Konopka K, Goslinski T
Department of Microbiology, University of the Pacific, Arthur A. Dugoni School of Dentistry, San Francisco, CA, USA.
J Dent Res. 2007 Aug;86(8):694-707. doi: 10.1177/154405910708600803.
Photodynamic therapy (PDT), also known as photoradiation therapy, phototherapy, or photochemotherapy, involves the use of a photoactive dye (photosensitizer) that is activated by exposure to light of a specific wavelength in the presence of oxygen. The transfer of energy from the activated photosensitizer to available oxygen results in the formation of toxic oxygen species, such as singlet oxygen and free radicals. These very reactive chemical species can damage proteins, lipids, nucleic acids, and other cellular components. Applications of PDT in dentistry are growing rapidly: the treatment of oral cancer, bacterial and fungal infection therapies, and the photodynamic diagnosis (PDD) of the malignant transformation of oral lesions. PDT has shown potential in the treatment of oral leukoplakia, oral lichen planus, and head and neck cancer. Photodynamic antimicrobial chemotherapy (PACT) has been efficacious in the treatment of bacterial, fungal, parasitic, and viral infections. The absence of genotoxic and mutagenic effects of PDT is an important factor for long-term safety during treatment. PDT also represents a novel therapeutic approach in the management of oral biofilms. Disruption of plaque structure has important consequences for homeostasis within the biofilm. Studies are now leading toward selective photosensitizers, since killing the entire flora leaves patients open to opportunistic infections. Dentists deal with oral infections on a regular basis. The oral cavity is especially suitable for PACT, because it is relatively accessible to illumination.
光动力疗法（PDT），也被称为光辐射疗法、光疗法或光化学疗法，是指在有氧气存在的情况下，使用一种光活性染料（光敏剂），该染料通过暴露于特定波长的光而被激活。从激活的光敏剂到可用氧气的能量转移会导致形成有毒的氧物种，如单线态氧和自由基。这些极具反应性的化学物质会损害蛋白质、脂质、核酸和其他细胞成分。PDT在牙科领域的应用正在迅速增长：用于治疗口腔癌、细菌和真菌感染，以及对口腔病变恶性转化的光动力诊断（PDD）。PDT在治疗口腔白斑、口腔扁平苔藓和头颈癌方面已显示出潜力。光动力抗菌化疗（PACT）在治疗细菌、真菌、寄生虫和病毒感染方面已取得成效。PDT不存在遗传毒性和致突变作用是治疗期间长期安全性的一个重要因素。PDT也是管理口腔生物膜的一种新型治疗方法。牙菌斑结构的破坏对生物膜内的稳态有重要影响。由于杀死整个菌群会使患者易患机会性感染，目前的研究正朝着选择性光敏剂方向发展。牙医经常处理口腔感染问题。口腔特别适合进行PACT，因为它相对容易接受光照。
