Table 3.
aPDT treatment in patients with endodontic infection.
| Author, year | Study design | Treatment groups | Investigated pathology | Photosensitizer, concentration | Light source parameters (wavelength, power, power density, irradiation time) and frequency of irradiation | Microorganisms | Follow-up periods | Outcomes |
|---|---|---|---|---|---|---|---|---|
| Ahangari et al. (2017) | Randomized clinical trial | Test 1: CMD + aPDT Test 2: CMD + Ca (OH)2 therapy | Persistent endodontic infection | Methylene blue, 0.05 mg/ml | Diode laser: 810 nm, 200 mW, NR, 10 s Single session | Enterococcus faecalis and Candida albicans | 2 weeks | aPDT presented similar CFU/ml reduction compared with Ca (OH)2 therapy. |
| Alves-Silva et al. (2022) | Randomized clinical trial | Test: CT + aPDT Control: CT | Primary endodontic infection | Methylene blue, 0.005% | Diode laser: 660 nm, 100 mW, 320 J/cm2, 90 s Single session | NR | 8, 12, 24, 48, and 72 h, 1 week | There was a statistically significant difference (p < 0.05) in the periods of 8, 12, 24, 48 and 72 h between the control group and the aPDT group. After 1 week, there was no statistically significant difference. |
| Asnaashari et al. (2017) | Randomized clinical trial | Test 1: CT + aPDT Test 2: CT + Ca (OH)2 therapy | Persistent endodontic infection | Tolouidine blue O, 0.1 mg/ml | LED: 635 nm, NR, 2–4 mW/cm2, 60 s Single session | Enterococcus faecalis | 2 weeks | The number of CFU/ml was lower in aPDT compared with Ca (OH)2 therapy |
| Coelho et al. (2019) | Randomized clinical trial | Test: CT + aPDT Control: CT | Primary endodontic infection | Methylene blue, 1.56 μM/ml | Diode laser: 660 nm, 100 mW, 600 J/cm2, 180 s Single session | NR | 24 and 72 h, 1 week | Postoperative pain was significantly decreased after aPDT at 24 and 72 h intervals. |
| da Silva et al. (2018) | Randomized clinical trial | Test: CMD + aPDT Control: CMD | Primary endodontic infection | Methylene blue, 0.1 mg/ml | Diode laser: 660 nm, 100 mW, NR, 40 s Single session | Enterococcus faecalis, Candida genus and Bacteria domain | 1 week | aPDT resulted in a significant reduction in the incidence of E. faecalis before root canal obturation at the second session in teeth with primary endodontic infections. |
| Di Taranto et al. (2022) | Randomized clinical trial | Test 1: CT + high-power laser Test 2: CT + aPDT | Primary endodontic infection | Toluidine blue O, 155 μg ml | Diode laser, 660 nm, 100 mW Single session | Enterococcus sp., Candida sp., Lactobacillus sp. and Phorphyromonas sp. | 1 week | The difference between CFUs before and after aPDT protocol was significant. Further statistically significant CFU reduction was seen after the second laser treatment in the aPDT group. |
| Guimaraes et al. (2021) | Randomized clinical trial | Test: CT + aPDT + LLLT Control: CT | Primary endodontic infection | Methylene blue, 0.01% | Diode laser: 660 nm, 100 mW, 300 J/cm2, 90 s Single session | NR | 2, 3, and 7 days | There were no significant differences in post-operative pain, tenderness, oedema and the use of analgesics between groups at any observation period. |
| Jurič et al. (2014) | Randomized clinical trial | Test 1: endodontic treatment with 2.5% NaOCl and 17% EDTA Test 2: aPDT Test 3: CT | Persistent endodontic infection | Phenothiazinium Chloride, 10 mg/ml | Diode laser: 660 nm, 100 mW, NR, 60 s Single session | Enterococcus faecalis, Peptostreptococcus, Actinomyces naeslundii, Actinomyces odontolyticus, Porphyromonas, Veillonella parvula, and Pseudomonas aeruginosa | 2 weeks | The combination of endodontic treatment and aPDT was statistically more effective than endodontic treatment alone. |
| de Miranda and Colombo (2018) | Randomized clinical trial | Test: CMD + aPDT Control: CMD | Primary endodontic infections | Methylene blue, 25 μg/ml | Diode laser: 660 nm, 100 mW, NR, 300 s Single session | Candida albicans, Dialister pneumosintes, Prevotella nigrescens, Prevotella tannerae, Parvimonas micra, Peptostreptococcus anaerobius, Propionibacterium acnes, and others | 3 and 6 months | aPDT presented a similar CFU/ml reduction compared with control. Significant decreases in PAI scores were observed in both groups over time, although at 6 M, the PDT group presented a significantly better healing score than the control. C. Albicans and D. Pneumosintes were still detected in high frequency in both groups at 3 M. |
| Moreira et al. (2021) | Randomized clinical trial | Test: CT + intracanal medication + aPDT Control: CT + intracanal medication | Primary endodontic infection | Methylene blue, 0.005% | Red laser: 660 nm, 90 s Two sessions | Enterococcus faecalis and Actinomyces israelii | 2 months | aPDT did not show better results, in comparison with conventional treatment. |
| Okamoto et al. (2020) | Randomized clinical trial | Test: CT + aPDT Control: CT | Primary endodontic infection | Methylene blue, 0.005% | 660 nm, 100 mW, 4 J/cm2, 40 s Single session | Total number of viable bacteria | 1 and 3 months | The difference between the control and test groups was not significant. |
| Pourhajibagher and Bahador (2018) | Randomized clinical trial | Test: aPDT Control: CT | Primary endodontic infection | Tolouidine blue O, 0.1 mg/ml | Diode laser: 635 nm, 220 mW, NR, 60 s Single session | V. parvula, P. gingivalis, Propionibacterium acnes, Lactobacillus acidophilus, C. rectus, S. exigua, A. actinomycetemcomitans, Pseudomonas aeruginosa, Actinomyces naeslundii, L. rhamnosus, L. casei, Candida albicans, P. aeruginosa, Enterococcus faecalis, Streptococcus sanguinis, A. naeslundii, S. salivarius, S. mitis, C. rectus, K. pneumoniase, S. epidermidis, and S. mutans | NR | There was a significant decrease in the microbial diversity and count of the infected root canal after aPDT. |
NR, not reported; nm: nanometers; mW, milliwatts; s, seconds; CT, conventional endodontic therapy; CMD, chemo-mechanical debridement; SSL, saline solution; LLLT, low-level laser therapy.