Photodynamic therapy in the root canal treatment of primary teeth: A systematic review of clinical trials

Lucas Peixoto de Araújo, Leandro Bueno Gobbo, Tamares Andrade da Silva, Wellington Luiz de Oliveira da Rosa, José Flávio Affonso de Almeida, Brenda P. F. A. Gomes, Caio Cezar Randi Ferraz

Dental caries is the most common oral disease worldwide, and it is estimated to affect 2.3 billion people, with at least 530 million of them being schoolchildren with decayed primary teeth. This condition can rapidly evolve into irreversible pulp inflammation and pulp necrosis and thus requiring endodontic intervention. Photodynamic therapy (PDT) is a supplementary method to conventional pulpectomy and is used to improve the disinfection protocol. Thus, the main objective of this study is to evaluate through a systematic review the efficacy of supplementary PDT on the pulpectomy of primary teeth. This review was registered a priori on the PROSPERO database (CRD42022310581). Two independent and blinded reviewers carried out a comprehensive search in five databases: PubMed, Cochrane, Scopus, Embase, and Web of Science. Eligible studies were randomized and nonrandomized clinical trials that evaluated in vivo microbiological load or clinical outcomes after using supplementary PDT in infected primary teeth. After the selection process, four studies met the inclusion criteria and were included in this study. Data regarding the sample characteristics and PDT protocols were retrieved. All included trials used phenothiazinium salts as photosensitizer agents. Only one study observed a significant difference in the in vivo microbiological load reduction outcome when performing PDT on primary teeth. The remaining studies all discussed the possible benefits of this intervention; however, none observed a significant difference in this outcome. In this systematic review, moderate to low certainty of the available evidence was observed, and thus, no significant conclusions can be drawn from the findings.