What is the potential of antibacterial, antiviral and antifungal photodynamic therapy in dentistry?

Design: A review of the principal clinical applications of antimicrobial photodynamic therapy (aPDT) in dentistry. Aim: To provide an overview of clinical applications and future perspectives of aPDT in dentistry. Methods: A comprehensive search was conducted on PubMed, Web of Science, Scopus, and Embase up to September 2022, where only data from randomized clinical trials were included. In vitro studies, animal studies, literature reviews, and duplicate articles were excluded from the review. Out of a total of 1042 references initially identified, only 89 studies were included in the review. Six main oral conditions for which aPDT has been used were identified: periodontal and peri-implant diseases, endodontics, bacterial plaque, caries, and fungal and viral infections. Results: The review suggests that aPDT can be used as an effective complementary treatment for reducing pathogenic microorganisms in bacterial plaque; carious lesions; and periodontal, peri-implant, endodontic, fungal, and viral infections. Conclusions: Despite the efficacy of aPDT against different types of microorganisms, there are no specific irradiation parameters for its respective photosensitizers due to the significant heterogeneity of clinical trials. Therefore, more studies are needed to determine irradiation protocols and development of new photosensitizers to improve the safety and efficacy of aPDT.