Garcez Aguinaldo S, Ribeiro Martha S, Tegos George P, Núñez Silvia C, Jorge Antonio O C, Hamblin Michael R
Center for Lasers and Applications, IPEN-CNEN/SP, São Paulo, SP, Brazil.
Lasers Surg Med. 2007 Jan;39(1):59-66. doi: 10.1002/lsm.20415.
To compare the effectiveness of antimicrobial photodynamic therapy (PDT), standard endodontic treatment and the combined treatment to eliminate bacterial biofilms present in infected root canals.
STUDY DESIGN/MATERIALS AND METHODS: Ten single-rooted freshly extracted human teeth were inoculated with stable bioluminescent Gram-negative bacteria, Proteus mirabilis and Pseudomonas aeruginosa to form 3-day biofilms in prepared root canals. Bioluminescence imaging was used to serially quantify bacterial burdens. PDT employed a conjugate between polyethylenimine and chlorin(e6) as the photosensitizer (PS) and 660-nm diode laser light delivered into the root canal via a 200-micro fiber, and this was compared and combined with standard endodontic treatment using mechanical debridement and antiseptic irrigation.
Endodontic therapy alone reduced bacterial bioluminescence by 90% while PDT alone reduced bioluminescence by 95%. The combination reduced bioluminescence by >98%, and importantly the bacterial regrowth observed 24 hours after treatment was much less for the combination (P<0.0005) than for either single treatment.
Bioluminescence imaging is an efficient way to monitor endodontic therapy. Antimicrobial PDT may have a role to play in optimized endodontic therapy.
比较抗菌光动力疗法（PDT）、标准根管治疗以及联合治疗在清除感染根管内细菌生物膜方面的有效性。
研究设计/材料与方法：将10颗新鲜拔除的单根人牙接种稳定的生物发光革兰氏阴性菌奇异变形杆菌和铜绿假单胞菌，在预备好的根管中形成3天的生物膜。采用生物发光成像对细菌负荷进行连续定量。PDT使用聚乙烯亚胺与二氢卟吩（e6）的共轭物作为光敏剂（PS），通过200微米光纤将660纳米二极管激光导入根管，并将其与使用机械清创和抗菌冲洗的标准根管治疗进行比较和联合。
单纯根管治疗使细菌生物发光降低90%，而单纯PDT使生物发光降低95%。联合治疗使生物发光降低>98%，重要的是，治疗后24小时观察到的联合治疗组细菌再生长比单一治疗组少得多（P<0.0005）。
生物发光成像为监测根管治疗的有效方法。抗菌PDT在优化根管治疗中可能发挥作用。
