Antibacterial efficiency of adjuvant photodynamic therapy and high-power diode laser in the treatment of young permanent teeth with chronic periapical periodontitis. A prospective clinical study

Photodiagnosis Photodyn Ther. 2023 Mar:41:103129. doi: 10.1016/j.pdpdt.2022.103129. Epub 2022 Sep 23.

Abstract

Background: The study aimed at determining antibacterial efficiency of adjuvant photodynamic therapy (PDT) and high-power diode laser (DL) in the treatment of chronic periapical periodontitis (CPP) in young permanent teeth.

Methods: Forty-four young permanent teeth with CPP were randomly divided into three groups (PDT, DL and control). Each tooth underwent standard chemo-mechanical treatment, while within tested groups was additionally treated by PDT or DL. Bacterial identification and quantification were provided by MALDI-TOF spectrometry and plate counting assay, performed after accessing the canal, following chemo-mechanical preparation, and after PDT or DL procedure where applicable.

Results: Thirty-nine young permanent teeth with CCP (patients age 9.77 ± 1.43) completed the study. Before the treatments, 202 isolates belonging to 13 genera/species, including Streptococcus (36), Actinomyces (34), Peptostreptococcus micros (27), Veillonella (25) and Enterococcus faecalis (22), were recovered. Chemo-mechanical treatment reduced CFU count in the all three groups (p < 0.001), but complete eradication was not observed for any of isolated species. Adjuvant PDT and DL completely eradicated isolates of 8 and 6 bacterial genera/species, resulting in complete bacterial elimination from 53.8% and 30.8% of root canals, respectively. In the rest canals, total Δlog CFUs were 4.71 and 4.58.

Conclusion: The results indicated that both PDT and DL could be performed as adjuvants to standard endodontic treatment of the young permanent teeth with CPP.

Keywords: Diode laser; Periapical periodontitis; Photodynamic therapy; Young permanent tooth.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Dental Pulp Cavity
  • Enterococcus faecalis
  • Humans
  • Lasers, Semiconductor / therapeutic use
  • Periapical Periodontitis* / drug therapy
  • Photochemotherapy* / methods
  • Photosensitizing Agents / therapeutic use
  • Prospective Studies

Substances

  • Anti-Bacterial Agents
  • Photosensitizing Agents