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González-Gil D, Flores-Fraile J, Vera-Rodríguez V, Martín-Vacas A, López-Marcos J. Comparative Meta-Analysis of Minimally Invasive and Conventional Approaches for Caries Removal in Permanent Dentition. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:402. [PMID: 38541128 PMCID: PMC10971845 DOI: 10.3390/medicina60030402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Revised: 02/13/2024] [Accepted: 02/22/2024] [Indexed: 07/23/2024]
Abstract
Background and Objectives: Addressing deep carious lesions poses significant challenges in daily dental practice due to the inherent complexity of their treatment. Traditionally, complete removal of carious tissues has been the norm, potentially leading to pulp tissue exposure and subsequent pulpitis. In contemporary dentistry, there is a growing preference for minimally invasive techniques, such as selective removal, offering a more conservative approach with enhanced predictability and success rates. Materials and Methods: Our study commenced with a comprehensive systematic review. After that, we performed a meta-analysis focused exclusively on randomized controlled trials involving permanent dentition. Our investigation incorporated seven selected articles, which scrutinized success rates and the incidence of pulp exposure in minimally invasive techniques (MIT) versus conventional techniques (CT). Statistical analysis employed U Mann-Whitney and Wilcoxon tests to interpret the results. Results: Although the difference did not reach statistical significance, MIT demonstrated marginally superior success rates compared to CT. Furthermore, MIT exhibited a lower percentage of pulp exposure when contrasted with CT. However, due to the limited sample size, statistical significance for this difference could not be established. Conclusions: Minimally invasive techniques for caries removal emerge as a conservative and promising approach to safeguard pulp tissues in comparison to conventional techniques. The need for additional randomized controlled trials is emphasized to unequivocally establish the superior success rates of these procedures over their conventional counterparts.
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Affiliation(s)
- Diego González-Gil
- Dental Clinic Faculty of Medicine, Surgery Department, University of Salamanca, 37007 Salamanca, Spain; (D.G.-G.); (J.L.-M.)
| | - Javier Flores-Fraile
- Dental Clinic Faculty of Medicine, Surgery Department, University of Salamanca, 37007 Salamanca, Spain; (D.G.-G.); (J.L.-M.)
| | | | | | - Joaquín López-Marcos
- Dental Clinic Faculty of Medicine, Surgery Department, University of Salamanca, 37007 Salamanca, Spain; (D.G.-G.); (J.L.-M.)
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Silva T, Lunardi AJL, Barros ACSM, Mandetta ARH, Grudzien E, San-Martín M, Horliana ACRT, Bussadori SK, Motta LJ. Application of Photodynamic Therapy in Pediatric Dentistry: Literature Review. Pharmaceutics 2023; 15:2335. [PMID: 37765303 PMCID: PMC10537059 DOI: 10.3390/pharmaceutics15092335] [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: 08/07/2023] [Revised: 08/29/2023] [Accepted: 09/14/2023] [Indexed: 09/29/2023] Open
Abstract
Microbiological control of dental pathologies presents a significant clinical challenge for dental surgeons, particularly considering drug-resistant microorganisms. To address this issue, Antimicrobial Photodynamic Therapy (PDT) has emerged as an effective and complementary technique for microbial reduction. This therapy involves the application of a photosensitizer dye (PS) either topically or systemically, followed by exposure to low-power lasers with appropriate visible light wavelengths. PDT has found a valuable place in dentistry across various specialties, including surgery, periodontics, endodontics, dentistry, implantology, orthodontics, and pediatrics. In the realm of pediatric dentistry, managing microorganisms during dental treatments has become a major challenge. Considering its promising results and ease of application, Photodynamic Therapy presents an interesting alternative for clinical practice. However, it is important to note that specific protocols must be followed for each application, encompassing the type of photosensitizer, concentration, pre-irradiation time, light type, wavelength, energy, power, and mode of light delivery. Researchers have been steadily refining these protocols to facilitate PDT's integration into clinical practice. The objective of this review is to describe in which procedures and oral health problems in children PDT can be applied. In this sense, we list what the literature brings about the possibilities of applying PDT in a pediatric dentistry clinic.
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Affiliation(s)
- Tamiris Silva
- Postgraduate Program in Biophotonics Applied to the Health Sciences, Nove de Julho University, São Paulo 01525-000, SP, Brazil (S.K.B.)
| | - Ana Júlia Lacerda Lunardi
- Postgraduate Program in Biophotonics Applied to the Health Sciences, Nove de Julho University, São Paulo 01525-000, SP, Brazil (S.K.B.)
| | | | - Amanda Rafaelly Honório Mandetta
- Postgraduate Program in Biophotonics Applied to the Health Sciences, Nove de Julho University, São Paulo 01525-000, SP, Brazil (S.K.B.)
| | - Elizabeth Grudzien
- Departamento de Bienestar y Salud, Universidad Católica del Uruguay, Av. 8 de Octubre 2738, Montevideo 11600, Uruguay
| | - Magdalena San-Martín
- Departamento de Bienestar y Salud, Universidad Católica del Uruguay, Av. 8 de Octubre 2738, Montevideo 11600, Uruguay
| | | | - Sandra Kalil Bussadori
- Postgraduate Program in Biophotonics Applied to the Health Sciences, Nove de Julho University, São Paulo 01525-000, SP, Brazil (S.K.B.)
| | - Lara Jansiski Motta
- Postgraduate Program in Biophotonics Applied to the Health Sciences, Nove de Julho University, São Paulo 01525-000, SP, Brazil (S.K.B.)
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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: 20] [Impact Index Per Article: 20.0] [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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