Photobiomodulation Therapy and Pulp-Regenerative Endodontics: A Narrative Review

Abstract

Regenerative endodontic procedures (REPs) were used to recover the dental pulp’s vitality in order to avoid the undesirable outcomes of conventional endodontic treatment and to promote dentinal formation, especially for immature permanent teeth. Photobiomodulation therapy (PBMT) exhibits photobiological and photochemical effects for improving the root canal’s environmental conditions by compensating for oxidative stress and increasing the blood supply to implanted stem cells and improving their survival. Basic research has revealed that PBMT can modulate human dental pulp stem cells’ (hDPSCs) differentiation, proliferation, and activity, and subsequent tissue activation. However, many unclear points still remain regarding the mechanisms of action induced by PBMT in REPs. Therefore, in this review, we present the applications of laser and PBMT irradiation to the procedures of REPs and in endodontics. In addition, the effects of PBMT on the regenerative processes of hDPSCs are reviewed from biochemical and cytological perspectives on the basis of the available literature. Furthermore, we consider the feasibility of treatment in which PBMT irradiation is applied to stem cells, including dental pulp stem cells, and we discuss research that has reported on its effect.

The effect of photobiomodulation therapy in common maxillofacial injuries: Current status

“…Cost-effectiveness: If PBMT is proven effective, it could offer a cost-effective treatment option compared to more invasive or resource-intensive interventions. 9,22,[26][27][28][29][30][31][32][33][34][35] In recent years, various in vitro, in vivo, and clinical studies have been performed to explore the impact of PBMT on maxillofacial tissues, and this review presents a summary of these studies.…”

“…4). 9 PBM may enhance differentiation, which increases the healing rate of tissues, by affecting susceptible stem cells and progenitor cells. PBMT improves stem cell proliferation in multiple studies, including gingival fibroblasts, as well as BM-and adipose-derived mesenchymal stem cells, and permanent teeth-and exfoliated deciduous teeth-derived DPSCs.…”

“…9 Laser phototherapy also appears to positively affect dental pulp stem cells (DPSCs), suggesting the importance of PBMT in stem cell-based tissue engineering. 9 It is worth noting that DPSCs, SCAPs, and bone marrow stromal cells (BMSCs) are possible sources of pulp regeneration via cell homing. 9 A monochromatic or narrow-band light is used for phototherapy to achieve its therapeutic effect.…”

“…9 It is worth noting that DPSCs, SCAPs, and bone marrow stromal cells (BMSCs) are possible sources of pulp regeneration via cell homing. 9 A monochromatic or narrow-band light is used for phototherapy to achieve its therapeutic effect. Cells' physiological and chemical functions are stimulated or inhibited by photobiomodulation (PBM).…”

“…According to Khadra et al, PBM improved cell migration and proliferation in epidermal stem cells, but differentiation was unaffected 138. One study found a F I G U R E 4 Irradiation of DPSCs with PBMT: molecular and cellular mechanisms 9. AP-1, activator protein 1; BMP, bone morphogenetic protein; cAMP, cyclic AMP; DPSC, dental pulp stem cells; NF-κB, nuclear factor-κB; NO, nitric oxide; PBMT, photobiomodulation therapy; TGF-β1, transforming growth factor-β1.…”