Rachel Garcia de Miranda1, Ana Paula Vieira Colombo2. 1. Department of Medical Microbiology, Federal University of Rio de Janeiro, Institute of Microbiology Paulo de Góes, R. Soares Cabral, 63/702, Laranjeiras, Rio de Janeiro, RJ, CEP 22240070, Brazil. miranda.rachel@gmail.com. 2. Department of Medical Microbiology, Federal University of Rio de Janeiro, Institute of Microbiology Paulo de Góes, R. Soares Cabral, 63/702, Laranjeiras, Rio de Janeiro, RJ, CEP 22240070, Brazil.
Abstract
INTRODUCTION: This short-term randomized controlled trial evaluated the effectiveness of photodynamic therapy (PDT) on clinical success (periapical healing) and on the microbiota of primary endodontic infections. METHODS:Thirty-two patients presenting mandibular molars with apical periodontitis (one tooth/patient) were selected and randomly allocated into two therapeutic groups: control (chemo-mechanical debridement [CMD]; n = 16) and PDT (CMD + PDT; n = 16). All teeth in both groups had intracanal medication with calcium hydroxide for 7 days before final obturation. Follow-up radiographs were made at 3 and 6 months. Periapical healing was evaluated by the periapical index (PAI). Samples were obtained at baseline, after CMD with or without PDT, and just before root filling to determine the frequency and levels of 37 taxa by checkerboard. RESULTS: Significant decreases in PAI scores were observed in both groups over time, although at 6 months, the PDT group presented a significantly better healing score than the control (p < 0.05). At baseline, the most prevalent species in all samples were Candida albicans (46.9%), Dialister pneumosintes (31.2%), Prevotella nigrescens (28.2%), Prevotella tannerae (28.1%), and Peptostreptococcus anaerobius (25%). Most species reduced over time in both groups, and no significant differences in frequency and levels of the tested species were observed between groups in any time point evaluated. C. albicans and D. pneumosintes were still detected in high frequency in both groups at 3 months post-therapy. CONCLUSIONS:Conventional endodontic therapy with or without PDT is effective in reducing microbial load, resulting in periapical healing. Nevertheless, adjunctive PDT provides better periapical healing at 6-month follow-up. CLINICAL RELEVANCE: Teeth with apical periodontitis treated with PDT adjunct to conventional treatment would demonstrate superior healing and reduction of microorganisms.
RCT Entities:
INTRODUCTION: This short-term randomized controlled trial evaluated the effectiveness of photodynamic therapy (PDT) on clinical success (periapical healing) and on the microbiota of primary endodontic infections. METHODS: Thirty-two patients presenting mandibular molars with apical periodontitis (one tooth/patient) were selected and randomly allocated into two therapeutic groups: control (chemo-mechanical debridement [CMD]; n = 16) and PDT (CMD + PDT; n = 16). All teeth in both groups had intracanal medication with calcium hydroxide for 7 days before final obturation. Follow-up radiographs were made at 3 and 6 months. Periapical healing was evaluated by the periapical index (PAI). Samples were obtained at baseline, after CMD with or without PDT, and just before root filling to determine the frequency and levels of 37 taxa by checkerboard. RESULTS: Significant decreases in PAI scores were observed in both groups over time, although at 6 months, the PDT group presented a significantly better healing score than the control (p < 0.05). At baseline, the most prevalent species in all samples were Candida albicans (46.9%), Dialister pneumosintes (31.2%), Prevotella nigrescens (28.2%), Prevotella tannerae (28.1%), and Peptostreptococcus anaerobius (25%). Most species reduced over time in both groups, and no significant differences in frequency and levels of the tested species were observed between groups in any time point evaluated. C. albicans and D. pneumosintes were still detected in high frequency in both groups at 3 months post-therapy. CONCLUSIONS: Conventional endodontic therapy with or without PDT is effective in reducing microbial load, resulting in periapical healing. Nevertheless, adjunctive PDT provides better periapical healing at 6-month follow-up. CLINICAL RELEVANCE: Teeth with apical periodontitis treated with PDT adjunct to conventional treatment would demonstrate superior healing and reduction of microorganisms.
Authors: Bruna Paloma de Oliveira; Carlos Menezes Aguiar; Andréa Cruz Câmara; Miracy Muniz de Albuquerque; Ana Cristina Regis de Barros Correia; Monica Felts de La Roca Soares Journal: Photodiagnosis Photodyn Ther Date: 2015-05-22 Impact factor: 3.631
Authors: Lea Assed Bezerra Silva; Arthur B Novaes; Rafael R de Oliveira; Paulo Nelson-Filho; Milton Santamaria; Raquel Assed Bezerra Silva Journal: J Endod Date: 2012-01-24 Impact factor: 4.171
Authors: Débora Heller; Victor M Varela; Mayra Xavier E Silva-Senem; Maria Cynesia B Torres; Eduardo Jorge Feres-Filho; Ana Paula Vieira Colombo Journal: J Clin Periodontol Date: 2011-02-08 Impact factor: 8.728