Ioana Roxana Bordea1, Reem Hanna2, Nasim Chiniforush3, Elena Grădinaru4, Radu Septimiu Câmpian1, Adina Sîrbu1, Andrea Amaroli5, Stefano Benedicenti5. 1. Department of Oral Rehabilitation, Oral Health and Dental Office Management, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. 2. Department of Surgical and Diagnostic Sciences (D.I.S.C), Laser Therapy Centre, University of Genoa, Genoa, Italy; Department of Oral Surgery, Dental Institute, King's College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK. Electronic address: reem.hanna@nhs.net. 3. Laser Research Center of Dentistry, Tehran University of Medical Sciences, Tehran, Iran. 4. Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania. 5. Department of Surgical and Diagnostic Sciences (D.I.S.C), Laser Therapy Centre, University of Genoa, Genoa, Italy.
Abstract
BACKGROUND: Any successful endodontic therapy requires elimination of the endodontic biofilms through meticulous root canal disinfection methods. Sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) are the most common effective irrigants, in removing smear-layer from the coronal and middle thirds of the dental canals but reduced considerably towards the apical one third. In recent years, newly alternative treatment modalities have been proposed, including high-power lasers and antimicrobial photodynamic therapy (aPDT). Our work was conducted to evalaute the outcome of root canal disinfection in relation to the efficacy of various treatment modalities. Furthermore, every effort was made to present an overview of the aPDT outcomes, as a model for this application, and to propose laser parameters protocol with positive results. METHODS: The electronic databases PubMed was searched from January 2013- January 2019. Our inclusive criteria based on laser therapy applications, as a model for root canal disinfection. The search terms utilised various combinations as follows: photodynamic therapy or antimicrobial photodynamic therapy or photoactivated disinfection or light activated disinfection or laser activated disinfection or laser therapy, and endodontic. RESULTS: The results of this systematic review concluded that the effectiveness of aPDT and various laser wavelengths protocols, in removing endodontic biofilms from infected root canals, remains unattainable. CONCLUSIONS: Study concluded that the combination of aPDT with antimicrobial irrigants could provide a synergetic effect. However, due to the heterogeneity of the selected studies and their limitations, in terms of lack of standardised protocol or discrepancy in the methodology, authors suggest further validated approaches to achieve optimal outcomes.
BACKGROUND: Any successful endodontic therapy requires elimination of the endodontic biofilms through meticulous root canal disinfection methods. Sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) are the most common effective irrigants, in removing smear-layer from the coronal and middle thirds of the dental canals but reduced considerably towards the apical one third. In recent years, newly alternative treatment modalities have been proposed, including high-power lasers and antimicrobial photodynamic therapy (aPDT). Our work was conducted to evalaute the outcome of root canal disinfection in relation to the efficacy of various treatment modalities. Furthermore, every effort was made to present an overview of the aPDT outcomes, as a model for this application, and to propose laser parameters protocol with positive results. METHODS: The electronic databases PubMed was searched from January 2013- January 2019. Our inclusive criteria based on laser therapy applications, as a model for root canal disinfection. The search terms utilised various combinations as follows: photodynamic therapy or antimicrobial photodynamic therapy or photoactivated disinfection or light activated disinfection or laser activated disinfection or laser therapy, and endodontic. RESULTS: The results of this systematic review concluded that the effectiveness of aPDT and various laser wavelengths protocols, in removing endodontic biofilms from infected root canals, remains unattainable. CONCLUSIONS: Study concluded that the combination of aPDT with antimicrobial irrigants could provide a synergetic effect. However, due to the heterogeneity of the selected studies and their limitations, in terms of lack of standardised protocol or discrepancy in the methodology, authors suggest further validated approaches to achieve optimal outcomes.