Outcome of curcumin-based photodynamic therapy in endodontic microsurgery: A case report

• Published in: Photodiagnosis and photodynamic therapy 2024-02, Vol.45, p.103994, Article 103994
• Main Authors: de Araújo, Lucas Peixoto, Marchesin, Analu Rodriguez, Carpena, Lucas Pinto, Gobbo, Leandro Bueno, Ferreira, Nadia de Souza, de Almeida, José Flávio Affonso, Ferraz, Caio Cezar Randi
• Format: Article
• Language: English
• Subjects: Endodontic microsurgery; Endodontics; Photodynamic Therapy; Surgery
• ISSN: 1572-1000; 1873-1597
• DOI: 10.1016/j.pdpdt.2024.103994

•The supplementary use of PDT in endodontic microsurgery has proven to be effective in this case.•The use of the novel curcumin-based photosensitizer mixed with 2 % chlorhexidine gel may improve clinical outcomes.•To endorse this treatment protocol, high-quality randomized clinical trials are still required. Persistent apical periodontitis after root canal treatment may require surgical retreatment when non-surgical options are ineffective or impractical due to anatomical challenges or iatrogenic errors. Endodontic microsurgery (EMS) is a precise technique that aims to overcome extraradicular biofilm and root morphology issues. Photodynamic therapy (PDT) is an emerging supplementary disinfection approach that utilizes a photosensitizer agent and light to eliminate microorganisms through oxidative reactions. A 60-year-old male with persistent apical periodontitis in a left maxillary first molar underwent non-surgical root canal retreatment followed by surgical reintervention due to anatomical complexities. During surgery, PDT was performed using a novel curcumin-based photosensitizer agent. After the procedure, the tooth was retrofilled with bioceramic cement, and photobiomodulation was applied to enhance tissue healing. One year post-surgery, the patient exhibited complete periradicular repair and remained asymptomatic. EMS is considered a last resort to salvage an endodontically treated tooth and has shown moderate success rates. PDT has demonstrated promise in improving periapical healing and reducing microorganisms. In this case, curcumin, diluted with 2 % chlorhexidine gel, served as an effective photosensitizer agent with antimicrobial properties. Moreover, performing photobiomodulation aided in cell recovery and reduced postoperative discomfort. The proposed EMS treatment protocol with PDT using curcumin yielded positive outcomes in this case report. Further randomized clinical trials are necessary to assess the efficacy of this approach in EMS. Additionally, further research on curcumin-based photosensitizer agents encapsulated in nanoparticles and enhanced antimicrobial agents is recommended to refine this treatment protocol for routine use.