Background: Antibiotic resistance has become a growing global problem where overprescription is a contributing factor for its development. In the endodontics field, complementary treatments, such as antimicrobial photodynamic therapy (aPDT), have been described to eliminate residual bacteria from the root canal space and reduce complications. The aim of this review is to describe the literature evidence up to now regarding the advantages, efficiency, and clinical outcomes of this therapy in endodontics as a possible tool to combat antibiotic resistance. Methods: A review of the literature from 2010 to 2021 was carried out using the PubMed and Web of Science databases. Two steps were taken: First, articles were compiled through the terms and MeSH terms “Photochesdmotherapy” and “endodontics.” Then, a second search was conducted using “photodynamic therapy” and “antibiotic resistance” or “drug resistance, microbial.” Results: A total of 51 articles were included for evaluation: 27 laboratory studies, 14 reviews, and 10 clinical studies. Laboratory studies show that aPDT achieves significant bacterial elimination, even against antibiotic-resistant species, and is also effective in biofilm disruption. Clinical studies suggest that aPDT can be considered a promising technique to reduce bacterial complications, and reviews about the issue confirm its advantages. Conclusion: The benefits of aPDT in reducing complications due to its antibacterial effects means a possible decrease in systemic antibiotic prescription in endodontics. In addition, it could be an alternative to local intracanal antibiotic therapy, avoiding the appearance of possible antibiotic resistance, as no bacterial resistance with aPDT has been described to date.

中文翻译：

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牙髓病中的光动力疗法：对抗抗生素耐药性的有用工具？文献综述


背景：抗生素耐药性已成为一个日益严重的全球性问题，过度处方是其发展的一个促成因素。在牙髓学领域，补充治疗，例如抗菌光动力疗法（aPDT），已被描述可以消除根管间隙中的残留细菌并减少并发症。本综述的目的是描述迄今为止关于牙髓治疗作为对抗抗生素耐药性的可能工具的优势、效率和临床结果的文献证据。方法：使用 PubMed 和 Web of Science 数据库对 2010 年至 2021 年的文献进行回顾。采取了两个步骤：首先，通过术语和 MeSH 术语“Photochesdmotherapy”和“endodontics”来编写文章。然后，使用“光动力疗法”和“抗生素耐药性”或“耐药性，微生物”进行第二次搜索。结果：总共纳入 51 篇文章进行评估：27 篇实验室研究、14 篇综述和 10 篇临床研究。实验室研究表明，aPDT 可以显着消除细菌，甚至对抗生素耐药的物种也是如此，并且在破坏生物膜方面也很有效。临床研究表明，aPDT 可以被认为是一种有前途的减少细菌并发症的技术，并且有关该问题的评论证实了其优势。结论：aPDT 由于其抗菌作用而可以减少并发症，这意味着牙髓治疗中全身抗生素处方可能会减少。此外，它可以作为局部根管内抗生素治疗的替代方案，避免出现可能的抗生素耐药性，因为迄今为止 aPDT 还没有细菌耐药性的描述。