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Liu H, Nio S, Shen Y. Sodium hypochlorite against Enterococcus faecalis biofilm in dentinal tubules: effect of concentration, temperature, and exposure time. Odontology 2024; 112:390-398. [PMID: 37646916 DOI: 10.1007/s10266-023-00850-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 08/18/2023] [Indexed: 09/01/2023]
Abstract
This study aimed to evaluate the effectiveness of two sodium hypochlorite concentrations at different exposure times and temperatures against Enterococcus faecalis biofilms of varying ages in human dentinal tubules. Dentin blocks were infected with E. faecalis for either 3 days or 3 weeks of incubation. Subsequently, the samples were exposed to sterile water, 2%, and 5.25% sodium hypochlorite for 3 and 10 min at 20 °C and 60 °C . Viability staining and confocal laser scanning microscopy were used to assess the proportion of killed bacteria in the dentinal tubules after exposure. There are no significant differences in the efficacy of E. faecalis killing between 2% sodium hypochlorite at 60 °C for various exposure times and 5.25% sodium hypochlorite at different temperatures or exposure times (P > 0.05). When both solutions were compared at the same temperatures with a 10-min exposure time, no significant differences in the effectiveness of E. faecalis killing between 2% and 5.25% sodium hypochlorite were observed (P > 0.05). To optimize the effectiveness of sodium hypochlorite in killing E. faecalis while minimizing potential damage to root dentin and soft tissue, clinicians should prioritize increasing the temperature or exposure time of sodium hypochlorite, rather than raising its concentration.
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Affiliation(s)
- He Liu
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Stefanie Nio
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Ya Shen
- Division of Endodontics, Department of Oral Biological and Medical Sciences, Faculty of Dentistry, University of British Columbia, 2199 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada.
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Shahbazi S, Esmaeili S, Feli M, Asnaashari M. Photodynamic Therapy in Root Canal Disinfection: A Case Series and Mini-Review. J Lasers Med Sci 2022; 13:e19. [PMID: 35996480 PMCID: PMC9392882 DOI: 10.34172/jlms.2022.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 03/12/2022] [Indexed: 02/03/2024]
Abstract
Introduction: Photodynamic therapy (PDT) is now a widely used treatment modality in many fields of dentistry, including endodontics. The most common application of PDT in endodontics is to disinfect root canals. The purpose of this study was to present the experience of using PDT in root canal disinfection of three patients. Case Presentation: Three patients referred to the Endodontics Department of Shahid Beheshti University of Medical Sciences were treated using 0.1 mg/mL Toluidine Blue (FotoSan® agent; CMS Dental, Denmark) irradiated with a light-emitting diode (LED) lamp (FotoSan®; CMS Dental, Denmark) with a mean wavelength of 630 nm and a mean power density of 3 W/cm2 over two 30-second periods. Conclusion: PDT using LED lighting can be used in conjunction with conventional root canal treatment (RCT) to achieve great results.
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Affiliation(s)
- Soheil Shahbazi
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Saharnaz Esmaeili
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mojgan Feli
- Department of Endodontics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Asnaashari
- Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Widbiller M, Rosendahl A, Wölflick M, Linnebank M, Welzenbach B, Hiller KA, Buchalla W, Galler KM. Isolation of Endogenous TGF-β1 from Root Canals for Pulp Tissue Engineering: A Translational Study. BIOLOGY 2022; 11:biology11020227. [PMID: 35205093 PMCID: PMC8869556 DOI: 10.3390/biology11020227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/24/2022] [Accepted: 01/28/2022] [Indexed: 11/28/2022]
Abstract
Simple Summary Tissue engineering of the dental pulp has been a goal of dental research for years. In this translational study, a chairside protocol is designed using endogenous dentin matrix proteins as signaling molecules for pulp regeneration. These bioactive molecules can be isolated from root canals by ultrasonic-activated irrigation, further processed chairside, and mixed with a hydrogel. The scaffold material is to be injected into the root canal and effect cell homing, i.e., allowing stem cells from the periapical space to migrate into the root canal. The aim of this innovative approach is the formation of an innervated and vascularized connective tissue that resembles the pulp in form and function. Abstract Cell homing for dental pulp tissue engineering has been advocated as a feasible approach to regenerate dental pulp in a clinical setting. In order to develop a translational protocol for clinical application, we wanted to determine the effects of disinfectants on the availability of growth factors from the root canal, the amount that can be obtained in this context, and whether they can be processed for use in tissue engineering procedures. The extraction of growth factors should also be confirmed in a clinical setting. Root canals were prepared in 36 extracted mature teeth, and the amount of TGF-β1 in solution was quantified after different irrigation protocols (sodium hypochlorite, chlorhexidine) and after intracanal medication (calcium hydroxide). Centrifugal filters with a cut-off of 10,000 Da and 3000 Da were used for efficient concentration, and volumes and amounts of retained TGF-β1 were measured at different time points. During conventional endodontic treatment, ethylenediaminotetraacetic acid (EDTA) solution was collected after ultrasonic activation from the root canals of mature teeth of 38 patients, and growth factor content was quantified via enzyme-linked immunosorbent assay (ELISA). Irrigation with sodium hypochlorite reduced TGF-β1 release into EDTA. This effect was partially reversed by canal enlargement after the use of sodium hypochlorite and by subsequent use of calcium hydroxide. A few minutes of centrifugation with a cut-off of 10,000 Da reduced the initial volume of the irrigant by 90% and led to a continuous increase in concentration to the same extent. Furthermore, TGF-β1 was obtained from root canals of mature teeth during endodontic treatment in quantities that have been shown to elicit desirable cellular responses in a subsequent clinical application. A mixture with a suitable scaffold material and injection into the root canal has the potential to promote dental pulp regeneration.
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Affiliation(s)
- Matthias Widbiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany; (A.R.); (M.W.); (M.L.); (K.-A.H.); (W.B.)
- Correspondence:
| | - Andreas Rosendahl
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany; (A.R.); (M.W.); (M.L.); (K.-A.H.); (W.B.)
| | - Melanie Wölflick
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany; (A.R.); (M.W.); (M.L.); (K.-A.H.); (W.B.)
| | - Moritz Linnebank
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany; (A.R.); (M.W.); (M.L.); (K.-A.H.); (W.B.)
| | | | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany; (A.R.); (M.W.); (M.L.); (K.-A.H.); (W.B.)
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Hospital Regensburg, 93053 Regensburg, Germany; (A.R.); (M.W.); (M.L.); (K.-A.H.); (W.B.)
| | - Kerstin M. Galler
- Department of Operative Dentistry and Periodontology, Friedrich-Alexander-University Erlangen-Nürnberg, 91054 Erlangen, Germany;
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Hoedke D, Kaulika N, Dommisch H, Schlafer S, Shemesh H, Bitter K. Reduction of dual-species biofilm after sonic- or ultrasonic-activated irrigation protocols: A laboratory study. Int Endod J 2021; 54:2219-2228. [PMID: 34418114 DOI: 10.1111/iej.13618] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 08/19/2021] [Accepted: 08/20/2021] [Indexed: 01/11/2023]
Abstract
AIM To evaluate the antibacterial effect of sonic- and ultrasonic-activated irrigation on bacterial reduction of a dual-species biofilm in root canals compared to nonactivated irrigation in a laboratory study. METHODOLOGY Two hundred and forty extracted human single-rooted maxillary anterior teeth were divided into two main groups (G, n = 120) according to the initial preparation size of the root canal (G1: size 25, 0.06 taper, G2: size 40, 0.06 taper). Root canals were inoculated with Enterococcus faecalis and Streptococcus oralis. After 5 days, G1 received combined instrumentation (up to size 40, 0.06 taper) and irrigation/activation, whereas G2 received solely irrigation/activation protocols. In both groups, irrigation was performed with sodium hypochlorite (NaOCl 1%) or physiological saline (NaCl 0.9%), using nonactivated syringe irrigation, sonic activation (2 x 30 s) or ultrasonic activation (2 x 30 s). Logarithmic reduction factors (LRFs) of colony-forming units were analysed separately for dentine-adherent and planktonic bacteria immediately after irrigation/activation protocols (time-point 1) or after 5 days of further incubation (time-point 2) by analysis of variance (anova) and post hoc tests (Tukey's HSD, t-test). The significance level was set at 0.05. RESULTS In G1 subgroups (combined instrumentation with irrigation/activation), LRFs were significantly affected by the applied irrigation solution (p < .0001), but not by the activation method (p > .05; anova). In G2 subgroups (solely irrigation/activation), both, irrigant solution and activation, significantly affected LRFs (p < .0001, anova). Sonic activation resulted in significantly higher LRFs than ultrasonic activation (p < .0001) which had significantly greater reductions than nonactivated irrigation (p < .05; Tukey's HSD). At T2, strong bacterial regrowth was observed in all groups; however, a significant bacterial reduction was detected for factors instrumentation, irrigant solution and activation (p < .0001; anova). Similar LRFs were found for dentine-adherent and planktonic bacterial cells in all groups (r = 0.91 at T1, r = 0.8 at T2). CONCLUSIONS In this laboratory study on extracted maxillary anterior teeth high-frequency sonic activation resulted in a greater bacterial reduction compared to ultrasonic activation in groups receiving solely irrigation/activation protocols; however, irrigation using NaOCl and ultrasonic activation also contributed significantly to bacterial reduction compared to the control groups.
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Affiliation(s)
- Daniela Hoedke
- Department of Periodontology, Oral Medicine and Oral Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Namira Kaulika
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Henrik Dommisch
- Department of Periodontology, Oral Medicine and Oral Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Department of Oral Health Sciences, University of Washington, Seattle, Washington, USA
| | - Sebastian Schlafer
- Section for Oral Ecology and Caries Control, Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Aarhus, Denmark
| | - Hagay Shemesh
- Department of Endodontology, Academic Center of Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands
| | - Kerstin Bitter
- Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Wang Y, Li J, Geng S, Wang X, Cui Z, Ma W, Yuan M, Liu C, Ji Y. Aloe-emodin-mediated antimicrobial photodynamic therapy against multidrug-resistant Acinetobacter baumannii: An in vivo study. Photodiagnosis Photodyn Ther 2021; 34:102311. [PMID: 33930578 DOI: 10.1016/j.pdpdt.2021.102311] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 04/10/2021] [Accepted: 04/23/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND AND AIM Antimicrobial photodynamic therapy (aPDT) has shown great potential for treatment of superficial or localized multidrug-resistant (MDR) Acinetobacter baumannii infections. The purpose of this study was to investigate the cytotoxicity and in vivo safety of aloe-emodin (AE), and its photodynamic treatment efficacy against MDR A. baumannii infections. METHODS The cytotoxicity (dark toxicity) and phototoxicity of AE to human immortalized keratinocytes and mice fibroblasts were detected by CCK-8 kit. Low and high doses of AE were intravenously injected into mice to evaluate the safety of AE in vivo. Bioluminescent MDR A. baumannii strain was employed to establish the infection model on BALB/c mice after skin scald, and infection status and therapeutic effect of AE-mediated aPDT were assessed by animal imaging system. The peripheral blood of mice was analyzed by flow cytometer. RESULTS AE had low cytotoxicity to human immortalized keratinocytes and mice fibroblasts, and had certain phototoxicity to these cells under light irradiation. The in vivo experiments demonstrated that AE caused no obvious effects on the weight and pathological changes of mice. AE-mediated aPDT was effective in the treatment of MDR A. baumannii caused infections in mice after skin scald. CONCLUSIONS AE has potential to be used in the photodynamic treatment of MDR A. baumannii caused superficial infections after scald.
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Affiliation(s)
- Yang Wang
- Department of Pathogenic Microbiology & Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, Xi'an, 710061, PR China
| | - Jiao Li
- Department of Pathogenic Microbiology & Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, Xi'an, 710061, PR China
| | - Songmei Geng
- Department of Dermatology, The Second Affiliated Hospital of College of Medicine, Xi'an Jiaotong University, 157 Xi Wu Road, Xi'an, 710004, PR China
| | - Xiaopeng Wang
- Department of Dermatology, The Second Affiliated Hospital of College of Medicine, Xi'an Jiaotong University, 157 Xi Wu Road, Xi'an, 710004, PR China
| | - Zixin Cui
- Department of Pathogenic Microbiology & Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, Xi'an, 710061, PR China
| | - Wenpeng Ma
- Department of Pathogenic Microbiology & Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, Xi'an, 710061, PR China
| | - Meng Yuan
- Department of Pathogenic Microbiology & Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, Xi'an, 710061, PR China
| | - Chengcheng Liu
- Department of Pathogenic Microbiology & Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, Xi'an, 710061, PR China.
| | - Yanhong Ji
- Department of Pathogenic Microbiology & Immunology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, 76 West Yanta Road, Xi'an, 710061, PR China.
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Improving the Efficiency of Photodynamic Chemotherapy in Root Canals against Enterococcus faecalis In Vitro. Antibiotics (Basel) 2020; 9:antibiotics9090543. [PMID: 32859004 PMCID: PMC7560177 DOI: 10.3390/antibiotics9090543] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 08/23/2020] [Accepted: 08/25/2020] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to evaluate the effect of photoactivated chemotherapy (PACT) on Enterococcus faecalis (E. faecalis) biofilms in root canals using an 90% isopropanol (IPA)-based photosensitizer and removing excess photosensitizer before light incubation. Three hundred and seven extracted human teeth with one root canal were infected with E. faecalis for 72 h and treated in groups: IPA irrigation; PACT; PACT and final rinse with IPA; PACT with photosensitizer removal using either 0.9% NaCl solution or sterile paper points or both; PACT using IPA-based photosensitizer with and without a final rinse of IPA. Root canals were sampled using sterile paper points and dentin chips collected from the root canal walls. Additionally, SEM (Scanning Electron Microscopy) images of the specimens were taken to evaluate the root canal walls for residue bacterial contamination. In all antimicrobial treatment groups treatments E. faecalis counts were significantly reduced in the root canals. Using IPA-based photosensitizer the antimicrobial effect of PACT was significantly enhanced. Irrigation with IPA alone or after PACT significantly increased the antimicrobial effect compared to PACT alone. The collected dentin chips revealed the highest amount of culture negative root canals (10%) after PACT using IPA-based photosensitizer. In the other groups, the culture negative samples ranged from only 0–2 specimens of 30 specimens. REM images show remaining E. faecalis cells on the root canal wall and inside dentin tubules. Using IPA-based photosensitizer significantly enhanced the antimicrobial effect of PACT against E. faecalis in the root canals.
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Strazzi-Sahyon HB, de Oliveira MS, da Silva PP, Banci HA, de Melo FS, Martinez CMT, Cintra LTA, Gomes-Filho JE, Dezan-Júnior E, dos Santos PH, Sivieri-Araujo G. Does photodynamic therapy with methylene blue affect the mechanical properties and bond strength of glass-fiber posts in different thirds of intraradicular dentin? Photodiagnosis Photodyn Ther 2020; 30:101673. [DOI: 10.1016/j.pdpdt.2020.101673] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 11/27/2019] [Accepted: 01/21/2020] [Indexed: 10/25/2022]
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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] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 06/02/2019] [Accepted: 06/03/2019] [Indexed: 01/06/2023]
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Maliszewska I, Wróbel J, Wanarska E, Podhorodecki A, Matczyszyn K. Synergistic effect of methylene blue and biogenic gold nanoparticles against Enterococcus faecalis. Photodiagnosis Photodyn Ther 2019; 27:218-226. [DOI: 10.1016/j.pdpdt.2019.05.042] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 04/26/2019] [Accepted: 05/31/2019] [Indexed: 12/20/2022]
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Neves SO, Magalhães LMD, Corrêa JD, Dutra WO, Gollob KJ, Silva TA, Horta MCR, Souza PEA. Composite-derived monomers affect cell viability and cytokine expression in human leukocytes stimulated with Porphyromonas gingivalis. J Appl Oral Sci 2019; 27:e20180529. [PMID: 31166413 PMCID: PMC6546269 DOI: 10.1590/1678-7757-2018-0529] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 12/09/2018] [Accepted: 12/30/2018] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES Dental composites release unreacted resin monomers into the oral environment, even after polymerization. Periodontal cells are, therefore, exposed to substances that potentially elicit the immune inflammatory response. The underlying molecular mechanisms associated with the interaction between resin monomers and human immune cells found in the gingival crevicular fluid are not fully understood yet. This study investigated the ability of bisphenol A-glycidyl methacrylate (BISGMA), urethane dimethacrylate (UDMA) and triethylene glycol dimethacrylate (TEGDMA) to induce apoptosis and cytokine release by human leukocytes stimulated with a periodontal pathogen. METHODOLOGY Peripheral blood mononuclear cells (PBMC) from 16 healthy individuals were included in this study. To determine the toxicity, the PBMC were incubated for 20 hours, with monomers, for the analysis of cell viability using MTT assay. To evaluate cell death in the populations of monocytes and lymphocytes, they were exposed to sub-lethal doses of each monomer and of heat-inactivated Porphyromonas gingivalis (P. gingivalis) for 5 hours. Secretions of IL-1β, IL-6, IL-10 and TNF-α were determined by ELISA after 20 hours. RESULTS UDMA and TEGDMA induced apoptosis after a short-time exposure. Bacterial challenge induced significant production of IL-1β and TNF-α (p<0.05). TEGDMA reduced the bacterial-induced release of IL-1β and TNF-α, whereas UDMA reduced IL-1β release (p<0.05). These monomers did not affect IL-10 and IL-6 secretion. BISGMA did not significantly interfere in cytokine release. CONCLUSIONS These results show that resin monomers are toxic to PBMC in a dose-dependent manner, and may influence the local immune inflammatory response and tissue damage mechanisms via regulation of bacterial-induced IL-1β and TNF-α secretion by PBMC.
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Affiliation(s)
- Sheyla Omonte Neves
- Pontifícia Universidade Católica de Minas Gerais, Departamento de Odontologia, Programa de Pós-graduação em Odontologia, Belo Horizonte, Minas Gerais, Brasil
| | - Luísa Mourão Dias Magalhães
- Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Departmento de Morfologia, Belo Horizonte, Minas Gerais, Brasil
| | - Jôice Dias Corrêa
- Pontifícia Universidade Católica de Minas Gerais, Departamento de Odontologia, Programa de Pós-graduação em Odontologia, Belo Horizonte, Minas Gerais, Brasil
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Belo Horizonte, Minas Gerais, Brasil
| | - Walderez Ornelas Dutra
- Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Departmento de Morfologia, Belo Horizonte, Minas Gerais, Brasil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais – INCT-DT, Belo Horizonte, Minas Gerais, Brasil
| | - Kenneth John Gollob
- International Research Center, A.C.Camargo Cancer Center, São Paulo, SP, Brasil
- Instituto Nacional de Ciência e Tecnologia em Doenças Tropicais – INCT-DT, Belo Horizonte, Minas Gerais, Brasil
| | - Tarcília Aparecida Silva
- Universidade Federal de Minas Gerais, Faculdade de Odontologia, Belo Horizonte, Minas Gerais, Brasil
| | - Martinho Campolina Rebello Horta
- Pontifícia Universidade Católica de Minas Gerais, Departamento de Odontologia, Programa de Pós-graduação em Odontologia, Belo Horizonte, Minas Gerais, Brasil
| | - Paulo Eduardo Alencar Souza
- Pontifícia Universidade Católica de Minas Gerais, Departamento de Odontologia, Programa de Pós-graduação em Odontologia, Belo Horizonte, Minas Gerais, Brasil
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YU MK, KIM MA, ROSA V, HWANG YC, DEL FABBRO M, SOHN WJ, MIN KS. Role of extracellular DNA in Enterococcus faecalis biofilm formation and its susceptibility to sodium hypochlorite. J Appl Oral Sci 2019; 27:e20180699. [PMID: 31411265 PMCID: PMC9648955 DOI: 10.1590/1678-7757-2018-0699] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 03/25/2019] [Indexed: 12/04/2022] Open
Abstract
Objective This study investigated the role of extracellular deoxyribonucleic acid (eDNA) on Enterococcus faecalis ( E. faecalis ) biofilm and the susceptibility of E. faecalis to sodium hypochlorite (NaOCl). Methodology E. faecalis biofilm was formed in bovine tooth specimens and the biofilm was cultured with or without deoxyribonuclease (DNase), an inhibitor of eDNA. Then, the role of eDNA in E. faecalis growth and biofilm formation was investigated using colony forming unit (CFUs) counting, eDNA level assay, crystal violet staining, confocal laser scanning microscopy, and scanning electron microscopy. The susceptibility of E. faecalis biofilm to low (0.5%) or high (5%) NaOCl concentrations was also analyzed by CFU counting. Results CFUs and biofilm formation decreased significantly with DNase treatment (p<0.05). The microstructure of DNase-treated biofilms exhibited less structured features when compared to the control. The volume of exopolysaccharides in the DNase-treated biofilm was significantly lower than that of control (p<0.05). Moreover, the CFUs, eDNA level, biofilm formation, and exopolysaccharides volume were lower when the biofilm was treated with DNase de novo when compared to when DNase was applied to matured biofilm (p<0.05). E. faecalis in the biofilm was more susceptible to NaOCl when it was cultured with DNase (p<0.05). Furthermore, 0.5% NaOCl combined with DNase treatment was as efficient as 5% NaOCl alone regarding susceptibility (p>0.05). Conclusions Inhibition of eDNA leads to decrease of E. faecalis biofilm formation and increase of susceptibility of E. faecalis to NaOCl even at low concentrations. Therefore, our results suggest that inhibition of eDNA would be beneficial in facilitating the efficacy of NaOCl and reducing its concentration.
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Affiliation(s)
- Mi-Kyung YU
- Chonbuk National University, Korea; Chonbuk National University, Korea; Chonbuk National University Hospital, Korea
| | | | | | | | - Massimo DEL FABBRO
- Università degli Studi di Milano, Italy; IRCCS Istituto Ortopedico Galeazzi, Italy
| | | | - Kyung-San MIN
- Chonbuk National University, Korea; Chonbuk National University, Korea; Chonbuk National University Hospital, Korea
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12
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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: 98] [Impact Index Per Article: 16.3] [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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Souza MA, Tumelero Dias C, Zandoná J, Paim Hoffmann I, Sanches Menchik VH, Palhano HS, Bertol CD, Rossato-Grando LG, Cecchin D, de Figueiredo JAP. Antimicrobial activity of hypochlorite solutions and reciprocating instrumentation associated with photodynamic therapy on root canals infected with Enterococcus faecalis – An in vitro study. Photodiagnosis Photodyn Ther 2018; 23:347-352. [DOI: 10.1016/j.pdpdt.2018.07.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Revised: 07/08/2018] [Accepted: 07/23/2018] [Indexed: 10/28/2022]
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14
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Ghorbanzadeh A, Fekrazad R, Bahador A, Ayar R, Tabatabai S, Asefi S. Evaluation of the antibacterial efficacy of various root canal disinfection methods against Enterococcus faecalis biofilm. An ex-vivo study. Photodiagnosis Photodyn Ther 2018; 24:44-51. [PMID: 30130574 DOI: 10.1016/j.pdpdt.2018.08.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 08/15/2018] [Accepted: 08/17/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Complete elimination of bacteria and their by-products from the root canal system is very difficult with current techniques. The purpose of this study was to compare the antibacterial efficacy of different disinfection protocols against Enterococcus faecalis (E. faecalis) biofilms. METHODS Seventy-six extracted single-rooted human teeth were selected. Root canal preparation was done by proTaper rotary instruments. The smear layer was removed by 17% EDTA, followed by 5.25% sodium hypochlorite. After sterilization using gamma irradiation, sterilized specimens were inoculated with an E. faecalis suspension, incubated for 4 days and 4 weeks and then randomly divided into two experimental groups (4 days, 4 weeks old biofilms). After the confirmation of biofilm formation with SEM, the specimens in the experimental groups were randomly divided into five experimental subgroups according to the method of disinfection applied, which included: Diode laser irradiation (810 nm, 2 W), Light activated disinfection (LAD) with Indocyanine Green, 0.2% Chlorhexidine gluconate (0.2% CHX), 0.2% CHX + LAD and 0.2% CHX + Diode groups. RESULTS Complete biofilm bacterial elimination was not observed in either of the experimental groups. CHX + LAD (0.2%) method exhibited the highest reduction value in biofilm and only Diode alone revealed the lowest in all the root canal portions. Disinfection protocols also showed significantly lower antibacterial efficacy against 4-week old than the 4-day old matured biofilms (P < 0.05). CONCLUSION All the evaluated methods in this study were effective in the relative elimination of the E. faecalis biofilms except diode laser alone. Nevertheless, 0.2% CHX + LAD exhibited significantly higher efficacy in reducing both 4-day and 4-week old biofilms.
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Affiliation(s)
- Abdollah Ghorbanzadeh
- Endodontic Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Reza Fekrazad
- Department of Periodontology, Dental Faculty - Laser Research Center in Medical Sciences, AJA University of Medical Sciences, Tehran, Iran; International Network for Photo Medicine and Photo Dynamic Therapy (INPMPDT), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
| | - Abbas Bahador
- Microbiology Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Sohrab Asefi
- Orthodontic Department, International Campus, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
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15
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Hoedke D, Enseleit C, Gruner D, Dommisch H, Schlafer S, Dige I, Bitter K. Effect of photodynamic therapy in combination with various irrigation protocols on an endodontic multispecies biofilmex vivo. Int Endod J 2017; 51 Suppl 1:e23-e34. [DOI: 10.1111/iej.12763] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 03/06/2017] [Indexed: 12/28/2022]
Affiliation(s)
- D. Hoedke
- Department of Periodontology and Synoptic Dentistry; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - C. Enseleit
- Department of Operative and Preventive Dentistry; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - D. Gruner
- Department of Operative and Preventive Dentistry; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - H. Dommisch
- Department of Periodontology and Synoptic Dentistry; Charité - Universitätsmedizin Berlin; Berlin Germany
| | - S. Schlafer
- Department of Dentistry; Health; Aarhus University; Aarhus Denmark
| | - I. Dige
- Department of Dentistry; Health; Aarhus University; Aarhus Denmark
| | - K. Bitter
- Department of Operative and Preventive Dentistry; Charité - Universitätsmedizin Berlin; Berlin Germany
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Effects of Diode Laser, Gaseous Ozone, and Medical Dressings on Enterococcus faecalis Biofilms in the Root Canal Ex Vivo. BIOMED RESEARCH INTERNATIONAL 2017; 2017:6321850. [PMID: 28567421 PMCID: PMC5439256 DOI: 10.1155/2017/6321850] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2017] [Accepted: 03/15/2017] [Indexed: 11/26/2022]
Abstract
The objective was to compare the antibacterial effects of adjunctive disinfection using diode laser and gaseous ozone compared to the medical dressings calcium hydroxide (Ca(OH)2) and chlorhexidine gel (CHX-Gel) on Enterococcus faecalis biofilms in human root canals ex vivo. Root canals of 180 human extracted teeth were infected by E. faecalis and divided into 3 main groups (G): G1, control; G2, instrumentation and irrigation using 0.9% NaCl; G3, instrumentation and irrigation using 1% NaOCl. In each main group, the following treatments were applied: gaseous ozone, diode laser, and medical dressings of Ca(OH)2 or CHX-Gel for 7 days (n = 15). Reduction of colony forming units (CFUs) inside the root canal of planktons and frequencies of adherent bacteria after treatment were calculated. Bacterial reduction was significantly affected by the irrigation protocol (p < 0.0005) and the disinfection method (p < 0.0005), and a significant interaction between both factors could be observed (p < 0.0005; ANOVA). In G3 (instrumentation using 1% NaOCl), no significant effect of disinfection methods could be demonstrated on planktonic bacteria (p = 0.062; ANOVA) and frequencies of adherent bacteria (p > 0.05; chi-square test). Instrumentation and irrigation using NaOCl combined with ozone or laser application resulted in comparable bacterial reduction on E. faecalis to the application of medical dressings.
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17
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Costa LM, Matos FDS, Correia AMDO, Carvalho NC, Faria-e-Silva AL, Paranhos LR, Ribeiro MAG. Tooth color change caused by photosensitizers after photodynamic therapy: An in vitro study. JOURNAL OF PHOTOCHEMISTRY AND PHOTOBIOLOGY B-BIOLOGY 2016; 160:225-8. [DOI: 10.1016/j.jphotobiol.2016.04.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2016] [Accepted: 04/16/2016] [Indexed: 10/21/2022]
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18
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Cieplik F, Pummer A, Leibl C, Regensburger J, Schmalz G, Buchalla W, Hiller KA, Maisch T. Photodynamic Inactivation of Root Canal Bacteria by Light Activation through Human Dental Hard and Simulated Surrounding Tissue. Front Microbiol 2016; 7:929. [PMID: 27379059 PMCID: PMC4908107 DOI: 10.3389/fmicb.2016.00929] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 05/31/2016] [Indexed: 11/16/2022] Open
Abstract
Introduction: Photodynamic inactivation of bacteria (PIB) may be a supportive antimicrobial approach for use in endodontics, but sufficient activation of photosensitizers (PS) in root canals is a critical point. Therefore, aim of this study was to evaluate the ability of PS absorbing blue (TMPyP) or red light (Methylene Blue; MB) for light activation through human dental hard and simulated surrounding tissue to inactivate root canal bacteria. Methods: A tooth model was fabricated with a human premolar and two molars in an acrylic resin bloc simulating the optical properties of a porcine jaw. The distal root canal of the first molar was enlarged to insert a glass tube (external diameter 2 mm) containing PS and stationary-phase Enterococcus faecalis. Both PS (10 μM) were irradiated for 120 s with BlueV (20 mW/cm2; λem = 400–460 nm) or PDT 1200L (37.8 mW/cm2; λem = 570–680 nm; both: Waldmann Medizintechnik), respectively. Irradiation parameters ensured identical numbers of photons absorbed by each PS. Three setups were chosen: irradiating the glass pipette only (G), the glass pipette inside the single tooth without (GT) and with (GTM) simulated surrounding tissues. Colony forming units (CFU) were evaluated. Transmission measurements of the buccal halves of hemisected mandibular first molars were performed by means of a photospectrometer. Results: PIB with both PS led to reduction by ≥ 5 log10 of E. faecalis CFU for each setup. From transmission measurements, a threshold wavelength λth for allowing an amount of light transmission for sufficient activation of PS was determined to be 430 nm. Conclusion: This study can be seen as proof of principle that light activation of given intra-canal PS from outside a tooth may be possible at wavelengths ≥ 430 nm, facilitating clinical application of PIB in endodontics.
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Affiliation(s)
- Fabian Cieplik
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg Regensburg, Germany
| | - Andreas Pummer
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg Regensburg, Germany
| | - Christoph Leibl
- Department of Conservative Dentistry and Periodontology, University Medical Center RegensburgRegensburg, Germany; Private PracticeGeiselhöring, Germany
| | | | - Gottfried Schmalz
- Department of Conservative Dentistry and Periodontology, University Medical Center RegensburgRegensburg, Germany; Department of Preventive, Restorative and Pediatric Dentistry, School of Dental Medicine, University of BernBern, Switzerland
| | - Wolfgang Buchalla
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg Regensburg, Germany
| | - Karl-Anton Hiller
- Department of Conservative Dentistry and Periodontology, University Medical Center Regensburg Regensburg, Germany
| | - Tim Maisch
- Department of Dermatology, University Medical Center Regensburg Regensburg, Germany
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Chiniforush N, Pourhajibagher M, Shahabi S, Kosarieh E, Bahador A. Can Antimicrobial Photodynamic Therapy (aPDT) Enhance the Endodontic Treatment? J Lasers Med Sci 2016; 7:76-85. [PMID: 27330702 DOI: 10.15171/jlms.2016.14] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In order to achieve a long-lasting effect, one of the main goals in root canal treatment is to eliminate the endodontic bacteria. Conventional chemomechanical debridement is considered as the basic treatment in root canal therapy, but adjunctive techniques such as antimicrobial photodynamic therapy (aPDT) can also be helpful. The aim of this study was to evaluate reports in the scientific literature that used different photosensitizers (PSs) for bacterial reduction. The literature search was conducted using databases including PubMed, Scopus, and Google Scholar with the keywords "photodynamic therapy," "antimicrobial photodynamic therapy," or "photoactivated disinfection" and "endodontic," "Enterococcus faecalis," or "root canal treatment," from 2000 to 2015. By evaluating different studies, it was concluded that aPDT should be applied in combination with conventional mechanical debridement and irrigants. However, it is also important to note that the success rate is critically dependent on the type of the PS, output power of the laser used, irradiation time, pre-irradiation time, and type of tips used.
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Affiliation(s)
- Nasim Chiniforush
- Laser Research Center of Dentistry, Dental Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Pourhajibagher
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sima Shahabi
- Dental biomaterials Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Emad Kosarieh
- Laser Research Center of Dentistry, Dental Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Bahador
- Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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20
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Photodynamic Antimicrobial Chemotherapy for Root Canal System Asepsis: A Narrative Literature Review. Int J Dent 2015; 2015:269205. [PMID: 26783392 PMCID: PMC4689923 DOI: 10.1155/2015/269205] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 10/08/2015] [Accepted: 11/04/2015] [Indexed: 11/17/2022] Open
Abstract
Aim. The aim of this comprehensive literature review was to address the question: Does photodynamic therapy (PDT) improve root canal disinfection through significant bacterial reduction in the root canal system? Methodology. A comprehensive narrative literature review was performed to compare PDT effect with sodium hypochlorite as the comparative classical irrigant. Two reviewers independently conducted literature searches using a combination of medical subject heading terms and key words to identify relevant studies comparing information found in 7 electronic databases from January 2000 to May 2015. A manual search was performed on bibliography of articles collected on electronic databases. Authors were contacted to ask for references of more research not detected on the prior electronic and manual searches. Results. The literature search provided 62 titles and abstracts, from which 29 studies were related directly to the search theme. Considering all publications, 14 (48%) showed PDT to be more efficient in antimicrobial outcome than NaOCl (0.5-6% concentration) used alone and 2 (7%) revealed similar effects between them. Toluidine blue and methylene blue are the most used photosensitizers and most commonly laser has 660 nm of wavelength with a 400 nm diameter of intracanal fiber. Conclusions. PDT has been used without a well-defined protocol and still remains at an experimental stage waiting for further optimization. The level of evidence available in clinical studies to answer this question is low and at high risk of bias.
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21
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Schmalz G, Widbiller M, Galler KM. Material Tissue Interaction--From Toxicity to Tissue Regeneration. Oper Dent 2015; 41:117-31. [PMID: 26645359 DOI: 10.2341/15-249-bl] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The topic of material tissue interaction has gained increasing interest over recent decades from both the dental profession and the public. The primary goal initially was to avoid adverse reactions after the application of dental materials. New laboratory test methods have been developed, and currently premarket testing programs, which attempt to guarantee a basic level of patient safety, are legally required worldwide. The dentist is responsible for selecting the correct indication as well as the proper handling of any newly emerging risk. Apart from this phenomenon-oriented "inert materials concept," the "analytical concept" focuses primarily on analyzing the reasons for adverse reactions, and identifying their associated modifying factors, in order to prevent them or to develop new and more biocompatible materials. The "concept of bioactivity" involves addressing the possibility of positively influencing tissue by materials application, such as the generation of tertiary dentin or antibacterial effects. Finally, tissue regeneration may be supported and promoted by the use of various suitable materials (matrices/scaffolds) into which stem cells can migrate or be seeded, leading to cell differentiation and the generation of new tissue. These new dental materials must also fulfill additional requirements such as controlled degradability in order to be suitable for clinical use. Clearly, the field of material tissue interaction is complex and comprises a wide range of issues. To be successful as dentists in the future, practitioners should remain informed of these important new developments and have the argumentative competence to both properly advise and treat their patients.
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22
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Tennert C, Drews AM, Walther V, Altenburger MJ, Karygianni L, Wrbas KT, Hellwig E, Al-Ahmad A. Ultrasonic activation and chemical modification of photosensitizers enhances the effects of photodynamic therapy against Enterococcus faecalis root-canal isolates. Photodiagnosis Photodyn Ther 2015; 12:244-51. [PMID: 25703104 DOI: 10.1016/j.pdpdt.2015.02.002] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 02/05/2015] [Accepted: 02/09/2015] [Indexed: 01/10/2023]
Abstract
BACKGROUND The aim of this study was to evaluate the effect of photodynamic therapy (PDT) on Enterococcus faecalis biofilms in artificially infected root canals using modified photosensitizers and passive ultrasonic activation. METHODS Two hundred and seventy extracted human teeth with one root canal were instrumented utilizing ProTaper files, autoclaved, infected with E. faecalis T9 for 72 h and divided into different groups: irrigation with 3% sodium hypochlorite (NaOCl), 20% ethylenediaminetetraacetic acid (EDTA), or 20% citric acid, PDT without irrigation, PDT accompanied by irrigation with NaOCl, EDTA, or citric acid, PDT using an EDTA-based photosensitizer or a citric-acid-based photosensitizer and PDT with ultrasonic activation of the photosensitizer. A 15 mg/ml toluidine blue served as the photosensitizer, activated by a 100 mW LED light source. Sterile paper points were used for sampling the root canals and dentin chips were collected to assess the remaining contamination after treatment. Samples were cultured on blood agar plates and colony forming units were quantified. RESULTS PDT alone achieved a reduction in E. faecalis counts by 92.7%, NaOCl irrigation alone and combined with PDT by 99.9%. The antibacterial effects increased by the combination of irrigation using EDTA or citric acid and PDT compared to irrigation alone. More than 99% of E. faecalis were killed using PDT with the modified photosensitizers and ultrasonic activation. CONCLUSIONS NaOCl based disinfection achieved the highest antimicrobial effect. Using PDT with an EDTA-based or citric-acid-based phozosensitizer or activating the photosensitizer with ultrasound resulted in a significantly higher reduction in E. faecalis counts compared to conventional PDT.
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Affiliation(s)
- C Tennert
- University of Freiburg-Medical Center, Department of Operative Dentistry and Periodontology, Hugstetter Str. 55, 79106 Freiburg, Germany.
| | - A M Drews
- University of Freiburg-Medical Center, Department of Operative Dentistry and Periodontology, Hugstetter Str. 55, 79106 Freiburg, Germany.
| | - V Walther
- University of Freiburg-Medical Center, Department of Operative Dentistry and Periodontology, Hugstetter Str. 55, 79106 Freiburg, Germany.
| | - M J Altenburger
- University of Freiburg-Medical Center, Department of Operative Dentistry and Periodontology, Hugstetter Str. 55, 79106 Freiburg, Germany.
| | - L Karygianni
- University of Freiburg-Medical Center, Department of Operative Dentistry and Periodontology, Hugstetter Str. 55, 79106 Freiburg, Germany.
| | - K T Wrbas
- University of Freiburg-Medical Center, Department of Operative Dentistry and Periodontology, Hugstetter Str. 55, 79106 Freiburg, Germany.
| | - E Hellwig
- University of Freiburg-Medical Center, Department of Operative Dentistry and Periodontology, Hugstetter Str. 55, 79106 Freiburg, Germany.
| | - A Al-Ahmad
- University of Freiburg-Medical Center, Department of Operative Dentistry and Periodontology, Hugstetter Str. 55, 79106 Freiburg, Germany.
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23
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da Frota MF, Guerreiro-Tanomaru JM, Tanomaru-Filho M, Bagnato VS, Espir CG, Berbert FLCV. Photodynamic therapy in root canals contaminated with Enterococcus faecalis using curcumin as photosensitizer. Lasers Med Sci 2014; 30:1867-72. [PMID: 25502831 DOI: 10.1007/s10103-014-1696-z] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Accepted: 11/30/2014] [Indexed: 12/27/2022]
Abstract
The aim of the study was to evaluate the photodynamic therapy (PDT) effect on root canals contaminated with Enterococcus faecalis using a light emitting diode (LED) light and a curcumin solution (CUR) as photosensitizer (PS). Eighty root canals from uniradicular human teeth were prepared with Protaper Universal rotary system and contaminated with E. faecalis for 21 days. They were divided as: GIa-PDT (CUR, pre-irradiation for 5 + 5 min of irradiation); GIb-PDT (CUR, pre-irradiation for 5 + 10 min of irradiation); GIIa-(CUR, pre-irradiation for 5 + 5 min without irradiation); GIIb-(CUR pre-irradiation for 5 + 10 min of irradiation); GIIIa-(physiological solution and irradiation for 5 min); and GIIIb-(physiological solution and irradiation for 10 min); positive and negative control groups. Collections from root canals were made at time intervals of 21 days after contamination, immediately after treatment, and 7 days after treatment, and submitted to colony forming units per milliter (CFU mL(-1)) counts. The data were submitted to ANOVA and Tukey multiple comparison tests, at a level of significance of 5 %. In the immediate post-treatment collection, group GIa showed greater bacterial reduction in comparison with GIIa, GIIb, GIIIa, GIIIb, and positive control (P < 0.05). At 7 days post-treatment, GIa showed significant bacterial reduction only in comparison with GIIIa (P < 0.05). Curcumin as sensitizer was effective by 5 min LED irradiation but not by 10 min irradiation PDT using LED light, and curcumin as PS was not effective in eliminating E. faecalis. No difference was observed for periods of irradiation.
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24
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The antimicrobial effectiveness of photodynamic therapy used as an addition to the conventional endodontic re-treatment: A clinical study. Photodiagnosis Photodyn Ther 2014; 11:549-55. [DOI: 10.1016/j.pdpdt.2014.10.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 10/09/2014] [Accepted: 10/13/2014] [Indexed: 11/30/2022]
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25
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Ghinzelli GC, Souza MA, Cecchin D, Farina AP, de Figueiredo JAP. Influence of ultrasonic activation on photodynamic therapy over root canal system infected with Enterococcus faecalis – an in vitro study. Photodiagnosis Photodyn Ther 2014; 11:472-8. [DOI: 10.1016/j.pdpdt.2014.07.004] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Revised: 07/21/2014] [Accepted: 07/23/2014] [Indexed: 10/24/2022]
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Singh S, Nagpal R, Manuja N, Tyagi SP. Photodynamic therapy: An adjunct to conventional root canal disinfection strategies. AUST ENDOD J 2014; 41:54-71. [PMID: 25404404 DOI: 10.1111/aej.12088] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Although chemical-based root canal disinfectants are important to reduce microbial loads and remove infected smear layer from root dentin, they have only a limited ability to eliminate biofilm bacteria, especially from root complexities. This paper explores the novel photodynamic therapy (PDT) for antimicrobial disinfection of root canals. The combination of an effective photosensitizer, the appropriate wavelength of light and ambient oxygen is the key factor in PDT. PDT uses a specific wavelength of light to activate a non-toxic dye (photosensitizer), leading to the formation of reactive oxygen species. These reactive oxygen molecules can damage bacterial proteins, membrane lipids and nucleic acids, which promote bacterial cell death. In, addition PDT may enhance cross-linking of collagen fibrils in the dentin matrix and thereby improving dentin stability. The concept of PDT is plausible and could foster new therapy concepts for endodontics. The available knowledge should enable and encourage steps forward into more clinical-oriented research and development. This article discusses PDT as related to root canal disinfection, including its components, mechanism of action, reviews the current endodontic literature and also highlights the shortcomings and advancements in PDT techniques.
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Affiliation(s)
- Shipra Singh
- Department of Conservative Dentistry and Endodontics, Kothiwal Dental College and Research Centre, Moradabad, India
| | - Rajni Nagpal
- Department of Conservative Dentistry and Endodontics, Kothiwal Dental College and Research Centre, Moradabad, India
| | - Naveen Manuja
- Department of Pediatric Dentistry, Kothiwal Dental College and Research Centre, Moradabad, India
| | - Sashi Prabha Tyagi
- Department of Conservative Dentistry and Endodontics, Kothiwal Dental College and Research Centre, Moradabad, India
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de Oliveira BP, Aguiar CM, Câmara AC. Photodynamic therapy in combating the causative microorganisms from endodontic infections. Eur J Dent 2014; 8:424-430. [PMID: 25202228 PMCID: PMC4144146 DOI: 10.4103/1305-7456.137662] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Photodynamic therapy (PDT) is presented as a promising antimicrobial therapy that can eliminate microorganisms present in endodontic infections. This treatment is based on the use of a nontoxic photosensitizing agent followed by irradiation of a resonant light source being capable of generating highly reactive species that are harmful to microorganisms. The purpose of this paper is to review the dental literature about the main factors that encompass the use of PDT combined with endodontic treatment for decontamination of the root canal system. A literature search was performed using the following index databases: PubMed, ISI Web of Knowledge and MedLine, between 2000 and 2014, looking for studies regarding antimicrobial action of PDT and its application to endodontic therapy. It was observed that despite numerous promising results, it is still necessary to establish different parameters so that PDT can be used with maximum effectiveness in eliminating microorganisms that cause endodontic infections.
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Affiliation(s)
- Bruna Paloma de Oliveira
- Department of Prosthodontics and Oral and Maxillofacial Surgery, Dental School, Federal University of Pernambuco, Brazil
| | - Carlos Menezes Aguiar
- Department of Prosthodontics and Oral and Maxillofacial Surgery, Dental School, Federal University of Pernambuco, Brazil
| | - Andréa Cruz Câmara
- Department of Prosthodontics and Oral and Maxillofacial Surgery, Dental School, Federal University of Pernambuco, Brazil
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28
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Cieplik F, Tabenski L, Buchalla W, Maisch T. Antimicrobial photodynamic therapy for inactivation of biofilms formed by oral key pathogens. Front Microbiol 2014; 5:405. [PMID: 25161649 PMCID: PMC4130309 DOI: 10.3389/fmicb.2014.00405] [Citation(s) in RCA: 154] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Accepted: 07/18/2014] [Indexed: 12/24/2022] Open
Abstract
With increasing numbers of antibiotic-resistant pathogens all over the world there is a pressing need for strategies that are capable of inactivating biofilm-state pathogens with less potential of developing resistances in pathogens. Antimicrobial strategies of that kind are especially needed in dentistry in order to avoid the usage of antibiotics for treatment of periodontal, endodontic or mucosal topical infections caused by bacterial or yeast biofilms. One possible option could be the antimicrobial photodynamic therapy (aPDT), whereby the lethal effect of aPDT is based on the principle that visible light activates a photosensitizer (PS), leading to the formation of reactive oxygen species, e.g., singlet oxygen, which induce phototoxicity immediately during illumination. Many compounds have been described as potential PS for aPDT against bacterial and yeast biofilms so far, but conflicting results have been reported. Therefore, the aim of the present review is to outline the actual state of the art regarding the potential of aPDT for inactivation of biofilms formed in vitro with a main focus on those formed by oral key pathogens and structured regarding the distinct types of PS.
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Affiliation(s)
- Fabian Cieplik
- Department of Operative Dentistry and Periodontology, University Medical Center Regensburg Regensburg, Germany
| | - Laura Tabenski
- Department of Operative Dentistry and Periodontology, University Medical Center Regensburg Regensburg, Germany
| | - Wolfgang Buchalla
- Department of Operative Dentistry and Periodontology, University Medical Center Regensburg Regensburg, Germany
| | - Tim Maisch
- Department of Dermatology, University Medical Center Regensburg Regensburg, Germany
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Figueiredo RA, Anami LC, Mello I, Carvalho EDS, Habitante SM, Raldi DP. Tooth Discoloration Induced by Endodontic Phenothiazine Dyes in Photodynamic Therapy. Photomed Laser Surg 2014; 32:458-62. [DOI: 10.1089/pho.2014.3722] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
| | - Lilian Costa Anami
- Department of Dental Materials and Prosthodontics, Institute of Science and Technology, UNESP – São Paulo State University, São Jose dos Campos, São Paulo, Brazil
| | - Isabel Mello
- Department of Restorative Dentistry, Division of Endodontology, University of Manitoba, Winnipeg, Manitoba, Canada
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Photodynamic killing of Enterococcus faecalis in dentinal tubules using mTHPC incorporated in liposomes and invasomes. Clin Oral Investig 2014; 19:373-84. [DOI: 10.1007/s00784-014-1271-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 06/09/2014] [Indexed: 10/25/2022]
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Du T, Wang Z, Shen Y, Ma J, Cao Y, Haapasalo M. Effect of Long-term Exposure to Endodontic Disinfecting Solutions on Young and Old Enterococcus faecalis Biofilms in Dentin Canals. J Endod 2014; 40:509-14. [DOI: 10.1016/j.joen.2013.11.026] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Revised: 11/20/2013] [Accepted: 11/23/2013] [Indexed: 01/12/2023]
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Pourabbas R, Kashefimehr A, Rahmanpour N, Babaloo Z, Kishen A, Tenenbaum HC, Azarpazhooh A. Effects of photodynamic therapy on clinical and gingival crevicular fluid inflammatory biomarkers in chronic periodontitis: a split-mouth randomized clinical trial. J Periodontol 2014; 85:1222-9. [PMID: 24527853 DOI: 10.1902/jop.2014.130464] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND There are limited clinical experiments addressing the effects of photodynamic therapy (PDT) as an adjunct to conventional scaling and root planing (SRP) on clinical and biologic features of periodontitis. This trial compares the clinical parameters and cytokine profiles in gingival crevicular fluid of patients with moderate-to-severe chronic periodontitis (CP) who have been treated using SRP alone or SRP + PDT. METHODS Twenty-two patients with two contralateral teeth affected with moderate-to-severe CP were selected. After SRP, the participants' teeth were randomized to receive either no further treatment or a single application of PDT using a 638-nm laser and toluidine blue. Although the change in probing depth was the primary outcome, bleeding on probing, clinical attachment level, gingival recession, interleukin-1β, tumor necrosis factor (TNF)-α, and matrix metalloproteinase 8 and 9 were also evaluated at baseline and 3 months postintervention. An oral rinse assay was also performed to determine the total levels of oral polymorphonuclear cells (PMNs) before and 3 months after the treatments. RESULTS Within each group, significant improvements (P <0.001) were found for all variables in 3-month follow-up compared with baseline. Only TNF-α was significantly improved in the PDT + SRP versus SRP group. Total levels of PMNs were reduced for all patients compared with baseline levels (P <0.001). CONCLUSION In patients with CP, a single application of PDT (using a 638-nm laser and toluidine blue) did not provide any additional benefit to SRP in terms of clinical parameters or inflammatory markers 3 months following the intervention.
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Affiliation(s)
- Reza Pourabbas
- Dental and Periodontal Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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A. S. Arneiro R, D. Nakano R, A. A. Antunes L, B. Ferreira G, B. F. C. Fontes K, S. Antunes L. Efficacy of antimicrobial photodynamic therapy for root canals infected with Enterococcus faecalis. J Oral Sci 2014; 56:277-85. [DOI: 10.2334/josnusd.56.277] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Siddiqui SH, Awan KH, Javed F. Bactericidal efficacy of photodynamic therapy against Enterococcus faecalis in infected root canals: A systematic literature review. Photodiagnosis Photodyn Ther 2013; 10:632-43. [DOI: 10.1016/j.pdpdt.2013.07.006] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 07/27/2013] [Accepted: 07/30/2013] [Indexed: 01/10/2023]
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