Antimicrobial photodynamic therapy combined with conventional endodontic treatment to eliminate root canal biofilm infection.
OBJECTIVE
To compare the effectiveness of antimicrobial photodynamic therapy (PDT), standard endodontic treatment and the combined treatment to eliminate bacterial biofilms present in infected root canals.


METHODS
Ten single-rooted freshly extracted human teeth were inoculated with stable bioluminescent Gram-negative bacteria, Proteus mirabilis and Pseudomonas aeruginosa to form 3-day biofilms in prepared root canals. Bioluminescence imaging was used to serially quantify bacterial burdens. PDT employed a conjugate between polyethylenimine and chlorin(e6) as the photosensitizer (PS) and 660-nm diode laser light delivered into the root canal via a 200-micro fiber, and this was compared and combined with standard endodontic treatment using mechanical debridement and antiseptic irrigation.


RESULTS
Endodontic therapy alone reduced bacterial bioluminescence by 90% while PDT alone reduced bioluminescence by 95%. The combination reduced bioluminescence by >98%, and importantly the bacterial regrowth observed 24 hours after treatment was much less for the combination (P<0.0005) than for either single treatment.


CONCLUSIONS
Bioluminescence imaging is an efficient way to monitor endodontic therapy. Antimicrobial PDT may have a role to play in optimized endodontic therapy.
Garcez
Aguinaldo S
AS
Center for Lasers and Applications, IPEN-CNEN/SP, São Paulo, SP, Brazil.
Ribeiro
Martha S
MS
Tegos
George P
GP
Núñez
Silvia C
SC
Jorge
Antonio O C
AO
Hamblin
Michael R
MR
D000890:Anti-Infective Agents / Q000627:therapeutic use*; D018441:Biofilms / Q000187:drug effects; D002735:Chlorophyllides; D003786:Dental Pulp Cavity / Q000187:drug effects* / Q000382:microbiology*; D003788:Dental Pulp Diseases / Q000628:therapy*; D004708:Endodontics / Q000379:methods; D006801:Humans; D049449:Luminescence; D010778:Photochemotherapy; D011094:Polyethyleneimine / Q000627:therapeutic use; D011166:Porphyrins / Q000627:therapeutic use; D011512:Proteus Infections / Q000188:drug therapy; D011513:Proteus mirabilis / Q000502:physiology; D011552:Pseudomonas Infections / Q000188:drug therapy; D011550:Pseudomonas aeruginosa / Q000502:physiology
D000890:Anti-Infective Agents; D002735:Chlorophyllides; D011166:Porphyrins; C062985:phytochlorin; D011094:Polyethyleneimine