to blue light-activated novel curcumin nanoparticle. Photodiagnosis Photodyn Ther 2023; 42:103322. [PMID: 36773754 DOI: 10.1016/j.pdpdt.2023.103322] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 12/29/2022] [Accepted: 02/03/2023] [Indexed: 02/12/2023]
Abstract
New therapies involving natural products and nanobiotechnology open additional perspectives to reduce endodontic infections. Curcumin is a natural polyphenol extracted from the dry rhizome of curcuma long Linn with therapeutic properties for application in nanobiotechnology and as a photosensitizer for photodynamic therapy. This study aimed to synthesize a novel polymeric nanoparticle of poly (lactic-co-glycolic acid) (PLGA) loaded with curcumin (NP+Cur), and evaluate its antimicrobial activity against endodontic biofilms. Additionally, its biocompatibility using oral keratinocytes was assessed. The polymeric NP+Cur was prepared by the nanoprecipitation method. Minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) were calculated for the three endodontic bacteria (Enterococcus faecalis, Streptococcus oralis and Actinomyces viscosus). Antibacterial activity of NP+Cur against single- and multispecies biofilm pre-formed on the botton 24-well plate and into dentin tubules of bovine teeth were evaluated by colony forming units and confocal laser scanning microscopy. The pre-irradiation time was 5 min followed by exposure to blue light-emitting diode at 450 nm for the photodynamic treatment. Cell viability using oral keratinocytes was assessed by Alamar Blue assay. MIC and MBC showed antibacterial activity of NP+Cur against endodontic bacteria. A treatment of pre-formed biofilms of endodontic bacteria with NP+Cur also significantly decreased bacterial viability. The concentration of 325 μg/mL of photoactivated NP+Cur was the one that most reduced the viability of the endodontic bacteria evaluated. Regarding biocompatibility, NP+Cur 325 μg/mL and pure nanoparticles showed a cell viability greater than 80%. The novel polymeric nanoparticles loaded with curcumin may be a promising adjunct use to treatment of endodontic infections.
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Affiliation(s)
- Vivian Maria Tellaroli Rodrigues Minhaco
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University (Unesp), Rua Humaitá, 1680, Araraquara, SP 14801-903, Brazil; Department of Oral Diagnosis and Surgery, School of Dentistry, São Paulo State University (Unesp), Rua Humaitá, 1680, Araraquara, SP 14801-903, Brazil
| | - Patricia Milagros Maquera Huacho
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University (Unesp), Rua Humaitá, 1680, Araraquara, SP 14801-903, Brazil
| | - Maria Júlia Mancim Imbriani
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University (Unesp), Rua Humaitá, 1680, Araraquara, SP 14801-903, Brazil; Department of Oral Diagnosis and Surgery, School of Dentistry, São Paulo State University (Unesp), Rua Humaitá, 1680, Araraquara, SP 14801-903, Brazil
| | - Caroline Coradi Tonon
- Wellman Center for Photomedicine, Massachusetts General Hospital, and Harvard Medical School, 40 Blossom St, Boston, MA 02114, United States
| | - Marlus Chorilli
- Department of Drugs and Medicines, International School of Pharmaceuticals Sciences, São Paulo State University (Unesp), Rodovia Araraquara Jaú, Km 01, Araraquara, SP 14800-903, Brazil
| | - Alessandra Nara de Souza Rastelli
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (Unesp), Rua Humaitá, 1680, Araraquara, SP 14801-903, Brazil
| | - Denise Madalena Palomari Spolidorio
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University (Unesp), Rua Humaitá, 1680, Araraquara, SP 14801-903, Brazil.
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Current Infections of the Orofacial Region: Treatment, Diagnosis, and Epidemiology. Life (Basel) 2023; 13:life13020269. [PMID: 36836626 PMCID: PMC9966653 DOI: 10.3390/life13020269] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/07/2023] [Accepted: 01/17/2023] [Indexed: 01/20/2023] Open
Abstract
Undoubtedly, diagnosing and managing infections is one of the most challenging issues for orofacial clinicians. As a result of the diversity of symptoms, complicated behavior, and sometimes confusing nature of these conditions, it has become increasingly difficult to diagnose and treat them. It also highlights the need to gain a deeper insight into the orofacial microbiome as we try to improve our understanding of it. In addition to changes in patients' lifestyles, such as changes in diet, smoking habits, sexual practices, immunosuppressive conditions, and occupational exposures, there have been changes in patients' lifestyles that complicate the issue. Recent years have seen the development of new infection treatments due to the increased knowledge about the biology and physiology of infections. This review aimed to provide a comprehensive overview of the types of infections in the mouth, including the types that viruses, fungi, or bacteria may cause. It is important to note that we searched the published literature in the Scopus, Medline, Google Scholar, and Cochran databases from 2010 to 2021 using the following keywords: "Orofacial/Oral Infections," "Viral/Fungal/Bacterial Infections", "Oral Microbiota" And "Oral Microflora" without limiting our search to languages and study designs. According to the evidence, the most common infections in the clinic include herpes simplex virus, human papillomavirus, Candida albicans, Aspergillus, Actinomycosis, and Streptococcus mutans. The purpose of this study is to review the new findings on characteristics, epidemiology, risk factors, clinical manifestations, diagnosis, and new treatment for these types of infectious diseases.
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Garcia de Carvalho G, Pacheco Mateo R, Costa E Silva R, Maquera Huacho PM, de Souza Rastelli AN, de Oliveira KT, Chierici Marcantonio RA, Zandim-Barcelos DL, Palomari Spolidorio DM. Chlorin-based photosensitizer under blue or red-light irradiation against multi-species biofilms related to periodontitis. Photodiagnosis Photodyn Ther 2022; 41:103219. [PMID: 36473689 DOI: 10.1016/j.pdpdt.2022.103219] [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: 09/05/2022] [Revised: 10/17/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022]
Abstract
In our previous study, Chlorin-e6 (Ce6) demonstrated a significant reduction of microorganisms' viability against single-species biofilm related to periodontitis once irradiated by red light (660 nm). Also, higher bacteria elimination was observed under blue light (450 nm) irradiation. However, the use of blue light irradiation of Ce6 for antimicrobial administration is poorly explored. This study evaluated the effect of chlorin-e6-mediated antimicrobial photodynamic therapy (aPDT) using different wavelengths (450 or 660 nm) against multi-species biofilms related to periodontitis. Streptococcus oralis, Fusobacterium nucleatum, Porphyromonas gingivalis, and Aggregatibacter actinomycetemcomitans composed the mature biofilm developed under proper conditions for five days. aPDT was performed using different concentrations of Ce6 (100 and 200 μM), wavelengths (450 or 660 nm), and comparisons were made after qPCR assay and confocal laser scanning microscopy (CLSM) analysis. The greatest bacterial elimination was observed in the groups where Ce6 was used with blue light, for S. orallis (2.05 Log10 GeQ mL-1, p < 0.0001) and P. gingivalis (1.4 Log10 GeQ mL-1, p < 0.0001), aPDT with red light showed significant bacteria reduction only for S. orallis. aPDT with blue light demonstrated statistically higher elimination in comparison with aPDT with red light. The aPDT did not show a statistically significant effect when tested against A. actinomycetemcomitans and F. nucleatum (p=0.776 and 0.988, respectively). The aPDT using blue light showed a promising higher photobiological effect, encouraging researchers to consider it in the irradiation of Ce6 for further investigations.
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Affiliation(s)
- Gabriel Garcia de Carvalho
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, Araraquara, SP 14801-903, Brazil
| | - Rafaela Pacheco Mateo
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, Araraquara, SP 14801-903, Brazil
| | - Rodrigo Costa E Silva
- Department of Chemistry, Federal University of São Carlos (UFSCar), São Carlos, SP 13565-905, Brazil
| | - Patricia Milagros Maquera Huacho
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, Araraquara, SP 14801-903, Brazil
| | - Alessandra Nara de Souza Rastelli
- Department of Restorative Dentistry, School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, Araraquara, SP 14801-903, Brazil
| | - Kleber Thiago de Oliveira
- Department of Chemistry, Federal University of São Carlos (UFSCar), São Carlos, SP 13565-905, Brazil
| | | | - Daniela Leal Zandim-Barcelos
- Department of Diagnosis and Surgery, School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, Araraquara, SP 14801-903, Brazil
| | - Denise Madalena Palomari Spolidorio
- Department of Physiology and Pathology, School of Dentistry, São Paulo State University (UNESP), Rua Humaitá, 1680, Araraquara, SP 14801-903, Brazil.
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The Potential Application of Natural Photosensitizers Used in Antimicrobial Photodynamic Therapy against Oral Infections. Pharmaceuticals (Basel) 2022; 15:ph15060767. [PMID: 35745686 PMCID: PMC9227410 DOI: 10.3390/ph15060767] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/14/2022] [Accepted: 06/16/2022] [Indexed: 02/05/2023] Open
Abstract
Oral health problems and the emergence of antimicrobial resistance among pathogenic bacterial strains have become major global challenges and are essential elements that negatively affect general well-being. Antimicrobial photodynamic therapy (APDT) is based on a light source and oxygen that activates a nontoxic photosensitizer, resulting in microbial destruction. Synthetic and natural products can be used to help the APDT against oral microorganisms. The undesirable consequences of conventional photosensitizers, including toxicity, and cost encourage researchers to explore new promising photosensitizers based on natural compounds such as curcumin, chlorella, chlorophyllin, phycocyanin, 5-aminolevulinic acid, and riboflavin. In this review, we summarize in vitro studies describing the potential use of APDT therapy conjugated with some natural products against selected microorganisms that are considered to be responsible for oral infections.
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Tuchin VV, Genina EA, Tuchina ES, Svetlakova AV, Svenskaya YI. Optical clearing of tissues: Issues of antimicrobial phototherapy and drug delivery. Adv Drug Deliv Rev 2022; 180:114037. [PMID: 34752842 DOI: 10.1016/j.addr.2021.114037] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 09/23/2021] [Accepted: 10/28/2021] [Indexed: 02/08/2023]
Abstract
This review presents principles and novelties in the field of tissue optical clearing (TOC) technology, as well as application for optical monitoring of drug delivery and effective antimicrobial phototherapy. TOC is based on altering the optical properties of tissue through the introduction of immersion optical cleaning agents (OCA), which impregnate the tissue of interest. We also analyze various methods and kinetics of delivery of photodynamic agents, nanoantibiotics and their mixtures with OCAs into the tissue depth in the context of antimicrobial and antifungal phototherapy. In vitro and in vivo studies of antimicrobial phototherapies, such as photodynamic, photothermal plasmonic and photocatalytic, are summarized, and the prospects of a new TOC technology for effective killing of pathogens are discussed.
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Genetic Factors Affect the Survival and Behaviors of Selected Bacteria during Antimicrobial Blue Light Treatment. Int J Mol Sci 2021; 22:ijms221910452. [PMID: 34638788 PMCID: PMC8508746 DOI: 10.3390/ijms221910452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 09/22/2021] [Accepted: 09/24/2021] [Indexed: 12/26/2022] Open
Abstract
Antimicrobial resistance is a global, mounting and dynamic issue that poses an immediate threat to human, animal, and environmental health. Among the alternative antimicrobial treatments proposed to reduce the external use of antibiotics is electromagnetic radiation, such as blue light. The prevailing mechanistic model is that blue light can be absorbed by endogenous porphyrins within the bacterial cell, inducing the production of reactive oxygen species, which subsequently inflict oxidative damages upon different cellular components. Nevertheless, it is unclear whether other mechanisms are involved, particularly those that can affect the efficacy of antimicrobial blue light treatments. In this review, we summarize evidence of inherent factors that may confer protection to a selected group of bacteria against blue light-induced oxidative damages or modulate the physiological characteristics of the treated bacteria, such as virulence and motility. These include descriptions of three major photoreceptors in bacteria, chemoreceptors, SOS-dependent DNA repair and non-SOS protective mechanisms. Future directions are also provided to assist with research efforts to increase the efficacy of antimicrobial blue light and to minimize the development of blue light-tolerant phenotypes.
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Effect of antimicrobial photodynamic therapy with Chlorella and Curcuma extract on Streptococcus mutans biofilms. Photodiagnosis Photodyn Ther 2021; 35:102411. [PMID: 34147697 DOI: 10.1016/j.pdpdt.2021.102411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 06/14/2021] [Accepted: 06/15/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Antimicrobial photodynamic therapy (aPDT) using natural photosensitive agents is an effective method for preventing oral diseases of bacterial origin. The purpose of this study was to evaluate the antimicrobial effect of aPDT, using powdered extracts of Chlorella and Curcuma, on the biofilms of Streptococcus mutans (S. mutans), a bacterium that is known to cause dental caries. METHODS Commercially available powdered Chlorella and Curcuma extracts were used as photosensitizers. S. mutans, cultured for 2 days, was inoculated (0.1 ml; 1 × 109 CFU/ml) on the surface of a hydroxyapatite (HA) disc and incubated for 24 h to allow the formation of a biofilm. The HA disc with the S. mutans biofilm was immersed in either Curcuma extract (0.5 mg/ml), Chlorella extract, distilled water (negative control), or Listerine (positive control) for 1 min and then irradiated with an LED (Qraycam; wavelength, 405 nm; energy, 59 mW) for 5 min. RESULTS The application of aPDT with Curcuma or Chlorella extract to S. mutans 24-hour biofilms significantly decreased the number of viable cells and the live/dead cell ratio when compared with those in the negative control (distilled water; p < 0.05). CONCLUSIONS aPDT using 405 nm light and Chlorella or Curcuma as a photosensitizer has significant antimicrobial effects against S. mutans biofilms. Thus, employing aPDT with natural plant extracts as photosensitizers could be an effective strategy for preventing dental caries but needs to be evaluated in properly controlled clinical trials..
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Woźniak A, Kruszewska B, Pierański MK, Rychłowski M, Grinholc M. Antimicrobial Photodynamic Inactivation Affects the Antibiotic Susceptibility of Enterococcus spp. Clinical Isolates in Biofilm and Planktonic Cultures. Biomolecules 2021; 11:693. [PMID: 34063146 PMCID: PMC8148121 DOI: 10.3390/biom11050693] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/28/2021] [Accepted: 05/02/2021] [Indexed: 12/30/2022] Open
Abstract
Enterococcus faecium and Enterococcus faecalis are opportunistic pathogens that can cause a vast variety of nosocomial infections. Moreover, E. faecium belongs to the group of ESKAPE microbes, which are the main cause of hospital-acquired infections and are especially difficult to treat because of their resistance to many antibiotics. Antimicrobial photodynamic inactivation (aPDI) represents an alternative to overcome multidrug resistance problems. This process requires the simultaneous presence of oxygen, visible light, and photosensitizing compounds. In this work, aPDI was used to resensitize Enterococcus spp. isolates to antibiotics. Antibiotic susceptibility testing according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) recommendations was combined with synergy testing methods recommended by the American Society for Microbiology. Two clinical isolates, E. faecalis and E. faecium, were treated with a combination of aPDI utilizing rose bengal (RB) or fullerene (FL) derivative as photosensitizers, antimicrobial blue light (aBL), and 10 recommended antibiotics. aPDI appeared to significantly impact the survival rate of both isolates, while aBL had no significant effect. The synergy testing results differed between strains and utilized methods. Synergy was observed for RB aPDI in combination with gentamycin, ciprofloxacin and daptomycin against E. faecalis. For E. faecium, synergy was observed between RB aPDI and gentamycin or ciprofloxacin, while for RB aPDI with vancomycin or daptomycin, antagonism was observed. A combination of FL aPDI gives a synergistic effect against E. faecalis only with imipenem. Postantibiotic effect tests for E. faecium demonstrated that this isolate exposed to aPDI in combination with gentamycin, streptomycin, tigecycline, doxycycline, or daptomycin exhibits delayed growth in comparison to untreated bacteria. The results of synergy testing confirmed the effectiveness of aPDI in resensitization of the bacteria to antibiotics, which presents great potential in the treatment of infections caused by multidrug-resistant strains.
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Affiliation(s)
- Agata Woźniak
- Laboratory of Molecular Diagnostics, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland; (A.W.); (B.K.); (M.K.P.)
| | - Beata Kruszewska
- Laboratory of Molecular Diagnostics, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland; (A.W.); (B.K.); (M.K.P.)
| | - Michał Karol Pierański
- Laboratory of Molecular Diagnostics, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland; (A.W.); (B.K.); (M.K.P.)
| | - Michał Rychłowski
- Laboratory of Virus Molecular Biology, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland;
| | - Mariusz Grinholc
- Laboratory of Molecular Diagnostics, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, 80-307 Gdansk, Poland; (A.W.); (B.K.); (M.K.P.)
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Assessment and Characterization of Some New Photosensitizers for Antimicrobial Photodynamic Therapy (aPDT). MATERIALS 2020; 13:ma13133012. [PMID: 32640635 PMCID: PMC7372345 DOI: 10.3390/ma13133012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 06/27/2020] [Accepted: 07/06/2020] [Indexed: 02/07/2023]
Abstract
The novelty of this study consists on the formulation and evaluation of five complex experimental natural photosensitizers (PS): gel with oregano essential oil (O), gel with methylene blue (AM), gel with a mixture of essential oils (Thieves-H), gel with arnica oil and curcuma extract (CU) and gel with frankincense essential oil (T), used as photosensitizing agents (PS) in antimicrobial photodynamic therapy (aPDT) in the control of microbial biofilm in oral cavity. The experimental PS were characterized by gas chromatography-mass spectrometry (GC-MS), Fourier-transform infrared spectroscopy (FTIR), UV-Vis spectroscopy, cytotoxicity assay, antimicrobial effect and scanning electron microscopy (SEM). The IR spectra of the experimental PS with essential oils exhibit absorption bands due to the presence of water and glycerol in high quantities. The studied compounds had a reduced cytotoxic effect on cell cultures. The lowest cytotoxic effect was observed in experimental PS with oregano essential oil and methylene blue PS. Essential oils with proven antibacterial capabilities used in experimental PS confer antibacterial activity to the gels in which they are incorporated, an activity that may be more efficient use of a PDT therapy. Single bacteria were detected mainly by SEM after 12 h, while aggregate bacteria and micro colonies dominated the samples at 48 h.
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Garcia de Carvalho G, Sanchez-Puetate JC, Donatoni MC, Maquera Huacho PM, de Souza Rastelli AN, de Oliveira KT, Palomari Spolidorio DM, Leal Zandim-Barcelos D. Photodynamic inactivation using a chlorin-based photosensitizer with blue or red-light irradiation against single-species biofilms related to periodontitis. Photodiagnosis Photodyn Ther 2020; 31:101916. [PMID: 32645434 DOI: 10.1016/j.pdpdt.2020.101916] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/13/2020] [Accepted: 06/29/2020] [Indexed: 12/12/2022]
Abstract
Chlorin-e6 (Ce6), as a photosensitizer (PS), has demonstrated significant reduction of microorganisms' viability when irradiated by red light. However, the main absorption peak of this PS is located at blue light spectrum, which is less investigated. This study aimed to evaluate the effect of pure-chlorin-e6-mediated photodynamic inactivation (PDI) using different light sources (450 or 660 nm) against biofilms related to periodontitis. Streptococcus oralis, Fusobacterium nucleatum, Porphyromonas gingivalis, and Aggregatibacter actinomycetemcomitans single-species biofilms were developed under proper conditions for five days. PDI was performed using different concentrations of Ce6 (100 and 200 mM), wavelengths (450 and 660 nm) and comparisons were made after colony forming unit and confocal laser scanning microscopy (CLSM) analysis. The use of light and PS were also individually tested. The greatest bacterial elimination was observed in the group where PDI was employed with blue light and concentration of 200 mM for all bacterial strains tested (4.01 log10 for A. actinomycetemcomitans, and total elimination for P. gingivalis and S. oralis), except for F. nucleatum, where 3.46 log10 reduction was observed when red light and 200 mM Ce6 were applied (p < 0.05). The antimicrobial effects of PDI mediated by Ce6 for all single pathogenic biofilms were confirmed by live/dead staining under CLSM analysis. For all single-species biofilms, the use of PDI mediated by chlorin-e6 photosensitizer under blue or red-light irradiation (450 and 660 nm) demonstrated a significant reduction in bacterial viability, but blue light showed a promising higher photobiological effect, encouraging its adjuvant use to basic periodontitis treatment.
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Affiliation(s)
- Gabriel Garcia de Carvalho
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, Rua Humaitá, 1680, 14801-903, Araraquara, SP, Brazil.
| | - Julio Cesar Sanchez-Puetate
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, Rua Humaitá, 1680, 14801-903, Araraquara, SP, Brazil.
| | - Maria Carolina Donatoni
- Department of Chemistry, Federal University of São Carlos (UFSCar), São Carlos, SP, 13565-905, Brazil.
| | - Patricia Milagros Maquera Huacho
- Department of Physiology and Pathology, São Paulo State University (Unesp), School of Dentistry, Rua Humaitá, 1680, 14801-903, Araraquara, SP, Brazil.
| | - Alessandra Nara de Souza Rastelli
- Department of Restorative Dentistry, São Paulo State University (Unesp), School of Dentistry, Rua Humaitá, 1680, 14801-903, Araraquara, SP, Brazil.
| | - Kleber Thiago de Oliveira
- Department of Chemistry, Federal University of São Carlos (UFSCar), São Carlos, SP, 13565-905, Brazil.
| | - Denise Madalena Palomari Spolidorio
- Department of Physiology and Pathology, São Paulo State University (Unesp), School of Dentistry, Rua Humaitá, 1680, 14801-903, Araraquara, SP, Brazil.
| | - Daniela Leal Zandim-Barcelos
- Department of Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, Rua Humaitá, 1680, 14801-903, Araraquara, SP, Brazil.
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Photodynamic therapy in oral lichen planus: A prospective case-controlled pilot study. Sci Rep 2020; 10:1667. [PMID: 32015380 PMCID: PMC6997407 DOI: 10.1038/s41598-020-58548-9] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 01/09/2020] [Indexed: 12/21/2022] Open
Abstract
Oral lichen planus (OLP) is a common, chronic relapsing inflammatory disorder of the mucous membranes, which causes major discomfort. Current treatment includes topical/systemic glucocorticoids, immune modulators and systemic immunosuppressants, which may lead to considerable side-effects. The aim of this study was to determine the clinical and immunological efficacy of photodynamic therapy (PDT) in OLP as an alternative, easy-to-use, safe and non-invasive treatment. Twenty patients with OLP were treated with PDT in a prospective case-controlled pilot-study. PDT was performed on the most extensive oral lesion in 4 sessions (day 1, 3, 7, 14). Peripheral blood and lesional T cells were analysed before (day 1) and after PDT treatment (day 28). PDT led to a statistically significant reduction of clinical parameters (lesion size, ABSIS, Thongprasom-score) and improvement of all evaluated quality-of-life (QOL) items. The clinical improvement was accompanied by a significant decrease of the relative number of CD4+ and CD8+ T cells in mucosal OLP-lesions. Furthermore, CXCL10 plasma levels were decreased and the number of activated peripheral CD4 + CD137+ and CD8 + CD137+ T cells and IL-17-secreting T cells was diminished. PDT treatment in OLP leads to lesion reduction and improvement of QOL, and induces local and systemic anti-inflammatory effects. The study identifies PDT as a novel therapeutic option in OLP.
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Diogo P, F Faustino MA, P M S Neves MG, Palma PJ, P Baptista I, Gonçalves T, Santos JM. An Insight into Advanced Approaches for Photosensitizer Optimization in Endodontics-A Critical Review. J Funct Biomater 2019; 10:E44. [PMID: 31575005 PMCID: PMC6963755 DOI: 10.3390/jfb10040044] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 09/10/2019] [Accepted: 09/23/2019] [Indexed: 02/07/2023] Open
Abstract
Apical periodontitis is a biofilm-mediated disease; therefore, an antimicrobial approach is essential to cure or prevent its development. In the quest for efficient strategies to achieve this objective, antimicrobial photodynamic therapy (aPDT) has emerged as an alternative to classical endodontic irrigation solutions and antibiotics. The aim of the present critical review is to summarize the available evidence on photosensitizers (PSs) which has been confirmed in numerous studies from diverse areas combined with several antimicrobial strategies, as well as emerging options in order to optimize their properties and effects that might be translational and useful in the near future in basic endodontic research. Published data notably support the need for continuing the search for an ideal endodontic photosensitizer, that is, one which acts as an excellent antimicrobial agent without causing toxicity to the human host cells or presenting the risk of tooth discoloration. The current literature on experimental studies mainly relies on assessment of mixed disinfection protocols, combining approaches which are already available with aPDT as an adjunct therapy. In this review, several approaches concerning aPDT efficiency are appraised, such as the use of bacteriophages, biopolymers, drug and light delivery systems, efflux pump inhibitors, negative pressure systems, and peptides. The authors also analyzed their combination with other approaches for aPDT improvement, such as sonodynamic therapy. All of the aforementioned techniques have already been tested, and we highlight the biological challenges of each formulation, predicting that the collected information may encourage the development of other effective photoactive materials, in addition to being useful in endodontic basic research. Moreover, special attention is dedicated to studies on detailed conditions, aPDT features with a focus on PS enhancer strategies, and the respective final antimicrobial outcomes. From all the mentioned approaches, the two which are most widely discussed and which show the most promising outcomes for endodontic purposes are drug delivery systems (with strong development in nanoparticles) and PS solubilizers.
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Affiliation(s)
- Patrícia Diogo
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal.
- FMUC, Faculty of Medicine, University of Coimbra, 3000-370 Coimbra, Portugal.
| | - M Amparo F Faustino
- QOPNA & LAQV-REQUIMTE and Chemistry Department, University of Aveiro, 3810-193 Aveiro, Portugal.
| | - M Graça P M S Neves
- QOPNA & LAQV-REQUIMTE and Chemistry Department, University of Aveiro, 3810-193 Aveiro, Portugal.
| | - Paulo J Palma
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal.
- FMUC, Faculty of Medicine, University of Coimbra, 3000-370 Coimbra, Portugal.
| | - Isabel P Baptista
- FMUC, Faculty of Medicine, University of Coimbra, 3000-370 Coimbra, Portugal.
- Institute of Periodontology, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal.
| | - Teresa Gonçalves
- FMUC, Faculty of Medicine, University of Coimbra, 3000-370 Coimbra, Portugal.
- CNC, Center for Neuroscience and Cell Biology, University of Coimbra, 3004-504 Coimbra, Portugal.
| | - João Miguel Santos
- Institute of Endodontics, Faculty of Medicine, University of Coimbra, 3000-075 Coimbra, Portugal.
- FMUC, Faculty of Medicine, University of Coimbra, 3000-370 Coimbra, Portugal.
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