Comparative Study Between Photodynamic Therapy with LED Associated with Probiotics in the Treatment of Halitosis
NCT Number: NCT06583720
Status: NOT_YET_RECRUITING
Study Type: INTERVENTIONAL
Phases: PHASE1
Conditions: Halitosis
Sponsor: University of Nove de Julho
Sex: ALL
Age: ADULT
Enrollment: 92
Study Design: Allocation: RANDOMIZED|Intervention Model: PARALLEL|Masking: NONE|Primary Purpose: TREATMENT
Start Date: 2024-11-01
Completion Date: 2025-12-30

Summary:
Halitosis is a term that defines any odor or bad smell coming from the oral cavity, which can have a local or systemic origin. This project aims to verify if there is a difference in the effectiveness of treatment with antimicrobial photodynamic therapy (aPDT) with LED associated with treatment using probiotics in reducing halitosis. 92 participants, aged 18 to 60 years, diagnosed with halitosis, presenting sulfhydride (SH2) ≥ 112 ppb in gas chromatography will be selected. Participants will be randomly divided into 4 groups (n=23), which will receive different treatments: Group 1 (control): brushing, dental floss and tongue scraper; Group 2: brushing, dental floss, tongue scraper and aPDT with blue LED and annatto; Group 3: brushing, dental flossing, tongue scraper and aPDT with blue LED, annatto and probiotics in chewing gum (Streptococcus salivarius K12 (1 x 109 UFC) and xylitol (280mg); Group 4: brushing, dental flossing, tongue scraper and probiotics in chewing gum (Streptococcus salivarius K12 (1 x 109 UFC) and xylitol (280mg). The results of the halimetry will be compared before, immediately after the treatments, thirty days after and sixty days after. The microbiological analysis will be performed by counting the colony forming unit of viable bacteria in the tongue coating at these same times. The microbiome analysis will be performed before, thirty days after and sixty days after the treatments after DNA extraction. All groups will be treated with oral hygiene instructions with a toothbrush, toothpaste and dental floss as well as receiving material for this practice. The normality of the data will be measured by the Shapiro-Wilk test, and in the case of normality the Analysis of Variance (ANOVA) test will be applied, and in the case of non-parametric data, the Kruskal-Wallis test will be used. The Wilcoxon test will be used to analyze the results of each treatment in the two study periods.

Primary Outcome Measures: Changes in Halimetry Levels, The collection of oral air will follow the manufacturer\&#39;s instructions (Oral ChromaTM Manual Instruction), where the participant will be instructed to rinse with cysteine (10 mM) for 1 minute, then keep their mouth closed for another minute. A syringe from the same manufacturer, suitable for collecting oral air, will be placed in the patient\&#39;s mouth. For 1 minute, the patient will remain with their mouth closed, breathing through their nose, without touching the syringe with their tongue. The plunger will be pulled out, we will empty the air from the syringe into the patient\&#39;s mouth again and pull the plunger again to fill the syringe with the breath sample. We will clean the tip of the syringe with gauze to remove moisture from the saliva, place the gas injection needle on the syringe, and adjust the plunger to 0.5 ml. The collected gases are injected into the inlet port of the device with a single movement., Baseline, immediately after treatment, 30 days after treatment and 60 days after treatment.
Secondary Outcome Measures: Changes in Microbiological Analysis, The samples will be collected with a swab on the back of the tongue, then placed in an eppendorf containing BHI (Brain Heart Infusion) serving as a transport medium, for later cultivation of these samples to be able to detect the total number of viable bacteria. Initially, the samples will be homogenized for 30 seconds in a Vortex apparatus, and then diluted in the order of 10-1 to 10-5 in a 96-well microtiter plate containing 180 microliters of PBS in each well. We take 20 microliters of each sample and follow the dilution sequence. After the dilution is performed, we will take 5 aliquots of 10 microliters of this suspension and they will be seeded in a petri dish with blood agar. The cultures will then be incubated for 72 hours at 37°C in an atmosphere of 85% nitrogen (N2), 10% carbon dioxide (CO2) and 5% hydrogen (H2), achieved through the use of an anaerobic generation system. This will provide visual access to the total number of viable bacteria in colony forming units (CFU)., Baseline, immediately after treatment, 30 days after treatment and 60 days after treatment.|Changes in Microbiome Analysis, Tongue coating samples will be collected from the posterior third of the tongue using a sterile swab and deposited in 1.5 mL centrifuge tubes containing Tris-EDTA buffer (10 mM Tris-HCL, 0.1 mM EDTA, pH 7.5) and stored at -80 °C. After thawing, the samples will be vortexed for one minute. DNA extraction will be performed using the Master Pure DNA Extraction Kit (Epicentre Technologies Corp., Chicago, IL, USA) according to the manufacturer\&#39;s instructions. The purified DNA will be resuspended in TE buffer. The microbiome and variations between communities will be analyzed using pyrosequencing and 16S rRNA gene metagenomics methods., Baseline, immediately after treatment, 30 days after treatment and 60 days after treatment.