International Journal of Dental Sciences and Research, 2018, Vol. 6, No. 2, 25-28
Available online at http://pubs.sciepub.com/ijdsr/6/2/1
©Science and Education Publishing
DOI:10.12691/ijdsr-6-2-1
Anti-microbial Photo Dynamic Therapy (aPDT) in
Endodontics: A Literature Review
Muhammad Zubair Ahmad
*
Assistant Professor, Restorative Dental Sciences Department, Alrass Dental College, Qassim University, Buraydha, Saudi Arabia
*Corresponding author: m.muhammad@qu.edu.sa
Abstract Elimination of root canal pathogens is one of the main objectives for successful outcome of root canal
treatment. Conventional chemo-mechanical debridement is not always successful in removing all bacteria.
Adjunctive use of antimicrobial photodynamic therapy (aPDT) can be a used as a practical approach for successful
elimination of all these bacteria. The aim of this review was to assess scientific literature that used various
photosensitizers for bacterial reduction using aPDT methods. A search of the PubMed and Cochrane data bases
using appropriate terms and keywords related to antimicrobial photodynamic therapy in endodontic disinfection was
conducted. A hand search also was conducted in the preceding 5 years of several journals. Full texts of the selected
articles were obtained and analyzed. A total of 177 articles published were identified at first stage of data extraction.
After final screening, 41 articles were included in this review. This review summarizes the usage principles of aPDT
and outlines the applications of aPDT in root canal disinfection procedures. It was concluded that aPDT should be
used in conjunction with the conventional chemo mechanical debridement and disinfection of root canal system. It is
critical to note that selection of photosensitizer dye, its correct delivery within the prepared root canal system, laser
application with correct type of tips are predictors for successful outcome of this protocol of root canal disinfection.
Keywords: Root canal disinfection, photodynamic therapy, E-faecalis
Cite This Article: Muhammad Zubair Ahmad, “Anti-microbial Photo Dynamic Therapy (aPDT) in
Endodontics: A Literature Review.” International Journal of Dental Sciences and Research, vol. 6, no. 2 (2018):
25-28. doi: 10.12691/ijdsr-6-2-1.
1. Introduction
Endodontic treatment outcome is dependent on the
presence and absence of microbes inside the root canal
system [1]. Failure of root canal treatment is attributed
to various causes from persistence of bacteria after
treatment to micro leakage from coronal restorations in
cases of late failures [2]. Variations and complexities of
the root canal system, in addition to composition of
dentin, are the main challenges to disinfect the root canal
system [3]. There are different antimicrobials that are
common in practice [4]; however, anatomical variations
and un-instrumented areas of the canal can reduce their
effectiveness considerably.
To enhance the root canal disinfection properties
of ordinary irrigants, using Anti-microbial photo dynamic
therapy (aPDT) protocol is proposed. High power
lasers due to their heat based destruction of microbes
aided in developing the methods that are useful in
root canals disinfection [5,6,7,8]. There are concerns
of some undesirable effects on surface of radicular
dentin that include carbonization and cratering with some
lasers types e.g. Nd:YAG and carbon dioxide lasers,
and this warrants following strict protocols to minimize
these effects during use of these lasers for root canal
disinfection [9].
2. Search methodology and Study
Selection
A search was done of the PubMed and Cochrane databases
using appropriate Medical Subject Headings terms and
keywords related to use and application of aPDT in root
canal disinfection. The following combination of MeSH
terms and keywords were used: “anti-microbial photodynamic
therapy” OR “photodynamic” OR “light activated disinfection”
OR “photodynamic therapy” OR “photo-activated disinfection”
AND “endodontics” OR “photodynamic therapy endodontics”
OR “anti-microbial light activated disinfection root canal”
OR “anti-microbial light activated disinfection endodontic”
OR “photo-activated disinfection endodontics.” No time
limit was applied. One hundred seventy-seven articles
published were identified. After removal of duplication
and full text screening of all the studies 41 articles were
selected. From each study information was gathered for
this review.
3. Disinfection by Photochemical Process
A light of an appropriate wavelength is used to irradiate
molecules of photosensitizer dyes, this promotes the target
molecule to a high energy state also called triplet state that
transfers its energy to oxygen molecule, which results in