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Abbara MT, Akil S, Hamadah O, Achour H, Mahayni G, Alsayed Tolibah Y. Can diode laser 810 nm decrease post endodontic pain in patients with asymptomatic necrotic maxillary incisors? A four-arm randomized controlled trial. BDJ Open 2024; 10:23. [PMID: 38485988 PMCID: PMC10940693 DOI: 10.1038/s41405-024-00203-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 02/05/2024] [Accepted: 02/05/2024] [Indexed: 03/18/2024] Open
Abstract
AIM To find the best method for applying the diode laser 810 nm to relieve post-endodontic pain on necrotic maxillary incisors with periapical lesions within a single-visit treatment. METHODS Eighty patients with a necrotic incisor, diagnosed with asymptomatic apical periodontitis, received standardized cleaning and shaping procedures, then divided randomly with a 1:1:1:1 allocation ratio into four groups: Group 1: control group with no laser application, Group 2: applying the diode laser as an irrigation activation system (IAS), Group 3: applying the diode laser from the buccal and palatal mucosa, Group 4: applying the diode laser as an IAS and from buccal and palatal mucosa. The postoperative pain was assessed using the visual analog scale (VAS) 1, 3, 7, and 14 days after the treatment. The mean values of the VAS score were statistically analyzed used Kruskal-Walis and Mann-Whitney U tests. The level of significance was set at a = 0.05. RESULTS During 14 days after treatment, there was a statistically significant difference between mean values of VAS scores in the four groups (P value < 0.05); Group 1 scored the highest score, whereas Group 4 showed the lowest one. Moreover, Group 4 showed favorable outcomes compared with Group 2 and Group 3 during the first three days after treatment. CONCLUSION Diode laser reduced postoperative pain after necrotic teeth with large-sized apical lesion treatment, whereas using diode laser either as an IAS or LLLT reduced the postoperative pain compared with the control group. Moreover, the usage of a diode laser in both previous techniques represents the best protocol for postoperative pain relief during 14 days of treatment. CLINICAL RELEVANCE The clinical significance of this study is to investigate the best method to reduce postoperative pain using diode lasers 810 nm; where the results of this study indicated that the more diode laser exposer in LLLT and IAS, the less postoperative pain after endodontic procedures.
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Affiliation(s)
- Mohammad Tamer Abbara
- DDs, MSc,Ph.D student at the department of Endodontics, Faculty of Dentistry, Damascus University, P.O. Box 3062, Damascus, Syria
| | - Samar Akil
- DDS,MSc,Ph.D Associate Professor at the department of Endodontics, Faculty of Dentistry, Damascus University, P.O. Box 3062, Damascus, Syria
| | - Omar Hamadah
- DDS,MSc,Ph.D Associate Professor at the department of Oral Medicine, Faculty of Dentistry, Damascus University, P.O. Box 3062, Damascus, Syria
| | - Hassan Achour
- DDS,MSc,Ph.D Associate Professor at the department of Endodontics, Faculty of Dentistry, Damascus University, P.O. Box 3062, Damascus, Syria
| | - Ghina Mahayni
- DDs, Faculty of Dentistry, Al-Sham Private University, P.O. Box 3062, Damascus, Syria
| | - Yasser Alsayed Tolibah
- DDs, MSc,Ph.D student at the department of Pediatric Dentistry, Faculty of Dentistry, Damascus, University, P.O. Box 3062, Damascus, Syria.
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Pažin B, Lauc T, Bago I. Effect of photodynamic therapy on the healing of periapical lesions after root canal retreatment: 1-year follow up randomized clinical trial. Photodiagnosis Photodyn Ther 2024; 45:103907. [PMID: 38013016 DOI: 10.1016/j.pdpdt.2023.103907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 11/22/2023] [Accepted: 11/22/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND The aim of this randomized clinical trial was to evaluate the effects of photodynamic therapy (PDT) after traditional activated final irrigation protocol (ultrasonically activated irrigation, UAI) on periapical lesion healing after single-visit root canal retreatment. METHODS We included 36 patients with asymptomatic chronic apical periodontitis with periapical lesions larger than 5 mm and teeth sensitive to percussion and palpation, who had previous root canal treatment. All patients who signed informed consent underwent cone-beam computed tomography (CBCT) to determine and calculate the preoperative volume of the periapical lesion. Patients were randomly distributed into two groups according to the final disinfection protocol: Group 1; UAI (NaOCl, EDTA, and NaOCl), Group 2; UAI + PDT. All patients underwent single-visit root canal retreatment using rotary instrumentation and standardized irrigation (3 %NaOCl) by the same endodontist. The root canals were filled with epoxy resin-based sealer and single-cone gutta-percha, followed by control radiography. After one year, a new CBCT scan of the teeth was performed to calculate the reduction in the initial periapical lesion as a measure of periapical healing. For the statistical analysis, the chi-square test variants, Fisher's exact test and the Fisher-Freeman-Halton test were used at the level of significance set at 5 %. RESULTS There were no significant differences between the groups in terms of age, sex, preoperative and postoperative lesion volume (p > 0.05), and reduction of periapical lesion volume (median, 86.98 % for UAI and 79.72 % for UAI+PDT) (p = 0.970). Additional use of PDT after UAI did not contribute to the healing of periapical lesions. CONCLUSION The UAI and UAI+PDT protocols had equal effects on healing of periapical lesion.
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Affiliation(s)
- Boris Pažin
- Department of Endodontics, Oral Patology and Periodontology, Dental Polyclinic Zagreb, Croatia
| | | | - Ivona Bago
- Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, Zagreb 10 000, Croatia.
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Abbara MT, Akil S, Hamadah O, Achour H, Mahayni G, Tolibah YA. The effect of the irrigant activation protocol on postoperative pain in maxillary incisors with asymptomatic apical periodontitis: A three-arm randomized clinical trial. Clin Exp Dent Res 2023; 9:868-878. [PMID: 37786913 PMCID: PMC10582227 DOI: 10.1002/cre2.786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 08/31/2023] [Accepted: 09/04/2023] [Indexed: 10/04/2023] Open
Abstract
OBJECTIVES This study aimed to compare the effects of three irrigation activation systems (IAS) on postoperative pain (PP) in activating three final irrigants: sodium hypochlorite 5.25%, ethylenediaminetetraacetic acid 17%, and chlorhexidine 2%. MATERIALS AND METHODS This parallel randomized clinical trial included referred patients with asymptomatic large-sized apical lesion incisors. A standard method was followed in the canal cleaning and shaping for all included patients in the study. Then, the patients were randomly assigned (1:1 allocation) into three groups: G1 (n = 20) with passive ultrasonic irrigation activation; G2 (n = 20) with XP-Endo Finisher file activation; and G3 (n = 20) with diode laser (810 nm) activation. PP was estimated in all groups using a visual analog scale after 1, 3, 7, and 14 days of treatment. Comparisons between the groups were made using the Kruskal-Wallis test, whereas the Mann-Whitney U test was used in the pairwise comparisons. RESULTS Sixty patients were followed-up in this trial. There were significant differences between the groups in terms of PP After 1, 3, and 7 days of treatment (p = 0.002, p = 0.017, and p = 0.006, respectively). On the first day of treatment, G3 showed the lowest PP compared with G1 and G2 (p = 0.007 and p = 0.001, respectively). On the third day of treatment, G3 showed less PP compared with G2 (p = 0.005). On the seventh day of treatment, G2 showed the highest PP compared with G1 and G3 (p = 0.012 and p = 0.003, respectively). CONCLUSIONS The XP-Endo Finisher file caused the highest PP level especially in the next day and 3 days of the treatment, whereas the diode laser had the lowest PP level during the first week of treatment. It is noteworthy that PP disappeared completely after 2 weeks of treatment with all three IASs. TRIAL REGISTRATION The trial was registered in the ISRCTN registry (Trial ID: SRCTN99457940).
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Affiliation(s)
| | - Samar Akil
- Department of Endodontics, Faculty of DentistryDamascus UniversityDamascusSyria
| | - Omer Hamadah
- Department of Oral Medicine, Faculty of DentistryDamascus UniversityDamascusSyria
| | - Hassan Achour
- Department of Endodontics, Faculty of DentistryDamascus UniversityDamascusSyria
| | - Ghina Mahayni
- Faculty of DentistryAl‐Sham Private UniversityDamascusSyria
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Wu Z, Wang G, Li Z, Li Z, Huang D, Huang M, Lin M. Dental Bleaching with Phthalocyanine Photosensitizers: Effects on Dentin Color and Collagen Content. Molecules 2023; 28:molecules28104223. [PMID: 37241963 DOI: 10.3390/molecules28104223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 04/21/2023] [Accepted: 05/09/2023] [Indexed: 05/28/2023] Open
Abstract
With the increasing demand for tooth bleaching in esthetic dentistry, its safety has been the focus of a comprehensive body of literature. In this context, the aim of the present study was to evaluate the application effects of pentalysine β-carbonylphthalocyanine zinc (ZnPc(Lys)5)-mediated photodynamic therapy in dentin bleaching and its effects on dentin collagen. We first established a new and reproducible tooth staining model using dentin blocks stained by Orange II and then bleached with ZnPc(Lys)5 (25 μM) and hydrogen peroxide (10% or 30%). Data were analyzed with one- and two-way ANOVA and a significance level of p < 0.05. ZnPc(Lys)5 effectively bleached the dentin samples to an extent comparable to hydrogen peroxide at either 10% or 30% concentrations. Further studies on the dentin morphology, chemical element distribution, and protein constituents, using an electron microscope, energy dispersive spectroscopy, X-ray photoelectron spectroscopy, and SDS-PAGE, demonstrated that treatment with the photosensitizer preserved the dentin structure and, at the same time, the major organic component, collagen type I. For comparison, hydrogen peroxide (10% or 30%) treatment significantly degraded the collagen protein. This work indicated that the photosensitizer exerts potent bleaching effects on dentin staining; importantly, does not damage dentin and its collagen content; and opens up a new strategy to further explore various photosensitizers for the bleaching of both tooth enamel and dentin.
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Affiliation(s)
- Zhouyan Wu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou 350002, China
- The Second Affiliated Hospital of Fujian University of Traditional Chinese Medicine, 282 Wusi Road, Fuzhou 350003, China
| | - Guodong Wang
- College of Chemistry, Fuzhou University, 2 Xueyuan Road, Fuzhou 350108, China
| | - Zhiming Li
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou 350002, China
| | - Zhengquan Li
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou 350002, China
| | - Dandan Huang
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou 350002, China
| | - Mingdong Huang
- College of Chemistry, Fuzhou University, 2 Xueyuan Road, Fuzhou 350108, China
| | - Minkui Lin
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Lab of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, 246 Yangqiao Zhong Road, Fuzhou 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou 350002, China
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Huang Q, Li Z, Lyu P, Zhou X, Fan Y. Current Applications and Future Directions of Lasers in Endodontics: A Narrative Review. Bioengineering (Basel) 2023; 10:bioengineering10030296. [PMID: 36978686 PMCID: PMC10044917 DOI: 10.3390/bioengineering10030296] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 02/09/2023] [Accepted: 02/13/2023] [Indexed: 03/02/2023] Open
Abstract
The utilization of lasers has been regarded as a novel technique for the purposes of clinical use in the dental field. Recently, numerous studies have been conducted on the potential applications of laser therapy in endodontics. Moreover, due to their ablation, penetrability, and disinfection capabilities, lasers have performed well with respect to endodontic treatments, including root canal treatment, vital pulp therapy (pulp capping and pulpotomy), dentinal hypersensitivity treatment, and management of dental pain related to pulp and periradicular disease. In particular, the superiorities of laser-aided pulp therapy are emphasized through condensed clinical controlled trials, and histological studies, in this review. Moreover, the ingenious use of laser applications with respect to aiding in the acceleration of root development and the extraction of foreign matters (i.e., broken files and fiber posts) in canals has quickly become the cutting-edge trend of current research. This review offers a summary and discussion of the current literature on all the aforementioned laser applications. Moreover, the characteristics of laser devices, including erbium lasers, neodymium-doped lasers, CO2 lasers, and diode lasers, are detailed and discussed here, providing useful references for laser application in endodontics. We also focus on the different wavelengths with respect to the lasers that are applied in endodontics. High-power lasers perform well as operative instruments; in addition, low-level lasers lead to the regulation of pulp inflammation, and the promotion of pulp healing. This narrative review provides a summary of the advanced applications of lasers in conjunction with various devices in the practice of endodontics, and aims to inspire innovative perspectives on lasers in the context of the treatment of dental diseases, especially pulp diseases, in the future.
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Gholami L, Shahabi S, Jazaeri M, Hadilou M, Fekrazad R. Clinical applications of antimicrobial photodynamic therapy in dentistry. Front Microbiol 2023; 13:1020995. [PMID: 36687594 PMCID: PMC9850114 DOI: 10.3389/fmicb.2022.1020995] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 11/30/2022] [Indexed: 01/07/2023] Open
Abstract
Given the emergence of resistant bacterial strains and novel microorganisms that globally threaten human life, moving toward new treatment modalities for microbial infections has become a priority more than ever. Antimicrobial photodynamic therapy (aPDT) has been introduced as a promising and non-invasive local and adjuvant treatment in several oral infectious diseases. Its efficacy for elimination of bacterial, fungal, and viral infections and key pathogens such as Streptococcus mutans, Porphyromonas gingivalis, Candida albicans, and Enterococcus faecalis have been investigated by many invitro and clinical studies. Researchers have also investigated methods of increasing the efficacy of such treatment modalities by amazing developments in the production of natural, nano based, and targeted photosensitizers. As clinical studies have an important role in paving the way towards evidence-based applications in oral infection treatment by this method, the current review aimed to provide an overall view of potential clinical applications in this field and summarize the data of available randomized controlled clinical studies conducted on the applications of aPDT in dentistry and investigate its future horizons in the dental practice. Four databases including PubMed (Medline), Web of Science, Scopus and Embase were searched up to September 2022 to retrieve related clinical studies. There are several clinical studies reporting aPDT as an effective adjunctive treatment modality capable of reducing pathogenic bacterial loads in periodontal and peri-implant, and persistent endodontic infections. Clinical evidence also reveals a therapeutic potential for aPDT in prevention and reduction of cariogenic organisms and treatment of infections with fungal or viral origins, however, the number of randomized clinical studies in these groups are much less. Altogether, various photosensitizers have been used and it is still not possible to recommend specific irradiation parameters due to heterogenicity among studies. Reaching effective clinical protocols and parameters of this treatment is difficult and requires further high quality randomized controlled trials focusing on specific PS and irradiation parameters that have shown to have clinical efficacy and are able to reduce pathogenic bacterial loads with sufficient follow-up periods.
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Affiliation(s)
- Leila Gholami
- Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, Vancouver, BC, Canada
| | - Shiva Shahabi
- Dental Implants Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Marzieh Jazaeri
- Dental Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Mahdi Hadilou
- Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Fekrazad
- Radiation Sciences Research Center, Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran,International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran,*Correspondence: Reza Fekrazad,
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Almadi KH. Impact of antimicrobial photodynamic therapy on the bond-strength and penetration of endodontic sealers: A systematic review. Photodiagnosis Photodyn Ther 2022; 41:103249. [PMID: 36563709 DOI: 10.1016/j.pdpdt.2022.103249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/08/2022] [Accepted: 12/19/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Antimicrobial photodynamic therapy (aPDT) has been used for the disinfection of root canals. Studies have been carried out on its effect on the bond-strength and penetration of endodontic sealers. The aim of this systematic review is to critically analyze the literature and summarize the outcomes of these studies. MATERIALS AND METHODS An electronic search was conducted on research databases PubMED/Medline, ISI Web of Knowledge, Embase, Scopus and Europe PMC using the following the medical subject headings (MeSH) terms and keywords: [((endodontic sealer) OR (endodontic sealant) OR (root canal sealer)) AND ((anti-microbial photodynamic therapy) OR (laser-assisted) OR (light-assisted) OR (photosensitive dye) OR (photosensitizer)) AND ((bond-strength) OR (penetration))] for all literature published from inception to September 2022. Clinical studies, animal studies, laboratory investigations and case reports were included. Data was extracted and the quality of the included studies was assessed. RESULTS Of the 204 studies screen initially, 12 laboratory studies were included in this review. Majority of the outcomes revealed that aPDT does not have an adverse impact on the bond-strength or sealer penetration. Furthermore, AH Plus (an epoxy-based sealer) resulted in higher bond-strengths than other types of sealers (MTA Fillapex, Sealapex and Bioceramics). 11 studies were graded as having 'medium' quality and one study was graded as 'low'. CONCLUSION Within the limitations of this review, aPDT does not have a significant impact on the bonding and penetration of endodontic sealers. Future studies should focus on standardization and optimization of aPDT procedures when assessing their impact on the interaction between sealers and dentine.
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Affiliation(s)
- Khalid H Almadi
- Department of Restorative Dental Science, Division of Endodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia.
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de Araújo LP, da Rosa WLDO, Gobbo LB, da Silva TA, de Almeida JFA, Ferraz CCR. Global research trends on photodynamic therapy in endodontics: A bibliometric analysis. Photodiagnosis Photodyn Ther 2022; 40:103039. [PMID: 35907620 DOI: 10.1016/j.pdpdt.2022.103039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Photodynamic therapy (PDT) is an adjunctive treatment that aims to inactivate microorganisms through an oxidative reaction produced by irradiating a photosensitizing agent. The quest for improved root canal disinfection has sought supplementary methods when performing chemomechanical procedures. From this perspective, PDT protocols were proposed as an auxiliary approach in endodontics. Thus, the aim of this study was to investigate publication metrics and research trends related to this scope. METHODS This review is reported in accordance with the PRISMA 2020 recommendations. Two blinded and independent reviewers systematically searched five electronic databases until December 2021. The acquired bibliometric parameters were analyzed through descriptive statistics and graphical mappings with VOSViewer software. RESULTS The search retrieved 342 studies from 84 journals originating from 33 countries. About 85% of the included studies were published over the last decade. Most of the available evidence is laboratory-based (74.5%), and the main clinical outcomes evaluated were microbiological load reduction and postoperative pain. Mayram Pourhajibagher is the researcher with the most publications as the first author (n = 16). Tehran University of Medical Sciences carried out the highest number of studies (n = 29), and Photodiagnosis and Photodynamic Therapy is the journal that most published on the theme (n = 111). CONCLUSIONS This bibliometric analysis mapped and discussed the scientific progress and publication metrics in PDT in endodontic research. Additionally, future perspectives were highlighted and should focus on discovering new photosensitizer agents, standardizing optimal photoactivation protocols, and conducting more clinical-oriented research.
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Affiliation(s)
- Lucas Peixoto de Araújo
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Avenue Limeira 901, Piracicaba, SP 13144-018, Brazil
| | | | - Leandro Bueno Gobbo
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Avenue Limeira 901, Piracicaba, SP 13144-018, Brazil
| | - Tamares Andrade da Silva
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Avenue Limeira 901, Piracicaba, SP 13144-018, Brazil
| | - José Flávio Affonso de Almeida
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Avenue Limeira 901, Piracicaba, SP 13144-018, Brazil
| | - Caio Cezar Randi Ferraz
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, State University of Campinas (UNICAMP), Avenue Limeira 901, Piracicaba, SP 13144-018, Brazil.
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Shahbazi S, Esmaeili S, Feli M, Asnaashari M. Photodynamic Therapy in Root Canal Disinfection: A Case Series and Mini-Review. J Lasers Med Sci 2022; 13:e19. [PMID: 35996480 PMCID: PMC9392882 DOI: 10.34172/jlms.2022.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 03/12/2022] [Indexed: 02/03/2024]
Abstract
Introduction: Photodynamic therapy (PDT) is now a widely used treatment modality in many fields of dentistry, including endodontics. The most common application of PDT in endodontics is to disinfect root canals. The purpose of this study was to present the experience of using PDT in root canal disinfection of three patients. Case Presentation: Three patients referred to the Endodontics Department of Shahid Beheshti University of Medical Sciences were treated using 0.1 mg/mL Toluidine Blue (FotoSan® agent; CMS Dental, Denmark) irradiated with a light-emitting diode (LED) lamp (FotoSan®; CMS Dental, Denmark) with a mean wavelength of 630 nm and a mean power density of 3 W/cm2 over two 30-second periods. Conclusion: PDT using LED lighting can be used in conjunction with conventional root canal treatment (RCT) to achieve great results.
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Affiliation(s)
- Soheil Shahbazi
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saharnaz Esmaeili
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mojgan Feli
- Department of Endodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Asnaashari
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Milani AS, Froughreyhani M, Taghiloo H, Nouroloyouni A, Jafarabadi MA. The effect of antibiotic use on endodontic post-operative pain and flare-up rate: a systematic review with meta-analysis. Evid Based Dent 2022:10.1038/s41432-021-0205-z. [PMID: 35165442 DOI: 10.1038/s41432-021-0205-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/14/2021] [Indexed: 06/14/2023]
Abstract
Aim Antibiotics are widely used to prevent flare-ups after endodontic treatment of non-vital teeth. This systematic review assessed the effect of antibiotic administration on post-endodontic treatment pain and flare-up rate.Methods Five major databases including Web of Science, Cochrane Library, PubMed, Scopus and Embase were searched to identify randomised clinical trials (RCTs) published until September 2020. Retrieved papers were critically appraised using the revised Cochrane risk of bias tool (RoB 2). To reduce the clinical heterogeneity, the included studies were divided into two groups: studies on symptomatic non-vital teeth and studies on asymptomatic non-vital teeth. The primary outcomes were 'post-operative pain' and 'flare-up rate'. The data of included studies were statistically combined through meta-analysis using random-effect model. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used to assess the quality of evidence.Results Six RCTs involving two RCTs (N = 61) on symptomatic teeth and four RCTs (N = 310) on asymptomatic teeth were included. In two RCTs on asymptomatic teeth, prophylactic antibiotic had been used, while in the remaining two RCTs, antibiotics had been administered after treatment. Quantitative synthesis of the RCTs showed that antibiotic administration following endodontic treatment of symptomatic non-vital teeth has no effect on pain severity at 24 hours following treatment (weighted mean difference [WMD] = -0.03; 95% confidence interval [CI]: -0.53 to 0.47), and the use of antibiotics before endodontic treatment of asymptomatic non-vital teeth has no effect on flare-up rate (relative risk [RR] = 0.58; 95% CI: 0.22-1.54). The GRADE approach revealed that the overall quality of evidence on the topic is low.Conclusions The antibiotic administration following endodontic treatment of symptomatic non-vital teeth has no effect on pain severity at 24 hours following treatment. Also, prophylactic antibiotics are ineffective in reducing the flare-up rate following treatment of asymptomatic non-vital teeth. However, to evaluate the effect of post-treatment antibiotics on flare-up rate in asymptomatic non-vital teeth, more high-quality RCTs are needed.
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Affiliation(s)
- Amin Salem Milani
- Associate Professor of Endodontics, Research Centre for Evidence-Based Medicine (EBM), Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Mohammad Froughreyhani
- Professor of Endodontics, Department of Endodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hamid Taghiloo
- Assistant Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tabriz University of Medical sciences, Tabriz, Iran
| | - Ahmad Nouroloyouni
- Assistant Professor of Endodontics, Department of Endodontics, Faculty of Dentistry, Ardebil University of Medical Sciences, Tabriz, Iran
| | - Mohammad Asghari Jafarabadi
- Department of Statistics and Epidemiology, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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Hespanhol FG, Guimarães LS, Antunes LAA, Antunes LS. Effect of intracanal cryotherapy on postoperative pain after endodontic treatment: systematic review with meta-analysis. RESTORATIVE DENTISTRY & ENDODONTICS 2022; 47:e30. [PMID: 36090511 PMCID: PMC9436646 DOI: 10.5395/rde.2022.47.e30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/31/2022] [Accepted: 02/15/2022] [Indexed: 11/13/2022]
Abstract
Objectives This study aimed to evaluate the effectiveness of final irrigation with cold saline solution after endodontic treatment compared with saline solution at room temperature against postoperative pain following endodontic treatment. Materials and Methods A broad search was performed in the PubMed, Web of Science, Scopus, Cochrane Library, Virtual Health Library (LILACS), and Grey Literature databases. Two independent reviewers performed data extraction, risk of bias using the Cochrane methodology, and certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach. Results Eight studies were included in qualitative synthesis. Intracanal cryotherapy favored the reduction of postoperative pain in the systematic review. Four studies were included in meta-analyses. The meta-analysis showed that intracanal cryotherapy reduced postoperative pain in teeth with symptomatic apical periodontitis (SAP) at 24 hours. There was no association between intracanal cryotherapy and control (room temperature) groups in teeth with normal periapical tissue with respect to postoperative pain at 24 hours and 48 hours. Conclusions Intracanal cryotherapy was effective in reducing postoperative pain after endodontic treatment in teeth with SAP.
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Affiliation(s)
| | - Ludmila Silva Guimarães
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Niterói, RJ, Brazil
| | - Lívia Azeredo Alves Antunes
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Niterói, RJ, Brazil
- Specific Formation Department, School of Dentistry of Nova Friburgo, Fluminense Federal University, Niterói, RJ, Brazil
| | - Leonardo Santos Antunes
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Niterói, RJ, Brazil
- Specific Formation Department, School of Dentistry of Nova Friburgo, Fluminense Federal University, Niterói, RJ, Brazil
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12
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Alves-Silva EG, Arruda-Vasconcelos R, Louzada LM, de-Jesus-Soares A, Ferraz CCR, de Almeida JFA, Marciano MA, Steiner-Oliveira C, Bello-Silva MS, Shemesh H, Paula Figueiredo de Almeida Gomes B. The effect of photodynamic therapy on postoperative pain in teeth with primary endodontic infection. Photodiagnosis Photodyn Ther 2021; 37:102700. [PMID: 34954090 DOI: 10.1016/j.pdpdt.2021.102700] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/10/2021] [Accepted: 12/20/2021] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The objective of this study was to investigate the action of photodynamic therapy on pain control after endodontic treatment in asymptomatic teeth with a primary infection, within a single visit. METHODS Sixty (60) single-rooted teeth with pulp necrosis and periapical lesions were selected and randomly divided into two (2) groups (n=30), according to the protocol; a control group (CG) and a group using photodynamic therapy (aPDT). The canals were instrumented with Reciproc files # 25 up to 40 along the entire length of the canal, using 2% chlorhexidine gel as the auxiliary chemical substance, followed by irrigation with sterile saline. The canals were filled with Endomethasone N cement, 0.005% methylene blue, using AsGaAl diode laser, 660 nm wavelength, 100 mW of power and 9 J of energy, using optical fibers with 365 µm in diameter. RESULTS Pain intensity was assessed at 8, 12, 24, 48, 72 hours and 1 week after endodontic treatment using a visual analogue scale. The level of pain was classified as none (0), mild (1-3), moderate (4-7) or severe (8-10). The data were at a significance level of 5%. There was a statistically significant difference (p<0.05) in the periods of 8, 12, 24, 48 and 72 hours between the control group and the aPDT group. After 1 week, there was no statistically significant difference. CONCLUSIONS It is concluded that photodynamic therapy had a significant effect on decreasing post-endodontic treatment pain in teeth with necrotic pulp and asymptomatic periapical lesions.
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Affiliation(s)
- Esdras Gabriel Alves-Silva
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Rodrigo Arruda-Vasconcelos
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Lidiane Mendes Louzada
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Adriana de-Jesus-Soares
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Caio Cezar Randi Ferraz
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - José Flávio Affonso de Almeida
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Marina Angélica Marciano
- Department of Restorative Dentistry, Division of Endodontics, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Carolina Steiner-Oliveira
- Department of Health Sciences and Pediatric Dentistry, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, SP, Brazil.
| | - Marina Stella Bello-Silva
- Special Laboratory of Lasers in Dentistry (LELO), Department of Restorative Dentistry, School of Dentistry, University of São Paulo, São Paulo, Brazil.
| | - Hagay Shemesh
- Department of Endodontology, Academic Centre for Dentistry of Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam, Amsterdam, The Netherlands..
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13
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Besegato JF, de Melo PBG, Tamae PE, Alves APAR, Rondón LF, Leanse LG, Dos Anjos C, Casarin HH, Chinelatti MA, Faria G, Dai T, Bagnato VS, Rastelli ANDS. How can biophotonics help dentistry to avoid or minimize cross infection by SARS-CoV-2? Photodiagnosis Photodyn Ther 2021; 37:102682. [PMID: 34910994 PMCID: PMC8666148 DOI: 10.1016/j.pdpdt.2021.102682] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 09/30/2021] [Accepted: 12/10/2021] [Indexed: 12/23/2022]
Abstract
Biophotonics is defined as the combination of biology and photonics (the physical science of the light). It is a general term for all techniques that deal with the interaction between biological tissues/cells and photons (light). Biophotonics offers a great variety of techniques that can facilitate the early detection of diseases and promote innovative theragnostic approaches. As the COVID-19 infection can be transmitted due to the face-to-face communication, droplets and aerosol inhalation and the exposure to saliva, blood, and other body fluids, as well as the handling of sharp instruments, dental practices are at increased risk of infection. In this paper, a literature review was performed to explore the application of Biophotonics approaches in Dentistry focusing on the COVID-19 pandemic and how they can contribute to avoid or minimize the risks of infection in a dental setting. For this, search-related papers were retrieved from PubMED, Scielo, Google Schoolar, and American Dental Association and Centers for Disease Control and Prevention databases. The body of evidence currently available showed that Biophotonics approaches can reduce microorganism load, decontaminate surfaces, air, tissues, and minimize the generation of aerosol and virus spreading by minimally invasive, time-saving, and alternative techniques in general. However, each clinical situation must be individually evaluated regarding the benefits and drawbacks of these approaches, but always pursuing less-invasive and less aerosol-generating procedures, especially during the COVID-19 pandemic.
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Affiliation(s)
- João Felipe Besegato
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Priscila Borges Gobbo de Melo
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Patrícia Eriko Tamae
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Ana Paula Aparecida Raimundo Alves
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Luis Felipe Rondón
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil
| | - Leon G Leanse
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | - Carolina Dos Anjos
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | - Heitor Hussni Casarin
- Dentistry School, Central Paulista University Center - UNICEP, São Carlos 13563-470, SP, Brazil
| | | | - Gisele Faria
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil.
| | - Tianhong Dai
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, University of Harvard, Boston, MA 02114, USA.
| | | | - Alessandra Nara de Souza Rastelli
- Department of Restorative Dentistry, School of Dentistry, Araraquara, São Paulo State University - UNESP, 1680 Humaitá Street - 3rd floor, Araraquara 14801-903, SP, Brazil.
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14
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Azarpazhooh A, Khazaei S, Jafarzadeh H, Malkhassian G, Sgro A, Elbarbary M, Cardoso E, Oren A, Kishen A, Shah PS. A Scoping Review of Four Decades of Outcomes in Nonsurgical Root Canal Treatment, Nonsurgical Retreatment, and Apexification Studies: Part 3-A Proposed Framework for Standardized Data Collection and Reporting of Endodontic Outcome Studies. J Endod 2021; 48:40-54. [PMID: 34688792 DOI: 10.1016/j.joen.2021.09.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 09/20/2021] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Despite initiatives to standardize and improve reporting of rapidly growing endodontic outcome research studies, issues related to missing and ambiguous information are still of great concern. In this article, we propose a framework for standardized data collection and a compiled checklist for reporting of various study designs on endodontic outcome. METHODS A comprehensive search was carried out to locate randomized controlled trials, cohorts, case-control studies, or case series of >100 patients that reported on endodontic outcomes. We reviewed these articles to develop a Data Collection Template and compiled a checklist for reporting of future endodontic outcome research. RESULTS Out of 354 eligible articles previously reported in our scoping review on endodontic outcome studies, 109 articles were selected and screened for study variables or levels of categorization. Our complied Data Collection Template was developed in 19 domains to highlight important demographic, preoperative, intraoperative, and postoperative variables. Because of the specific needs for endodontic outcome literature, we also proposed a compiled checklist (consisting of 4 main domains) to facilitate the reporting of various study designs on endodontic outcome studies. This checklist included simple descriptions of the required items and examples on reporting from published endodontic studies. CONCLUSIONS By facilitating the collection and reporting of relevant research data by investigators in private practice and academia, we hope that the proposed Data Collection Template and reporting guideline can highlight the importance of standardization among clinicians and researchers while producing valid scientific information that will support evidence-based treatment decisions.
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Affiliation(s)
- Amir Azarpazhooh
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada.
| | - Saber Khazaei
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | - Hamid Jafarzadeh
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada
| | | | - Adam Sgro
- Mount Sinai Hospital, Toronto, ON, Canada
| | | | - Elaine Cardoso
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
| | - Ariel Oren
- Mount Sinai Hospital, Toronto, ON, Canada
| | - Anil Kishen
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
| | - Prakesh S Shah
- Faculty of Dentistry, University of Toronto, Toronto, ON, Canada; Mount Sinai Hospital, Toronto, ON, Canada
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15
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de Freitas Portela FSM, De Martin AS, Pelegrine RA, Gutmann JL, Kato AS, Bueno CEDS. Effect of Foraminal Enlargement on Postoperative Pain in Necrotic Single-Rooted Teeth: A Randomized Clinical Trial. J Endod 2021; 47:1046-1051. [DOI: 10.1016/j.joen.2021.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
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16
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Guimarães LDS, da Silva EAB, Hespanhol FG, Fontes KBFDC, Antunes LAA, Antunes LS. Effect of photobiomodulation on post-operative symptoms in teeth with asymptomatic apical periodontitis treated with foraminal enlargement: A randomized clinical trial. Int Endod J 2021; 54:1708-1719. [PMID: 34173988 DOI: 10.1111/iej.13593] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 11/26/2022]
Abstract
AIM To assess the efficacy of photobiomodulation in reducing post-operative symptoms and use of analgesics in teeth with asymptomatic apical periodontitis treated with foraminal enlargement in a single visit. METHODOLOGY This prospective double-blind, controlled, superiority, randomized clinical trial enrolled 70 patients requiring root canal treatment of one single-rooted tooth with asymptomatic apical periodontitis. The participants were randomized into one of the following two groups: 35 patients in the control group (C.G) - root canal treatment with foraminal enlargement, without any additional treatment and 35 patients in the photobiomodulation group (PBM.G) - root canal treatment with foraminal enlargement associated with photobiomodulation (antimicrobial photodynamic therapy and low-level laser therapy). The outcome variables were post-operative pain, tenderness, oedema and the use of analgesics. Pain intensity was measured using a visual analogue scale (recorded every day for 7 days, then the 14th and 30th days after root canal treatment). Facial oedema was assessed subjectively by two independent evaluators using photographs taken by one of the researchers at 48 h, 72 h and 7 days after the procedures. Data were tabulated and analysed using the Mann-Whitney U, Chi-Square, Fisher`s Exact, Student T and Ordinal Logistic Regression by Generalized Estimating Equations tests in SPSS software. RESULTS There were no significant differences in post-operative pain and tenderness between the groups at any observation period (p > .05). Photobiomodulation (beta = -0.77 / p = .01), time (beta = -0.23 / p < .01), and male gender (beta = -1.20 / p < .01) were associated with decreased post-operative pain. Only time (beta: -0.10; p < .01) and male gender (beta: -1.04; p < .01) were associated with decreased tenderness. For oedema and use of analgesics, there was no difference between the groups (p > .05). CONCLUSIONS Photobiomodulation had no significant effect on post-operative pain, tenderness, oedema and the use of analgesics after root canal treatment with foraminal enlargement, in single-rooted teeth treated in a single visit. Register of Clinical Trials: NCT03704857. Research Ethics Committee: no 2.353.996 / CAAE 74185417.9.0000.5626.
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Affiliation(s)
| | | | | | | | - Livia Azeredo Alves Antunes
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Niterói, Brazil.,Department of Specific Formation, School of Dentistry, Fluminense Federal University, Nova Friburgo, Brazil.,Postgraduate Program in Dentistry of Health Institute of Nova Friburgo, Fluminense Federal University, Nova Friburgo, Brazil
| | - Leonardo Santos Antunes
- Postgraduate Program, School of Dentistry, Fluminense Federal University, Niterói, Brazil.,Department of Specific Formation, School of Dentistry, Fluminense Federal University, Nova Friburgo, Brazil.,Postgraduate Program in Dentistry of Health Institute of Nova Friburgo, Fluminense Federal University, Nova Friburgo, Brazil
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17
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Vilas-Boas L, Cozer V, Tawil PZ, Coelho MS. Effect of Photodynamic Therapy on Postoperative Pain in Posterior Teeth with Symptomatic Apical Periodontitis. Photodiagnosis Photodyn Ther 2021; 35:102348. [PMID: 34033935 DOI: 10.1016/j.pdpdt.2021.102348] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 05/07/2021] [Accepted: 05/14/2021] [Indexed: 10/21/2022]
Abstract
This study aimed to evaluate the impact of photodynamic therapy (PDT) after root canal preparation on pain relief in posterior teeth presenting with symptomatic apical periodontitis (SAP). A visual analog scale (VAS) was completed by the patients which registered their pain perception as none (0), mild (1-3), moderate (4-7), or severe (8-10). Only patients who registered moderate or severe pain were included. Seventy patients were allocated to two groups (n=35): a control group (CG) without the PDT application and an intervention group with PDT application (PG). The same chemo-mechanical preparation was achieved in both groups. In the PG, 150 µM methylene blue (MB)Please remove the underline was placed inside the canal for 2 minutes and a 660 nm wavelength laser was applied through a fiber for 3 minutes (100 mW, 600 J/cm², total 18J). The patients were asked to register their pain perception in the VAS document after 24-h, 72-h, and 1-week intervals. The number of tablets taken for pain relief was also recorded. The Mann-Whitney, Students T-test and Fisher´s exact tests were used for statistical analysis (P < .05). After 1 week, 32 patients in the CG and 33 in the PG returned their VAS cards. The PG resulted in lower pain levels after the 24-hour interval (median 0) than the CG (median 2); there was no difference between both groups at 72-h and 1-week intervals. The decrease in pain was higher in the PG at all time-intervals when compared to the CG. There was no difference in the mean number of tablets taken for pain relief (P > .05). Within the limitations of this study, it can be concluded that PDT was efficient in decreasing pain in teeth presenting with SAP. There was no difference observed after 72 hours and there was no impact on the intake of pain relief medication.
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Affiliation(s)
- Larissa Vilas-Boas
- São Leopoldo Mandic School of Dentistry, Rua Emilio Ribas 776 sala 13, Campinas, SP, 13025-141, Brazil
| | - Viviany Cozer
- Universidade Federal Fluminense - UFF, School of Dentistry, Department of Endodontics, Niterói, RJ , Brazil
| | | | - Marcelo Santos Coelho
- São Leopoldo Mandic School of Dentistry, Rua Emilio Ribas 776 sala 13, Campinas, SP, 13025-141, Brazil.
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Cheung AWT, Lee AHC, Cheung GSP. Clinical efficacy of activated irrigation in endodontics: a focused review. Restor Dent Endod 2021; 46:e10. [PMID: 33680899 PMCID: PMC7906851 DOI: 10.5395/rde.2021.46.e10] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/27/2020] [Accepted: 11/03/2020] [Indexed: 02/02/2023] Open
Abstract
Root canal debridement, which includes the removal of infected tissues and microbial biofilms, is considered the corner stone of root canal treatment. Chemical adjuncts play a multitude of functions in this regard, as tissue solvents, antimicrobial agents and for removing the smear layer. These adjuncts (irrigants) are usually delivered using a syringe and needle. With increasing knowledge of the complexity of root canal anatomy and tenacity of microbial biofilms, the need for strategies that potentiate the action of these irrigants within the root canal system cannot be overemphasized. Several such activated irrigation strategies exist. The aim of this review is to comprehensively discuss the different irrigant activation methods from the context of clinical studies.
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Affiliation(s)
- Amelia Wan Tin Cheung
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Angeline Hui Cheng Lee
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Gary Shun Pan Cheung
- Discipline of Endodontology, Division of Restorative Dental Sciences, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
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Laser-Assisted aPDT Protocols in Randomized Controlled Clinical Trials in Dentistry: A Systematic Review. Dent J (Basel) 2020; 8:dj8030107. [PMID: 32971996 PMCID: PMC7558404 DOI: 10.3390/dj8030107] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 07/13/2020] [Accepted: 09/13/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Antimicrobial photodynamic therapy (aPDT) has been proposed as an effective alternative method for the adjunctive treatment of all classes of oral infections. The multifactorial nature of its mechanism of action correlates with various influencing factors, involving parameters concerning both the photosensitizer and the light delivery system. This study aims to critically evaluate the recorded parameters of aPDT applications that use lasers as the light source in randomized clinical trials in dentistry. METHODS PubMed and Cochrane search engines were used to identify human clinical trials of aPDT therapy in dentistry. After applying specific keywords, additional filters, inclusion and exclusion criteria, the initial number of 7744 articles was reduced to 38. RESULTS Almost one-half of the articles presented incomplete parameters, whilst the others had different protocols, even with the same photosensitizer and for the same field of application. CONCLUSIONS No safe recommendation for aPDT protocols can be extrapolated for clinical use. Further research investigations should be performed with clear protocols, so that standardization for their potential dental applications can be achieved.
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20
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Systematic Review on the Role of Lasers in Endodontic Therapy: Valuable Adjunct Treatment? Dent J (Basel) 2020; 8:dj8030063. [PMID: 32630217 PMCID: PMC7559699 DOI: 10.3390/dj8030063] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 06/19/2020] [Accepted: 06/28/2020] [Indexed: 12/16/2022] Open
Abstract
(1) Background: Adjunctive instruments, such as lasers have been investigated to address the risk of failure of endodontic therapy due to the complexity of the root canal system. Lasers have been used therapeutically, in direct irradiation of the root canals or adjunct to irrigants placed into the canals, in combination with a photosensitizer (antimicrobial photodynamic therapy) and in pain management (photobiomodulation). The purpose of this systematic review was to evaluate the evidence in clinical use within these three areas of therapy. (2) Methods: PubMed, Cochrane and Scopus search engines were used to identify human clinical trials regarding the use of lasers in endodontic therapy. (3) Results: After applying the keywords and additional filters, inclusion and exclusion criteria, the initial number of 1486 articles was reduced to 17. It was revealed that almost all studies (14/17) presented a statistically significant improved outcome in laser-assisted endodontic therapy, with the remaining three not showing any adverse effects. (4) Conclusions: The use of laser photonic energy of appropriate delivered parameters can be proposed as useful adjunctive when considering optimal treatment modalities in orthograde endodontics. Additionally, a tendency of research towards pain modulation in this field is developing.
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21
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Yuan L, Lyu P, Huang YY, Du N, Qi W, Hamblin MR, Wang Y. Potassium iodide enhances the photobactericidal effect of methylene blue on Enterococcus faecalis as planktonic cells and as biofilm infection in teeth. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2019; 203:111730. [PMID: 31855718 DOI: 10.1016/j.jphotobiol.2019.111730] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 11/20/2019] [Accepted: 12/03/2019] [Indexed: 02/09/2023]
Abstract
OBJECTIVE To explore the effectiveness, biosafety, photobleaching and mechanism of antimicrobial photodynamic therapy (aPDT) using methylene blue (MB) plus potassium iodide (KI), for root canal infections. METHODS Different combinations and concentrations of MB, KI and 660 nm LED light were used against E. faecalis in planktonic and in biofilm states by colony-forming unit (CFU), confocal laser scanning microscopy (CLSM), scanning electron microscopy (SEM). Human gingival fibroblasts (HGF) were used for safety testing by Cell Counting Kit-8 (CCK8) and fluorescence microscopy (FLM). The photobleaching effect and mechanisms were analyzed. RESULTS KI could not only enhance MB aPDT on E. faecalis in both planktonic and biofilm states even in a hypoxic environment, but also produced a long-lasting bactericidal effect after end of the illumination. KI could accelerate photobleaching to reduce tooth staining by MB, and the mixture was harmless for HGFs. Mechanistic studies showed the generation of hydrogen peroxide and free iodine, and iodine radicals may be formed in hypoxia. CONCLUSION aPDT with MB plus KI could be used for root canal disinfection and clinical studies are worth pursuing.
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Affiliation(s)
- Lintian Yuan
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, China; National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China
| | - Peijun Lyu
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, China; National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China
| | - Ying-Ying Huang
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Ning Du
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China; Central Laboratory, Peking University School and Hospital of Stomatology, Beijing, China
| | - Wei Qi
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China; Department of General Dentistry, Peking University School and Hospital of Stomatology, Beijing 100081, China
| | - Michael R Hamblin
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; Laser Research Centre, Faculty of Health Science, University of Johannesburg, Doornfontein 2028, South Africa.
| | - Yuguang Wang
- Center of Digital Dentistry, Peking University School and Hospital of Stomatology, Beijing, China; National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.
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