Bahrami Rashin, Pourhajibagher Maryam, Nikparto Nariman, Bahador Abbas
Department of Orthodontics, School of Dentistry, Iran University of Medical Sciences, Tehran, Iran.
Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
J Dent Sci. 2024 Oct;19(4):1924-1933. doi: 10.1016/j.jds.2024.06.022. Epub 2024 Jul 17.
Antimicrobial photodynamic therapy (aPDT) is a non-invasive approach used for microbial decontamination, and it can also be beneficial as an adjunctive strategy for oral infections. The success of treatment in the long term is increasingly recognized to be influenced by patient's perception of the disease and its improvement. Recently, aPDT has been suggested as a dual approach to tissue repair, pain relief, and enhancement of oral health-related quality of life (OHRQoL). The first pathway involves the antimicrobial and anti-inflammatory effects of aPDT. It not only eliminates microorganisms but also helps regulate the immune response and reduce inflammation, leading to a faster and more effective healing process. This, in turn, provides relief from pain and associated symptoms, aiding in the management of treatment complications. The second pathway involves aPDT's ability to modulate nociception and alleviate pain. aPDT induces analgesia by releasing neurotransmitters such as β-endorphin, serotonin, and acetylcholinesterase. It also interacts with mitochondria through photoreceptors, initiating intracellular processes that alleviate pain. Furthermore, the therapy inhibits nerve fibers, reducing nerve impulse conduction and altering the pain threshold. Considering that the impact on patients' pain and OHRQoL is an important aspect of the decision-making process, this study aimed to review patient-based outcome measures during aPDT and assess its effects on pain and OHRQoL in patients. Understanding these factors will contribute to a better assessment of the overall benefits and effectiveness of aPDT as a treatment option for oral infections.
抗菌光动力疗法（aPDT）是一种用于微生物去污的非侵入性方法，作为口腔感染的辅助治疗策略也可能有益。长期治疗的成功越来越被认为受患者对疾病的认知及其改善情况的影响。最近，aPDT被认为是一种促进组织修复、缓解疼痛和提高口腔健康相关生活质量（OHRQoL）的双重方法。第一条途径涉及aPDT的抗菌和抗炎作用。它不仅能消除微生物，还有助于调节免疫反应和减轻炎症，从而实现更快、更有效的愈合过程。这反过来又能缓解疼痛和相关症状，有助于处理治疗并发症。第二条途径涉及aPDT调节伤害感受和减轻疼痛的能力。aPDT通过释放β-内啡肽、血清素和乙酰胆碱酯酶等神经递质诱导镇痛。它还通过光感受器与线粒体相互作用，启动减轻疼痛的细胞内过程。此外，该疗法会抑制神经纤维，减少神经冲动传导并改变疼痛阈值。鉴于对患者疼痛和OHRQoL的影响是决策过程的一个重要方面，本研究旨在回顾aPDT治疗期间基于患者的结局指标，并评估其对患者疼痛和OHRQoL的影响。了解这些因素将有助于更好地评估aPDT作为口腔感染治疗选择的总体益处和有效性。
