Comparison of Antibacterial Effects of Photodynamic Therapy and An Irrigation Activation System on Root Canals Infected With Enterococcus faecalis: An In Vitro Study
Journal of Lasers in Medical Sciences,
Vol. 11 No. 3 (2020),
21 June 2020
,
Page 243-248
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.
- Enterococcus faecalis
- Photodynamic therapy
- GentleFile
- Irrigation activation system
- Sodium hypochlorite
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References
Dianat O, Saedi S, Kazem M, Alam M. Antimicrobial activity of nanoparticle calcium hydroxide against Enterococcus faecalis: an in vitro study. Iranian endodontic Endod journalJ. 2015;10(1):39-43.
Abdulla M, Ng Y, Gulabivala K, Moles DR, Spratt DA. Susceptibility of two Enterococcus faecalis phenotypes to root canal medicaments. J Endod. 2005;31(1):30-6. doi: 10.1097/01.don.0000136205.80807.5a.
Mohammadi Z. Chlorhexidine gluconate, its properties and applications in endodontics. Iranian endodontic Endod journalJ. 2008;2(4):113-25.
Stuart CH, Schwartz SA, Beeson TJ, Owatz CB. Enterococcus faecalis: its role in root canal treatment failure and current concepts in retreatment. Journal ofJ endodonticsEndod. 2006;32(2):93-8. doi: 10.1016/j.joen.2005.10.049.
Buck RA, Eleazer PD, Staat RH, Scheetz JP. Effectiveness of three endodontic irrigants at various tubular depths in human dentin. Journal ofJ Endodontics. 2001;27(3):206-8. doi: 10.1097/00004770-200103000-00017.
Gordon W, Atabakhsh VA, Meza F, Doms A, Nissan R, Rizoiu I, et al. The antimicrobial efficacy of the erbium, chromium: yttrium-scandium-gallium-garnet laser with radial emitting tips on root canal dentin walls infected with Enterococcus faecalis.. The Journal ofJ the American Dent al Association. 2007;138(7):992-1002. doi: 10.14219/jada.archive.2007.0297.
Nageshwar Rao N, Kidiyoor H, Hegde C. Efficacy of calcium hydroxide-chlorhexidene paste against Enterococcus faecalis–an in -vitro study. Endodontology. 2004;16:61-4.
Pinheiro ET, Gomes BP, Drucker DB, Zaia AA, Ferraz CC, Souza‐Filho FJ. Antimicrobial susceptibility of Enterococcus faecalis isolated from canals of root filled teeth with periapical lesions. Int ernational eEndod ontic journalJ. 2004;37(11):756-63. doi: 10.1111/j.1365-2591.2004.00865.x.
Peciuliene V, Reynaud AH, Balciuniene I, Haapasalo M. Isolation of yeasts and enteric bacteria in root‐filled teeth with chronic apical periodontitis. Int ernational eEndodontic journalJ. 2001;34(6):429-34. doi: 10.1046/j.1365-2591.2001.00411.x.
Bumb SS, Bhaskar DJ, Agali CR, Punia H, Gupta V, Singh V, et al. Assessment of photodynamic therapy (PDT) in disinfection of deeper dentinal tubules in a root canal system: an in vitro study. Journal ofJ clinical Clin Dand diagnostic researchRes: JCDR. 2014;8(11):ZC67-71. doi: 10.7860/JCDR/2014/11047.5155.
BYSTRÖM Byström A, SundqvistUNDQVIST G. Bacteriologic evaluation of the efficacy of mechanical root canal instrumentation in endodontic therapy. European Journal of Oral SciencesScand J Dent Res. 1981;89(4):321-8. doi: 10.1111/j.1600-0722.1981.tb01689.x.
Cha S, Park Y-S. Plasma in dentistry. Clinical plasma Plasma medicineMed. 2014;2(1):4-10. doi: 10.1016/j.cpme.2014.04.002.
Prabhakar J, Senthilkumar M, Priya MS, Mahalakshmi K, Sehgal PK, Sukumaran VG. Evaluation of antimicrobial efficacy of herbal alternatives (Triphala and green tea polyphenols), MTAD, and 5% sodium hypochlorite against Enterococcus faecalis biofilm formed on tooth substrate: an in vitro study. Journal ofJ endodonticsEndod. 2010;36(1):83-6. doi: 10.1016/j.joen.2009.09.040.
Carvalho EdS, 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 icine and lLaser surgerySurg. 2011;29(8):559-63. doi: 10.1089/pho.2010.2922.
de Oliveira BP, Aguiar CM, Câmara AC. Photodynamic therapy in combating the causative microorganisms from endodontic infections. European Jjournal of dentistryDent. 2014;8(3):424-30. doi: 10.4103/1305-7456.137662.
Soukos NS, Wilson M, Burns T, Speight PM. Photodynamic effects of toluidine blue on human oral keratinocytes and fibroblasts and Streptococcus sanguis evaluated in vitro. Lasers in Surggery and Medicine: The Official Journal of the American Society for Laser Medicine and Surgery. 1996;18(3):253-9. doi: 10.1002/(SICI)1096-9101(1996)18:3<253::AID-LSM6>3.0.CO;2-R.
Souza LC, Brito PR, de Oliveira JCM, Alves FR, Moreira EJ, Sampaio-Filho HR, et al. Photodynamic therapy with two different photosensitizers as a supplement to instrumentation/irrigation procedures in promoting intracanal reduction of Enterococcus faecalis. Journal ofJ endodonticsEndod. 2010;36(2):292-6. doi: 10.1016/j.joen.2009.09.041.
Sen BH, Piskin B, Demirci T. Observation of bacteria and fungi in infected root canals and dentinal tubules by SEM. Endod Dental Traumatology. 1995;11(1):6-9. doi: 10.1111/j.1600-9657.1995.tb00671.x.
Usacheva MN, Teichert MC, Biel MA. The interaction of lipopolysaccharides with phenothiazine dyes. Lasers in Surgery and Medicine: The Official Journal of the American Society for Laser Medicine and Surgery. 2003;33(5):311-9. doi: 10.1002/lsm.10226.
Urban K, Donnermeyer D, Schäfer E, Bürklein S. Canal cleanliness using different irrigation activation systems: a SEM evaluation. Clin ical oOral investigationsInvestig. 2017;21(9):2681-7. doi: 10.1007/s00784-017-2070-x.
Neelakantan P., Khan K., Li K.Y., Shetty H., Xi W. Effectiveness of supplementary irrigant agitation with the Finisher GF Brush on the debridement of oval root canals instrumented with the Gentlefile or nickel titanium rotary instruments. Int. Endod . J.. 2018;51(7):800-–807. doi: 10.1111/iej.12892.
Mehrvarzfar P, Saghiri MA, Asatourian A, Fekrazad R, Karamifar K, Eslami G, et al. Additive effect of a diode laser on the antibacterial activity of 2.5% NaOCl, 2% CHX and MTAD against Enterococcus faecalis contaminating root canals: an in vitro study. Journal ofJ oral Oral scienceSci. 2011;53(3):355-60. doi: 10.2334/josnusd.53.355.
Elumalai D, Kumar A, Tewari RK, Mishra SK, Iftekhar H, Alam S, et al. Newer Endodontic irrigation devices: An update. IOSR. J Dent Med Sci. 2014;13(6):4-8.
Ragul P, Dhanraj M, Jain AR. Irrigation technique used in cleaning and shaping during endodontic treatment - A review. Drug Invention Today. 2018;10(5):739-43.
Siddiqui SH, Awan KH, Javed F. Bactericidal efficacy of photodynamic therapy against Enterococcus faecalis in infected root canals: a systematic literature review. Photodiagnosis and pPhotodynamic therapyTher. 2013;10(4):632-43. doi: 10.1016/j.pdpdt.2013.07.006.
Fimple JL, Fontana CR, Foschi F, Ruggiero K, Song X, Pagonis TC, et al. Photodynamic treatment of endodontic polymicrobial infection in vitro. Journal of endodonticsEndod. 2008;34(6):728-34. doi: 10.1016/j.joen.2008.03.011.
Soares JA, Soares SMCS, de Jesus Tavarez RR, de Castro Rizzi C, Vaz Rodrigues SCGV, Maia Filho EM, et al. Exploring different photodynamic therapy parameters to optimize elimination of Enterococcus faecalis in planktonic form. Photodiagnosis and pPhotodynamic therapyTher. 2018;22:127-31. doi: 10.1016/j.pdpdt.2018.03.009.
Hoedke D, Enseleit C, Gruner D, Dommisch H, Schlafer S, Dige I, et al. Effect of photodynamic therapy in combination with various irrigation protocols on an endodontic multispecies biofilm ex vivo. Int ernational eEndod ontic journalJ. 2018;51:e23-e34. doi: 10.1111/iej.12763.
Nagendrababu V, Jayaraman J, Suresh A, Kalyanasundaram S, Neelakantan P., Effectiveness of ultrasonically activated irrigation on root canal disinfection: a systematic review of in vitro studies. Clin Oral Investig. 2018;22(2):655-670. doi: 10.1007/s00784-018-2345-x. Epub 2018 Jan 25.
Orozco EIF, Toia CC, Cavalli D, Khoury RD, da Rosa Cardoso FGDR, Bresciani E, Valera MCet al. Effect of passive ultrasonic activation on microorganisms in primary root canal infection: a randomized clinical trial. J Appl Oral Sci. 2019 Nov 28;28:e20190100. doi: 10.1590/1678-7757-2019-0100. PMID: 31800872; PMCID: PMC6886399.
Susila A, Minu J. Activated Irrigation vs. Conventional non-activated Irrigation in Endodontics – A Systematic Review. Eur Endod J. 2019; 3: 96-110. doi: 10.14744/eej.2019.80774.
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