Oral Decontamination of Orthodontic Patients Using Photodynamic Therapy Mediated by Blue-Light Irradiation and Curcumin Associated with Sodium Dodecyl Sulfate

Objective: The aim of this study was to investigate the effects of the antimicrobial photodynamic therapy (aPDT) using the association of curcumin with the surfactant sodium dodecyl sulfate (SDS) for oral decontamination in orthodontic patients. Background data: The installation of the orthodontic appliances promotes an increase in the retentive area that is available for microbial aggregation and makes difficult the oral health promotion. However, aPDT is one possible approach that is used for the reduction of oral microbial load. Materials and methods: Twenty-four patients (n=24) were randomly distributed into four groups: Light group: which was treated only with the blue light, no drug; PDT group, which was treated with curcumin and blue light; PDT+S group, which was treated with curcumin plus surfactant and irradiated with blue light; and Chlorhex group, which was treated with chlorhexidine. The photosensitizer agent was prepared by adding 0.1% of SDS to a curcumin solution of 1g/L. Two distinct LED devices emitting blue light (450 +/- 10nm) were used as follows: extra-oral irradiation (200mW, 80mW/cm(2), 36J and 14J/cm(2)) and intra-oral irradiation (1200mW, 472mW/cm(2), 216J and 85J/cm(2)).The collection of nonstimulated saliva (n=3; 3mL/collection) was performed at the following steps: (1) immediately before swishing (curcumin, chlorhexidine, or water); (2) after swishing; and (3) after performing aPDT treatments. The colony-forming units (CFU) were counted visually, and the values were adjusted to CFU/mL. Results: There was significant Log reduction for PDT (from 6.33 +/- 0.92 to 5.78 +/- 0.96, p<0.05), PDT+S (from 5.44 +/- 0.94 to 3.83 +/- 0.71, p<0.01), and Chlorhex (from 5.89 +/- 0.97 to 2.55 +/- 1.80, p<0.01) groups. The survival rate was significantly reduced in both PDT+S and Chlorhex groups compared with all situations (p<0.05). However, there was no significant difference between PDT+S and Chlorhex groups (p0.05). Conclusions: These results indicate that when associated with the surfactant SDS, the aPDT can be used as an adjutant and a convenient agent to promote the oral decontamination in clinical practice.