传统化学机械清创术单独使用和联合光活化消毒及激光照射对抗粪肠球菌生物膜的体外比较。
Ex vivo comparison of antibacterial efficacy of conventional chemomechanical debridement alone and in combination with light-activated disinfection and laser irradiation against Enterococcus faecalis biofilm.
机构信息
Endodontic Department, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran.
Microbiology Department, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
出版信息
Photodiagnosis Photodyn Ther. 2020 Mar;29:101648. doi: 10.1016/j.pdpdt.2019.101648. Epub 2020 Jan 2.
BACKGROUND AND OBJECTIVES
Intracanal disinfection plays an important role in endodontic treatment success. Enterococcus faecalis (E. faecalis) is a resistant microorganism responsible for endodontic infections. We aimed to assess the bactericidal effects of three disinfection methods on E. faecalis biofilm.
MATERIALS AND METHODS
Fifty-five freshly extracted single-rooted human teeth were evaluated. A barbed broach was used to extract the pulp tissue. No further root canal preparation was performed. Specimens were sterilized with gamma radiation, and inoculated with E. faecalis suspension. They were then incubated for 4 days and 4 weeks. Biofilm formation was confirmed using a scanning electron microscope (SEM). The teeth were randomly assigned to three subgroups (n = 7) to assess the antimicrobial efficacy of the following three disinfection methods against immature (4-day) and mature (4-week) biofilms: the conventional chemomechanical debridement (CCMD), CCMD + light-activated disinfection (LAD; 810 nm, 0.3 W, 120 J/cm) with indocyanine Green (EmunDo) as photosensitizer and CCMD + diode laser irradiation (810 nm, 2 W). The teeth were then longitudinally split into two halves and the colony count was reported as colony forming units (CFUs) to assess bacterial viability after each disinfection protocol.
RESULTS
None of the disinfection methods could completely remove the biofilm. CCMD + LAD caused the highest and CCMD + diode laser caused the lowest reduction in biofilm. Antibacterial efficacy was significantly lower against the mature (4-week) biofilm compared with immature (4-day) biofilm in all groups (P < 0.05).
CONCLUSION
All three disinfection methods were effective for partial elimination of E. faecalis biofilm. But CCMD + LAD was significantly more efficacious in decreasing both mature and immature biofilms.
背景与目的
根管内消毒在根管治疗成功中起着重要作用。粪肠球菌（E. faecalis）是一种耐药微生物，可导致根管感染。我们旨在评估三种消毒方法对粪肠球菌生物膜的杀菌效果。
材料与方法
评估了 55 颗新鲜拔出的单根人牙。使用有倒刺的扩孔锉提取牙髓组织。未进行进一步的根管预备。标本用伽马射线消毒，并用粪肠球菌悬浮液接种。然后将其孵育 4 天和 4 周。使用扫描电子显微镜（SEM）确认生物膜形成。将牙齿随机分为三组（n = 7），以评估以下三种消毒方法对未成熟（4 天）和成熟（4 周）生物膜的抗菌效果：常规化学机械清创术（CCMD），CCMD +光激活消毒（LAD；810nm，0.3W，120J/cm），使用吲哚菁绿（EmunDo）作为光敏剂和 CCMD +二极管激光照射（810nm，2W）。然后将牙齿纵向分为两半，报告菌落计数作为菌落形成单位（CFU），以评估每种消毒方案后细菌的活力。
结果
没有一种消毒方法可以完全清除生物膜。CCMD + LAD 导致生物膜减少最多，而 CCMD +二极管激光导致生物膜减少最少。与未成熟（4 天）生物膜相比，所有组中成熟（4 周）生物膜的杀菌效果明显降低（P <0.05）。
结论
三种消毒方法均可有效部分消除粪肠球菌生物膜。但 CCMD + LAD 对成熟和未成熟生物膜的减少效果均明显优于其他两种方法。
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