Banca de DEFESA: SARAH EMMILY MELO DA SILVA

Uma banca de DEFESA de MESTRADO foi cadastrada pelo programa.
STUDENT : SARAH EMMILY MELO DA SILVA
DATE: 17/07/2026
TIME: 14:30
LOCAL: Auditório do Departamento de Odontologia da UFRN
TITLE:

Antimicrobial Photodynamic Therapy in the Management of Oral Candidiasis Among Intensive Care Unit Patients: A Randomized Controlled Trial

KEY WORDS:

oral candidiasis; photodynamic therapy; intensive care unit.

PAGES: 111
BIG AREA: Ciências da Saúde
AREA: Odontologia
SUBÁREA: Clínica Odontológica
SUMMARY:

Introduction: Patients admitted to intensive care units (ICUs) are at increased risk of developing opportunistic infections, such as oral candidiasis (OC), due to critical illness and immunosuppression. Although antifungal therapies are generally effective, their frequent use may contribute to antimicrobial resistance and drug interactions. In this context, antimicrobial photodynamic therapy (aPDT) has emerged as a promising non-pharmacological adjunctive approach for the management of oral candidiasis. This therapy combines low-level laser therapy (LLLT) with a photosensitizing agent to generate reactive oxygen species capable of selectively eliminating the microorganisms responsible for the infection. Objectives: To evaluate the efficacy of antimicrobial photodynamic therapy (aPDT) as an adjunctive treatment for oral candidiasis in patients admitted to an intensive care unit. Methods: This randomized controlled clinical trial was conducted at Hospital Giselda Trigueiro (Natal, Rio Grande do Norte, Brazil). Patients with a clinical diagnosis of oral candidiasis were randomly allocated into two groups. The control group (CG) received standardized oral hygiene, topical nystatin (100,000 IU every 8 hours for 7 days), and intravenous systemic fluconazole (150 mg/day for 5 days). The experimental group (aPDT) received the same oral hygiene protocol and systemic fluconazole, in addition to two sessions of adjunctive topical antimicrobial photodynamic therapy. The aPDT protocol consisted of applying 0.1% methylene blue for 10 minutes followed by irradiation with a red low-level laser (4 J per point over the affected areas) on the day of the initial assessment and again after 72 hours. Clinical and cytological responses were evaluated at baseline, on day 3, and on day 7. The assessed outcomes included the presence of oral candidiasis, the number of affected sites, and lesion extent. Results: Fifty-six patients were equally allocated between the two groups, with a mean age of 60.4 years. All patients presented pseudomembranous candidiasis affecting the tongue (100%), and nine patients also presented concomitant angular cheilitis. Regarding the primary outcome, clinical cure on day 7 was observed exclusively in the aPDT group (p = 0.001). Concerning the number of affected sites, a statistically significant difference was observed between the treatment groups on day 7 (p < 0.0001), with a greater reduction in the number of affected sites in the aPDT group compared with the CG. Regarding lesion extent, statistically significant differences were found between the groups on day 3 (p = 0.022) and day 7 (p = 0.013), with a greater reduction in lesion size in the aPDT group. Cytopathological analysis showed complete agreement with the clinical diagnosis at baseline; however, five discordant cases between the clinical and cytological diagnoses were identified at days 3 and 7. A statistically significant association was also observed between the clinicopathological classification and treatment group, with remission being associated with the aPDT group and persistence of infection with the control group. Conclusion: In critically ill patients, adjunctive antimicrobial photodynamic therapy proved to be more effective than conventional treatment alone for the management of oral candidiasis. These findings suggest that aPDT is a promising adjunctive therapeutic strategy for the management of this opportunistic infection in the hospital setting.

COMMITTEE MEMBERS:
Interna - 2492713 - ERICKA JANINE DANTAS DA SILVEIRA
Externa ao Programa - 3469623 - MAURILIA RAQUEL DE SOUTO MEDEIROS - UFRNExterna à Instituição - NADIA DO LAGO COSTA - UFG