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BMC Oral Health

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Open Access 01-12-2023 | Photodynamic Therapy | Research

Efficacy of photodynamic therapy in the treatment of oral candidiasis: a systematic review and meta-analysis

Authors: Qiaoyu Hu, Ting Li, Jiadi Yang, Yanhui Peng, Qing Liu, Na Liu

Published in: BMC Oral Health | Issue 1/2023

Abstract

Objective

To evaluate the clinical efficacy of photodynamic therapy (PDT) as an adjunct or alternative to traditional antifungal drugs in the treatment of oral candidiasis, and to provide evidence-based medical evidence for its use in the treatment of oral candidiasis.

Methods

Computer combined with manual retrieval of China Academic Journals Full-text Database (CNKI), China Biomedical Literature Database (CBM), Chinese Science and Technology Journal Database (VIP), Wanfang Database, PubMed, Web of Science, Cochrane Library, Embase, Scopus retrieval for articles published before January 2023, basic information and required data were extracted according to the inclusion and exclusion criteria, and the Revman V5.4 software was used to conduct Meta-analysis of the included literature.

Results

A total of 11 articles were included, 7 of which used nystatin as an antifungal drug, 2 of which were combined treatment of PDT and nystatin, 2 of the remaining 4 articles were treated with fluconazole, and 2 were treated with miconazole. Meta results showed that PDT was superior to nystatin in reducing the number of oral candida colonies in the palate of patients MD = -0.87, 95%CI = (-1.52,-0.23), P = 0.008, the difference was statistically significant, and the denture site MD = -1.03, 95%CI = (-2.21, -0.15), P = 0.09, the difference was not statistically significant; compared with the efficacy of fluconazole, RR = 1.01, 95%CI = (0.56,1.83), P = 0.96; compared with miconazole RR = 0.55, 95%CI = (0.38, 0.81), P = 0.002; PDT combined with nystatin RR = 1.27, 95%CI = (1.06, 1.52), P = 0.01; recurrence rate RR = 0.28, 95%CI = (0.09, 0.88), P = 0.03.

Conclusions

PDT was effective in the treatment of oral candidiasis; PDT was more effective than nystatin for the treatment of denture stomatitis in the palate, while there was no significant difference between the two for the denture site; The efficacy of PDT for oral candidiasis was similar to that of fluconazole; PDT was less effective than miconazole for oral candidiasis; Compared with nystatin alone, the combination of PDT and nystatin is more effective in treating oral candidiasis with less risk of recurrence.

Available only for authorised users

DY Wei, ZM Yan. Prospects and research progress of photodynamic therapy in oral candidiasis. Oral Med Res. 2020;36(12):1087-1090. https://doi.org/10.13701/j.cnki.kqyxyj.2020.12.002.

Lu SY. Oral Candidosis: pathophysiology and best practice for diagnosis, classification, and successful management. J Fungi (Basel). 2021;7(7):555. https://doi.org/10.3390/jof7070555.CrossRefPubMed

Pappas PG, Kauffman CA, Andes D, et al. Clinical practice guidelines for the management of candidiasis: 2009 update by the Infectious Diseases Society of America. Clin Infect Dis. 2009;48(2009):503–35. https://doi.org/10.1086/596757.CrossRefPubMed

Akpan A, Morgan R. Oral candidiasis. Postgrad Med J. 2002;78:455–9. https://doi.org/10.1136/pmj.78.922.455.CrossRefPubMedPubMedCentral

Yan ZM, Hua H. Standardized diagnosis concept and prevention strategy of oral candidiasis. Chin J Stomatology. 2022;57(7):780–5. https://doi.org/10.3760/cma.j.cn112144-20220418-00195.CrossRef

Goldman GH, da Silva Ferreira ME, dos Reis Marques E, et al. Evaluation of fluconazole resistance mechanisms in Candida albicans clinical isolates from HIV- infected patients in Brazil. Diagn Microbiol Infect Dis. 2004;50:25–32. https://doi.org/10.1016/j.diagmicrobio.2004.04.009.CrossRefPubMed

Cinzia C, Fanuli M, Viganò L. Photodynamic therapy for oral candidosis: a new option? Juniper Online J Case Stud. 2018;6(5):1–3. https://doi.org/10.19080/JOJCS.2018.06.555698.CrossRef

Wiench R, Skaba D, Matys J, Grzech-Leśniak K. Efficacy of Toluidine Blue-Mediated Antimicrobial Photodynamic Therapy on Candida spp. A Systematic Review Antibiotics (Basel). 2021;10(4):349. https://doi.org/10.3390/antibiotics10040349.CrossRefPubMed

Wilson M, Yianni C. Killing of methicillin-resistant Staphylococcus aureus by low-power laser light. J Med Microbiol. 1995;42(1):62–6. https://doi.org/10.1099/00222615-42-1-62.CrossRefPubMed

10.

Siqueira JF Jr, Rôças IN. Polymerase chain reaction-based analysis of microorganisms associated with failed endodontic treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2004;97(1):85–94. https://doi.org/10.1016/s1079-2104(03)00353-6.CrossRefPubMed

11.

Hoedke D, Enseleit C, Gruner D, Dommisch H, Schlafer S, Dige I, Bitter K. Effect of photodynamic therapy in combination with various irrigation protocols on an endodontic multispecies biofilm ex vivo. Int Endod J. 2018;51(Suppl 1):e23–34. https://doi.org/10.1111/iej.12763.CrossRefPubMed

12.

Donnelly RF, McCarron PA, Tunney MM. Antifungal photodynamic therapy. Microbiol Res. 2008;163:1–12. https://doi.org/10.1016/j.micres.2007.08.001.CrossRefPubMed

13.

Konopka K, Goslinski T. Photodynamic therapy in dentistry. J Dent Res. 2007;86:694–707. https://doi.org/10.1177/154405910708600803.CrossRefPubMed

14.

EG de Oliveira Mima, AC Pavarina, LN Dovigo, CE Vergani, CA de Souza Costa, C Kurachi, VS Bagnato. Susceptibility of Candida albicans to photodynamic therapy in a murine model of oral candidosis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109:392–401. https://doi.org/10.1016/j.tripleo.2009.10.006.

15.

Gu Y, Zhang X, Liu J, et al. Photodynamic therapy for denture stomatitis. J Modern Dent. 2021;35(03):204–7.

16.

Dompe C, Moncrieff L,Matys J, et al. Photobiomodulation—Underlying Mechanism and Clinical Applications. J Clin Med. 2020;9(6). https://doi.org/10.3390/jcm9061724.

17.

Jin WW, et al. Research progress of photosensitizers in photodynamic therapy. Guangdong Chemistry. 2022;49(18):76–7.

18.

Hui XU, Hongxia CHEN, Xianbiao ZOU. Experimental study on the photodynamic inhibitory effect of different photosensitizer incubation time in Candida albicans. Chinese Journal of Mycology. 2015;10(03):146–50.

19.

Mima EG, et al. Comparison of Photodynamic Therapy versus conventional antifungal therapy for the treatment of denture stomatitis: a randomized clinical trial. Clin Microbiol Infect. 2012;18(10):E380–8. https://doi.org/10.1111/j.1469-0691.2012.03933.x.CrossRefPubMed

20.

de Senna AM. et al. Photodynamic inactivation of Candida ssp. on denture stomatitis. A clinical trial involving palatal mucosa and prosthesis disinfection. Photodiagnosis Photodyn Ther. 2018;22. https://doi.org/10.1016/j.pdpdt.2018.04.008.

21.

Maciel CM, et al. Methylene Blue-Mediated Photodynamic Inactivation Followed by Low-Laser Therapy versus Miconazole Gel in the Treatment of Denture Stomatitis. J Prosthodont. 2016;25(1):28–32. https://doi.org/10.1111/jopr.12284.CrossRefPubMed

22.

Page, Matthew J, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev. 2021;10(1):89. https://doi.org/10.1186/s13643-021-01626-4.

23.

Higgins JP, Altman DG, Gøtzsche PC, et al. The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials [J]. BMJ. 2011;343:d5928. https://doi.org/10.1136/bmj.d5928.CrossRefPubMedPubMedCentral

24.

Roomaney IA, Holmes HK, Engel MM. Treatment of oral fungal infections using photodynamic therapy: Systematic review and meta-analysis. Clin Exp Dent Res. 2021;7(3):354–64. https://doi.org/10.1002/cre2.408.CrossRefPubMedPubMedCentral

25.

Atkins D, et al. Systems for grading the quality of evidence and the strength of recommendations II: pilot study of a new system. BMC Health Serv Res. 2005;5(1):25. https://doi.org/10.1186/1472-6963-5-25.CrossRefPubMedPubMedCentral

26.

Labban N, et al. Efficacy of Rose Bengal and Curcumin mediated photodynamic therapy for the treatment of denture stomatitis in patients with habitual cigarette smoking: A randomized controlled clinical trial. Photodiagnosis Photodyn Ther. 2021;35:102380. https://doi.org/10.1016/j.pdpdt.2021.102380.CrossRefPubMed

27.

Alves F, et al. A randomized clinical trial evaluating Photodithazine-mediated Antimicrobial Photodynamic Therapy as a treatment for Denture stomatitis. Photodiagnosis Photodyn Ther. 2020;32:102041. https://doi.org/10.1016/j.pdpdt.2020.102041.CrossRefPubMed

28.

Alrabiah M, et al. Efficacy of photodynamic therapy versus local nystatin in the treatment of denture stomatitis: A randomized clinical study. Photodiagnosis Photodyn Ther. 2019;28:98–101. https://doi.org/10.1016/j.pdpdt.2019.08.028.CrossRefPubMed

29.

Chen C. Zheila Ekranmu & T Guo, Efficacy and safety analysis of mycoplasma combined with photodynamic antimicrobial therapy in the treatment of oral candidiasis. Chinese Journal of Modern Medicine. 2022;32(4):9–13.

30.

Afroozi B, et al. Comparison of the efficacy of indocyanine green-mediated photodynamic therapy and nystatin therapy in treatment of denture stomatitis. Photodiagnosis Photodyn Ther, 2019:193–197. https://doi.org/10.1016/j.pdpdt.2019.06.005.

31.

Y Zhao. Efficacy of photodynamic antimicrobial therapy on oral candidiasis in AIDS patients with combined oral cavity. Guangxi Medical University; MA thesis; 2018.

32.

JM Qin. Study on the antibacterial effect of photodynamic therapy on oral candidiasis in patients with AIDS. Guangxi Medical University; MA thesis; 2018.

33.

Scwingel AR, et al. Antimicrobial photodynamic therapy in the treatment of oral candidiasis in HIV-infected patients. Photomed Laser Surg. 2012;30(8):429–32. https://doi.org/10.1089/pho.2012.3225.CrossRefPubMed

34.

Klotz SA, Drutz DJ, Zajic JE. Factors governing adherence of Candida species to plastic surfaces. Infect Immun. 1985;50:97–101. https://doi.org/10.1128/iai.50.1.97-101.1985.CrossRefPubMedPubMedCentral

35.

Chandra J, Mukherjee PK, Leidich SD, Faddoul FF, Hoyer LL, Douglas LJ, et al. Antifungal resistance of Candidal biofilms formed on denture acrylic in vitro. J Dent Res. 2001;80:903–8. https://doi.org/10.1177/00220345010800031101.CrossRefPubMed

36.

Paranhos HFO, Silva-Lovato CH, Souza RF, Cruz PC, Freitas KM, Peracini A. Effects of mechanical and chemical methods on denture biofilm accumulation. Randomized Controlled Trial J Oral Rehabil. 2007;34:606–12. https://doi.org/10.1111/j.1365-2842.2007.01753.x.CrossRefPubMed

37.

Jayatilake JA, Samaranayake YH, Samaranayake LP. An ultrastructural and a cytochemical study of candidal invasion of reconstituted human oral epithelium. J Oral Pathol Med. 2005;34:240–6. https://doi.org/10.1111/j.1600-0714.2005.00307.x.CrossRefPubMed

38.

Abduljabbar T, Al-Askar M, Baig MK, AlSowygh ZH, Kellesarian SV, Vohra F. Efficacy of photodynamic therapy in the inactivation of oral fungal colonization among cigarette smokers and non-smokers with denture stomatitis. Photodiagnosis Photodyn Ther. 2017;18:50–3. https://doi.org/10.1016/j.pdpdt.2017.01.182.CrossRefPubMed

39.

YX Xiao, YT Sun, YM Xu et al. Meta-analysis of the efficacy and safety of topical antifungal drugs in the treatment of oral candidiasis[C]//Chinese Oral Mucosal Disease Committee, Chinese Oral Medical Association, Chinese Oral Medical Association, Chinese Medicine and Western Medicine Committee. Compilation of papers from the 13th National Oral Mucosal Pathology and the 11th National Conference on Combination of Chinese and Western Medicine in Stomatology of the Chinese Society of Stomatology. [publisher unknown], 2021:2. https://doi.org/10.26914/c.cnkihy.2021.062872.

40.

He C, Song Y, Chang XK. Pathogenicity and drug-resistance analysis of Candida glabrata in patients with oral candidiasis. Zhonghua Yi Xue Za Zhi. 2020;100(23):1778–82.PubMed

41.

Zhang YY, et al. Advances in the resistance mechanism of Candida albicans to clinically used antifungal drugs. Chinese Journal of Mycology. 2022;17(03):251–4.

42.

Rautemaa R, Ramage G. Oral candidosis–clinical challenges of a biofilm disease. Crit Rev Microbiol. 2011;37:328–36. https://doi.org/10.3109/1040841X.2011.585606.CrossRefPubMed

43.

Kashef N, Hamblin MR. Can microbial cells develop resistance to oxidative stress in antimicrobial photodynamic inactivation? Drug resistance updates: reviews and commentaries in antimicrobial and anticancer chemotherapy. 2017;31:31–42. https://doi.org/10.1016/j.drup.2017.07.003.CrossRefPubMed

44.

Kinoshita H, Yoshioka M, Ihara F, Nihira T. Cryptic antifungal compounds active by synergism with polyene antibiotics. J Biosci Bioeng. 2016;121:394–8. https://doi.org/10.1016/j.jbiosc.2015.08.003.CrossRefPubMed

45.

Baltazar LM, et al. Antimicrobial photodynamic therapy: an effective alternative approach to control fungal infections. F Microbiol. 2015;6:202. https://doi.org/10.3389/fmicb.2015.00202.CrossRef

46.

Muzurovic S, Hukic M, Babajic E, Smajic R. The relationship between cigarette smoking and oral colonization with Candida species in healthy adult subjects. Med Glas (Zenica). 2013;10:397–9.PubMed

47.

Soysa N, Ellepola A. The impact of cigarette/tobacco smoking on oral candidosis: an overview. Oral Dis. 2005;11:268–73. https://doi.org/10.1111/j.1601-0825.2005.01115.x.CrossRefPubMed

48.

Alaizari NA, Al-Anazi JR. Oral Candida carriage in smokers and tobacco users: A systematic review and meta-analysis of observational studies. J Oral Biosci. 2020;62(4):342–8. https://doi.org/10.1016/j.job.2020.09.006.CrossRefPubMed

Title: Efficacy of photodynamic therapy in the treatment of oral candidiasis: a systematic review and meta-analysis
Authors: Qiaoyu Hu
Ting Li
Jiadi Yang
Yanhui Peng
Qing Liu
Na Liu
Publication date: 01-12-2023
Publisher: BioMed Central
Keywords: Photodynamic Therapy
Nystatin
Candidiasis
Candidiasis
Denture
Fluconazole
Published in: BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI: https://doi.org/10.1186/s12903-023-03484-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Efficacy of photodynamic therapy in the treatment of oral candidiasis: a systematic review and meta-analysis

Abstract

Objective

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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