Sergio Santos Romero1, Katia Llanos do Vale2, Vanessa Gomes Remolina3, Thayná Gomes Silva4, Tânia Oppido Schalch5, Karen Muller Ramalho6, Renata Matalon Negreiros7, Ellen Sayuri Ando8, Marcia Pinto Alves Mayer9, Raquel Agnelli Mesquita Ferrari10, Lara Jansiski Motta11, Kristianne Porta Santos Fernandes12, Sandra Kalil Bussadori13, Anna Carolina Ratto Tempestini Horliana14. 1. Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho, University UNINOVE, São Paulo, São Paulo, Brazil. Electronic address: sergioromero@uni9.pro.br. 2. Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho, University UNINOVE, São Paulo, São Paulo, Brazil. Electronic address: katiadovale7@gmail.com. 3. Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho, University UNINOVE, São Paulo, São Paulo, Brazil. Electronic address: vanessaremolina@gmail.com. 4. Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho, University UNINOVE, São Paulo, São Paulo, Brazil. Electronic address: thaynagomesesilva@gmail.com. 5. Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho, University UNINOVE, São Paulo, São Paulo, Brazil. Electronic address: taniaschalch@gmail.com. 6. Universidade Ibirapuera, Av. Interlagos, 1329, São Paulo, São Paulo, Brazil. Electronic address: karenramalho@hotmail.com. 7. Specialization in Oral Maxillofacial Surgery and Traumatology at Fundecto - FFO, School of Dentistry - FOUSP, University of São Paulo, São Paulo, Brazil. Electronic address: renata.matalon@gmail.com. 8. Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil. Electronic address: esa.2406@gmail.com. 9. Department of Microbiology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil. Electronic address: mpamayer@icb.usp.br. 10. Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho, University UNINOVE, São Paulo, São Paulo, Brazil. Electronic address: raquel.mesquita@gmail.com. 11. Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho, University UNINOVE, São Paulo, São Paulo, Brazil. Electronic address: larajmotta@uni9.pro.br. 12. Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho, University UNINOVE, São Paulo, São Paulo, Brazil. Electronic address: kristianneporta@gmail.com. 13. Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho, University UNINOVE, São Paulo, São Paulo, Brazil. Electronic address: sandraskb@gmail.com. 14. Postgraduate Program in Biophotonics Applied to Health Sciences, Nove de Julho, University UNINOVE, São Paulo, São Paulo, Brazil. Electronic address: annacrth@gmail.com.
Abstract
BACKGROUND: Although antimicrobial photodynamic therapy (aPDT) can reduce halitosis immediately after application, it returns after a week. This probably occurs because bacteria residing in the oral cavity may recolonize the dorsum of the tongue. OBJECTIVE: Verify if modification of oral hygiene behavior associated with aPDT or lingual scraper can reduce halitosis after a 90-day follow-up. METHODS:Forty adults with positive halitosis were randomized in G1 (n = 20) -aPDT + oral hygiene behavior (OHB) or G2 (n = 20)- lingual scraper + OHB. G1 group were submitted to 0.005 % methylene blue in the middle and posterior third of the tongue, with pre-irradiation of 1 min. Irradiations were performed with red laser diode (λ =660 nm), 100 mW, 318 J/cm2, 3537 mW/cm2, 9 J per point at 6 points. In the G2 group, the tongue was scraped 10 times on the right side and on the left side with a tongue scraper. All patients were instructed on OHB at baseline, 7 and 90 days (guidance on the use of dental floss and the Bass technique for brushing). Halitosis was evaluated by gas chromatography (OralChroma®). Values > 112 ppb for Hydrogen sulfide (H2S) gas was considered positive halitosis. Methylmercaptanes and dimethylsulfide were also measured. The gas measures were assessed at baseline, immediately, and at 7 and 90 days. Paired t-test was used for the statistical analysis. For comparison between groups, the t-test was used. Values of p < 0.05 were considered statistically significant. RESULTS: There was no difference between groups immediately after treatment (p = .1532) after 7 days (p = 0.9312) and 90 days (p = 0.6642). For the aPDT group, there was a decrease in hydrogen sulfide immediately after treatment (p = 0.0001), after 7 days, values remained 3-fold smaller (p = 0.0088) and 2-fold smaller after 90 days (p = 0.0270). For the scraper group, there was a decrease immediately after treatment (p = 0.0001), the values remains 2-fold smaller (p = 0.0003) after 7 days and 3 months (p = 0.0001). CONCLUSION: The oral hygiene behavior associated with aPDT or tongue scraper was not able to reduce halitosis after 90-day follow-up. Despite halitosis remaining higher than 112 ppb in all follow-up periods, the mean values remain 2 or 3 fold smaller than baseline values. Future studies should include other oral hygiene behavior to achieve better results in the treatment of halitosis.
RCT Entities:
BACKGROUND: Although antimicrobial photodynamic therapy (aPDT) can reduce halitosis immediately after application, it returns after a week. This probably occurs because bacteria residing in the oral cavity may recolonize the dorsum of the tongue. OBJECTIVE: Verify if modification of oral hygiene behavior associated with aPDT or lingual scraper can reduce halitosis after a 90-day follow-up. METHODS: Forty adults with positive halitosis were randomized in G1 (n = 20) -aPDT + oral hygiene behavior (OHB) or G2 (n = 20)- lingual scraper + OHB. G1 group were submitted to 0.005 % methylene blue in the middle and posterior third of the tongue, with pre-irradiation of 1 min. Irradiations were performed with red laser diode (λ =660 nm), 100 mW, 318 J/cm2, 3537 mW/cm2, 9 J per point at 6 points. In the G2 group, the tongue was scraped 10 times on the right side and on the left side with a tongue scraper. All patients were instructed on OHB at baseline, 7 and 90 days (guidance on the use of dental floss and the Bass technique for brushing). Halitosis was evaluated by gas chromatography (OralChroma®). Values > 112 ppb for Hydrogen sulfide (H2S) gas was considered positive halitosis. Methylmercaptanes and dimethylsulfide were also measured. The gas measures were assessed at baseline, immediately, and at 7 and 90 days. Paired t-test was used for the statistical analysis. For comparison between groups, the t-test was used. Values of p < 0.05 were considered statistically significant. RESULTS: There was no difference between groups immediately after treatment (p = .1532) after 7 days (p = 0.9312) and 90 days (p = 0.6642). For the aPDT group, there was a decrease in hydrogen sulfide immediately after treatment (p = 0.0001), after 7 days, values remained 3-fold smaller (p = 0.0088) and 2-fold smaller after 90 days (p = 0.0270). For the scraper group, there was a decrease immediately after treatment (p = 0.0001), the values remains 2-fold smaller (p = 0.0003) after 7 days and 3 months (p = 0.0001). CONCLUSION: The oral hygiene behavior associated with aPDT or tongue scraper was not able to reduce halitosis after 90-day follow-up. Despite halitosis remaining higher than 112 ppb in all follow-up periods, the mean values remain 2 or 3 fold smaller than baseline values. Future studies should include other oral hygiene behavior to achieve better results in the treatment of halitosis.