Abstract
ABSTRACT This article describes the application of Photodynamic Therapy as an aid to the endodontic treatment performed on a permanent tooth iatrogenically perforated and with pulp necrosis. After clinical and radiographic examination, the coronary access, curettage of the drilling area and mechanized preparation with the Reciproc System were performed. The drilling area was sealed with Mineral Trioxide Aggregate after prior alkalinization and decontamination by a calcium hydroxide buffer. After successive intracanal medication changes, the remission of the fistula, a clinical sign of endodontic infection, was not observed. Photodynamic therapy was then performed to reduce bacterial load in the root canal system, which resulted in fistula suppression. Then, it was possible to end the treatment with the obturation of the ducts by the Tagger Hybrid thermomechanical technique. After a year of proservation, the tooth presents no symptomatology and it is concluded that the Photodynamic Therapy was an effective solution in this case.
Highlights
The current endodontic techniques are not yet able to remove all the bacteria from the Complex Root Canal System (RCS), which makes it difficult to completely remove the microorganisms and bacterial persistence can occur after treatment [1,2,]
The removal of microorganisms remaining from RCS and the prevention of subsequent reinfection are the most important objectives in the success of endodontic treatment [3]
This work reported a case with apical periodontitis with persistent fistula in a tooth with pulp necrosis in which Photodynamic Therapy was used as an additional resource in the elimination of RCS microorganisms
Summary
The current endodontic techniques are not yet able to remove all the bacteria from the Complex Root Canal System (RCS), which makes it difficult to completely remove the microorganisms and bacterial persistence can occur after treatment [1,2,]. The removal of microorganisms remaining from RCS and the prevention of subsequent reinfection are the most important objectives in the success of endodontic treatment [3]. The failures in conventional endodontic treatment are related to residual and permanent infections, which require additional strategies for disinfection [4]. PDT does not have serious side effects and can be repeated frequently. It destroys cells by necrosis or apoptosis and can be used for localized destruction of living tissue with abnormal growth [7]
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