# Antimicrobial Efficacy of Photodynamic Therapy as an Adjunct to Brix 3000 in Minimally Invasive Management of Carious Lesions in Primary Teeth

**Authors:** Zornitsa Lazarova, Raina Gergova, Nadezhda Mitova

PMC · DOI: 10.3390/ph19020310 · Pharmaceuticals · 2026-02-12

## TL;DR

This study shows that adding photodynamic therapy to Brix 3000 improves antimicrobial effectiveness in treating carious lesions in children's primary teeth.

## Contribution

The study demonstrates that photodynamic therapy enhances the antimicrobial efficacy of Brix 3000 in minimally invasive caries treatment.

## Key findings

- Brix 3000 reduced microbial diversity and quantity but left S. mutans at lower levels.
- Adjunctive photodynamic therapy eliminated all microorganisms from partially infected dentin.
- PDT provides non-invasive antimicrobial disinfection suitable for minimally invasive caries management.

## Abstract

Background/Objectives: In the context of minimally invasive dentistry, photodynamic therapy (PDT) is regarded as a biologically oriented method for controlling microbial activity during caries excavation. Brix 3000 is a modern material used in chemo-mechanical removal of carious lesions, enabling selective elimination of infected dentin. The present study compares the antimicrobial effectiveness of Brix 3000 and adjunctive PDT performed with the FotoSan 630 Intro Kit. Methods: This study included 30 children aged 4–7 years with carious lesions on primary molars classified as ICDAS II code 06. The lesions were allocated into two groups: Group 1 (the control group), encompassing 15 lesions excavated using Brix 3000 only, and Group 2 (the experimental group), encompassing 15 lesions excavated with Brix 3000 followed by adjunctive PDT with the FotoSan 630 Intro Kit. A total of 75 microbiological samples were collected: 30 from infected dentin before excavation, 30 from partially infected dentin after Brix 3000, and 15 (experimental group only) after subsequent PDT. Results: The results revealed a wide diversity of cariogenic microorganisms in the infected dentin, with S. mutans being the most frequently isolated and present in the highest quantities. Using Brix 3000 reduced microbial diversity and quantity following excavation of partially infected dentin, although S. mutans persisted at lower levels. Conclusions: After the additional photodynamic disinfection, no microorganisms were isolated from the partially infected dentin. Adjunctive PDT provides localized, non-invasive antimicrobial disinfection and can be integrated into minimally invasive caries management in primary teeth.

## Linked entities

- **Species:** Streptococcus mutans (taxon 1309)

## Full-text entities

- **Diseases:** pulpitis (MESH:D011671), cytotoxic (MESH:D064420), infected (MESH:D007239), Carious Lesions (MESH:D003731), hypoxic (MESH:D002534), injury to (MESH:D014947), pulp inflammation (MESH:D007249)
- **Chemicals:** reactive oxygen species (MESH:D017382), hydrogen (MESH:D006859), lipids (MESH:D008055), CO2 (MESH:D002245), indocyanine green (MESH:D007208), calcium hydroxide (MESH:D002126), superoxide (MESH:D013481), Brix (-), hydrogen peroxide (MESH:D006861), hydroxyl radicals (MESH:D017665), toluidine blue (MESH:D014048), methylene blue (MESH:D008751), oxygen (MESH:D010100), singlet oxygen (MESH:D026082)
- **Species:** Streptococcus mitis (species) [taxon 28037], Staphylococcus epidermidis (species) [taxon 1282], Homo sapiens (human, species) [taxon 9606], Streptococcus parasanguinis (species) [taxon 1318], Streptococcus sanguinis (species) [taxon 1305], Streptococcus mutans (species) [taxon 1309]

## Full text

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## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12944514/full.md

## References

27 references — full list in the complete paper: https://tomesphere.com/paper/PMC12944514/full.md

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Source: https://tomesphere.com/paper/PMC12944514