Abstract
Light-activated disinfection (LAD) has emerged as a novel approach toward antimicrobial disinfection within the root canal. This approach is based on the concept that porphyrins and photosensitizers (PSs) can be activated by light to produce cytotoxic elements that induce the desired therapeutic effect. Unlike antibiotics, LAD can act on multiple targets within a bacterial cell, including membrane lipids, genomic DNA and various proteins, including enzymes, thus reducing the ability of the organism to acquire resistance.The aim of this review was to develop an understanding of the potential use of LAD in endodontics and to suggest strategies to maximize the antibacterial effects of LAD.The electronic searches of the PubMed/MEDLINE, Web of Science, Scopus, and Cochrane databases were complemented by a manual hand search. A total of 303 studies were evaluated for essential parameters, which included the origin, types/variations, methodology, and application of LAD in in vitro and in vivo studies.It can be concluded that LAD is effective against the vast majority of bacterial pathogens, including antibioticresistant Gram-negative and Gram-positive bacteria, along with several yeasts, viruses and protozoan species. The literature tends to suggest that LAD can be used either as a substitute or an adjunct to the conventional antimicrobial treatment regimens that are implemented to battle polymicrobial biofilms.
Highlights
There are over 700 microbial species that can be present in the oral cavity, and an individual can have 100–200 species at any given time.[1]
Light-activated disinfection (LAD) can act on multiple targets within a bacterial cell, including membrane lipids, genomic DNA and various proteins, including enzymes, reducing the ability of the organism to acquire resistance
The aim of this review was to develop an understanding of the potential use of LAD in endodontics and to suggest strategies to maximize the antibacterial effects of LAD
Summary
There are over 700 microbial species that can be present in the oral cavity, and an individual can have 100–200 species at any given time.[1]. Primary root canal infections are polymicrobial in nature and are dominated by anaerobic bacterial species.[2]. Most anaerobes are easy to eliminate during root canal treatment, but facultative bacteria may survive the disinfection procedures.[2]. Enterococcus faecalis is the microorganism that has been isolated in most cases of failed root canal treatment, and has been mentioned in the literature as one of the chief causative agents.[3]. Along with E. faecalis, Staphylococcus, Enterococcus, Enterobacter, Bacillus, Pseudomonas, Stenotrophomonas, Sphingomonas, Candida, and Actinomyces spp. have been isolated from root-filled teeth with posttreatment disease.[4–9]. Antibacterial agents are widely used in the treatment of bacterial infections, but the emergence of bacterial pathogens resistant to the commonly used chemotherapeutics has led to a search for alternative drugs and/or therapies to overcome the development of resistant species Along with E. faecalis, Staphylococcus, Enterococcus, Enterobacter, Bacillus, Pseudomonas, Stenotrophomonas, Sphingomonas, Candida, and Actinomyces spp. have been isolated from root-filled teeth with posttreatment disease.[4–9] Antibacterial agents are widely used in the treatment of bacterial infections, but the emergence of bacterial pathogens resistant to the commonly used chemotherapeutics has led to a search for alternative drugs and/or therapies to overcome the development of resistant species
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