Abstract
Elimination of root canal pathogens is one of the main objectives for successful outcome of root canal treatment. Conventional chemo-mechanical debridement is not always successful in removing all bacteria. Adjunctive use of antimicrobial photodynamic therapy (aPDT) can be a used as a practical approach for successful elimination of all these bacteria. The aim of this review was to assess scientific literature that used various photosensitizers for bacterial reduction using aPDT methods. A search of the PubMed and Cochrane data bases using appropriate terms and keywords related to antimicrobial photodynamic therapy in endodontic disinfection was conducted. A hand search also was conducted in the preceding 5 years of several journals. Full texts of the selected articles were obtained and analyzed. A total of 177 articles published were identified at first stage of data extraction. After final screening, 41 articles were included in this review. This review summarizes the usage principles of aPDT and outlines the applications of aPDT in root canal disinfection procedures. It was concluded that aPDT should be used in conjunction with the conventional chemo mechanical debridement and disinfection of root canal system. It is critical to note that selection of photosensitizer dye, its correct delivery within the prepared root canal system, laser application with correct type of tips are predictors for successful outcome of this protocol of root canal disinfection.
Highlights
Endodontic treatment outcome is dependent on the presence and absence of microbes inside the root canal system [1]
In Anti-microbial photo dynamic therapy (aPDT), it is ensured that reactive oxygen species (ROS) and singlet oxygen are applied only to bacterial structures and not to human cells by selective distribution using a dye which only binds to microbes
Results of recent studies are encouraging to use of aPDT as an adjunct to the usual root canal preparation and irrigation techniques
Summary
Endodontic treatment outcome is dependent on the presence and absence of microbes inside the root canal system [1]. To enhance the root canal disinfection properties of ordinary irrigants, using Anti-microbial photo dynamic therapy (aPDT) protocol is proposed. High power lasers due to their heat based destruction of microbes aided in developing the methods that are useful in root canals disinfection [5,6,7,8]. There are concerns of some undesirable effects on surface of radicular dentin that include carbonization and cratering with some lasers types e.g. Nd:YAG and carbon dioxide lasers, and this warrants following strict protocols to minimize these effects during use of these lasers for root canal disinfection [9]
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