Translating Red-Light Therapy into Restorative Dentistry: Clinical Efficacy and Safety - ABSTRACT The American Dental Association (ADA) estimates that approximately 3-6 million dental restorations fail prematurely annually in the U.S.1, 2 A major concern is that endodontic complications are the leading cause of these short-term failures, accounting for nearly 80% of the cases.2 These complications are closely linked to persistent or exacerbated inflammatory responses, which may result not only from the disease but also from the mechanical trauma of caries removal, the restorative procedure itself, and other correlated but unavoidable factors.3-7 In this context, red light therapy has gained increasing attention as an adjunct approach to enhance clinical recovery and improve post-operative outcomes. Systematic reviews demonstrate that red light therapy can triple the likelihood of successful tissue healing in oral procedures.8-11 Thus, even if only a fraction of this benefit translated clinically, this would correspond to ~300,000–1.2 million fewer failed restorations annually in the U.S. On the other side, a practical challenge in adopting red-light therapy in the dental routine is that this treatment is still delivered as a separate procedure, requiring additional equipment and chair time. Thus, our group have been working on strategies that could integrate red light therapy directly into the restorative workflow, so that therapeutic benefit occurs at the exact moment of tissue stress. However, the drawback was that current restorative materials relied on camphorquinone, a photoinitiator that is exclusively activated by the blue spectrum, for its hardening. Thus, addressing this challenge required rethinking light activation in restorative materials. To overcome this hurdle, our group synthesized the first photoinitiator activated by red light, now opening the door to routinely incorporate red-light therapy during clinical care. Thus, building upon our work, we have assembled a multidisciplinary team with expertise in chemistry, dental biomaterials, and translational animal models for dentistry to be the first to translate red-light curing from concept to clinically viable technology, shifting red light therapy from an adjunctive therapy to an integrated restorative solution. Specifically, we aim to: 1) define the chemical, physical, and biological properties of the first dental restorative material formulated with the novel red-light-activated photoinitiator, and 2) evaluate the in vivo therapeutic benefits of red light on pulpal and gingival tissues using a porcine model. The expected outcomes of this work are to fully characterize the first restorative material cured with red light and provide comprehensive in vivo data on the therapeutic benefits of red light to pulpal and gingival health. The successful completion of this project will lay the foundation for subsequent clinical trials with the ultimate goal of adopting red-light therapy in dental practice to reduce treatment complications, making a tangible impact on patient outcomes, and reducing long-term healthcare burden.
