Efeito da terapia fotodinâmica com urucum e led e probióticos na redução da halitose: ensaio clínico controlado randomizado

Abstract

Halitosis is a term that defines any odor or bad smell originating from the oral cavity, which may have local or systemic origin. This project aims to verify whether treatment with antimicrobial photodynamic therapy (aPDT) and treatment with probiotics are effective in eliminating it. 52 patients were selected, aged 18 to 25 years, diagnosed with halitosis, presenting sulfide (SH2) ≥ 112 ppb on gas chromatography. Participants were randomly divided into 4 groups (n=13), which received different treatments: Group 1: treatment with brushing, dental floss (all participants were instructed through a lecture to brush with a toothpaste containing amine fluoride in its composition (Elmex®) and use of dental floss, 3 times a day after meals for 30 days and tongue scraper; Group 2: brushing, dental floss and aPDT with annatto and blue LED, applied to the back and middle third of the tongue ; Group 3: brushing, dental floss and probiotics (capsules manufactured in a pharmacy containing strains of Lactobacillus salivarius WB21 (6.7 x 108 CFU) and xylitol (280mg). 42 capsules were given to each patient, who ingested 1 capsule, 3 times a day after meals, for 14 days; Group 4: brushing, flossing, aPDT and probiotics. Clinical results showed an immediate reduction in halitosis with aPDT, with the use of the scraper and with the use of both therapies combined. The immediate results show the effectiveness of the treatments, for a period shorter than 7 days, which has yet to be discovered. The use of probiotics showed no difference in sulfide levels compared to initial levels. As for the microbiological results, when the tongue coating samples were analyzed by quantitative PCR for Porphyromonas gingivalis, Tannerella forsythia, Tannerella forsythia, it was not possible to observe a difference (p<0.05) between the groups for any of the bacteria evaluated. As for the microbiome, a representative sample was analyzed. There was no difference in alpha diversity between the samples studied by Chao1, Shannon and Simpson analysis. Regarding the analysis of relative abundance regarding the genera found, a difference was observed only in the genus Pseudarthrobacter (p<0.05) between G2 and G3 at 14 days. In relation to other groups and times, there was no difference (p<0.05) regarding relative abundance for species and genus. Therefore, taking into account the limitations of this study, it can be concluded that treatment with aPDT or probiotics were not able to alter the microbiota in the tongue coating of patients with halitosis under these experimental conditions.