Application of Photodynamic Therapy and Diode Laser for Endodontic Therapy of Young Permanent Teeth

Summary

The pulp necrosis of permanent immature teeth implies the interruption of the root formation and apical closure. Diode lasers have been used in many areas of dentistry, with tendency of good results in canal and dentine disinfection. The bactericidal effect of high-power lasers is based on dose dependent heat generation. Its antimicrobial effectiveness against diverse microorganisms has already been demonstrated. Photodynamic therapy (PDT) is a two-step therapeutic approach starting with the application of a photosensitizing agent and followed by irradiation with light energy that is spectrally matched to activate the drug. The balance between disinfection and the creation of an intracanal microenvironment conducive for the proliferation of stem cells requires further investigation. Aims of study are to compare the time required to obtain the clinical healing and the disappearance of clinical symptoms, and absence of periapical radiolucency, by using PDT and diode laser, with standard disinfection alone; to assess specificity of microbial load in permanent immature teeth, and root canal disinfection ability of PDT and diode laser, in compare with standard disinfection alone.

Timeline

Start

2017-02-10

Primary completion

2017-12-15

Completion

2018-05-15

Publications

• Background Diogenes AR, Ruparel NB, Teixeira FB, Hargreaves KM. Translational science in disinfection for regenerative endodontics. J Endod. 2014 Apr;40(4 Suppl):S52-7. doi: 10.1016/j.joen.2014.01.015.
• Background Siqueira JF Jr, Rocas IN. Clinical implications and microbiology of bacterial persistence after treatment procedures. J Endod. 2008 Nov;34(11):1291-1301.e3. doi: 10.1016/j.joen.2008.07.028. Epub 2008 Sep 17.
• Background Shabahang S, Pouresmail M, Torabinejad M. In vitro antimicrobial efficacy of MTAD and sodium hypochlorite. J Endod. 2003 Jul;29(7):450-2. doi: 10.1097/00004770-200307000-00006.
• Background Waltimo T, Trope M, Haapasalo M, Orstavik D. Clinical efficacy of treatment procedures in endodontic infection control and one year follow-up of periapical healing. J Endod. 2005 Dec;31(12):863-6. doi: 10.1097/01.don.0000164856.27920.85.
• Background Pearson GJ, Schuckert KH. The role of lasers in dentistry: present and future. Dent Update. 2003 Mar;30(2):70-4, 76. doi: 10.12968/denu.2003.30.2.70.
• Background Gutknecht N, Franzen R, Schippers M, Lampert F. Bactericidal effect of a 980-nm diode laser in the root canal wall dentin of bovine teeth. J Clin Laser Med Surg. 2004 Feb;22(1):9-13. doi: 10.1089/104454704773660912.
• Background Soukos NS, Chen PS, Morris JT, Ruggiero K, Abernethy AD, Som S, Foschi F, Doucette S, Bammann LL, Fontana CR, Doukas AG, Stashenko PP. Photodynamic therapy for endodontic disinfection. J Endod. 2006 Oct;32(10):979-84. doi: 10.1016/j.joen.2006.04.007. Epub 2006 Jul 13.
• Background Chrepa V, Kotsakis GA, Pagonis TC, Hargreaves KM. The effect of photodynamic therapy in root canal disinfection: a systematic review. J Endod. 2014 Jul;40(7):891-8. doi: 10.1016/j.joen.2014.03.005. Epub 2014 May 2.
• Background Xu Y, Young MJ, Battaglino RA, Morse LR, Fontana CR, Pagonis TC, Kent R, Soukos NS. Endodontic antimicrobial photodynamic therapy: safety assessment in mammalian cell cultures. J Endod. 2009 Nov;35(11):1567-72. doi: 10.1016/j.joen.2009.08.002. Epub 2009 Sep 20.
• Background Toomarian L, Fekrazad R, Tadayon N, Ramezani J, Tuner J. Stimulatory effect of low-level laser therapy on root development of rat molars: a preliminary study. Lasers Med Sci. 2012 May;27(3):537-42. doi: 10.1007/s10103-011-0935-9. Epub 2011 May 26.
• Background Martens LC. Laser physics and a review of laser applications in dentistry for children. Eur Arch Paediatr Dent. 2011 Apr;12(2):61-7. doi: 10.1007/BF03262781.
• Background Stein E, Koehn J, Sutter W, Schmidl C, Lezaic V, Wendtlandt G, Watzinger F, Turhani D. Phenothiazine chloride and soft laser light have a biostimulatory effect on human osteoblastic cells. Photomed Laser Surg. 2009 Feb;27(1):71-7. doi: 10.1089/pho.2008.2265.
• Background Juric IB, Plecko V, Panduric DG, Anic I. The antimicrobial effectiveness of photodynamic therapy used as an addition to the conventional endodontic re-treatment: a clinical study. Photodiagnosis Photodyn Ther. 2014 Dec;11(4):549-55. doi: 10.1016/j.pdpdt.2014.10.004. Epub 2014 Oct 24.

Drugs

Indications