Clinical and microbiological effectiveness of photodynamic therapy on primary endodontic infections: a 6-month randomized clinical trial

  • Rachel Garcia de Miranda
  • Ana Paula Vieira Colombo
Original Article
  • 138 Downloads

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.

Keywords

Apical periodontitis Checkerboard DNA-DNA hybridization Randomized clinical trial Success and failure rate 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed involving human participants were in accordance and approved with the ethical standards by the Human Research Ethics Committee of the University Hospital, Federal University of Rio de Janeiro (UFRJ), protocol #707.472, and conducted in accordance with the CONSORT 2010 Statement.

Informed consent

For this type of study, informed consent was obtained from all individual participants included in the study.

Supplementary material

784_2017_2270_MOESM1_ESM.doc (218 kb)
ESM 1 (DOC 217 kb)
784_2017_2270_MOESM2_ESM.docx (33 kb)
ESM 2 (DOCX 32 kb)

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  1. 1.Department of Medical MicrobiologyFederal University of Rio de Janeiro, Institute of Microbiology Paulo de GóesRio de JaneiroBrazil

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