Removal of black stains from teeth by photodynamic therapy: clinical and microbiological analysis.

Black-pigmented bacteria (BPB) are Gram-negative anaerobic, non-motile, proteolytic rods strongly implicated in the pathogenesis of periodontal disease. Although pigments are produced in vitro, black pigmentation is rarely found clinically. However, it may compromise aesthetics and contribute to gingival inflammation. The aim of this report is to describe a clinical case of a 10-year-old boy showing black pigmentation covering all teeth and to propose an alternative therapy for removal of black pigmentation, based on photodynamic therapy (PDT). In order to perform microbiological analysis, plaque samples were collected before and after PDT, and analysed by real-time-PCR (RT-PCR). The results showed a significant reduction in BPB levels after therapy, along with clinical evidence of absence of black pigmentation and reduction in gingival bleeding, although the plaque index remained unaltered. This case showed that PDT is effective for eliminating black pigmentation caused by BPB, without recurrence during a follow-up period of 7 months.