Chiniforush Nasim, Pourhajibagher Maryam, Shahabi Sima, Bahador Abbas
Laser Research Center of Dentistry (LRCD), Dental Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Department of Microbiology, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
J Lasers Med Sci. 2015 Fall;6(4):139-50. doi: 10.15171/jlms.2015.09. Epub 2015 Oct 27.
The main goal in endodontic treatment is to eradicate or at least reduce intraradicular microbial population to levels that are more compatible with periapical lesions healing process. Since endodontic infections are polymicrobial in nature, intraradicular survival of endodontic microbiota and their pathogenic properties are influenced by a combination of their virulence factors. The purpose of this article is to review the endodontic microbiota and their respective virulence attributes, as well as perform a literature review of the effects of disinfection procedures in the treatment of endodontic infections to gain best practices. Conventional technique for root canal preparation includes mechanical debridement and application of antimicrobial irrigants. Recently, laser irradiation has been used to enhance the results of root canal treatment through its thermal effect. To reduce thermal side effects, laser activated irrigation (LAI) and photon induced photoacoustic streaming (PIPS) were introduced. Antimicrobial photodynamic therapy (aPDT) by photochemical reaction uses light at a specific wavelength to activate a nontoxic photosensitizer (PS) in the presence of oxygen to produce cytotoxic products. Different PSs are used in dentistry including methylene blue (MB), toluidine blue O (TBO), indocyanine green (ICG) and curcumin. Among different options, ICG could be the best choice due to its peak absorption at wavelength of 808 nm, which coincides with the commercial diode laser devices. Also, this wavelength has more penetration depth compared to other wavelengths used in aPDT.
牙髓治疗的主要目标是根除或至少将根管内微生物数量减少到与根尖周病变愈合过程更相符的水平。由于牙髓感染本质上是多微生物的，根管内牙髓微生物群的存活及其致病特性受其毒力因子组合的影响。本文的目的是综述牙髓微生物群及其各自的毒力属性，并对消毒程序在牙髓感染治疗中的作用进行文献综述，以获取最佳实践方法。传统的根管预备技术包括机械清创和应用抗菌冲洗液。最近，激光照射已被用于通过其热效应提高根管治疗的效果。为了减少热副作用，引入了激光激活冲洗（LAI）和光子诱导光声流（PIPS）。通过光化学反应的抗菌光动力疗法（aPDT）在有氧存在的情况下使用特定波长的光来激活无毒的光敏剂（PS）以产生细胞毒性产物。牙科中使用了不同的PS，包括亚甲蓝（MB）、甲苯胺蓝O（TBO）、吲哚菁绿（ICG）和姜黄素。在不同的选择中，ICG可能是最佳选择，因为其在808nm波长处有峰值吸收，这与商用二极管激光设备一致。此外，与aPDT中使用的其他波长相比，该波长具有更大的穿透深度。
