Chrepa Vanessa, Kotsakis Georgios A, Pagonis Tom C, Hargreaves Kenneth M
Department of Endodontics, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
Department of Developmental and Surgical Sciences, University of Minnesota, Minneapolis, Minnesota.
J Endod. 2014 Jul;40(7):891-8. doi: 10.1016/j.joen.2014.03.005. Epub 2014 May 2.
Effective root canal disinfection is a fundamental component of successful root canal treatment. Photodynamic therapy (PDT) has been proposed as a new adjunctive method for additional disinfection of the root canal system with the possibility of improved treatment outcomes. The aim of this systematic review was to investigate the effect of PDT on bacterial load reduction during root canal disinfection.
Two reviewers independently conducted a comprehensive literature search using a combination of medical subject heading terms and key words to identify studies relevant to the Population Intervention Control Outcome question. The selection of articles for inclusion was performed in 2 phases based on predetermined eligibility criteria according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Inter-reviewer agreement for each phase was recorded. The effect of PDT on bacterial load reduction during root canal disinfection was evaluated as the primary outcome variable during data extraction.
The literature search provided 57 titles and abstracts. Three articles met the inclusion criteria and were selected for this systematic review. The reasons for study exclusion in each phase were recorded. Because of the heterogeneity in clinical indications and PDT protocols among the included studies, a meta-analysis could not be performed. All included studies showed a positive effect of PDT in the reduction of microbial load in root canal treatment ranging from 91.3%-100%.
Limited clinical information is currently available on the use of PDT in root canal disinfection. If supported by future clinical research, PDT may have efficacy for additional root canal disinfection, especially in the presence of multi-drug-resistant bacteria.
有效的根管消毒是成功进行根管治疗的基本组成部分。光动力疗法（PDT）已被提议作为一种新的辅助方法，用于根管系统的额外消毒，有可能改善治疗效果。本系统评价的目的是研究光动力疗法在根管消毒过程中对减少细菌载量的效果。
两名评价者独立进行全面的文献检索，使用医学主题词和关键词相结合的方式，以识别与“人群-干预-对照-结局”问题相关的研究。根据系统评价和Meta分析的首选报告项目（PRISMA）指南，基于预先确定的纳入标准，分两个阶段进行文章的纳入选择。记录每个阶段评价者之间的一致性。在数据提取过程中，将光动力疗法在根管消毒过程中对减少细菌载量的效果作为主要结局变量进行评估。
文献检索共获得57个标题和摘要。三篇文章符合纳入标准，被选入本系统评价。记录了每个阶段研究被排除的原因。由于纳入研究之间临床适应证和光动力疗法方案存在异质性，无法进行Meta分析。所有纳入研究均表明，光动力疗法在根管治疗中对降低微生物载量有积极作用，降低幅度为91.3%-100%。
目前关于光动力疗法在根管消毒中的应用的临床信息有限。如果未来的临床研究提供支持，光动力疗法可能对额外的根管消毒有效，特别是在存在多重耐药菌的情况下。
