Photodynamic Therapy (Part 1: Applications in Dentistry)

Abstract

Aim: To overview the effectiveness of photodynamic therapy (PDT) along with different types of photosensitizers and the lasers associated with them. Background: Administration of drugs for oral infections and pathologies are accompanied with a lot of limitations like lack of patient compliance, microbial resistance in the biofilm, systemic side effects, failure on the antibiotics to act on non-perfused areas, allergy and the limitation of spectrum of microorganisms affected. To overcome this, an effective and an alternative therapy needs to replace the conventional treatment. Indians since ancient past have been using the extracts of Psoralea corylifolia which contains furocoumarins, given orally, and followed by exposure to sunlight in order to treat vitiligo. Thus, PDT was investigated in the past as a promising alternative if not replacement for the conventional treatment. Clinical significance: It has been seen that various combinations of photosensitizer and lasers are effective against a broad spectrum of microorganisms. Porphyrin photosensitizers and temoporfin have been used successfully in the past against premalignant and malignant intraoral lesions. They are excellent options for palliative treatment for cases refractory to conventional therapy. Phenothiazinium photosensitizers like methylene blue and toluidine blue have shown to be effective against bacterias, viruses and fungal infections. Hence, they are effective tools for the treatment of refractory periodontics and endodontic infections. Conclusion: With the revolution of lasers in the field of dentistry and oncology, a new minimally invasive and precise approach towards the pathology is being developed. However, further research needs to be done in terms of development of newer formulations and dosimetry for more consistent results free of side effects.