Background: A pivotal issue to achieve success in the treatment of the root canal is root canal disinfection. One of the most important bacteria that infect root canal is enterococcus faecalis. This study seeks to examine the effectiveness of three methods for disinfecting the root canal: photodynamic therapy, modified triple antibiotic paste (MTAP) and calcium hydroxide.
Method and material: 62 single-rooted extracted anterior teeth were collectected.After cleaning and disinfection, crowns were cut at the CEJ point. The root canals were shaped to the working length up to file F3 protaper (F1, F2, F3). EDTA 17% and sodium hypochlorite 2.5% were used for 5 minutes to wash and remove the smear layer, and then the apical foramen was sealed using composite. After that, the teeth were sterilized in an autoclave at 121° C for 15 minutes. Then 10 samples were taken randomly as the negative control. The remaining samples were immersed and cultivated in a suspension containing enterococcus faecalis for 21 days. Then samples were divided into 5 groups: two positive control groups, one group treated with the antibiotic paste with the concentration of 1mg/ml, one group treated with calcium hydroxide, and one group treated with photodynamic therapy. Then, to collect the biofilm, the protaper file F4 was used. After that, the microbial suspension was provided and counting the colonies to compare the groups was carried out.
Results: The findings indicated that the amount of CFU/mg of MTAP samples, including clindamycin, metronidazole and ciprofloxacin in the concentration of 1mg/ml and photodynamic therapy and calcium hydroxide was lower than that in the control group. Antibiotic paste, cleansed the root canal up to 99.9%. Photodynamic therapy reduced the amount of CFU/mg to 98.8%, and calcium hydroxide reduced the amount of CFU/mg to 94.13%.Conclusion: Using photodynamic therapy causes a reduction in biofilm and inhibits the growth of enterococcus faecalis bacterium. In addition, in this study MTAP with the concentration of 1mg/ml was used, which expunged the bacteria completely. Meanwhile, calcium hydroxide had the weakest effect of all on the enterococcus faecalis bacterium
deOliviera BP, Aguiar CM, Câmara AC. Photodynamic therapy in combating the causative microorganisms from endodontic infections. Eur J Dent. 2014;8(3):424-30. doi:10.4103/1305-7456.137662.
Sjögren U, Figdor D, Persson S, Sundqvist G. Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis. Int Endod J. 1997;30(5):297–306. doi: 10.1046/j.1365-2591.1997.00092.x.
Asgary S, Shadman B, Ghalamkarpour Z, Shahravan A, Ghoddusi J, Bagherpour A, et al. Periapical status and
quality of root canal fillings and coronal restorations in Iranian population. Iran Endod J. 2010;5(2):74-82. doi:10.22037/iej.v5i2.1650.
Bahcall JK, Barss JT. Understanding and evaluating the endodontic file. Gen Dent. 2000;48(6):690-2.5. Schäfer E, Bössmann K. Antimicrobial efficacy of chlorhexidine and two calcium hydroxide formulations
against Enterococcus faecalis. J Endod. 2004;31(1):53-6. doi:10.1097/01.DON.0000134209.28874.1C.
Sedgley C. Root canal irrigation--a historical perspective. J Hist Dent. 2004;52(2):61-5.
Sundqvist G, Figdor D, Persson S, Sjögren U. Microbiologic analysis of teeth with failed endodontic treatment and the
outcome of conservative re-treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;85(1):86-93. doi:10.1016/s1079-2104(98)90404-8.
Mohammadi Z, Jafarzadeh H, Shalavi S, Yaripour S, Sharifi F, Kinoshita JI. A review on triple antibiotic paste as a
suitable material used in regenerative endodontics. Iran Endod J. 2018;13(1):1–6. doi:10.22037/iej.v13i1.17941.
Prather BT, Ehrlich Y, Spolnik K, Platt JA, Yassen GH. Effects of two combinations of triple antibiotic paste
used in endodontic regeneration on root microhardness and chemical structure of radicular dentine. J Oral Sci.
;56(4):245-51. doi: 10.2334/josnusd.56.245.
Sabrah AH, Yassen GH, Spolnik KJ, Hara AT, Platt JA, Gregory RL. Evaluation of residual antibacterial effect of
human radicular dentin treated with triple and double antibiotic pastes. J Endod. 2015;41(7):1081-4. doi: 10.1016/j.
Hargreaves KM, Cohen S, Berman LH. Cohen’s pathways of the Pulp. 10th ed. St. Louis, Mo.: Mosby Elsevier; 2011
Parhizkar A, Nojehdehian H, Asgary S. Triple antibiotic paste: momentous roles and applications in endodontics:
a review. Restor Dent Endod. 2018;43(3):e28. doi:10.5395/rde.2018.43.e28.
Frough Reyhani MF, Rahimi S, Fathi Z, Shakouie S, Salem Milani A, Soroush Barhaghi MH, et al. Evaluation of antimicrobial effects of different concentrations of triple antibiotic paste on mature biofilm of Enterococcus faecalis.
J Dent Res Dent Clin Dent Prospects. 2015;9(3):138-43. doi:10.15171/joddd.2015.027.
Adl A, Shojaee NS, Motamedifar M. A comparison between the antimicrobial effects of triple antibiotic paste and calcium hydroxide against Entrococcus faecalis. Iran Endod J. 2012;7(3):149-55. doi: 10.22037/iej.v7i3.3418.
Asnaashari M, Godiny M, Azari-Marhabi S, Tabatabaei FS, Barati M. Comparison of the antibacterial effect of 810 nm diode laser and photodynamic therapy in reducing the microbial flora of root canal in endodontic retreatment
in patients with periradicular lesions. J Lasers Med Sci. 2016;7(2):99-104. doi:10.15171/jlms.2016.17
Soukos NS, Chen PS, Morris JT, Ruggiero K, Abernethy AD, Som S, et al. Photodynamic therapy for endodontic disinfection. J Endod. 2006;32(10):979–84. doi: 10.1016/j.joen.2006.04.007.
Carvalho Edos S, Mello I, Albergaria SJ, Habitante SM, Lage-Marques JL, Raldi DP. Effect of chemical substances in removing methylene blue after photodynamic therapy in root canal treatment. Photomed Laser Surg. 2011;29(8):559–63. doi: 10.1089/pho.2010.2922.