Endodontic treatment of a large periapical cyst with the aid of antimicrobial photodynamic therapy - Case report

Abstract

Introduction: Periapical cysts, especially those of great extension, represent a challenge for endodontics, since they are not repaired with traditional treatment. The aim of this case report was to evaluate the effectivity of antimicrobial photodynamic therapy “aPDT” when associated with calcium hydroxide Ca(OH)2 in treating such cysts. Case report: A 40-year-old female patient complained of bulging in the upper anterior region of the mouth. The clinical examination showed an extensive swollen periodontal area, painful with digital palpation, with a negative response to thermal tests on teeth 11 and 21. After traditional treatment, the canals of 11 and 21 were filled with photosensitizer methylene blue 0.005% pre irradiation time (PIT) of 5 minutes and irradiation by low power diode laser with visible red wavelength (660 nm) during 2 minutes without intervals, using an optical fiber delivering system with a helical movement from apical to cervical. Then the canal were filled with Ca(OH)2 paste for 45 days being changed each 15 days, and repeating the radiation. Results: After 45 days, the patient already had a bulging remission, with painless resistance to apical pressure in the region and signs of bone repair at the radiographic examination, and total absence of signs or symptoms. Conclusion: the association of aPDT with Ca(OH)2 paste is effective in treating of periapical lesions of great extension and avoid surgical treatment.Keywords: Antimicrobial; Calcium hydroxide; Diode Laser; Periapical cysts; Photodynamic Therapy; Root canal treatment.

Apicoectomy of Perforated Root Canal Using Bioceramic Cement and Photodynamic Therapy

“…Even more, aPDT was used both in root canal retreatment as it was indicated as an effective complementary technique over resistant microorganisms [ 6 ] and in the surgical site because it induces reparation of the lesion [ 5 ].…”

“…The symptomatic periapical periodontitis is an endodontic disease of the necrosed pulp and its management depends mainly on root canal disinfection [ 1 ] in which the manual/automated instruments remove the microorganisms mechanically and the auxiliary chemical substances act chemically [ 2 – 4 ]. However, in some cases, additional complementary techniques are indicated to provide more favorable decontamination using photodynamic therapy (PDT) [ 5 , 6 ] and passive ultrasonic irrigation (PUI) [ 7 , 8 ]. As well, the endodontic irrigants play a principal role in reducing torsional and fatigue resistance during instrumentation [ 9 ].…”

“…The photodynamic therapy is a complementary technique, which aids in additional disinfection using a light source like laser or light-emitting diode (LED) acting over a photosensitizer and thus liberating reactive oxygen specimens that disinfect some facultative microorganisms [ 23 ] and resulting in more accelerated tissue repair [ 5 , 24 , 25 ].…”

The biocompatibility of Achyrocline satureioides plant extract over human gingival fibroblasts

“…Phytotherapy was used in dentistry and more specifically in endodontics since the last century (Groppo et al, 2008) due to its antimicrobial, anti-inflammatory and antifungal actions and because it is considered biocompatible (Guandalini Cunha et al, 2020;De La Chapa, Singha, Lee, & Gonzales, 2018;Marcia C Valera et al, 2016;Viegas et al, 2020) in addition to other techniques like photodynamic therapy and passive ultrasonic irrigation (Abu Hasna, Ferrari, & Talge Carvalho, 2019;Abu Hasna, Khoury, et al, 2020;Abu Hasna, Pereira Da Silva, et al, 2020). This use was encouraged by the World Health Organization (WHO); however, the agency establishes specific safety requirements including traditional use certificate and toxicity analyzes of the extracts (Organization, 2019).…”

Systematic review of the effect of endodontic irrigants over coronaviruses

“…The root canal treatment "RCT" success depends mainly on microorganisms disinfection (Abu Hasna, Ferrari, & Talge Carvalho, 2019;Abu Hasna, Khoury, et al, 2020;Abu Hasna, Ungaro, et al, 2019). More than 700 microorganism species exist in the root canal (Aas, Paster, Stokes, Olsen, & Dewhirst, 2005) those complicate the root canal disinfection because of the resistance of some microorganisms and the limited actions of some antimicrobial agents (Cavalli et al, 2017;Maekawa et al, 2013).…”