Evaluation of Photodynamic Therapy in Teeth with Fistula and Apical Periodontitis: A Case Series

Abstract

Aim: This case series aimed to demonstrate the adjunctive effect of antimicrobial photodynamic therapy (aPDT) in the treatment of teeth with fistula and apical periodontitis, with a methylene blue photosensitizer boosted by sodium dodecyl sulfate (SDS). Presentation: The six participants underwent conventional endodontic treatment combined with aPDT using diode laser equipment with a wavelength of 660 nm, power of 100 mW, irradiated for 2 minutes at each point, and a pre-irradiation time of 1 minute with the photosensitizer. All cases were performed at the University Health Clinic of the Catholic University of Uruguay. Infection resolution was achieved 15 days after the treatment was completed in all cases. Discussion: The surfactant effect of SDS combined with methylene blue may have been responsible for the clinical success of the reported cases, as the minimization of photosensitizer dimerization maximizes the phototoxic effects, accelerating the resolution of infection sites and consequently reducing the healing time of the fistulas. Conclusion: aPDT can be indicated as an adjunctive treatment to conventional endodontic therapy, reducing both costs and the risks associated with the development of bacterial resistance.