Antimicrobial Photodynamic Therapy as a Co‐adjuvant in Endodontic Treatment of Deciduous Teeth: Case Series

Abstract

To assure the success of endodontic treatment, the root canal must be completely decontaminated. Thus, some methods have been researched in an attempt to effectively eliminate microorganisms from the interior of the root canal system. Among them is conventional endodontic therapy in conjunction with photodynamic therapy (PDT). Five anterior deciduous teeth were treated endodontically with the conventional technique and PDT. For PDT, 0.005% methylene blue was used as a photosensitizer and a 660 nm laser. After the conventional endodontic therapy, the photosensitizer was applied inside the root canal, 3 min of pre-irradiation time, and then, the laser was applied for 40s with an energy of 4J. Afterward, the canal was irrigated with saline solution and the sealing material of the root canal was placed. The microbiological analysis of the samples was collected before and after the treatments were performed. Observing the results obtained in this case series, which showed a bacterial reduction from 37.57% to 100%, and the clear difficulty in the success of endodontic treatment of deciduous teeth, antimicrobial photodynamic therapy can be considered an alternative of easy application that does not generate microbial resistance, to act as a support in the decontamination of the root canals.

Utility of Photodynamic Therapy in Dentistry: Current Concepts

“…Microbiological samples of the infected and disinfected root canal were taken, and the bacterial colonies were examined under a microscope. The results showed a bacterial reduction from 37.6% to a whopping 100%, further underlying the statement that PDT can be considered an alternative method to act as a support to root canal disinfection [93]. Compared with irrigation by the conventional sodium hypochlorite (which is considered to be the gold standard for root canal irrigation), PDT has shown very promising results.…”

“…Recently, research has been conducted to support the use of PDT in conjunction with conventional chemo-mechanical preparations (Figure 4) [92]. The most recent evidence was shown by Okamoto et al; after conventional root canal treatment was carried out on five anterior and deciduous teeth, PDT was conducted using the photosensitizer methylene blue and a 660 nm laser light [93]. The root canal was then irrigated with saline and a sealant was placed.…”

Antimicrobial Photodynamic Therapy in the Endodontic Treatment of Deciduous Teeth: In Vivo Pilot Study

“…Therefore, it is important to use additional techniques that may offer assistance with antimicrobial activity [7,8]. Different studies have concluded that photodynamic therapy can aid in the endodontic treatment of deciduous teeth, resulting in a significant reduction in the number of microbiota present in deciduous teeth with necrotic pulp [1,9]. Photodynamic antimicrobial therapy (aPDT) is based on the concept that a non-toxic dye, known as photosensitizer (FS), can be activated by low doses of visible light and an appropriate wavelength to generate singlet oxygen and free radicals, which are cytotoxic to bacterial cells [10].…”

“…Blue dyes, especially toluidine blue and methylene blue, used with a low-intensity laser are effective in eliminating bacteria [11]. Photodynamic therapy has been used in some studies as a support for the elimination of microorganisms, along with the mechanical-chemical preparation of the root canals of deciduous teeth [1,6,8,9,12]. The aPDT can then be an auxiliary therapy to reduce the microbiota in the endodontic treatment of deciduous teeth [1,6,9].…”

“…Photodynamic therapy has been used in some studies as a support for the elimination of microorganisms, along with the mechanical-chemical preparation of the root canals of deciduous teeth [1,6,8,9,12]. The aPDT can then be an auxiliary therapy to reduce the microbiota in the endodontic treatment of deciduous teeth [1,6,9]. Thus, the objective of this study was to conduct an evaluation in vivo of the effect of aPDT therapy on the microbiota present in the root canals of deciduous teeth.…”