445/970nm 半导体激光对体外人牙根管内混合生物膜的光激活和光热效应：一项初步研究。
The photo-activated and photo-thermal effect of the 445/970 nm diode laser on the mixed biofilm inside root canals of human teeth in vitro: A pilot study.
机构信息
Department of Endodontics and Restorative Dentistry, School of Dental Medicine, University of Zagreb, Gundulićeva 5, 10000, Zagreb, Croatia.
Department of Clinical and Molecular Microbiology, University Hospital Centre Zagreb, Kišpatićeva 12, 10000, Zagreb, Croatia.
出版信息
Photodiagnosis Photodyn Ther. 2019 Jun;26:277-283. doi: 10.1016/j.pdpdt.2019.04.014. Epub 2019 Apr 14.
AIMS
- Evaluation of the photo-thermal (PT) and photo-activated (PAD) antibacterial effect of the 445/970 nm diode laser on E. faecalis, S. aureus and C. albicans mixed biofilms grown together inside root canals of human teeth. 2) Defining a potentially efficient clinical protocol for safe and predictable usage in endodontic procedures.
METHODOLOGY
The root canals of 100 extracted human teeth with single straight canals were prepared with ProTaper NEXT files, sterilized, contaminated with a combination of three cultures (E. faecalis, S. aureus, C. albicans) and incubated for 15 days. The samples were randomly distributed into three groups (n = 20) and treated as follows: Group 1 (G1) - the 445 nm photo-thermal (PT) effect, Group 2 (G2) - a combination of the 445 nm and 970 nm PT effect, Group 3 (G3) - the 445 nm photo-activated (PAD) effect with 0.1% riboflavin, Group 4 (G4) - a combination of 3% sodium hypochlorite (NaOCl) and the 445 nm PAD effect. Four samples were used as positive control (non-treated) and four as a negative control. 12 aditional samples were used as a control for the G4 (3% NaOCl rinse without the laser). The number of viable microbes in each canal was determined by the colony forming unit (CFU) count.
RESULTS
A statistically significant reduction in the microbial population after all treatments was observed (P < 0.001). Groups 2 and 3 showed similar results, both better than Group 1. Group 4 produced the best results.
CONCLUSIONS
The 445 nm PAD protocol has a stronger antimicrobial effect than the 445 nm PT protocol. Prolonged exposure time to laser light and a combination of wavelengths (445/970 PT protocol) helps in the reduction of microbes. C. albicans appears to be more sensitive to laser irradiation than the other bacteria tested in this study. Following current results, tested laser protocols could be recommended for clinical usage but only as an adjunct to "classic" NaOCl rinse since alone they are not able to completely eradicate all microorganisms.
目的
1）评估 445/970nm 二极管激光对粪肠球菌、金黄色葡萄球菌和白色念珠菌混合生物膜的光热（PT）和光激活（PAD）抗菌效果，这些生物膜共同生长在人类牙齿的根管内。2）定义一种潜在有效的临床方案，以确保在牙髓治疗过程中的安全和可预测性。
方法
用 ProTaper NEXT 锉对 100 颗具有单一直根管的人离体牙进行根管预备，经消毒，用三种细菌（粪肠球菌、金黄色葡萄球菌、白色念珠菌）的混合物污染，并孵育 15 天。将样本随机分为三组（每组 20 个样本），并进行如下处理：组 1（G1）-445nm 光热（PT）效应，组 2（G2）-445nm 和 970nm PT 联合效应，组 3（G3）-0.1%核黄素的 445nm 光激活（PAD）效应，组 4（G4）-3%次氯酸钠（NaOCl）和 445nm PAD 联合效应。四个样本作为阳性对照（未处理），四个样本作为阴性对照。另外 12 个样本作为 G4（无激光冲洗的 3%NaOCl）的对照。通过菌落形成单位（CFU）计数确定每个根管中存活微生物的数量。
结果
所有处理后，微生物数量均有统计学显著减少（P<0.001）。组 2 和组 3 的结果相似，均优于组 1。组 4 的效果最好。
结论
445nm PAD 方案比 445nm PT 方案具有更强的抗菌效果。延长激光照射时间和联合波长（445/970nm PT 方案）有助于减少微生物。与本研究中测试的其他细菌相比，白色念珠菌似乎对激光照射更敏感。根据目前的结果，测试的激光方案可以推荐用于临床应用，但只能作为“经典”NaOCl 冲洗的辅助手段，因为单独使用它们不能完全消除所有微生物。
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