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      Uso del laser de baja potencia como coadyuvante en el tratamiento de lesiones periapicales. Revisión sistemática Translated title: Use of low power laser as an adjuvant in the treatment of periapical lesions. Systematic review

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          Abstract

          Resumen Las lesiones periapicales son el resultado de la exposición crónica de la pulpa dental a los microorganismos del medio oral, y afectan progresivamente la región periapical del diente afectado. En la actualidad, el láser de baja potencia (LBP) se emplea como coadyuvante en el tratamiento de este tipo de lesiones, al cual se le atribuyen propiedades analgésicas, antiinflamatorias, bio-estimulantes y promotoras de la respuesta tisular. Este trabajo consistió en revisar sistemáticamente la literatura que evidenciara el uso y la efectividad terapéutica del LBP como coadyuvante en el tratamiento de lesiones periapicales. Para esto se realizó una búsqueda en la base de datos PubMed empleando los termino MeSH [low-level light therapy], [periapical diseases], [endodontics] y [laser therapy]. Tras realizar la búsqueda no se encontró literatura relacionada que demostrara la efectividad del LBP. Sin embargo, cuatro documentos reportaron la utilidad del láser de alta potencia como alterativa terapéutica de primera elección o como coadyuvante de terapéuticas actuales. No se encontró evidencia que sustente el uso del LBP en el tratamiento de lesiones periapicales.

          Translated abstract

          Abstract Periapical lesions result in the chronic exposure of the dental pulp to oral microorganisms that progressively affect the periapical region of the involved tooth. Today, low power laser (LPL) is used as an adjuvant in the treatment of these types of lesions, as it promotes tissue response and because of its analgesic, anti-inflammatory and bio-stimulant properties. The present article consists of a systematic review of the literature that will evidence the effectiveness of low power laser therapy as an adjuvant in the treatment of periapical lesions. A search in the Pubmed database was performed using the MeSH terms [low-level light therapy], [periapical diseases], [endodontics] and [laser therapy]. After the search was performed, no related literature demonstrated the effectiveness of low power laser therapy. However, 4 documents reported the usefulness of high power laser therapy as a first choice alternate therapy or as an adjuvant of actual protocols. No evidence was found that supported the use of low power laser therapy in the treatment of periapical lesions.

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          Photodynamic therapy in dentistry: a literature review.

          The purpose of this review was to summarize recent developments regarding photodynamic therapy (PDT) in the field of dentistry. A review of pertinent literature was carried out in PubMED to determine the current position of PDT applications in dentistry. One hundred thirteen relevant articles were retrieved from PubMED by inserting the keywords "photodynamic therapy", "dentistry", "periodontology", "oral surgery", and "endodontics". It is anticipated that this overview will create a specific picture in the practitioner's mind regarding the current status and use of PDT. In spite of different results and suggestions brought about by different researchers, PDT can be considered as a promising and less invasive technique in dentistry. PDT seems to be an effective tool in the treatment of localized and superficial infections. Within the limitations of the present review, it can be concluded that although PDT cannot replace antimicrobial therapy at its current stage, it may be used as an adjunctive tool for facilitating the treatment of oral infections. Oral infections (such as mucosal and endodontic infections, periodontal diseases, caries, and peri-implantitis) are among the specific targets where PDT can be applied. Further long-term clinical studies are necessary in establishing a more specific place of the technique in the field of dentistry.
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            Antimicrobial effects of photodynamic therapy on patients with necrotic pulps and periapical lesion.

            This study analyzed the antimicrobial effect of photodynamic therapy (PDT) in association with endodontic treatment. Twenty patients were selected. Microbiological samples were taken after accessing the canal, endodontic therapy, and PDT. At the end of the first session, the root canal was filled with Ca(OH)(2), and after 1 week, a second session of the therapies was performed. Endodontic therapy gave a mean reduction of 1.08 log. The combination with PDT significantly enhanced the reduction (1.83 log, p = 0.00002). The second endodontic session gave a similar diminution to the first (1.14 log), and the second PDT was significantly more effective than the first (p = 0.002). The second total reduction was significantly higher than the second endodontic therapy (p = 0.0000005). The total first + second reduction (3.19 log) was significantly different from the first combination (p = 0.00006). Results suggest that the use of PDT added to endodontic treatment leads to an enhanced decrease of bacterial load and may be an appropriate approach for the treatment of oral infections.
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              Photodynamic therapy associated with conventional endodontic treatment in patients with antibiotic-resistant microflora: a preliminary report.

              This study reports the antimicrobial effect of photodynamic therapy (PDT) combined with endodontic treatment in patients with necrotic pulp infected with microflora resistant to a previous antibiotic therapy. Thirty anterior teeth from 21 patients with periapical lesions that had been treated with conventional endodontic treatment and antibiotic therapy were selected. Microbiological samples were taken (1) after accessing the root canal, (2) after endodontic therapy, and (3) after PDT. All the patients had at least 1 microorganism resistant to antibiotics. PDT used polyethylenimine chlorin(e6) as a photosensitizer and a diode laser as a light source (P = 40 mW, t = 4 minutes, E = 9.6 J). Endodontic therapy alone produced a significant reduction in numbers of microbial species but only 3 teeth were free of bacteria, whereas the combination of endodontic therapy with PDT eliminated all drug-resistant species and all teeth were bacteria-free. The use of PDT added to conventional endodontic treatment leads to a further major reduction of microbial load. PDT is an efficient treatment to kill multi-drug resistant microorganisms. Copyright 2010 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Journal
                sun
                Revista Salud Uninorte
                Salud, Barranquilla
                Fundación Universidad del Norte, División de Ciencias de la (Barranquilla, Atlantico, Colombia )
                0120-5552
                2011-7531
                December 2018
                : 34
                : 3
                : 797-805
                Affiliations
                [1] Magdalena orgnameUniversidad del Magdalena Colombia
                [2] Bolívar orgnameUniversidad de Cartagena Colombia
                [3] Bolívar orgnameUniversidad de Cartagena Colombia
                Article
                S0120-55522018000300797
                f68aac10-c0eb-4fc1-834f-03542c6d096e

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 15 February 2018
                : 07 August 2018
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 50, Pages: 9
                Product

                SciELO Colombia

                Categories
                Artículo de revisión

                periapical diseases,endodontics and laser therapy (MeSH),terapia por luz de baja intensidad,enfermedades periapicales,endodoncia y terapia por láser. (DeCS),low-level light therapy

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