Evaluation of the use of photodynamic therapy (PDT) with methylene blue photosensitizer in the restorative treatment of patients with radiation caries.
“Radiation caries, radiation-related caries, head and neck cancer, radiotherapy, antimicrobial photodynamic therap
“Introduction:Cancer patients undergoing radiotherapy treatment in the head and neck region experience various acute and chronic toxicities in the oral cavity,including radiation caries,which,if left untreated,can lead to premature tooth loss, infection, and osteoradionecrosis. Objectives:To evaluate the use of Photodynamic Therapy (PDT) with methylene blue photosensitizer in the restorative treatment of patients with radiation caries.Retorations (with and without PDT) performed on radiation caries were clinically analyzed by comparing the clinical characteristics of the restorations and observing their duration over a period of 2 years.The null hypothesis is that PDT with methylene blue does not influence the durability of resin restorations. Materials and methods: In this clinical study,seven patients were selected,five men and two women, who had received radiation therapy in the head and neck cancer region.The sample consisted of 55 pairs of restorations that were evaluated using modified USPHS/RYGE(United States Public Health Service/Restorative and Prosthetic Dentistry Group) criteria to assess the duration and clinical characteristics of the restorations:marginal retention,marginal adaptation,restoration staining, and secondary caries. Results:Retention failure and restoration loss were the most common failures,mainly on the restoration side without PDT use. In one clinical case, the durability of the restorations was much higher on the side where photodynamic therapy was used.Other patients had failures in a small number of restorations without PDT use. In incisal regions, failures occurred on both sides, and some patients had no failures on either side. Conclusion:PDT with methylene blue may be an adjuvant treatment that appears to influence the duration of restorations in radiation caries.