EVALUATION OF SUPPLEMENTAL PHOTODYNAMIC THERAPY FOR POSTOPERATIVE PAIN IN ENDODONTICS
Main Article Content
Keywords
Antimicrobial, Periodontal Therapy, Photodynamic Therapy, Postoperative Pain
Abstract
Background: Photodynamic therapy (PDT) is an emerging adjunct in endodontic treatment, aimed at reducing postoperative pain. Conventional root canal disinfection methods may not always achieve complete microbial elimination, necessitating the exploration of alternative approaches like PDT.
Objective: This study aimed to evaluate the effectiveness of photodynamic therapy (PDT) as an adjunct in endodontic treatment by assessing its impact on postoperative pain and associated symptoms compared to conventional methods.
Methods: A quasi-experimental study was conducted on 50 patients (25 per group) requiring root canal treatment for apical periodontitis. The experimental group (PDT) received photodynamic therapy using toluidine blue and a red laser (30 mW, 9 J/cm² for 90 seconds), while the control group (CMP) underwent conventional disinfection. Postoperative pain was measured using a visual analog scale (VAS) at 24, 48, and 72 hours.
Results: The mean age of participants was 35.6 ± 8.4 years in the experimental group and 36.2 ± 7.9 years in the control group. The majority of participants were male, comprising 68.0% (n=17) in the experimental group and 64.0% (n=16) in the control group, while females accounted for 32.0% (n=8) and 36.0% (n=9), respectively. The mean radiolucency size was 3.5 ± 1.1 mm in the experimental group and 3.4 ± 1.0 mm in the control group. The mean postoperative pain score (VAS) at 24 hours was significantly lower in the experimental group (PDT) (2.8 ± 1.1) compared to the control group (CMP) (4.5 ± 1.4) (p = 0.001), indicating that PDT was effective in reducing postoperative pain.
Conclusion: Photodynamic therapy (PDT) effectively reduces early postoperative pain in endodontic treatment, with significant pain relief observed within the first 72 hours. However, its long-term benefits remain uncertain as pain levels between groups equalize after one week.
References
2. Ahangari Z, Asnaashari M, Akbarian Rad N, Shokri M, Azari-Marhabi S, Asnaashari N, et al. Investigating the antibacterial effect of passive ultrasonic irrigation, photodynamic therapy and their combination on root canal disinfection. J Lasers Med Sci. 2021;12(3):e81-e85. doi: 10.34172/jlms.2021.81.
3. Ye L, Cao L, Song W, Yang C, Tang Q, Yuan Z. Interaction between apical periodontitis and systemic disease. International journal of molecular medicine. 2023 Jul 1;52(1):1-9. doi: 10.3892/ijmm.2023.5263
4. Ioana RB, Reem H, Nasim C, Elena G, Radu SC, Adina S, et al. Evaluation of the outcome of various laser therapy applications in root canal disinfection: A systematic review, Photodiagn Photo Therap. 2020, 29(5):1016-21. doi.org/10.1016/j.pdpdt.2019.101611.
5. De VNG, Dos Santos KSA, de Souza Sales Rocha EAL. Antibacterial effect of photodynamic therapy on root canal disinfection combined with different irrigation protocols. Iran Endod J. 2020;15(2):90-95. doi: 10.22037/iej.v15i2.27801
6. Gholami L, Shahabi S, Jazaeri M, Hadilou M, Fekrazad R. Clinical applications of antimicrobial photodynamic therapy in dentistry. Front Microbiol. 2023;13(6):1020995. doi.org/10.3389/fmicb.2022.1020995
7. Suresh N, Joseph B, Sathyan P, Sweety VK, Waltimo T, Anil S. Photodynamic therapy: An emerging therapeutic modality in dentistry. Bioorg Med Chem. 2024;19(3):117962.
8. Gomes BP, Aveiro E, Kishen A. Irrigants and irrigation activation systems in Endodontics. Brazil Dental J. 2023;34(4):1-33. doi: 10.1590/0103-6440202305577
9. Wong J, Manoil D, Näsman P, Belibasakis GN, Neelakantan P. Microbiological aspects of root canal infections and disinfection strategies: an update review on the current knowledge and challenges. Front Oral Health. 2021;25(2):672887.
10. Segura‐Egea JJ, Gould K, Şen BH, Jonasson P, Cotti E, Mazzoni A, Sunay H, Tjäderhane L, Dummer PM. Antibiotics in Endodontics: a review. International endodontic journal. 2017 Dec;50(12):1169-84.
11. Wong J, Manoil D, Näsman P, Belibasakis GN, Neelakantan P. Microbiological aspects of root canal infections and disinfection strategies: an update review on the current knowledge and challenges. Frontiers in Oral Health. 2021 Jun 25;2:672887.
12. Jiao Y, Tay FR, Niu LN, Chen JH. Advancing antimicrobial strategies for managing oral biofilm infections. International journal of oral science. 2019 Sep;11(3):28.
13. Vilas-Boas L, Cozer V, Tawil PZ, Coelho MS. Effect of photodynamic therapy on postoperative pain in posterior teeth with symptomatic apical periodontitis. Photodiagnosis and Photodynamic Therapy. 2021 Sep 1;35:102348.
14. Alves-Silva EG, Arruda-Vasconcelos R, Louzada LM, de-Jesus-Soares A, Ferraz CC, Almeida JF, Marciano MA, Steiner-Oliveira C, Bello-Silva MS, Shemesh H, de Almeida Gomes BP. The effect of photodynamic therapy on postoperative pain in teeth with primary endodontic infection. Photodiagnosis and Photodynamic Therapy. 2022 Mar 1;37:102700.
15. Seyyedi SA, Fini MB, Fekrazad R, Abbasian S, Abdollahi AA. Effect of photobiomodulation on postoperative endodontic pain: A systematic review of clinical trials. Dental Research Journal. 2024 Jan 1(1):7.
16. Yoshinari FM, Pereira KF, Beraldo DZ, Silva JC, Zafalon EJ, Silva PG. Influence of photodynamic therapy in the control of postoperative pain in endodontic treatment: A cross-sectional randomized clinical trial. Pesquisa Brasileira em Odontopediatria e Clínica Integrada. 2019 Oct 10;19:e4369.
17. Luo Z, He Y, Wu H, Li Y, Shen L, Cheng L, Zhou X, He L, Chen J. Efficacy of laser adjuvant therapy in the management of post‐operative endodontic pain: A systematic review and meta‐analysis. International Endodontic Journal. 2024 Dec;57(12):1700-16.
18. Bharti R, Tikku AP, Chandra A, Gupta P. Antimicrobial effectiveness of photodynamic therapy, 5% sodium hypochlorite and 2% chlorhexidine gluconate in root canal treated teeth: a clinical study. Journal of Advanced Oral Research. 2021 Nov;12(2):193-9.
19. Conejero MJ, Almenar A, Forner L, Sanz JL, Llena C. Retrospective clinical evaluation of root canal treatment with or without photodynamic therapy for necrotic teeth and teeth subjected to retreatment. Journal of Oral Science. 2021;63(2):163-6.
20. Alshareef RA, Mobarki GA, Alshemaisi MM, Altkhais YM, Alotaibi BS, Alshehri LS, Zarei LA, Abduljabar AH, Alghenaim FA, Alshammari AS. Evaluation of the use of photodynamic therapy in endodontics. Pharmacophore. 2021;12(6-2021):37-42.
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Misbah Ashfaq
BDS, FCPS Operative Dentistry and Endodontics, Senior Registrar, Department of Operative Dentistry and Endodontics, FMH College of Medicine And Dentistry Lahore,
Ghafeer Ahmad Malik
BDS, Chief Dental Surgeon, Dental & Muneer Shaheed Dental Clinic,
Saroosh Ehsan
BDS, FCPS, ICMT, Professor, Operative Dentistry and Endodontics, Fatima Memorial College of Medicine and Dentistry,
Talha Ahmad Malik
BDS, Associate Dental Surgeon Muneer Shaheed Dental Clinic,
Adeela Rafique
MSC Restorative Dentistry, Associate Professor, FMH College of Medicine and Dentistry,
Ayesha Nadeem
BDS, FCPS Resident, FCPS 4th year PGR, Operative Dentistry Fatima Memorial Hospital