Wince Carolina, Kassa Claudio T, Insper Joaquin, Amzallag Daniela, Consonlandich Wilhem, Tortamano Ana Carolina A C, Magalhães Fabiana Divino, Lestido Valentina, Pavani Christiane, Prates Renato A
Universidad Catolica del Uruguay, Montevideo, Uruguay.
Postgraduate Program in Biophotonics Medicine Applied to Health Sciences, Universidade Nove de Julho, Sao Paulo, Brazil.
PLoS One. 2024 Dec 19;19(12):e0315169. doi: 10.1371/journal.pone.0315169. eCollection 2024.
This study aims to evaluate the efficacy of photodynamic therapy as an adjunct to conventional endodontic treatment in patients with apical periodontitis and fistulas. In this study, a fistula is characterized as a pathological conduit originating from the infected region at the root apex of the tooth, traversing the oral mucosa, and extending to the external surface of the gingiva. This pathological condition frequently complicates the management of endodontic infections, thereby necessitating the evaluation of supplementary therapeutic interventions. The standard treatment for endodontic infections involves thorough disinfection of the root canal system to remove microbial contamination from the canal and surrounding tissues. To potentially augment the efficacy of conventional treatment, aPDT is proposed as a supplementary, non-invasive technique. This innovative technique uses a photosensitizer, which is a light-sensitive dye, in combination with a light source to produce reactive oxygen species. Reactive oxygen species can effectively target and eliminate bacteria in the root canal system, potentially enhancing treatment outcomes.
The study will involve 140 teeth with apical periodontitis and fistulas. The teeth will be randomly assigned to one of two treatment groups. Group I will receive only the conventional endodontic treatment, which includes root canal cleaning, shaping, and obturation. Group II will undergo the same conventional endodontic treatment, but with an additional step of aPDT. The aPDT procedure involves applying a photosensitizer to the root canal and irradiating it with light to produce reactive oxygen species. Each group will consist of 70 teeth to ensure adequate statistical power. The primary outcome is fistula resolution, assessed clinically at 15 and 30 days post-treatment. The secondary outcome is the comparison of apical radiolucency from periapical radiographs to evaluate healing and reduction of periapical pathology.
The study aims to determine if adding aPDT significantly improves the management of apical periodontitis and overall success rates of endodontic treatment. The results will provide insights into the effectiveness of aPDT as an adjunctive treatment and its potential benefits in clinical practice.
本研究旨在评估光动力疗法作为辅助手段用于治疗根尖周炎并伴有瘘管患者的常规根管治疗的疗效。在本研究中，瘘管的特征是一种病理性管道，起源于牙齿根尖的感染区域，穿过口腔黏膜，并延伸至牙龈外表面。这种病理状况常常使根管感染的处理变得复杂，因此需要评估补充性治疗干预措施。根管感染的标准治疗包括对根管系统进行彻底消毒，以清除根管和周围组织中的微生物污染。为了潜在地提高传统治疗的疗效，提出将光动力疗法（aPDT）作为一种补充性的非侵入性技术。这种创新技术使用一种光敏剂（一种对光敏感的染料）与光源结合产生活性氧。活性氧可以有效靶向并消除根管系统中的细菌，有可能提高治疗效果。
该研究将纳入患有根尖周炎并伴有瘘管的140颗牙齿。这些牙齿将被随机分配到两个治疗组之一。第一组仅接受常规根管治疗，包括根管清理、成形和充填。第二组将接受相同的常规根管治疗，但增加光动力疗法这一步骤。光动力疗法程序包括将光敏剂应用于根管并用光照射以产生活性氧。每组将由70颗牙齿组成，以确保有足够的统计效力。主要结局是瘘管愈合情况，在治疗后15天和30天进行临床评估。次要结局是通过根尖X线片比较根尖透影区，以评估根尖周病变的愈合和减轻情况。
本研究旨在确定添加光动力疗法是否能显著改善根尖周炎的治疗及根管治疗的总体成功率。研究结果将为光动力疗法作为辅助治疗的有效性及其在临床实践中的潜在益处提供见解。
