title: Antimicrobial photodynamic therapy as an adjunct for treatment of deep carious lesions-A systematic review.
abstract: For deep carious lesions, a more conservative treatment modality ("selective caries removal") has been proposed, where only the heavily contaminated dentine is removed. In this regard, effective adjuncts for cavity disinfection such as the antimicrobial photodynamic therapy (aPDT) can be valuable clinically prior to definitive restoration. Therefore, the aim of this study was to systematically assess clinical studies on the effectiveness of aPDT as a supplementary tool in the treatment of deep caries lesions. Searches were performed in four databases (PubMed, EMBASE, ISI Web of Science, ClinicalTrials.gov) from 1st January, 2011 until 21st June, 2016 for search terms relevant to the observed parameters, pathological condition, intervention and anatomic entity. The pooled information was evaluated according to PRISMA guidelines. At first, 1651 articles were recovered, of which 1249 full-text articles were evaluated, 270 articles thereof were reviewed for eligibility and finally 6 articles met all inclusion criteria. The aPDT protocols involved Methylene Blue, Toluidine Blue and aluminium-chloride-phthalocyanine as photosensitizers and diode lasers, light-emitting diodes and halogen light-sources. The data from five reports, utilizing both culture-dependent and -independent methods, disclosed significant reduction of cariogenic bacterial load after mechanical caries removal with adjunct aPDT. As these studies exhibit some methodological limitations, e.g. lack of positive controls, this systematic review can support the application of aPDT to a limited extent only in terms of reducing the microbial load in deep carious lesions before restorative treatment.
authors.affiliation: Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany. Electronic address: fabian.cieplik@ukr.de.
authors.forename: Fabian
authors.initials: F
authors.lastname: Cieplik
authors.affiliation: Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany.
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Buchalla
authors.affiliation: Department of Operative Dentistry and Periodontology, Center for Dental Medicine, University of Freiburg, Freiburg, Germany.
authors.forename: Elmar
authors.initials: E
authors.lastname: Hellwig
authors.affiliation: Department of Operative Dentistry and Periodontology, Center for Dental Medicine, University of Freiburg, Freiburg, Germany.
authors.forename: Ali
authors.initials: A
authors.lastname: Al-Ahmad
authors.affiliation: Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg, Regensburg, Germany.
authors.forename: Karl-Anton
authors.initials: KA
authors.lastname: Hiller
authors.affiliation: Department of Dermatology, University Medical Center Regensburg, Regensburg, Germany.
authors.forename: Tim
authors.initials: T
authors.lastname: Maisch
authors.affiliation: Department of Operative Dentistry and Periodontology, Center for Dental Medicine, University of Freiburg, Freiburg, Germany.
authors.forename: Lamprini
authors.initials: L
authors.lastname: Karygianni
mesh_terms: D001424:Bacterial Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000473:pathology; D058491:Bacterial Load / Q000706:statistics & numerical data; D003131:Combined Modality Therapy / Q000379:methods; D003731:Dental Caries / Q000188:drug therapy* / Q000453:epidemiology* / Q000473:pathology; D004203:Disinfection / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D006801:Humans; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use*; D015995:Prevalence; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D017319:Photosensitizing Agents
keywords: Antimicrobial; Caries treatment; Deep carious lesions; Photodynamic; aPDT