title: Effect of Photodynamic Antimicrobial Chemotherapy on Mono- and Multi-Species Cariogenic Biofilms: A Literature Review.
abstract: OBJECTIVE
  The aim of this literature review is to study the effect of photodynamic antimicrobial chemotherapy (PACT) on mono- and multi-species cariogenic biofilms.
  
  
  METHODS
  To this purpose, the database, PubMed, was searched using the descriptors, photodynamic therapy, antimicrobial photodynamic chemotherapy, and photoinactivation, associated with the mandatory presence of the word biofilm. A total of 98 references published from 2003 to 2016 were selected. Moreover, literature reviews (15), investigations that did not have biofilms related to dental caries (65), and those that did not have Streptococcus mutans count as an outcome (7) were excluded, yielding a final amount of 11 publications.
  
  
  RESULTS
  The results revealed that Toluidine Blue O was the most used photosensitizer. Among the sources of light, light-emitting diode was the choice, and the biofilm models varied between in vitro and in situ. Multi-species biofilms were more resistant to the antimicrobial effects of PACT due to the thickness and complexity they have, which impede the penetration of the photosensitizer. This fact may also be associated with the type of photosensitizer used as well as with the light exposure time since the antimicrobial effect seems to be dose dependent. Despite this, in all the included publications, the therapy was effective in reducing S. mutans count.
  
  
  CONCLUSIONS
  This review demonstrated that under different conditions, PACT is effective in reducing S. mutans count in monospecies biofilms. Multi-species biofilms were more resistant to the antimicrobial action of the therapy, possibly due to their thickness and complexity.
authors.affiliation: 1 Department of Microbiology, College of Dentistry, Federal University of Ceara , Sobral, Ceara, Brazil .
authors.forename: Maria Tayara Marques
authors.initials: MTM
authors.lastname: de Freitas
authors.affiliation: 1 Department of Microbiology, College of Dentistry, Federal University of Ceara , Sobral, Ceara, Brazil .
authors.forename: Talyta Teixeira
authors.initials: TT
authors.lastname: Soares
authors.affiliation: 1 Department of Microbiology, College of Dentistry, Federal University of Ceara , Sobral, Ceara, Brazil .
authors.forename: Maria Gerusa Brito
authors.initials: MGB
authors.lastname: Aragão
authors.affiliation: 2 Department of Dental Clinics, School of Pharmacy, Dentistry and Nursing, Federal University of Ceara , Fortaleza, Ceara, Brazil .
authors.forename: Ramille Araújo
authors.initials: RA
authors.lastname: Lima
authors.affiliation: 3 Department of Basic Science and Craniofacial Biology, College of Dentistry, New York University , New York, New York.
authors.forename: Simone
authors.initials: S
authors.lastname: Duarte
authors.affiliation: 1 Department of Microbiology, College of Dentistry, Federal University of Ceara , Sobral, Ceara, Brazil .
authors.forename: Iriana Carla Junqueira
authors.initials: ICJ
authors.lastname: Zanin
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D018441:Biofilms / Q000187:drug effects; D003731:Dental Caries / Q000188:drug therapy* / Q000382:microbiology*; D006801:Humans; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000494:pharmacology*; D014048:Tolonium Chloride / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D017319:Photosensitizing Agents; D014048:Tolonium Chloride
keywords: Streptococcus mutans; antimicrobial photodynamic chemotherapy; caries; photodynamic therapy; photoinactivation