Treatment of complicated gangrene using infrared photodynamic therapy

摘要

Background Antimicrobial photodynamic therapy (aPDT) is one of the treatment options of local infections. Conventional aPDT systems have physical limitations such as low light penetration and the need for long irradiation time to achieve the necessary light dose. With new forming specific complex of methylene blue dye molecules it is possible to reach efficient excitation processes at 810nm. At 810nm, there is increased light penetration depth in comparison to 670nm. This means that we are now able to excite the sensitizer in deeper areas and activate it transgingivally. Purpose Preserving teeth with complicated gangrene is a great challenge if root canal is obstructed. Lacking the possibility to perform the conventional mechanical cleaning of root canals, we have used infrared photodynamic therapy for elimination radicular bacterial infiltration Materials and methods We investigated 14 cases with complicated gangrene and totally or partially obstructed root canal. We deposited the sensitizer - Photolase Photolase GMBH Germany - in the pulp chamber and closed it for a week. This procedure was repeated three times. After the sensitizer penetrated we applied the light. We used G-Box 810 nm laser - Gigaa Laser China - at 0,8W/cm~2, 40s buccal and 40s oral side. Results 6 month later we performed follow-up CBCT. Out of 14 cases significant healing was detected in 10. In 4 cases no change was observable. Discussion and conclusion Infrared aPDT seems effective in eliminating bacterial infiltrations in deeper areas. It can be a minimal invasive method in the case of obstructed root canals.