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Doctoral Thesis
DOI
10.11606/T.85.2011.tde-09052012-145939
Document
Author
Full name
André Machado de Senna
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 2012
Supervisor
Committee
Vieira, Martha Marques Ferreira (President)
Bertolin, Aparecido Osdimir
Corrêa, Luciana
Junqueira, Juliana Campos
Ribeiro, Martha Simões
Title in Portuguese
Terapia fotodinâmica antimicrobiana no tratamento da estomatite protética
Keywords in Portuguese
candida
candidíase atrófica crônica
estomatite protética
laser
prótese total
terapia fotodinâmica
Abstract in Portuguese
A estomatite protética (EP), também designada de candidíase atrófica crônica, é a infecção fúngica bucal mais comum em indivíduos portadores de prótese total. Possui etiologia multifatorial, no entanto a presença de Candida spp. no biofilme da prótese é tida como o fator mais importante para o estabelecimento da EP. Este trabalho teve como objetivo avaliar o tratamento da EP por meio do uso da terapia fotodinâmica antimicrobiana (PDT), mediada pelo azul de metileno. Foram realizados estudos pré-clínicos e clínicos. Protótipos simuladores de prótese total foram confeccionados com polímero de metilmetacrilato, para servir de base para o crescimento do biofilme das seguintes espécies do gênero Candida: C. albicans, C. glabrata, C. dubliniensis, C. krusei, C. tropicalis, C. parapsilosis e C. guilliermondii. Como fotossensibilizador foi utilizada a solução de azul de metileno em uma concentração de 450μg/mL. Os protótipos com os biofilmes foram irradiados com um laser de comprimento de onda de 660 nm, potência de 100 mW, por um tempo de 80 segundos. Para o estudo clínico, os indivíduos foram divididos em dois grupos. O primeiro grupo recebeu tratamento convencional, à base do antifúngico Miconazol. O segundo grupo recebeu como tratamento a PDT. Os resultados pré-clínicos mostraram que todas as espécies do gênero Candida foram susceptíveis à PDT, ocorrendo uma redução de colônias que variou de 2,48 a 3,93 log10. Os resultados clínicos foram avaliados tanto quanto à redução de colônias de Candida spp. na mucosa e na prótese, como quanto à melhora do aspecto clínico da mucosa afetada. Tanto a terapia convencional quanto a PDT foram eficientes em tratar a EP. Não houve diferença estatística significante entre os tratamentos instituídos para nenhum dos fatores avaliados. Assim, concluiu-se que a PDT é efetiva no tratamento da estomatite protética.
Title in English
Photodymanic antimicrobial therapy in the treatment of denture stomatitis
Keywords in English
candida
chronic atrophic candidiasis
complete denture
denture stomatitis
laser
photodynamic therapy
Abstract in English
Denture stomatitis (DS), also called chronic atrophic candidiasis, is the most common oral fungal infection in denture wearers. It has a multifactorial etiology, but the presence of Candida spp. biofilm on the denture is considered the most important factor for the establishment of the DS. This study aimed to evaluate the treatment of DS through the use of photodynamic antimicrobial therapy (PAT), mediated by methylene blue. For this purpose, preclinical studies and clinical trials were performed. Simulators prototypes dentures were made of methyl methacrylate polymer to serve as a basis for biofilm growth of the following species of Candida: C. albicans, C. glabrata, C. dubliniensis, C. krusei, C. tropicalis, C. parapsilosis and C. guilliermondii. Methylene blue solution at a concentration of 450μg/mL was used as a photosensitizer. The prototypes and biofilms were irradiated with a laser of wavelength of 660 nm, potency of 100 mW, for 80 seconds. For the clinical study, subjects were divided into two groups. The first group received conventional treatment based on the use of antifungal Miconazole. The second group received the treatment by PAT. The preclinical results showed that all species of the genus Candida were susceptible to PAT, with a reduction in colonies that ranged from 2.48 to 3.93 log10. Clinical outcomes were evaluated for the reduction of colonies of Candida spp. located in the mucosa and in the prosthesis and relative to the improvement of the clinical aspect of the affected mucosa. Both the conventional therapy and PAT were effective in treating DS. There was no significant statistical difference between PAT and conventional treatment for any of the factors evaluated. Thus, it was concluded that PAT is effective in the treatment of denture stomatitis.
 
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2012SennaTerapia.pdf (1.98 Mbytes)
Publishing Date
2012-05-30
 
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