Effective disinfection of primary molar root canals remains challenging due to complex canal anatomy and limitations of conventional chemo-mechanical preparation. Photodynamic therapy (PDT) has emerged as a novel adjunctive antimicrobial approach in pediatric endodontics. This randomized clinical study aimed to clinically and radiographically assess the efficacy of PDT in rootcanal treatment of primary molars. Sixty primary mandibular molars from children aged 4–7 years with clinical and radiographic signs of pulpal necrosis were randomly assigned to three groups (n = 20): Group I—conventional root canal treatment (RCT); Group II—PDT; and Group III—modified PDT. Clinical and radiographic outcomes were evaluated at 5, 10, and 15 months postoperatively. Statistical analysis revealed no significant differences among the groups regarding overall clinical and radiographic success; however, both PDT and modified PDT groups exhibited significantly less root resorption compared with the conventional RCT group at the end of the 15-month follow-up. These findings indicate that photodynamic therapy provide clinical and radiographic outcomes comparable to conventional RCT while offering the additional benefit of reduced root resorption. PDT represents a minimally invasive, time-efficient adjunctive strategy suitable for pediatric patients, supporting improved treatment outcomes and enhanced patient-centered care in primary teeth.

Mohamed Elsayed Abo Farrag is a Pediatric Dentist holding an MSc and PhD in Pediatric Dentistry. He is a Lecturer of Pediatric Dentistry at Mansoura University, Egypt. He is an active researcher and international scientific author with interests in pediatric endodontics, minimally invasive dentistry, and photodynamic therapy in primary teeth. He is actively involved in undergraduate and postgraduate teaching, clinical supervision, and research aimed at improving treatment outcomes and patient-centered care in pediatric dentistry.