Asnaashari Mohammad, Ashraf Hengameh, Rahmati Afsaneh, Amini Neda
Laser Application in Medical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Endodontic Department, Dental School, Shahid Beheshti University of Medical Science, Tehran, Iran.
Photodiagnosis Photodyn Ther. 2017 Mar;17:226-232. doi: 10.1016/j.pdpdt.2016.12.009. Epub 2016 Dec 28.
Insufficient root canal disinfection is one of the main reasons for persistent periapical pathology. Photodynamic therapy (PDT) has been proven effective in disinfecting infected root canals. The aim of this study was to evaluate the antimicrobial effect of photo activated disinfection (PAD) when using toluidine blue as photosensitizer and a LED lamp after the conventional treatment, and comparing it with calcium hydroxide therapy in vivo.
This clinical trial includes 20 patients with molars requiring endodontic retreatment. After the conventional treatment, first microbiological samples were obtained using sterile rotary ProTaper F2 file and 3 paper points and transferred to a microbiology laboratory. Group 1 (n=10) specimens underwent PAD with photosensitizer (PS) solution (0.1mg/mL TB) and irradiation with Fotosan light emitting diode (LED) lamp (635nm, 200mW/cm2) for 60s. Creamy Ca(OH)2 paste was used in group 2 (n=10) for two weeks. A second sample was then obtained. The samples were cultured and then bacterial colonies were counted. Data included number of colony forming units (CFUs) before and after treatments, analyzed by t-test and analysis of covariance (ANCOVA) using SPSS vs.18.
A significant difference between results of before and after treatment of both groups (calcium hydroxide therapy p=0.02<0.05, PAD p<0.0001) indicated the efficacy of both treatments. The mean numbers for log 10CFUs/mL before calcium hydroxide therapy and PAD with LED irradiation was 10.1968 and 11.3773. After treatment, the mean numbers were 9.4202 and 8.3772, respectively. The difference in results after treatment between groups was significant (p=0.01<0.05) and indicate that PAD was more effective.
PAD and calcium hydroxide therapy, as auxiliary methods adjunct to conventional root canal therapy, are both effective in root canal disinfection. In comparison with calcium hydroxide therapy, PAD leads to a greater reduction in enterococcus faecalis number in the infected root canals.
根管消毒不充分是根尖周病变持续存在的主要原因之一。光动力疗法（PDT）已被证明在感染根管消毒方面有效。本研究的目的是评估在传统治疗后使用甲苯胺蓝作为光敏剂和LED灯进行光活化消毒（PAD）的抗菌效果，并在体内将其与氢氧化钙疗法进行比较。
本临床试验纳入20例需要进行根管再治疗的磨牙患者。在传统治疗后，首先使用无菌旋转ProTaper F2锉和3个纸尖获取微生物样本，并转移至微生物实验室。第1组（n = 10）的样本用光敏剂（PS）溶液（0.1mg/mL TB）进行PAD，并用Fotosan发光二极管（LED）灯（635nm，200mW/cm2）照射60秒。第2组（n = 10）使用膏状氢氧化钙糊剂治疗两周。然后获取第二个样本。对样本进行培养，然后计算细菌菌落数。数据包括治疗前后的菌落形成单位（CFU）数量，使用SPSS 18.0通过t检验和协方差分析（ANCOVA）进行分析。
两组治疗前后的结果存在显著差异（氢氧化钙疗法p = 0.02<0.05，PAD p<0.0001），表明两种治疗方法均有效。氢氧化钙疗法和LED照射的PAD治疗前每毫升log10CFU的平均数分别为10.1968和11.3773。治疗后，平均数分别为9.4202和8.3772。两组治疗后的结果差异显著（p = 0.01<0.05），表明PAD更有效。
作为传统根管治疗辅助方法的PAD和氢氧化钙疗法在根管消毒方面均有效。与氢氧化钙疗法相比，PAD能使感染根管中的粪肠球菌数量有更大程度的减少。
