Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, Rome, Italy.
Department of Public Health and Infectious Diseases, Microbiology Section, Sapienza University of Rome, Rome, Italy.
Photobiomodul Photomed Laser Surg. 2021 Jan;39(1):62-69. doi: 10.1089/photob.2020.4879. Epub 2020 Dec 17.
This study aimed to evaluate the efficacy of laser-activated irrigation using photon-induced photoacoustic streaming (PIPS) and photoactivated disinfection (PAD) techniques and their combination to improve penetration and activation of toluidine blue in the endodontic space of teeth experimentally infected with . Twenty-seven extracted single-root teeth were instrumented, sterilized, and infected with and divided into seven groups of three teeth each: Group A [sodium hypochlorite (NaClO) 5% hand irrigation], Group B [NaClO 5% hand irrigation+ethylenediaminetetraacetic acid (EDTA)+NaClO 5% activated by PIPS], Group C (EDTA+NaClO 5% activated by PIPS), Group D (toluidine blue activated by PAD), Group E (toluidine blue activated by PIPS and PAD), Group F (NaClO 5% hand irrigation+toluidine blue activated by PAD), and Group G (NaClO 5% hand irrigation+toluidine blue activated by PIPS and PAD). Finally, positive and negative group controls were prepared. The presence of biofilms after the treatments was assessed by the BioTimer assay. PIPS was performed with an Er:YAG laser (2940 nm, LightWalker, Fotona d.o.o., Slovenia) at 20 mJ, 15 Hz, 0.3 W, and 50-μs pulse duration. PAD was performed with a 635 nm diode laser (Smart M, Lasotronix, Poland) at 400 mW in continuous wave (CW). When NaClO was used, significant decontamination ( ≤ 0.05) was obtained in all experimental groups with respect to the positive control, other than Group G. Irrigation with EDTA+NaClO activated by PIPS produced a higher level of decontamination than Group A ( ≤ 0.05). Significant results in reducing biofilm load compared with the control and Group A were observed when NaClO was coupled with toluidine blue activated by PAD ( ≤ 0.05). Disinfection of root canals can be obtained using a combination of different irrigants, photosensitizers, and activation protocols. EDTA+NaClO using the PIPS protocol and toluidine blue activated by PAD (both preceded by NaClO irrigation) can be considered effective tools. The possibility of replacing NaClO with toluidine blue, whatever the method of activation, should be further investigated.
本研究旨在评估激光激活冲洗技术（光诱导光声流（PIPS）和光活化消毒（PAD））及其联合应用在经 实验感染的牙齿根管内提高甲苯胺蓝渗透和激活的效果。将 27 颗单根牙进行器械处理、消毒并感染 ，然后将其分为 7 组，每组 3 颗牙：组 A [次氯酸钠（NaClO）5%手动冲洗]、组 B [NaClO 5%手动冲洗+乙二胺四乙酸（EDTA）+NaClO 5%用 PIPS 激活]、组 C（EDTA+NaClO 5%用 PIPS 激活）、组 D（甲苯胺蓝用 PAD 激活）、组 E（甲苯胺蓝用 PIPS 和 PAD 激活）、组 F（NaClO 5%手动冲洗+甲苯胺蓝用 PAD 激活）和组 G（NaClO 5%手动冲洗+甲苯胺蓝用 PIPS 和 PAD 激活）。最后，制备阳性和阴性对照组。通过 BioTimer 测定评估治疗后生物膜的存在。用 Er:YAG 激光（2940nm，LightWalker，Fotona d.o.o.，斯洛文尼亚）以 20mJ、15Hz、0.3W 和 50-μs 脉冲持续时间进行 PIPS。用 635nm 二极管激光（Smart M，Lasotronix，波兰）以 400mW 在连续波（CW）下进行 PAD。当使用 NaClO 时，除组 G 外，所有实验组相对于阳性对照组均获得显著的去污效果（≤0.05）。用 PIPS 激活的 EDTA+NaClO 冲洗产生的去污水平高于组 A（≤0.05）。与对照组和组 A 相比，当 NaClO 与甲苯胺蓝用 PAD 激活（均先用 NaClO 冲洗）结合使用时，观察到生物膜载量显著降低（≤0.05）。可以使用不同的冲洗液、光敏剂和激活方案的组合获得根管消毒。可以考虑 EDTA+NaClO 与 PIPS 方案结合使用以及甲苯胺蓝用 PAD 激活（均先用 NaClO 冲洗）作为有效的工具。无论激活方法如何，用甲苯胺蓝替代 NaClO 的可能性都需要进一步研究。
