光动力疗法应用于根管消毒的研究进展

Advances in the application of photodynamic therapy to root canal disinfection

现阶段常规根管消毒未能达到最理想的效果,近年来很多学者致力于研究光动力疗法对根管消毒的疗效。有一些临床医生在根管消毒中尝试使用光动力疗法,期望得到比传统根管消毒更佳的效果。本文就光动力疗法运用于根管消毒的作用机制、作用效果及其影响因素、局限性等方面展开综述。目前的研究表明,细菌种类和状态、光敏剂、光源、操作环境和方法的不同均会影响光动力疗法的根管消毒效果;大部分研究认为光动力疗法用于根管消毒是有效的,具有基本无毒性、无刺激性、有利于牙髓再生术和舒适化口腔治疗等优点,但存在杀菌效果不如次氯酸钠的局限性,目前不能代替传统的化学冲洗,但是一种很有前途的辅助性补充方法;光敏剂的配方设计、光源的能量剂量和照射的最佳时间等还需要进一步的研究,在根管治疗中的应用也仍需更多的临床验证。

In recent years,many researchers have devoted themselves to the application of photodynamic therapy(PDT)in root canal disinfection,as conventional root canal disinfection methods have failed to achieve the optimal effect.Some clinicians have also applied PDT to root canal disinfection.PDT is expected to have a better effect than traditional root canal disinfection.This paper reviews the research progress on the mechanism,effect,influencing factors and limita⁃tions of PDT in root canal disinfection.Current research suggests that differences in the type and status of the bacteria,photosensitizers,light sources,operating environment and methods all affect the efficacy of root canal disinfection of PDT.Most of the research into PDT for root canal disinfection finds that it is effective,nontoxic,advantageous to dental pulp regeneration and comfortable for the patient,as well as lacking an excitant;however,its bactericidal effect is inferi⁃or to that of sodium hypochlorite.At present,it cannot replace traditional chemical washing but is a promising auxiliary method.The design of the photosensitizer,the energy dose of the light source and the optimal irradiation time need to be determined by further experiments,and more clinical verification is needed before its application in root canal therapy.