Illuminating the Root Canal: A Comprehensive Review of Photodynamic Therapy in Endodontic Disinfection

Background: Successful endodontic therapy depends on effective elimination of microorganisms from the root canal system; however, complex anatomy and resistant biofilms, particularly Enterococcus faecalis, limit complete disinfection with conventional methods. Introduction: Antimicrobial photodynamic therapy (aPDT) has emerged as a non-antibiotic adjunct that utilizes a photosensitizer, light, and oxygen to generate reactive oxygen species capable of destroying microbial cells and disrupting biofilms within dentinal tubules. Aim: This review aims to evaluate the mechanism of action, photosensitizers, light delivery systems, and current evidence regarding the effectiveness of aPDT in endodontic disinfection. Conclusion: Current evidence indicates that aPDT enhances microbial reduction when used as an adjunct to chemo-mechanical preparation, particularly in complex canal anatomy. However, variability in protocols and limited long-term clinical data restrict its routine application, necessitating further standardized clinical trials.