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Godoy RDCL, Bueno CEDS, De Martin AS, Pelegrine RA, Fontana CE, Duarte MAH, Vivan RR, Nascimento WM, da Silva Limoeiro AG, Pedro Rocha DG. Ex vivo evaluation of the efficacy of photodynamic therapy in eliminating Enterococcus faecalis from dentinal tubules by confocal laser scanning microscopy. J Endod 2023:S0099-2399(23)00277-7. [PMID: 37225038 DOI: 10.1016/j.joen.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 05/01/2023] [Accepted: 05/11/2023] [Indexed: 05/26/2023]
Abstract
INTRODUCTION The aim of the present study was to investigate ex vivo by confocal laser scanning microscopy (CLSM) the antibacterial effect of photodynamic therapy (PDT) on dentinal tubules in the apical 5 mm of human mandibular premolars contaminated with Enterococcus faecalis. METHODS Thirty-four teeth were standardized to 20 mm and foraminal anatomic diameters using instrument K#20. Samples were contaminated for 21 days and divided into three experimental groups (n=10): PDT group - instrumented canals and PDT; PUI group - instrumented canals and passive ultrasonic irrigation (PUI); PUI-PDT group - instrumented canals, PUI and PDT; and a control group (n=4): non-instrumented canals. The canals in the experimental groups were instrumented with ProTaper Next up to X3 and rinsed with EDTA-sodium hypochlorite. The photosensitizer used was 0.01% methylene blue with a pre-irradiation time of 5 minutes and a diode laser with 4J energy and 660 nm wavelength. Cross sections were made 5 mm from the apex of all samples, which were taken for analysis by CLSM. The results were analyzed using the Shapiro-Wilk and Kruskal-Wallis (Dunn) tests. RESULTS There was a lower percentage of live bacteria in the PUI-PDT group, with a statistical difference compared with the control and PDT groups (p< 0.05). There was no statistical difference in the percentage of live bacteria between PUI-PDT and PUI (p > 0.05). CONCLUSION It is concluded that the PUI-PDT association was most effective in disinfecting root canals compared to the control group and PDT.
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Affiliation(s)
- Roberta de Castro Leitão Godoy
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Departament of Endodontics, Campinas, SP, Brazil
| | | | - Alexandre Sigrist De Martin
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Departament of Endodontics, Campinas, SP, Brazil
| | - Rina Andrea Pelegrine
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Departament of Endodontics, Campinas, SP, Brazil
| | - Carlos Eduardo Fontana
- PUC Campinas, Center of Life Sciences, Programa de pós-graduação em Ciências da Saúde, Campinas, SP, Brazil
| | | | | | - Wayne Martins Nascimento
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Departament of Endodontics, Campinas, SP, Brazil
| | - Ana Grasiela da Silva Limoeiro
- Faculdade São Leopoldo Mandic, Instituto de Pesquisas São Leopoldo Mandic, Departament of Endodontics, Campinas, SP, Brazil.
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Piksa M, Lian C, Samuel IC, Pawlik KJ, Samuel IDW, Matczyszyn K. The role of the light source in antimicrobial photodynamic therapy. Chem Soc Rev 2023; 52:1697-1722. [PMID: 36779328 DOI: 10.1039/d0cs01051k] [Citation(s) in RCA: 39] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Antimicrobial photodynamic therapy (APDT) is a promising approach to fight the growing problem of antimicrobial resistance that threatens health care, food security and agriculture. APDT uses light to excite a light-activated chemical (photosensitiser), leading to the generation of reactive oxygen species (ROS). Many APDT studies confirm its efficacy in vitro and in vivo against bacteria, fungi, viruses and parasites. However, the development of the field is focused on exploring potential targets and developing new photosensitisers. The role of light, a crucial element for ROS production, has been neglected. What are the main parameters essential for effective photosensitiser activation? Does an optimal light radiant exposure exist? And finally, which light source is best? Many reports have described the promising antibacterial effects of APDT in vitro, however, its application in vivo, especially in clinical settings remains very limited. The restricted availability may partially be due to a lack of standard conditions or protocols, arising from the diversity of selected photosensitising agents (PS), variable testing conditions including light sources used for PS activation and methods of measuring anti-bacterial activity and their effectiveness in treating bacterial infections. We thus sought to systematically review and examine the evidence from existing studies on APDT associated with the light source used. We show how the reduction of pathogens depends on the light source applied, radiant exposure and irradiance of light used, and type of pathogen, and so critically appraise the current state of development of APDT and areas to be addressed in future studies. We anticipate that further standardisation of the experimental conditions will help the field advance, and suggest key optical and biological parameters that should be reported in all APDT studies. More in vivo and clinical studies are needed and are expected to be facilitated by advances in light sources, leading to APDT becoming a sustainable, alternative therapeutic option for bacterial and other microbial infections in the future.
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Affiliation(s)
- Marta Piksa
- Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Science, Weigla 12, 53-114, Wroclaw, Poland
| | - Cheng Lian
- Organic Semiconductor Centre, SUPA, School of Physics and Astronomy, University of St Andrews, Fife, KY16 9SS, UK.
| | - Imogen C Samuel
- School of Medicine, University of Manchester, Manchester, M13 9PL, UK
| | - Krzysztof J Pawlik
- Ludwik Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Science, Weigla 12, 53-114, Wroclaw, Poland
| | - Ifor D W Samuel
- Organic Semiconductor Centre, SUPA, School of Physics and Astronomy, University of St Andrews, Fife, KY16 9SS, UK.
| | - Katarzyna Matczyszyn
- Institute of Advanced Materials, Faculty of Chemistry, Wroclaw University of Science and Technology, Wyb. Wyspianskiego 27, 50-370 Wroclaw, Poland.
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Li M, Wong W, Xiong H, Chen K. In vitro antibacterial effects of photodynamic therapy against Enterococcus faecalis in root canals of deciduous teeth. BMC Oral Health 2022; 22:554. [PMID: 36457124 PMCID: PMC9714005 DOI: 10.1186/s12903-022-02523-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 10/19/2022] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE This study aimed at evaluating the in vitro antibacterial efficacy of photodynamic therapy (PDT) on planktonic E. faecalis and its biofilm in the root canal of infected deciduous teeth. METHODS Forty root canals of maxillary deciduous anterior teeth were enlarged up to #35 K-file and inoculated with E. faecalis for 21 days. The root canals were randomly assigned into four groups (n = 10): The normal saline group (control), 1% NaClO group, PDT group, and the 1% NaClO + PDT group. Paper point samples were obtained at baseline (S1) and after treatment (S2). The colony-forming units (CFU) were counted, and the bacterial growth rate calculated. From each subgroup, 5 samples were randomly selected after treatment and a scanning laser confocal microscope (CLSM) used to determine the distribution of dead / living bacteria on the biofilm surface of each subgroup. A scanning electron microscope (SEM) was used to observe bacterial morphologies in the root canal walls of the remaining 5 samples in each subgroup. The Kruskal-Wallis test and Dunn test with boferroni adjustment were used to analyze the effect of the different treatment techniques on the E. faecalis in root canals. RESULTS Compared to the saline group, PDT significantly reduced bacterial counts in the root canal (p < 0.05). The CFU counts were lowest (p < 0.05) in the 1% NaClO and in 1% NaClO + PDT groups. The rate of bacterial death on the surface of the biofilm in the PDT group was significantly increased after treatment (p < 0.05), and the rate of bacterial death was highest in 1%NaClO group and 1%NaClO + PDT group (p < 0.05). CONCLUSION PDT has an antibacterial activity against E. faecalis in the root canal of deciduous teeth. Its activity against planktonic E. faecalis is better than the activity on the intact biofilm. The antibacterial activity of PDT on E. faecalis in root canals of deciduous teeth is lower compared to that of 1% NaClO.
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Affiliation(s)
- Meimei Li
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - WenChee Wong
- Stomatological Hospital, Southern Medical University, Guangzhou, China
| | - Huacui Xiong
- Stomatological Hospital, Southern Medical University, Guangzhou, China.
| | - Ke Chen
- Stomatological Hospital, Southern Medical University, Guangzhou, China.
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D’Ercole S, Carlesi T, Dotta TC, Pierfelice TV, D’Amico E, Tripodi D, Iezzi G, Piattelli A, Petrini M. 5-Aminolevulinic Acid and Red Led in Endodontics: A Narrative Review and Case Report. Gels 2022; 8:697. [PMID: 36354605 PMCID: PMC9689491 DOI: 10.3390/gels8110697] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/17/2022] [Accepted: 10/26/2022] [Indexed: 08/26/2023] Open
Abstract
The present study aims to discuss the main factors involving the use of 5-aminolevulinic acid together with red LED light and its application in endodontic treatment through a narrative review and a case report. Persistence of microorganisms remaining on chemical-mechanical preparation or intracanal dressing is reported as the leading cause of failure in endodontics. Photodynamic therapy has become a promising antimicrobial strategy as an aid to endodontic treatment. Being easy and quick to apply, it can be used both in a single session and in several sessions, as well as not allowing forms of microbial resistance. 5-aminolevulinic acid in combination with red LED light has recently been studied in many branches of medicine, with good results against numerous types of bacteria including Enterococuss faecalis. The case report showed how bacterial count of CFU decreased by half (210 CFU/mL), after 45 min of irrigation with a gel containing 5% of 5-aminolevulinic acid compared to the sample before irrigation (420 CFU/mL). The subsequent irradiation of red LED light for 7 min, the bacterial count was equal to 0. Thus, it is concluded that the use of 5-aminolevulinic acid together with red LED light is effective in endodontic treatment.
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Affiliation(s)
- Simonetta D’Ercole
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Teocrito Carlesi
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Tatiane Cristina Dotta
- Department of Dental Materials and Prosthodontics, School of Dentistry of Ribeirão Preto, University of São Paulo, São Paulo 14040-904, Brazil
| | - Tania Vanessa Pierfelice
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Emira D’Amico
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Domenico Tripodi
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Giovanna Iezzi
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
| | - Adriano Piattelli
- School of Dentistry, Saint Camillus International University for Health Sciences (Unicamillus), 00131 Rome, Italy
- Fondazione Villa Serena per la Ricerca, 65013 Città Sant’Angelo, Italy
- Casa di Cura Villa Serena, 65013 Città Sant’Angelo, Italy
| | - Morena Petrini
- Department of Medical, Oral and Biotechnological Sciences, University of Chieti-Pescara, 66100 Chieti, Italy
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de Martínez Gerbi MEM, Soares IV, Miranda JM, Moreno LMM, de Melo EL, Lyra da Paz ES, de Menezes MRA, Brugnera Júnior A, Soares LGP, Pinheiro ALB. Evaluation of the Antimicrobial Effect of Photodynamic Therapy and Er:YAG Laser Irradiation on Root Canals Infected with Enterococcus faecalis. Photobiomodul Photomed Laser Surg 2022; 40:559-564. [DOI: 10.1089/photob.2021.0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Iracy Vasconcelos Soares
- Laser Center, Department of Postgraduate Dentistry, School of Dentistry, University of Pernambuco, Santo Amaro, Pernambuco, Brazil
| | - Jéssica Meirinhos Miranda
- Laser Center, Department of Postgraduate Dentistry, School of Dentistry, University of Pernambuco, Santo Amaro, Pernambuco, Brazil
- Department of Restorative Dentistry and Endodontics, School of Dentistry, Universidade de Pernambuco, Camaragibe, Pernambuco, Brazil
| | - Lara Marques Magalhães Moreno
- Laser Center, Department of Postgraduate Dentistry, School of Dentistry, University of Pernambuco, Santo Amaro, Pernambuco, Brazil
- Department of Restorative Dentistry and Endodontics, School of Dentistry, Universidade de Pernambuco, Camaragibe, Pernambuco, Brazil
| | - Eloiza Leonardo de Melo
- Laser Center, Department of Postgraduate Dentistry, School of Dentistry, University of Pernambuco, Santo Amaro, Pernambuco, Brazil
- Department of Restorative Dentistry and Endodontics, School of Dentistry, Universidade de Pernambuco, Camaragibe, Pernambuco, Brazil
| | - Eliana Santos Lyra da Paz
- Laser Center, Department of Postgraduate Dentistry, School of Dentistry, University of Pernambuco, Santo Amaro, Pernambuco, Brazil
| | - Maria Regina Almeida de Menezes
- Laser Center, Department of Postgraduate Dentistry, School of Dentistry, University of Pernambuco, Santo Amaro, Pernambuco, Brazil
| | - Aldo Brugnera Júnior
- Department of São Carlos Institute of Physics-University of São Paulo, São Paulo, Brazil
| | - Luiz Guilherme Pinheiro Soares
- Center of Biophotonics, Department of Propedeutics and Integrated Clinic, School of Dentistry, Federal University of Bahia—UFBA, Salvador, Brazil
| | - Antonio Luiz Barbosa Pinheiro
- Center of Biophotonics, Department of Propedeutics and Integrated Clinic, School of Dentistry, Federal University of Bahia—UFBA, Salvador, Brazil
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Namba AM, Santos ELDS, Garcia MT, Ribeiro FDC, Figueiredo-Godoi LMA, Rossoni RD, Junqueira JC. Farnesol as a potentiator of antimicrobial photodynamic inactivation on Enterococcus faecalis. Photodiagnosis Photodyn Ther 2022; 39:102928. [DOI: 10.1016/j.pdpdt.2022.102928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/20/2022] [Accepted: 05/25/2022] [Indexed: 11/24/2022]
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Sampaio LS, de Annunzio SR, de Freitas LM, Dantas LO, de Boni L, Donatoni MC, de Oliveira KT, Fontana CR. Influence of light intensity and irradiation mode on methylene blue, chlorin-e6 and curcumin-mediated photodynamic therapy against Enterococcus faecalis. Photodiagnosis Photodyn Ther 2020; 31:101925. [DOI: 10.1016/j.pdpdt.2020.101925] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 07/01/2020] [Accepted: 07/06/2020] [Indexed: 12/11/2022]
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Asnaashari M, Kooshki N, Salehi MM, Azari-Marhabi S, Amin Moghadassi H. Comparison of Antibacterial Effects of Photodynamic Therapy and an Irrigation Activation System on Root Canals Infected With Enterococcus faecalis: An In Vitro Study. J Lasers Med Sci 2020; 11:243-248. [PMID: 32802282 DOI: 10.34172/jlms.2020.41] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Introduction: Enterococcus faecalis is a resistant bacterium which is the most abundant species in infected root canals. Photodynamic therapy (PDT) is a method for killing the bacteria with active Oxygen radicals generated in a photosensitizer when exposed to centralized light. Furthermore, as a new method of canal disinfection, a variety of irrigation activation systems have been introduced, one of which is GentleFile (GF) with rotary movements and spiral effects for antibacterial action. This study aimed to compare the effectiveness of the two mentioned methods when used with and without Sodium Hypochlorite in eliminating E. faecalis from infected root canals. Methods: Fifty-eight uniradicular teeth were randomly divided into 4 experimental groups of 14. Two specimens were selected for later scanning electron microscopy in order to screen the procedure steps. In each experimental group, 10 samples were selected to be treated with GF or PDT; 3 of them were selected as positive controls and the other one sample was chosen as a negative control. Experimental groups were as follows: (1) Irrigation activation system, (2) Irrigation activation system + sodium hypochlorite, (3) PDT, and (4) PDT+ sodium hypochlorite. The specimens were then cultured for a bacterial colony count. Results: The decrease in the bacterial count after the treatment with the irrigation activation system was 99.8% (P =0.011) and when the system was used with sodium hypochlorite, it was 100% (P =0.001). The antibacterial effect of PDT was 90.08% (P =0.011) and it was 99.7% when PDT was combined with sodium hypochlorite (P =0.011). Conclusion: All four methods can be administered as complementary methods in root canal disinfection. According to the results of disinfection in the experimental groups of current study it is concluded that integration of new technologies such as activation irrigation system or PDT in Combination with NaOCl ameliorates disinfection of root canal and can provide several advantages in the endodontic outcome.
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Affiliation(s)
- Mohammad Asnaashari
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Niloufar Kooshki
- DDS, Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Mahdi Salehi
- Dental students' research committee, faculty of dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saranaz Azari-Marhabi
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hedieh Amin Moghadassi
- Research Assistant, Chronic Respiratory Diseases Research Center (CRDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences,Tehran, Iran
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Evidence of hypericin photoinactivation of E. faecalis: From planktonic culture to mammalian cells selectivity up to biofilm disruption. Photodiagnosis Photodyn Ther 2020; 31:101759. [PMID: 32380254 DOI: 10.1016/j.pdpdt.2020.101759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 03/22/2020] [Accepted: 03/27/2020] [Indexed: 12/28/2022]
Abstract
Antimicrobial Photodynamic Therapy (aPDT) is an alternative for microbiological inactivation. The aPDT is a method that uses a photosensitizer (PS) excited by visible light at the appropriate wavelength and the molecular oxygen present in the tissues resulting in the production of reactive oxygen species, which causes oxidative damage to biological molecules. This study aimed to perform an in vitro experimental sequence for photoinactivation of E. faecalis using Hypericin (HY) from planktonic culture to selectivity assays using mammalian cells up to biofilm. The results show that E. faecalis rapidly absorb HY. The levels of inactivation of E. faecalis reached up to 99% in planktonic culture. Transmission and Scanning Electron Microscopy demonstrate the remarkable morphological alterations resulting from photooxidation being the loss of membrane integrity assessed by fluorescence microscopy combined with a LIVE/DEAD™ kit. HY did not present cytotoxicity to the fibroblasts cell at the used conditions proving to be a selective molecule. Finally, 60% of photoinactivation was observed in the biofilm of E. faecalis when subject to HY-aPDT. These outcomes show the advantages of sequential in vitro experiments besides showing that HY is a potential PS for clinical trials due to its selectivity and photodynamic effect. This study also draws attention to the benefits of using methodologies that can evidence the antimicrobial effect beyond the typical constellation of cell death.
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Evaluation of Photodynamic Therapy Using a Diode Laser 635 nm as an Adjunct to Conventional Chemo-Mechanical Endodontic Procedures against Enterococcus faecalis Biofilm: Ex-Vivo Study. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10082925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The study aimed to evaluate the antimicrobial effect of photodynamic therapy (PDT) with the use of Toluidine Blue (TB) on extracted teeth infected with biofilms of Enterococcus faecalis. Fifty-four extracted teeth with single-roots and single canals were mechanically shaped, autoclaved, and contaminated with E. faecalis. They were randomly divided into six groups: two groups were negative and positive control groups, two groups were subjected to mechanical instrumentation and PDT with different pre-irradiation times and irradiation times, and two groups were subjected to chemo-mechanical endodontic treatment and PDT with different pre-irradiation times and irradiation times. In PDT groups, after the application of TB, the canals were irradiated with a diode laser of wavelength 635 nm, with a fiber diameter of 200 μm and 100 mW of power in continuous mode. The bacterial load was evaluated using a BioTimer Assay protocol. The greatest reduction of bacterial load was observed in groups of combined PDT with chemo-mechanical treatment. The reductions of bacterial load in groups of combined PDT with chemo-mechanical treatment, and in the positive control group, were significant (p < 0.01) when compared to that of the negative control group. Photodynamic therapy as an adjunctive modality may improve the disinfection capacity of conventional endodontic treatment against E. faecalis.
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Pattern of Disinfection of Root Canal Dentin by Alternated Acid-Base Irrigating Regimen. ScientificWorldJournal 2019; 2019:9219238. [PMID: 30692877 PMCID: PMC6332882 DOI: 10.1155/2019/9219238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 09/03/2018] [Accepted: 11/06/2018] [Indexed: 12/21/2022] Open
Abstract
Objective To quantify Enterococcus faecalis density in root canal dentin after chemomechanical preparation (CMP) using alternated irrigating regimen. Methodology Root canals (RC) were contaminated with E. faecalis (ATCC 19433) for 3 weeks and evident biofilms were obtained. After initial sampling (S1), the CMP was aided by irrigants: saline solution (control; n=12), a conventional regimen (CR) (group 1; n=12) using 5.25% NaOCl and a final rinse with 17% EDTA, and an alternating regimen (AR) of intercalated use of NaOCl and EDTA (group 2, n=12), followed by a second sampling (S2). After 2 weeks, S3 was obtained. Two roots were analyzed by scanning electron microscopy. Each root was divided into cervical, mild, and apical segments and sampling of the superficial (n=90) and deep (n=90) dentin layers was obtained using Gates-Glidden burs. The E. faecalis density (CFU/mg) in log10 was categorized as residual (0 > 0.2), moderate (0.2 ≥ 0.5), or elevated (> 0.5). The prevalence of positive samples in BHI and BHI-A was analyzed by Pearson's chi-square test. The data were normalized by a log10 transformation of CFU and were analyzed by one-way ANOVA and Tukey's tests. Results Biofilms were observed only in the control root canal walls. Topographically, the controls and CR showed similar distributions of E. faecalis in the dentin. Microbiologically positive root canals harbored much E. faecalis in the adjacent dentin (p < 0.05). Irrigating saline provided moderate density of E. faecalis in the dentin while CR and AR resulted in a residual density of microorganisms (p < 0.05). Conclusions The Enterococcus faecalis density in dentin was influenced by the irrigating regimen and the microbiological status of the root canal. The CMP aided by the alternating regimen interfered with the recolonization of the root canal and topographic distribution of Enterococcus in root dentin.
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Plotino G, Grande NM, Mercade M. Photodynamic therapy in endodontics. Int Endod J 2018; 52:760-774. [PMID: 30548497 DOI: 10.1111/iej.13057] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 12/06/2018] [Indexed: 01/14/2023]
Abstract
Photodynamic therapy (PDT) is a treatment modality that was initiated in 1900; however, it was not until the last decade that PDT regained attention for its several favourable features during the treatment of microbial infections in endodontics. Recently, several papers advocated its use for root canal treatment. The concept of photodynamic inactivation requires microbial exposure to either exogenous or endogenous photosensitizer molecules, followed by visible light energy, typically wavelengths in the red/near-infrared region that cause the excitation of the photosensitizers resulting in the production of singlet oxygen and other reactive oxygen species that react with intracellular components and consequently produce cell inactivation and death. Recently, PDT has been suggested as a promising effective adjunct to standard antimicrobial intracanal cleaning and shaping for the treatment of periapical lesions. Current publications tested PDT in terms of bacterial load reduction in vivo, in vitro and ex vivo, showing promising results. The purpose of this article was to review the existing literature on PDT in the endodontic field regarding its mechanism of action, photosensitizers and light sources, limitations and clinical procedures. Although positive results have been demonstrated in vitro, there are considerably fewer in vivo investigations. In conclusion, more in vivo studies are needed on the use of antimicrobial PDT in root canal treatment.
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Affiliation(s)
| | - N M Grande
- Catholic University of Sacred Heart, Rome, Italy
| | - M Mercade
- Department of Dentistry, Universitat de Barcelona, Barcelona, Spain.,Researcher IDIBELL Institute, Barcelona, Spain
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