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Photodynamic therapy for root canal disinfection in endodontics: an umbrella review

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Abstract

To evaluate and synthesize the evidence from the individual reviews that evaluated the efficacy of PDT therapy in root canal disinfection by undertaking an umbrella review. The protocol of the review was registered in the PROSPERO database under number CRD42021214056. The literature search was conducted using the following electronic databases: PubMed, Scopus, Web of Science, BVS, Cochrane Database of Systematic Reviews, Embase, and Epistemonikos, from inception to July 2021. Systematic reviews that evaluated the efficacy of PDT for root canal disinfection were included. Two authors independently performed a literature search, data extraction, and quality assessment of the included studies. Any disagreements were resolved by a third reviewer. The quality of the reviews was assessed using the AMSTAR 2 tool and the final categorization of each systematic reviews was classified as of “high,” “moderate,” “low,” or “critically low” quality. Six systematic reviews were included in the current umbrella review and all of them were graded as critically low quality. From the critically low-quality evidence available, this umbrella review showed that the efficacy of PDT in root canal disinfection remains yet undetermined.

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References

  1. Zehnder M (2006) Root canal irrigants. J Endod 32:389–398

    Article  Google Scholar 

  2. Neelakantan P, Herrera DR, Pecorari VGA, Gomes B (2019) Endotoxin levels after chemomechanical preparation of root canals with sodium hypochlorite or chlorhexidine: a systematic review of clinical trials and meta-analysis. Int Endod J 52:19–27

    Article  CAS  Google Scholar 

  3. Paiva SS, Siqueira JF Jr, Rocas IN, Carmo FL, Leite DC, Ferreira DC, Rachid CT, Rosado AS (2016) Clinical antimicrobial efficacy of NiTi rotary instrumentation with NaOCl irrigation, final rinse with chlorhexidine and interappointment medication: a molecular study. Int Endod J 46:225–233

    Article  Google Scholar 

  4. Siqueira Junior JF, Rocas IDN, Marceliano-Alves MF, Perez AR, Ricucci D (2018) Unprepared root canal surface areas: causes, clinical implications, and therapeutic strategies. Braz O Res 32:e65

    Google Scholar 

  5. Asnaashari M, Ashraf H, Rahmati A, Amini N (2017) A comparison between effect of photodynamic therapy by LED and calcium hydroxide therapy for root canal disinfection against Enterococcus faecalis: a randomized controlled trial. Photodiagnosis Photodyn Ther 17:226–232

    Article  CAS  Google Scholar 

  6. Kist S, Kollmuss M, Jung J, Schubert S, Hickel R, Huth KC (2017) Comparison of ozone gas and sodium hypochlorite/chlorhexidine two-visit disinfection protocols in treating apical periodontitis: a randomized controlled clinical trial. Clin Oral Investig 21:995–1005

    Article  Google Scholar 

  7. Sarda RA, Shetty RM, Tamrakar A, Shetty SY (2019) Antimicrobial efficacy of photodynamic therapy, diode laser, and sodium hypochlorite and their combinations on endodontic pathogens. Photodiagnosis Photodyn Ther 28:265–272

    Article  CAS  Google Scholar 

  8. Sasanakul P, Ampornaramveth RS, Chivatxaranukul P (2019) Influence of adjuncts to irrigation in the disinfection of large root canals. J Endod 45:332–337

    Article  Google Scholar 

  9. Fimple JL, Fontana CR, Foschi F, Ruggiero K, Song X, Pagonis TC, Tanner AC, Kent R, Doukas AG, Stashenko PP, Soukos NS (2008) Photodynamic treatment of endodontic polymicrobial infection in vitro. J Endod 34:728–734

    Article  Google Scholar 

  10. Fonseca MB, Junior PO, Pallota RC, Filho HF, Denardin OV, Rapoport A, Dedivitis RA, Veronezi JF, Genovese WJ, Ricardo AL (2008) Photodynamic therapy for root canals infected with Enterococcus faecalis. Photomed Laser Surg 26:209–213

    Article  Google Scholar 

  11. Cheng X, Guan S, Lu H, Zhao C, Chen X, Li N, Bai Q, Tian Y, Yu Q (2012) Evaluation of the bactericidal effect of Nd:YAG, Er:YAG, Er, Cr:YSGG laser radiation, and antimicrobial photodynamic therapy (aPDT) in experimentally infected root canals. Lasers Surg Med 44:824–831

    Article  Google Scholar 

  12. Garcez AS, Arantes-Neto JG, Sellera DP, Fregnani ER (2015) Effects of antimicrobial photodynamic therapy and surgical endodontic treatment on the bacterial load reduction and periapical lesion healing. Three years follow up. Photodiagnosis Photodyn Ther 12:575–580

    Article  Google Scholar 

  13. Siddiqui SH, Awan KH, Javed F (2013) Bactericidal efficacy of photodynamic therapy against Enterococcus faecalis in infected root canals: a systematic literature review. Photodiagnosis Photodyn Ther 10:632–643

    Article  CAS  Google Scholar 

  14. Pourhajibagher M, Bahador A (2019) Adjunctive antimicrobial photodynamic therapy to conventional chemo-mechanical debridement of infected root canal systems: a systematic review and meta-analysis. Photodiagnosis Photodyn Ther 26:19–26

    Article  CAS  Google Scholar 

  15. Zheng T, Zheng J, Liu H, Wang P (2019) Efficacy of photodynamic therapy and sodium hypochlorite on the disinfection of Enterococcus faecalis in infected root canal: a meta-analysis. Chin J Evid-Based Med 19:946–952

    Google Scholar 

  16. Kattan S, Lee SM, Kohli MR, Setzer FC, Karabucak B (2018) Methodological Quality Assessment of Meta-analyses in Endodontics. J Endod 44:22–31

    Article  Google Scholar 

  17. Kranke P (2010) Evidence-based practice: how to perform and use systematic reviews for clinical decision-making. Eur J Anaesthesiol 27:763–772

    Article  Google Scholar 

  18. Gopalakrishnan S, Ganeshkumar P (2013) Systematic reviews and meta-analysis: understanding the best evidence in primary healthcare. J Family Med Prim Care 2:9–14

    Article  CAS  Google Scholar 

  19. Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med 151:264–269

    Article  Google Scholar 

  20. Jakovljevic A, Duncan HF, Nagendrababu V, Jacimovic J, Milasin J, Dummer PMH (2020) Association between cardiovascular diseases and apical periodontitis - An umbrella review. Int Endod J 53:1374–1386

    Article  CAS  Google Scholar 

  21. Maldonado EQ, Morales EC, Herrera AH (2018) Uso del laser de baja potencia como coadyuvante en el tratamiento de lesiones periapicales. Revisión sistemática Revista Salud Uninorte 34:797–805

    Google Scholar 

  22. Oliveira FAM, Martins MT, Ribeiro MA, Mota PHA, Paula MVQ (2018) Indications and treatments of low level laser therapy in dentistry: a systematic review of the literature. HU rev 44:85–96

    Article  Google Scholar 

  23. Moshari A, Vatanpour M, Zakershahrak M (2016) The efficacy of low-level laser treatment in reducing pain and swelling after endodontic surgery: a systematic review. Lasers Med Sci 9670. https://doi.org/10.1117/12.2192525

  24. Estrela C, Sydney GB, Figueiredo JA, Estrela CR (2009) Antibacterial efficacy of intracanal medicaments on bacterial biofilm: a critical review. J Appl Oral Sci 17:1–7

    Article  CAS  Google Scholar 

  25. Chen Y, Chen XL, Zou XL, Chen SZ, Zou J, Wang Y (2019) Efficacy of low-level laser therapy in pain management after root canal treatment or retreatment: a systematic review. Lasers Med Sci 34:1305–1316

    Article  CAS  Google Scholar 

  26. Alonaizan FA, AlFawaz YF (2019) Is phototherapy effective in the management of post-operative endodontic pain? A systematic review of randomized controlled clinical trials. Photodiagnosis Photodyn Ther 26:53–58

    Article  Google Scholar 

  27. Sadık B, Arıkan S, Beldüz N, Yaşa Y, Karasoy D, Cehreli M (2013) Effects of laser treatment on endodontic pathogen Enterococcus faecalis: a systematic review. Photomed Laser Surg 31:192–200

    Article  Google Scholar 

  28. Arneiro RA, Nakano RD, Antunes LA, Ferreira GB, Fontes K, Antunes LS (2014) Efficacy of antimicrobial photodynamic therapy for root canals infected with Enterococcus faecalis. J Oral Sci 56:277–285

    Article  Google Scholar 

  29. Fransson H, Larsson KM, Wolf E (2013) Efficacy of lasers as an adjunct to chemo-mechanical disinfection of infected root canals: a systematic review. Int Endod J 46:296–307

    Article  CAS  Google Scholar 

  30. Chrepa V, Kotsakis GA, Pagonis TC, Hargreaves KM (2014) The effect of photodynamic therapy in root canal disinfection: a systematic review. J Endod 40:891-898.

  31. Bordea IR, Hanna R, Chiniforush N, Grădinaru E, Câmpian RS, Sîrbu A, Amaroli A, Benedicenti S (2020) Evaluation of the outcome of various laser therapy applications in root canal disinfection: A systematic review. Photodiagnosis Photodyn Ther 29:101611.

    Article  Google Scholar 

  32. Guyatt G, Sacket D, Cook D (1993) Users′ guides to the medical literature II. How to use an article about therapy and prevention. A. Are the results of the study valid? Evidence Based Medicine Working Group. JAMA 270:2598–2601.

    Google Scholar 

  33. Guyatt G, Sacket D, Cook D (1994) Users′ guides to the medical literature II. How to use an article about therapy and prevention. B. What were the results and will they help me in caring for my patients? Evidence-Based Medicine Working Group. JAMA 271:59–63.

    Article  Google Scholar 

  34. Sharif MO, Janjua-Sharif FN, Ali H, Ahmed F (2013) Systematic reviews explained: AMSTAR-how to tell the good from the bad and the ugly. Oral Health Dent Manag 12:9–16.

    Article  Google Scholar 

  35. Rabello DGD, Corazza BJM, Ferreira LL, Santamaria MP, Gomes APM, Martinho F (2017) Does supplemental photodynamic therapy optimize the disinfection of bacteria and endotoxins in one-visit and two-visit root canal therapy? A randomized clinical trial. Photodiagnosis Photodyn Ther 19:205-211.

    Google Scholar 

  36. Moradi Eslami L, Vatanpour M, Aminzadeh N, Mehrvarzfar P, Taheri S (2019) The comparison of intracanal medicaments, diode laser and photodynamic therapy on removing the biofilm of Enterococcus faecalis and Candida albicans in the root canal system (ex-vivo study). Photodiagnosis Photodyn Ther 26:157-161.

  37. Shea BJ, Reeves BC, Wells G, Thuku M, Hamel C, Moran J, Moher D, Tugwell P, Welch V, Kristjansson E, Henry DA (2017) AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ 21:358:j4008

    Article  Google Scholar 

  38. de Vries RB, Hooijmans CR, Langendam MW, van Lujik J, Leenars M, Ritskes-Hoitinga M, Wever KE (2015) A protocol format for the preparation, registration and publication of systematic reviews of animal intervention studies. Evid-based Preclinical Med 2:1–9.

  39. Paez A (2017) Gray literature: An important resource in systematic reviews. J Evid Based Med 10:233-240.

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors declare no competing interests.

Funding

This research was supported by the Brazilian Government research funding agency Higher Education Personnel Improvement Coordination (CAPES) number 001.

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Authors and Affiliations

  1. Department of Endodontics, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil

    Ana Flávia Almeida Barbosa, Luciana Moura Sassone & Emmanuel João Nogueira Leal Silva

  2. Department of Dentistry, Federal University of Juiz de Fora (UFJF-GV), Governador Valadares, MG, Brazil

    Carolina Oliveira de Lima

  3. Department of Preventive and Community Dentistry, School of Dentistry, Rio de Janeiro State University (UERJ), Rio de Janeiro, RJ, Brazil

    Thiago Moreira & Tatiana Kelly da Silva Fidalgo

  4. Department of Endodontics, Grande Rio University (UNIGRANRIO), Rio de Janeiro, RJ, Brazil

    Emmanuel João Nogueira Leal Silva

Authors
  1. Ana Flávia Almeida Barbosa
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  2. Carolina Oliveira de Lima
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  3. Thiago Moreira
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  4. Luciana Moura Sassone
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  5. Tatiana Kelly da Silva Fidalgo
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  6. Emmanuel João Nogueira Leal Silva
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Contributions

Ana Barbosa: contributed to conceptualization, methodology, investigation, and original draft preparation.

Carolina Lima: contributed to methodology, investigation, and original draft preparation.

Thiago Moreira: contributed to the original draft preparation.

Luciana Sassone: contributed to the critical review and final approval of the version to be published.

Tatiana Fidalgo: contributed substantially to analysis and interpretation of data.

Emmanuel Silva: contributed to conceptualization, to hypothesis, critical review, and final approval of the version to be published.

Corresponding author

Correspondence to Carolina Oliveira de Lima.

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Barbosa, A.F.A., de Lima, C.O., Moreira, T. et al. Photodynamic therapy for root canal disinfection in endodontics: an umbrella review. Lasers Med Sci 37, 2571–2580 (2022). https://doi.org/10.1007/s10103-022-03569-1

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  • DOI: https://doi.org/10.1007/s10103-022-03569-1

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