PHOTODYNAMIC THERAPY VS. SODIUM HYPOCHLORITE FOR ROOT CANAL DISINFECTION: A SYSTEMATIC REVIEW
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Keywords
Photodynamic Therapy, Sodium Hypochlorite, Root Canal Disinfection, Systematic Review, Endodontic Treatment
Abstract
Introduction: Root canal therapy (RCT) is essential for treating infections within the root canal system, with effective disinfection being crucial for successful outcomes. Sodium hypochlorite (NaOCl) has long been the standard due to its strong antimicrobial properties and tissue dissolution capabilities. However, increasing concerns about its limitations and the emergence of alternative technologies, such as Photodynamic Therapy (PDT), have spurred interest in evaluating new disinfection strategies. This systematic review aims to compare the effectiveness of PDT and NaOCl in root canal disinfection.
Methods: A comprehensive search was conducted across PubMed, PMC, Google Scholar, and ScienceDirect for systematic reviews published in the last decade. Studies were selected based on their comparison of PDT and NaOCl for root canal disinfection. Data on antimicrobial efficacy, clinical outcomes, and methodological differences were extracted and analyzed.
Results: The review identified 10 studies including 6 systematic reviews, 1RCTs, 1 case series, 1 Experimental study and 1 cohort studies. PDT demonstrated potential in reducing bacterial counts, especially in challenging areas, and showed promise in targeting resistant biofilms. However, the effectiveness varied due to differences in photosensitizers and light parameters. NaOCl remained highly effective in microbial reduction and tissue dissolution but was associated with tissue damage and incomplete disinfection in complex systems.
Discussion: PDT offers a promising alternative or adjunct to NaOCl, particularly in cases involving biofilm-resistant bacteria and minimizing tissue damage. Despite this, current evidence for PDT is inconclusive and highlights the need for further high-quality research. NaOCl continues to be the gold standard, though its limitations necessitate careful management and consideration of adjunctive treatments.
Conclusion: This review underscores PDT's potential benefits and the ongoing role of NaOCl in root canal disinfection. Further research is needed to validate PDT’s clinical efficacy and establish standardized protocols, while NaOCl’s application should be continuously evaluated to optimize its use and address its limitations.
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Dr. Wajeeha Batool
Department of Orthodontics, Karachi Medical and Dental College, KMU, Pakistan.
Dr. Asfia Anwar
Assistant Professor, Department of Community Dentistry, Liaquat College of Medicine and Dentistry, Karachi, Pakistan.
Dr. Syed Ashar Imtiaz
Dental Surgeon, Department of Operative Dentistry, Health Department Govt. of Sindh, Pakistan.
Dr. Shajia Haider
Karachi Medical and Dental College, KMU (Karachi Metropolitan University), Pakistan.
Dr. Uzma Yasmeen
Registrar, Department of Operative Dentistry, Liaquat College of Medicine and Dentistry Pakistan.
Dr. Syed Saqib Raza
Demonstrator, Department of Operative Dentistry, Karachi Medical and Dental College, KMU, Pakistan.