Bactericidal efficacy of photodynamic therapy against Enterococcus faecalis in infected root canals: A systematic literature review

Objective: The aim was to review the bactericidal efficacy of photodynamic therapy (PDT) against Enterococcus faecalis (E. faecalis) in infected root canals. Methods: To address the focused question Does PDT exhibit bactericidal effects against E. faecalis in infected root canals? PubMed/Medline and Google-Scholar databases were searched from 1985 up to August 2013 using various combinations of the following key words: antibacterial; bactericidal; endodontic; root canal and photodynamic therapy. Original studies, experimental studies and articles published only in English language were included. Letters to the editor, historic reviews and unpublished data were excluded. The pattern of the present review was customized to primarily summarize the pertinent information. Results: Seventeen studies (16 ex vivo and one in vivo) were included. In these studies, numbers of teeth used ranged between 30 and 220 teeth. In these studies, wavelengths of diode laser used, diameter of fiber and power output ranged between 625 and 805 nm, 200 mu m and 0.4 cm, and 40 mW and 5W respectively. Twelve studies reported PDT to be effective in eliminating E. faecalis from infected root canals. Four studies reported conventional irrigation and instrumentation to be more efficient in killing E. faecalis than PDT. One study reported PDT and conventional endodontic regimes to be equally effective in eliminating E. faecalis from infected root canals. In most studies, toluidine blue and/or methylene blue were used as photosensitizers. Conclusion: Efficacy of PDT in eliminating E. faecalis from infected root canals remains questionable. Crown Copyright (C) 2013 Published by Elsevier B.V. All rights reserved.