AÇÃO ANTIMICROBIANA DA TERAPIA FOTODINÂMICA EM CANAIS RADICULARES: UMA REVISÃO DE LITERATURA INTEGRATIVA

Ana Carla Barboza Leão, Brenda Letícya Chaves Teixeira, Joelson Nascimento de Carvalho, João Daniel Mendonça de Moura, Ana Raquel Lopes dos Santos Miranda, Cláudia de Moura Carreira

Resumo


Introdução: A erradicação de microrganismos dos canais radiculares é um dos principais objetivos da terapia endodôntica. A terapia fotodinâmica (TFD) é uma alternativa coadjuvante ao preparo químico- mecânico (PQM) muito promissora na desinfecção do sistema de canais radiculares. Objetivo: O objetivo do presente trabalho foi avaliar bibliograficamente os parâmetros e resultados da ação antimicrobiana da TFD utilizada na desinfecção de canais radiculares registrada na literatura do ano de 2016 a 2021e eleger o melhor protocolo clínico de aplicação da técnica. Material e métodos: Uma revisão de literatura integrativa foi feita a partir da seguinte questão: “A terapia fotodinâmica como coadjuvante ao tratamento endodôntico aumenta o índice de descontaminação dos canais radiculares?”. A busca bibliográfica foi feita nas bases de dados Pubmed, Scielo, Medline, BVS e Science Direct no período de 2016 a 2021, utilizando os descritores: Ação antimicrobiana, Fotoquimioterapia, Lasers e Tratamento do canal radicular. Como critérios de inclusão foram adotados artigos de terapia fotodinâmica com enfoque na ação antimicrobiana. Foram incluídos estudos in-vivo, in-vitro, ex-vivo, revisões de literatura e relatos de casos escritos em inglês e português. Aqueles que se enquadraram no enfoque do trabalho e os mais relevantes foram incluídos Resultados: A amostra final correspondeu a um total de 30 artigos, sendo estes: 3 estudos ex-vivo, 12 estudos in-vitro, 5 estudos in-vivo, 9 revisões de literatura e 1 relato de caso, revisados sob a forma de tópicos relevantes. Conclusão: A diversidade dos protocolos investigados e adotados leva a dificuldades de padronização de um protocolo de aplicação da TFD, necessitando de mais estudos acerca de seu uso. Baseado na literatura encontrada, entretanto, propõe-se o protocolo: utilizar o laser de diodo com comprimento de onda entre 600-660 nm por 90 a 180 segundos com intensidade de 100 mW, após o preparo químico mecânico, associado ao fotossensibilizador (Azul de Metileno a 0,01%) com tempo de pré-irradiação de 5 minutos. Junto a isso, pode-se recorrer ao uso de hidróxido de cálcio como medicação intracanal para aprimorar os resultados da terapia endodôntica. Desse modo, conclui-se que apesar da diversidade de protocolos, a TFD é eficaz na redução do nível microbiano em canais radiculares quando utilizada de maneira associada aos procedimentos convencionais do tratamento endodôntico.

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