Photodynamic Antimicrobial Chemotherapy for Root Canal System Asepsis: A Narrative Literature Review

Table 3

Ex vivo studies compilation.

Study type	Groups	% NaOCl	Substracte	Photosensitizer	Laser	Parameters evaluated	Conclusion
Ex vivo, 7 studies
Lim et al. 2009 [77]	Experiment #1; Test groups:Group #1: laser (; Group #2: PDT + PS in water (); Group #3: NaOCl (); Group #4: PDT + PS in Mix (); Control groups:Group #5: no treatment (): positive control; Experiment #2; Test groups: Group #1: PDT + PS in water (); Group #2: PDT + PS in Mix (); Group #3: cleaning and shaping (); Group #4: PDT + PS in Mix +; cleaning and shaping (); Control groups: Group #5: no treatment (): positive control	5.25	E. faecalis (ATCC29212)	MB; 100 M; PIT: NS; Dissolved in water and MIX	Model PPM35; 660 nm; IT: 1200 s	Cell viability; CFU (log10)	NaOCl showed best results that conventional PDT.
	Sample: 85 freshly extracted uniradicular human teeth
Ng et al. 2011 [78]	Test groups:Group #1: chemomechanical debridement with NaOCl (); Group #2: PDT + chemomechanical debridement with NaOCl (); Control groups: ⌀	6	Human intracanal dentinal shavings	MB; 50 g mL^−1; PIT: 300 s	BWTEK Inc.; 665 nm; IT: 150 s-break 150 s-150 s	DNA probes; Cell viability; CFU (log10)	PDT + NaOCl showed better results when compared to NaOCl alone.
	Sample: 52 freshly extracted human teeth with pulpal necrosis (9 incisors, 5 canines, 12 premolars, and 26 molars)
Stojicic et al. 2013 [5]	Test groups:Group #1: 0.1% EDTA + 0.1% H2O2 (1 min); Group #2: 0.1% EDTA + 0.1% Chx (1 min); Group #3: MB 15 (PIT = 5 min) 1 min LASER; Group #4: MB 100 (no PIT) 1 min LASER; Group #5: MB 100 (PIT = 5 min) 1 min LASER; Group #6: MB 100 (PIT = 5 min) + 0.1% EDTA + 0.1% H2O2 1 min LASER; Group #7: MB 100 (PIT = 5 min) + 0.1% EDTA + 0.1% Chx 1 min LASER; Group #8: 2% CHX 1 min; Group #9: 1% NaOCl 1 min; Group #10: 2% NaOCl 1 min; Control groups: Group #11: 1 mL of sterile water for 6 min: positive control	1.0; 2.0	E. faecalis; (VP3-181, VP3-180, Gel 31, and Gel 32)	MB; BS – [15 mol L^−1]; Biofilm – [100 mol L^−1]; PIT: 300 s	Twin Laser; (MMOptics); 660 nm; IT: 30 s, 60 s, 180 s	Viability staining; CLSM	Modified PDT killed 20 times more than conventional PDT and up to 8 times more than 2% CHX and 1% NaOCl.
	Sample: Bacterial plaque from 3 adult volunteers used in 4 strains of E. faecalis (originally isolated from root canals of the teeth with periapical lesions)
Bago et al. 2013 [79]	Test groups:Group #1: NaOCl (); Group #2: EndoActivator + NaOCl (); Group #3: Diode laser (); Group #4: PDT (); Group #5: PDT + 3D Endoprobe (); Control groups: Group #6: NaCl (): positive control	2.5	E. faecalis (ATCC29212)	Phenothiazine chloride/TBO; 10 mg mL^−1/155 g mL^−1; PIT: 60, 120 s	Helbo and Laser HF; 660 nm; IT: 60 s; The 2 lasers have the same wavelength.	SEM; Cell viability; CFU (log10); PCR	PDT using both laser systems and the sonic activated NaOCl irrigation were significantly more effective than diode irradiation and single NaOCl.
	Sample: 120 uniradicular human teeth (mandibular incisors and maxillary second premolar extracted because of periodontal disease or extensive carious lesions without root caries or previous endodontic treatment)
Hecker et al. 2013 [80]	Test groups:Group #1: NaOCl (0.5%, 1.0% or 3.0%) for 30, 60, or 600 s (); Group #2: NaOCl (0.5%, 1.0% or 3.0%) for 30, 60, or 600 s + neutralizing solution (); Group #3: PDT (); Control groups; Group #4: TBO (only) (); Group #5: laser (only) (); Group #6: apical section as sterile control: negative control; Group #7: middle section to confirm successful infection: positive control	0.5; 1.0; 3.0	E. faecalis (ATCC29212)	TBO; NS; PIT: 60 s	Pact 200 system; 635 nm; IT: 240, 360 s	Cell viability; CFU (log10); SEM	The antibacterial PDT system did not achieve sufficient disinfection when compared to NaOCl.
	Sample: roots of freshly extracted permanent bovine mandibular incisors (total number of teeth unknown)
Muhammad et al. 2014 [82]	Test groups:Group #1: PDT with Aseptim Plus - LED disinfection system (); Group #2: PDT with diode laser; Group #3: PUI + 17% EDTA + 2.6% NaOCl; Control groups; Group #4: no inoculation (); negative control; Group #5: with inoculation (): positive control	2.6	E. faecalis; S. salivarius; (ATCC7073); P. gingivalis; (ATCC 33277); P. intermedia	TBO; 15 g mL^−1]; PIT: 60 s	LED; 635 nm; Diode laser; 650 nm; : 120 s	SEM; Scores for levels of infection; (Bonsor et al. 2006 [35, 73])	The group treated with PUI + 2.5% NaOCl + 17% EDTA solution has the best results when compared to PDT with 2 different light sources.
	Sample: 30 roots obtained from 50 extracted human single and multirooted teeth
Xhevdet et al. 2014 [81]	Experiment #1; E. faecalis (); Test groups:Group #1: PDT (1 min) (); Group #2: PDT (3 min) (); Group #3: PDT (5 min) (); Group #4: NaOCl + PBS (); Group #5: NaOCl + 10 sec passive ultrasonic irrigation (PUI) (); Control groups: Group #6: no treatment (): positive control; Experiment #2; C. albicans; (); Test groups: Group #1: PDT (1 min) (); Group #2: PDT (3 min) (); Group #3: PDT (5 min) (); Group #4: NaOCl + PBS (); Group #5: NaOCl + 10 sec PUI (); Control groups: Group #6: no treatment (): positive control	2.5	E. faecalis (ATC29121); Candida albicans (ATCC60193)	Phenothiazine chloride; 10 mg mL^−1]; PIT: 60 s	HELBO; 660 nm; IT: 60, 180, 300 s	Flow cytometry; SEM; Cell viability; CFU (log10)	Irrigation with NaOCl showed similar results to 5 min irradiation of PDT.
	Sample: 156 extracted uniradicular human teeth