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利用细菌自体荧光实时检测牙髓感染。

Real-time optical detection of endodontic infection using bacterial autofluorescence.

机构信息

Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea.

Department of Preventive Dentistry & Public Oral Health, BK21 FOUR Project, Yonsei University College of Dentistry, Seoul, Korea; Department of Preventive Dentistry, Academic Centre for Dentistry Amsterdam, Amsterdam, The Netherlands; Inspektor Research Systems BV, Amsterdam, The Netherlands.

出版信息

J Dent. 2023 Sep;136:104600. doi: 10.1016/j.jdent.2023.104600. Epub 2023 Jun 29.

DOI:10.1016/j.jdent.2023.104600

PMID:37392816

Abstract

OBJECTIVES

For successful root canal treatment (RCT), it is essential to objectively assess the presence and activity of bacteria in the root canal system. However, current methods rely on subjective observations of root canal exudates. This study aimed to confirm whether real-time optical detection using bacterial autofluorescence can evaluate endodontic infection status by assessing the red fluorescence (RF) detected from root canal exudates.

METHODS

During RCT, endodontic paper points were used to collect root canal exudates scored using conventional organoleptic tests to assess the severity of root canal infections. RF on the paper points was assessed using quantitative light-induced fluorescence (QLF) technology. RF intensity and area from the paper points were quantified, and their correlations with infection severity were assessed using their organoleptic scores. The oral microbiome composition of RF samples was compared with non-red fluorescent (non-RF) samples.

RESULTS

The RF detection rate was nil and >98% in the non-infectious and severe groups. The RF intensity and area significantly increased with infection severity (p<0.001) and showed strong correlations with organoleptic scores (r=0.72, 0.82, respectively). The diagnostic accuracy for detecting root canal infection using RF intensity was good to excellent (AUC = 0.81-0.95) and increased with infection severity. The microbial diversity of the RF samples was significantly lower than that of the non-RF samples. Gram-negative anaerobic bacteria such as Prevotella and Porphyromonas were more predominant in RF samples.

CONCLUSIONS

Optical detection using bacterial autofluorescence can objectively evaluate endodontic infection status in real-time by assessing the RF of endodontic root canal exudates.

CLINICAL SIGNIFICANCE

This real-time optical technology can be utilised to detect endodontic bacterial infection without conventional incubation, allowing clinicians to determine the endpoint of chemomechanical debridement and increase the positive outcomes of RCTs.

摘要

目的

为了实现成功的根管治疗（RCT），客观评估根管系统中细菌的存在和活性至关重要。然而，目前的方法依赖于对根管渗出物的主观观察。本研究旨在通过评估从根管渗出物中检测到的红色荧光（RF），证实使用细菌自发荧光的实时光学检测是否可以通过评估根管感染状态。

方法

在 RCT 期间，使用根管纸尖收集使用传统感官测试评估根管感染严重程度的根管渗出物。使用定量光致荧光（QLF）技术评估纸尖上的 RF。对纸尖上的 RF 强度和面积进行量化，并评估它们与感染严重程度的感官评分之间的相关性。比较 RF 样本与非红色荧光（非-RF）样本的口腔微生物组组成。

结果

非感染和严重组的 RF 检测率均为零和>98%。RF 强度和面积随着感染严重程度的增加而显著增加（p<0.001），与感官评分呈强相关性（r=0.72，0.82）。使用 RF 强度检测根管感染的诊断准确性良好到优秀（AUC=0.81-0.95），并且随着感染严重程度的增加而提高。RF 样本的微生物多样性明显低于非-RF 样本。RF 样本中更主要的革兰氏阴性厌氧菌如普雷沃菌属和卟啉单胞菌属。