Investigating the Antibacterial Effect of Passive Ultrasonic Irrigation, Photodynamic Therapy and Their Combination on Root Canal Disinfection PUI, PDT and PUI/PDT Effect on Root Canal Disinfection
Journal of Lasers in Medical Sciences,
Vol. 12 (2021),
13 February 2021
,
Page e81
Abstract
Introduction: Enterococcus faecalis is a gram-positive, facultative anaerobic bacterium associated with persistent endodontic infections. Conventional disinfection methods may not completely eradicate the bacteria within the root canal system. Therefore, novel modalities have been suggested to optimize root canal disinfection. The aim of this study was to evaluate and compare the antibacterial effect of photodynamic therapy (PDT), passive ultrasonic irrigation (PUI) and their combination in addition to conventional endodontic irrigation against E. faecalis biofilms in root canals.
Methods: Root canals of 50 single-rooted extracted human teeth were prepared and incubated with E. faecalis for 21 days. They were then divided into 4 treatment groups and a control group as follows: (1) NaOCl—Syringe irrigation with 2.5% NaOCl, (2) PUI—Passive ultrasonic irrigation with NaOCl, (3) NaOCl+PDT—Photodynamic therapy following syringe irrigation with NaOCl, (4) PUI+PDT, (5) Control—Syringe irrigation with saline. Colony-forming units were counted and bacterial reduction was calculated for each treatment group.
Results: All treatments led to significant reductions in the bacterial load compared to the control group. PUI and PUI+PDT led to the complete elimination of the bacteria from the root canals. NaOCl and NaOCl+PDT treatments reduced the bacteria by 99.9% and 99.5% respectively. NaOCl+PDT was significantly less effective in reducing the bacteria compared to other treatment groups. There were no significant differences between the NaOCl, PUI, and PUI+PDT groups.
Conclusion: Passive ultrasonic irrigation with or without the combination of Photodynamic therapy completely eradicated the bacteria. The use of PDT as an adjunction to NaOCl syringe irrigation and PUI did not enhance their antibacterial effect.
- Antimicrobial photodynamic therapy; Passive ultrasonic irrigation; Sodium hypochlorite; Enterococcus faecalis
How to Cite
References
Siqueira JF, Rôças IN. Present status and future directions in endodontic microbiology. Endod Topics. 2014;30(1):3-22. doi:10.1111/ETP.12060
Bago I, Plečko V, Gabrić Pandurić D, Schauperl Z, Baraba A, Anić I. Antimicrobial efficacy of a high-power diode laser, photo-activated disinfection, conventional and sonic activated irrigation during root canal treatment. Int Endod J. 2013;46(4):339-47. doi: 10.1111/j.1365-2591.2012.02120.x..
Moradi Eslami L, Vatanpour M, Aminzadeh N, Mehrvarzfar P, Taheri S. The comparison of intracanal medicaments, diode laser and photodynamic therapy on removing the biofilm of Enterococcus faecalis and Candida albicans in the root canal system (ex-vivo study). Photodiagnosis Photodyn Ther. 2019;26:157-161. doi: 10.1016/j.pdpdt.2019.01.033.
Lane J, Bonsor S. Survival rates of teeth treated with bacterial photo-dynamic therapy during disinfection of the root canal system. Br Dent J. 2019;226(5):333-339. doi: 10.1038/s41415-019-0026-z.
Neelakantan P, Romero M, Vera J, Daood U, Khan AU, Yan A, et al. Biofilms in Endodontics-Current Status and Future Directions. Int J Mol Sci. 2017;18(8):1748. doi: 10.3390/ijms18081748.
De Meyer S, Meire MA, Coenye T, De Moor RJ. Effect of laser-activated irrigation on biofilms in artificial root canals. Int Endod J. 2017;50(5):472-479. doi: 10.1111/iej.12643.
Tennert C, Drews AM, Walther V, Altenburger MJ, Karygianni L, Wrbas KT, et al. Ultrasonic activation and chemical modification of photosensitizers enhances the effects of photodynamic therapy against Enterococcus faecalis root-canal isolates. Photodiagnosis Photodyn Ther. 2015;12(2):244-51. doi: 10.1016/j.pdpdt.2015.02.002.
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.
Stuart CH, Schwartz SA, Beeson TJ, Owatz CB. Enterococcus faecalis: Its role in root canal treatment failure and current concepts in retreatment. J Endod. 2006;32(2):93-8. doi: 10.1016/j.joen.2005.10.049.
Căpută PE, Retsas A, Kuijk L, Chávez de Paz LE, Boutsioukis C. Ultrasonic Irrigant Activation during Root Canal Treatment: A Systematic Review. J Endod. 2019;45(1):31-44.e13. doi: 10.1016/j.joen.2018.09.010.
Pourhajibagher M, Bahador A. Adjunctive antimicrobial photodynamic therapy to conventional chemo-mechanical debridement of infected root canal systems: A systematic review and meta-analysis. Photodiagnosis Photodyn Ther. 2019;26:19-26. doi: 10.1016/j.pdpdt.2019.02.009.
Plotino G, Grande NM, Mercade M. Photodynamic therapy in endodontics. Int Endod J. 2019; 52(6):760-774. doi: 10.1111/iej.13057.
Silva EJNL, Rover G, Belladonna FG, Herrera DR, De-Deus G, da Silva Fidalgo TK. Effectiveness of passive ultrasonic irrigation on periapical healing and root canal disinfection: a systematic review. Br Dent J. 2019; 227(3):228-234. doi: 10.1038/s41415-019-0532-z.
Walsh LJ, George R. Activation of alkaline irrigation fluids in endodontics. Materials (Basel). 2017;10(10):1214. doi: 10.3390/ma10101214.
Saber Sel-D, Hashem AA. Efficacy of different final irrigation activation techniques on smear layer removal. J Endod. 2011;37(9):1272-5. doi: 10.1016/j.joen.2011.06.007.
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.
Virdee SS, Seymour DW, Farnell D, Bhamra G, Bhakta S. Efficacy of irrigant activation techniques in removing intracanal smear layer and debris from mature permanent teeth: a systematic review and meta-analysis. Int Endod J. 2018; 51(6):605-621. doi: 10.1111/iej.12877.
Niavarzi S, Pourhajibagher M, Khedmat S, Ghabraei S, Chiniforush N, Bahador A. Effect of ultrasonic activation on the efficacy of antimicrobial photodynamic therapy: Evaluation of penetration depth of photosensitizer and elimination of Enterococcus faecalis biofilms. Photodiagnosis Photodyn Ther. 2019;27:362-366. doi: 10.1016/j.pdpdt.2019.06.001.
Rosa RAD, Santini MF, Figueiredo JAP, Visioli F, Pereira JR, Vivan RR, et al. Effectiveness of photodynamic therapy associated with irrigants over two biofilm models. Photodiagnosis Photodyn Ther. 2017; 20:169-174. doi: 10.1016/j.pdpdt.2017.10.003.
Konopka K, Goslinski T. Photodynamic therapy in dentistry. J Dent Res. 2007;86(8):694-707. doi: 10.1177/154405910708600803.
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 Endod J. 2018;51 (Suppl 1):e23-e34. doi: 10.1111/iej.12763.
Bonsor SJ, Nichol R, Reid TM, Pearson GJ. Microbiological evaluation of photo-activated disinfection in endodontics (an in vivo study). Br Dent J. 2006;200(6):337-329. doi:10.1038/sj.bdj.4813371
Garcez AS, Nuñez SC, Hamblim MR, Suzuki H, Ribeiro MS. Photodynamic therapy associated with conventional endodontic treatment in patients with antibiotic-resistant microflora: a preliminary report. J Endod. 2010 ;36(9):1463-6. doi: 10.1016/j.joen.2010.06.001.
Chiniforush N, Pourhajibagher M, Shahabi S, Kosarieh E, Bahador A. Can Antimicrobial Photodynamic Therapy (aPDT) enhance the Endodontic Treatment? J Lasers Med Sci. 2016;7(2):76-85. doi: 10.15171/jlms.2016.14.
Nagata JY, Hioka N, Kimura E, Batistela VR, Terada RS, Graciano AX, et al. Antibacterial photodynamic therapy for dental caries: evaluation of the photosensitizers used and light source properties. Photodiagnosis Photodyn Ther. 2012 ;9(2):122-31. doi: 10.1016/j.pdpdt.2011.11.006.
Schlafer S, Vaeth M, Hørsted-Bindslev P, Frandsen EV. Endodontic photoactivated disinfection using a conventional light source: an in vitro and ex vivo study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109(4):634-41. doi: 10.1016/j.tripleo.2009.12.027.
wimberghe RCD, Coenye T, De Moor RJG, Meire MA. Biofilm model systems for root canal disinfection: a literature review. Int Endod J. 2019;52(5):604-628. doi: 10.1111/iej.13050.
Van Acker H, Van Dijck P, Coenye T. Molecular mechanisms of antimicrobial tolerance and resistance in bacterial and fungal biofilms. Trends Microbiol. 2014; 22(6):326-33. doi: 10.1016/j.tim.2014.02.001.
Shen Y, Stojicic S, Haapasalo M. Antimicrobial efficacy of chlorhexidine against bacteria in biofilms at different stages of development. J Endod. 2011;37(5):657-61. doi: 10.1016/j.joen.2011.02.007.
Prada I, Micó-Muñoz P, Giner-Lluesma T, Micó-Martínez P, Muwaquet-Rodríguez S, Albero-Monteagudo A. Update of the therapeutic planning of irrigation and intracanal medication in root canal treatment. A literature review. J Clin Exp Dent. 2019 ;11(2):e185-e193. doi: 10.4317/jced.55560.
Asnaashari M, Mojahedi SM, Asadi Z, Azari-Marhabi S, Maleki A. A comparison of the antibacterial activity of the two methods of photodynamic therapy (using diode laser 810 nm and LED lamp 630 nm) against Enterococcus faecalis in extracted human anterior teeth. Photodiagnosis Photodyn Ther. 2016; 13:233-237. doi: 10.1016/j.pdpdt.2015.07.171.
Muhammad OH, Chevalier M, Rocca JP, Brulat-Bouchard N, Medioni E. Photodynamic therapy versus ultrasonic irrigation: Interaction with endodontic microbial biofilm, an ex vivo study. Photodiagnosis Photodyn Ther. 2014; 11(2):171-81. doi: 10.1016/j.pdpdt.2014.02.005
Samiei M, Shahi S, Abdollahi AA, Eskandarinezhad M, Negahdari R, Pakseresht Z. The Antibacterial Efficacy of Photo-Activated Disinfection, Chlorhexidine and Sodium Hypochlorite in Infected Root Canals: An in Vitro Study. Iran Endod J. 2016; 11(3):179-183. doi:10.7508/iej.2016.03.006.
Rios A, He J, Glickman GN, Spears R, Schneiderman ED, Honeyman AL. Evaluation of photodynamic therapy using a light-emitting diode lamp against Enterococcus faecalis in extracted human teeth. J Endod. 2011; 37(6):856-9. doi: 10.1016/j.joen.2011.03.014.
de Oliveira BP, Aguiar CM, Câmara AC, de Albuquerque MM, Correia AC, Soares MF. The efficacy of photodynamic therapy and sodium hypochlorite in root canal disinfection by a single-file instrumentation technique. Photodiagnosis Photodyn Ther. 2015; 12(3):436-43. doi: 10.1016/j.pdpdt.2015.05.004.
Mohmmed SA, Vianna ME, Penny MR, Hilton ST, Mordan NJ, Knowles JC. Investigations into in situ Enterococcus faecalis biofilm removal by passive and active sodium hypochlorite irrigation delivered into the lateral canal of a simulated root canal model. Int Endod J. 2018; 51(6):649-662. doi: 10.1111/iej.12880.
Eneide C, Castagnola R, Martini C, Grande NM, Bugli F, Patini R, et al. Antibiofilm activity of three different irrigation techniques: an in vitro study. Antibiotics (Basel). 2019;8(3):112. doi: 10.3390/antibiotics8030112.
Xhevdet A, Stubljar D, Kriznar I, Jukic T, Skvarc M, Veranic P, et al. The disinfecting efficacy of root canals with laser photodynamic therapy. J lasers Med Sci. 2014;5(1):19-26.
Wang Y, Huang X. Comparative antibacterial efficacy of photodynamic therapy and ultrasonic irrigation against Enterococcus faecalis in vitro. Photochem Photobiol. 2014; 90(5):1084-8. doi: 10.1111/php.12293.
- Abstract Viewed: 809 times
- PDF Downloaded: 455 times