Tuesday, June 18, 2024

Comparative Study on Conventional Endodontic Treatment and Antimicrobial Photodynamic Therapy for Apical Lesions

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Recent advancements in dental treatments have brought forth the potential of combining conventional endodontic treatment with antimicrobial photodynamic therapy (aPDT) for better outcomes in patients suffering from apical lesions. This study aims to explore the efficacy of such a combination, examining whether aPDT can serve as a beneficial adjunct to the standard endodontic procedures.

Study Design and Methodology

This clinical trial adopts a controlled, double-blind, and randomized approach, structured as a superiority study with three parallel arms. Randomization occurs in blocks of six with a 1:1:1 allocation ratio. Participants are divided into three groups: the control group receiving conventional endodontic treatment (ET), experimental group 1 (EG1) receiving conventional ET plus aPDT with a laser at 660 nm and a fluence of 600 J/cm2, and experimental group 2 (EG2) receiving conventional ET plus aPDT with a laser at 660 nm and a fluence of 1200 J/cm2.

Outcome Measurements

The primary outcomes are evaluated based on canal disinfection before treatment through colony formation analysis (CFU/mL) and the success rate after six months, assessed by clinical and radiographic evaluations. For continuous outcomes, mean and standard deviations will be calculated, while the CFU/mL mean between groups will be examined using the ANOVA test. Binary outcomes will be analyzed using the Chi-squared test, and logistic regression will be employed to determine differences in success rates between groups, adjusted for covariates.

Key Findings and Usable Inferences

– Combining conventional ET with aPDT at different fluences could enhance the disinfection process.
– Higher fluence levels (1200 J/cm2) in aPDT might contribute to more effective root canal disinfection.
– Clinical and radiographic evaluations indicate a potential increase in treatment success rates with aPDT.
– The study underscores the need for further RCTs with larger participant groups to validate these findings for routine clinical practice.

The study concludes that there is a noteworthy potential for aPDT to serve as an adjunct to conventional endodontic treatment. However, additional research involving a larger number of participants is essential to confirm the efficacy and practicality of incorporating aPDT into standard dental practices.

Original Article: Photobiomodul Photomed Laser Surg. 2024 May;42(5):366-374. doi: 10.1089/photob.2023.0186.

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