PHOTODYNAMIC THERAPY AS AN ADJUNCT IN THE MANAGEMENT OF APICAL PERIODONTITIS: EVIDENCE AND CLINICAL APPLICATIONS
DOI:
https://doi.org/10.56238/arev7n10-270Keywords:
Photodynamic Therapy, Apical Periodontitis, Endodontic Disinfection, Adjunctive TreatmentAbstract
Objective: This narrative literature review aims to analyze the current evidence regarding the use of photodynamic therapy (PDT) as an adjunctive approach in the management of apical periodontitis, emphasizing its antimicrobial effectiveness, clinical outcomes, and biological mechanisms. Methodology: A comprehensive search was conducted in PubMed, Scopus, Cochrane Library, and Google Scholar databases using combinations of the keywords “Photodynamic Therapy,” “Apical Periodontitis,” “Endodontic Disinfection,” and “Adjunctive Treatment.” Boolean operators “AND” and “OR” were used to refine results. After removing duplicates, studies were screened by title, abstract, and full text. Both in vitro and clinical trials published in English between 2000 and 2025 were considered, focusing on the use of PDT as an adjunct to conventional endodontic therapy. Results: The reviewed literature demonstrates that PDT enhances microbial reduction within the root canal system when used alongside conventional chemomechanical preparation. The activation of photosensitizers, such as methylene blue or toluidine blue, by low-level laser light results in the generation of reactive oxygen species capable of disrupting bacterial membranes and biofilms. Clinical studies report improved healing of periapical lesions, reduced postoperative symptoms, and lower bacterial persistence compared to conventional disinfection alone. However, variations in laser parameters, photosensitizers, and irradiation protocols hinder direct comparison across studies. Conclusion: Photodynamic therapy represents a promising adjunctive approach in the management of apical periodontitis, offering enhanced antimicrobial efficacy and potential improvement in periapical healing. Standardization of protocols and high-quality randomized clinical trials are still required to consolidate its clinical indications.
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