Department of Restorative Dentistry, Endodontic Division, São José dos Campos Dental School, State University of São Paulo, UNESP, Brazil.
Department of Restorative Dentistry, Endodontic Division, São José dos Campos Dental School, State University of São Paulo, UNESP, Brazil; University of Maryland-Baltimore, Department Oral Sciences & Therapeutics, School of Dentistry, Baltimore, Maryland 21201.
Photodiagnosis Photodyn Ther. 2017 Sep;19:205-211. doi: 10.1016/j.pdpdt.2017.06.005. Epub 2017 Jun 12.
To evaluate the effectiveness of supplemental photodynamic therapy (PDT) in optimizing the removal of bacteria and endotoxins from primarily infected root canals after one-visit and two-visit treatments.
Twenty-four primarily infected root canals with apical periodontitis were selected and randomly divided into one-visit (n=12) and two-visit treatment groups (n=12). Chemo-mechanical preparation (CMP) was performed by using the single-file reciprocating technique+2.5% NaOCL and a final rinse with 17% EDTA. The photosensitizer agent (methylene blue 0.1mg/mL) was applied to root canals for 60s before application of laser with a potency of 60mW and energy density of 129J/cm for 120s after CMP in the one-visit treatment and after 14-day inter-appointment medication with Ca(OH)+Saline solution (SSL) in the two-visit treatment. Samples were collected before and after root canal procedures. Endotoxins were quantified by chromogenic limulus amebocyte lysate assay. Culture techniques were used to determine bacterial colony-forming unit counts.
Bacteria and endotoxins were detected in 100% of the initial samples, with median values of 1.97×10 CFU/mL and 24.983EU/mL, respectively. The CMP using single-file reciprocating technique was effective in the reduction of bacteria and endotoxins (All, p<0.05). The supplemental PDT was effective in reducing bacterial load in the one-visit (p<0.05) but not in the two-visit treatment after use of Ca(OH) medication for 14days (p>0.05). In the two-visit group, after 14days of inter-appointment medication with Ca(OH), a significant reduction in the median levels of endotoxins was found in comparison to CMP alone (from 1.041 to 0.094EU/mL) (p<0.05). Despite the type of treatment, the supplemental PDT was not effective against endotoxins (p>0.05).
The photodynamic therapy optimized the disinfection of bacteria from root canals in one-visit but not for two visit treatment modality with the accomplishment of calcium hydroxide medication. Despite the type of treatment, the supplemental PDT was not effective against endotoxins.
评估补充光动力疗法（PDT）在一次就诊和两次就诊治疗后优化主要感染根管中细菌和内毒素清除的效果。
选择 24 例患有根尖周炎的主要感染根管，随机分为一次就诊（n=12）和两次就诊治疗组（n=12）。使用单文件往复技术+2.5%次氯酸钠进行化学机械预备，并用 17% EDTA 进行最终冲洗。在一次就诊治疗中，在 CMP 后将光敏剂（亚甲蓝 0.1mg/mL）应用于根管中 60s，然后在 CMP 后用功率为 60mW 和能量密度为 129J/cm 的激光照射 120s；在两次就诊治疗中，在 14 天的预约药物治疗（氢氧化钙+生理盐水溶液（SSL））后进行。在根管操作前后采集样本。通过显色鲎阿米巴细胞溶解物测定法定量内毒素。使用培养技术确定细菌菌落形成单位计数。
初始样本中 100%检测到细菌和内毒素，中位数分别为 1.97×10 CFU/mL 和 24.983EU/mL。使用单文件往复技术的 CMP 可有效减少细菌和内毒素（均，p<0.05）。补充 PDT 在一次就诊治疗中有效降低细菌负荷（p<0.05），但在两次就诊治疗中在使用氢氧化钙进行 14 天药物治疗后无效（p>0.05）。在两次就诊组中，在使用氢氧化钙进行 14 天预约药物治疗后，与单独 CMP 相比，内毒素的中位数水平显著降低（从 1.041 降至 0.094EU/mL）（p<0.05）。尽管治疗类型不同，补充 PDT 对内毒素无效（p>0.05）。
光动力疗法优化了一次就诊根管中细菌的消毒效果，但对于完成氢氧化钙药物治疗的两次就诊治疗方式无效。尽管治疗类型不同，补充 PDT 对内毒素无效。
