Longitudinal effect of curcumin-photodynamic antimicrobial chemotherapy in adolescents during fixed orthodontic treatment: a single-blind randomized clinical trial study

Abstract

White spot lesions are one of the concerns during the fixed orthodontic treatment. Thus, the aim of the present study was to evaluate the antimicrobial/anti-inflammatory effect of curcumin-photodynamic antimicrobial chemotherapy (c-PACT) and chlorhexidine varnish on the plaque accumulation and gingival bleeding in adolescents under fixed orthodontic treatment. A randomized clinical trial was performed with an initial number of 45 patients being distributed into three groups: group I-chlorhexidine varnish 2%, group II-placebo varnish, and group III-c-PACT (curcumin at 1.5 mg.mL(-1)) exposed to blue Light-emitting diode (LED) light at 450 nm (power density = 165 mW.cm(-2), fluency = 96 J.cm(-2), total dose = 150.7 J). The treatments were performed for four consecutive times with an interval of 1 week each. After the interventions, two calibrated examiners (Kappa value = 0.75) analyzed the dental plaque accumulation by plaque index (PI) and gingivitis condition by gingival bleeding index (GBI) with 1 and 3 months of follow-up after the treatments comprised a final sample of 35 patients. No significant difference was found to PI between the groups during baseline and 1-month period. Group III (1.52 ± 0.51) presented significance difference from group I (0.91 ± 0.75) and group II (1.03 ± 0.51) at 3 months of follow-up. In this same period, there was more plaque accumulation with significant statistical difference (P ≤ 0.05) in comparison to the other periods to all studied groups. There was a GBI reduction statistically significant to groups I and III at 1-month follow-up in comparison to other periods. No effect was verified to dental plaque accumulation after the photodynamic application mediated with curcumin activated with a blue LED light.

An update on Curcuma as a functional food in the control of cancer and inflammation

“…Treatments were performed four consecutive times with an interval of 1 week each. The gingivitis condition as measured by gingival bleeding index was reduced statistically significantly in the two groups compared with placebo [37].…”

Curcumin-mediated Photodynamic Therapy for the treatment of oral infections—A review

“…Several investigations have evaluated the antimicrobial effect against oral bacteria [9][10][11][12][13][14][15]24,43,44], fungi [7,8,25] and strains resistant to conventional drugs [6]. Some studies have assessed the PDI efficacy in pathogens that can also be related with systemic conditions such as Enterococcus faecalis (Ef) [42,[45][46][47][48][49][50] and Escherichia coli (Ec) [45][46][47]49].…”

“…Most in vitro tests (86.36%) were conducted using planktonic cultures of the microorganisms [6][7][8]10,12,13,15,41,[43][44][45][46][47][48][49], followed by investigations on single-species [6][7][8]42,43,48,50] and multi-species [11] biofilms. Additionally, one animal study [25] and three clinical trials were found [9,14,24]. CUR protocols vary widely among studies, which possibly explain the different results observed in some cases.…”

“…CUR protocols vary widely among studies, which possibly explain the different results observed in some cases. CUR concentrations ranged from 0.005 to 8000 μM and the use of a 'pure' CUR (57.69% of articles) was described [6][7][8]12,15,25,[41][42][43][44]48,51] as well as a mixture of curcuminoids (42.3% of articles), including CUR, demethoxy-CUR and bisdemethoxy-CUR [9][10][11]13,14,24,[45][46][47]49]. In addition, it is important to inform that only one study did not mention the type of CUR applied [50] (Table 3).…”

“…More recently, growing antibiotic resistance has demanded the reassessment of antimicrobial PDT, particularly for superficial infections wherein the contact with light is facilitated [5]. In this scenario, numerous investigations started to study PDT against microorganisms (MOs) [6][7][8][9][10][11][12][13][14][15], and suggested this therapy in cases of microbial resistance or in association with the existing drugs to enhance its effectiveness [16]. Photodynamic inactivation of microorganisms is also known as Photodynamic Antimicrobial Chemotherapy (PACT) [5] or Photodynamic Inactivation (PDI) [17].…”