Department of Periodontology and Synoptic Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Int Endod J. 2018 Jan;51 Suppl 1:e23-e34. doi: 10.1111/iej.12763. Epub 2017 Apr 10.
To analyse the antibacterial effect of photodynamic therapy (PDT) in combination with various irrigation protocols on a multispecies biofilm in root canals ex vivo.
A total of 160 extracted human single-rooted teeth were divided into four groups (n = 40). In group G1, root canals were instrumented up to size 60 (control group), whereas in G2 to G4 canals were enlarged up to size 40. All root canals were inoculated with a multispecies biofilm (Enterococcus faecalis, Streptococcus oralis, Prevotella intermedia) for 5 days. In G2 to G4, instrumentation up to size 60 was performed using 0.9% sodium chloride (NaCl) (G2), 1% sodium hypochlorite (NaOCl) (G3), 1% NaOCl and a final irrigation with 2% chlorhexidine (CHX) (G4), respectively. In all groups half of the specimens received adjunctive PDT using phenothiazine chloride as photosensitizer and a diode laser (wavelength 660 nm). Counts of colony-forming units (CFUs) in each group were analysed separately for planktonic and dentine-adherent bacteria immediately after therapy (T1) and after 5 days of further incubation (T2). Descriptive statistics and two-way analysis of variance were carried out to analyse reduction of planktonic bacteria and nonparametric tests were used to analyse dentine-adherent bacteria.
CFU reduction in planktonic bacteria was significantly affected by the irrigation protocol at T1 and T2 (P < 0.0001), but PDT significantly reduced CFUs only at T2 (P = 0.01; anova). Irrigation using NaOCl, CHX and adjunctive PDT significantly reduced CFUs at T2 (P < 0.0001; Tukey HSD) compared to the control group. In 85.6% of all samples the same categories of CFU counts in both planktonic and dentine-adherent bacteria were detected at T1 and T2.
Adjunctive photodynamic therapy in combination with an irrigation protocol including NaOCl and CHX was an effective method for reduction of bacterial biofilm inside the root canals of extracted teeth.
分析光动力疗法（PDT）联合各种冲洗方案对体外根管内多菌种生物膜的抗菌效果。
共选取 160 颗离体人单根牙，分为 4 组（n=40）。在 G1 组，根管扩至 60 号（对照组），而在 G2 至 G4 组，根管扩至 40 号。所有根管均接种多菌种生物膜（粪肠球菌、口腔链球菌、中间普雷沃菌）5 天。在 G2 至 G4 组中，分别用 0.9%氯化钠（G2）、1%次氯酸钠（G3）、1%次氯酸钠和最后冲洗 2%洗必泰（G4）进行 60 号器械扩大。所有组的一半标本用氯化苯并噻嗪作为光敏剂和二极管激光（波长 660nm）进行辅助 PDT。对每组浮游和牙本质附着细菌的菌落形成单位（CFU）计数，分别在治疗后即刻（T1）和进一步孵育 5 天后（T2）进行分析。采用描述性统计和双向方差分析分析浮游细菌的减少，采用非参数检验分析牙本质附着细菌。
浮游细菌的 CFU 减少在 T1 和 T2 时受到冲洗方案的显著影响（P<0.0001），但 PDT 仅在 T2 时显著降低 CFU（P=0.01；方差分析）。与对照组相比，使用次氯酸钠、洗必泰和辅助 PDT 冲洗在 T2 时显著降低 CFU（P<0.0001；Tukey HSD）。在所有样本的 85.6%中，在 T1 和 T2 时检测到浮游和牙本质附着细菌的 CFU 计数相同类别。
在包括次氯酸钠和洗必泰的冲洗方案中联合辅助光动力疗法是减少离体牙根管内细菌生物膜的有效方法。
