title: Photodynamic therapy versus ultrasonic irrigation: interaction with endodontic microbial biofilm, an ex vivo study.
abstract: BACKGROUND
  Photodynamic therapy was introduced as an adjuvant to conventional chemo-mechanical debridement during endodontic treatment to overcome the persistence of biofilms. The aim of this study was to evaluate the ability of photodynamic therapy (PDT) to disrupt an experimental microbial biofilm inside the root canal in a clinically applicable working time.
  
  
  METHODS
  Thirty extracted teeth were prepared and then divided in three groups. All samples were infected with an artificially formed biofilm made of Enterococcus faecalis, Streptococcus salivarius, Porphyromonas gingivalis and Prevotella intermedia bacteria. First group was treated with Aseptim Plus® photo-activated (LED) disinfection system, second group by a 650 nm Diode Laser and Toluidine blue as photosensitizer, and the third group, as control group, by ultrasonic irrigation (PUI) using EDTA 17% and NaOCl 2.6% solutions. The working time for all three groups was fixed at 3 min. Presence or absence of biofilm was assessed by aerobic and anaerobic cultures.
  
  
  RESULTS
  There was no statistically significant difference between results obtained from groups treated by Aseptim Plus® and Diode Laser (P<0.6267). In cultures of both groups there was a maximal bacterial growth. The group that was treated by ultrasonic irrigation and NaOCl and EDTA solutions had the best results (P<0.0001): there was a statistically significant reduction of bacterial load and destruction of microbial biofilm.
  
  
  CONCLUSIONS
  Under the condition of this study, Photodynamic therapy could not disrupt endodontic artificial microbial biofilm and could not inhibit bacterial growth in a clinically favorable working time.
authors.affiliation: Laboratory of Oral Health and Aging, URE 001, Faculty of Dentistry, 24, Avenue des Diables Bleus, 06357 Nice Cedex 4, France.
authors.forename: Omid H
authors.initials: OH
authors.lastname: Muhammad
authors.affiliation: Laboratory of Oral Health and Aging, URE 001, Faculty of Dentistry, 24, Avenue des Diables Bleus, 06357 Nice Cedex 4, France.
authors.forename: Marlene
authors.initials: M
authors.lastname: Chevalier
authors.affiliation: Laboratory of Oral Health and Aging, URE 001, Faculty of Dentistry, 24, Avenue des Diables Bleus, 06357 Nice Cedex 4, France; Restorative Dentistry and Endodontics Department, Faculty of Dentistry, University of Nice-Sophia Antipolis, 24, Avenue des Diables Bleus, 06357 Nice Cedex 4, France; Pôle Odontologie, CHU Nice Saint Roch, 5 rue Pierre Devoluy, 06000 Nice, France.
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Rocca
authors.affiliation: Laboratory of Oral Health and Aging, URE 001, Faculty of Dentistry, 24, Avenue des Diables Bleus, 06357 Nice Cedex 4, France; Restorative Dentistry and Endodontics Department, Faculty of Dentistry, University of Nice-Sophia Antipolis, 24, Avenue des Diables Bleus, 06357 Nice Cedex 4, France; Pôle Odontologie, CHU Nice Saint Roch, 5 rue Pierre Devoluy, 06000 Nice, France.
authors.forename: Nathalie
authors.initials: N
authors.lastname: Brulat-Bouchard
authors.affiliation: Laboratory of Oral Health and Aging, URE 001, Faculty of Dentistry, 24, Avenue des Diables Bleus, 06357 Nice Cedex 4, France; Restorative Dentistry and Endodontics Department, Faculty of Dentistry, University of Nice-Sophia Antipolis, 24, Avenue des Diables Bleus, 06357 Nice Cedex 4, France; Pôle Odontologie, CHU Nice Saint Roch, 5 rue Pierre Devoluy, 06000 Nice, France. Electronic address: etienne.medioni@unice.fr.
authors.forename: Etienne
authors.initials: E
authors.lastname: Medioni
mesh_terms: D058491:Bacterial Load / Q000187:drug effects / Q000528:radiation effects; D018441:Biofilms / Q000187:drug effects* / Q000254:growth & development / Q000528:radiation effects; D003786:Dental Pulp Cavity / Q000187:drug effects / Q000382:microbiology* / Q000528:radiation effects; D004203:Disinfection / Q000379:methods*; D004708:Endodontics / Q000379:methods; D006801:Humans; D066298:In Vitro Techniques; D010778:Photochemotherapy / Q000379:methods*; D017319:Photosensitizing Agents / Q000627:therapeutic use; D007507:Therapeutic Irrigation / Q000379:methods*; D014048:Tolonium Chloride / Q000627:therapeutic use*; D016896:Treatment Outcome; D014464:Ultrasonic Therapy / Q000379:methods*
chemical_list: D017319:Photosensitizing Agents; D014048:Tolonium Chloride
keywords: Biofilm; Passive ultrasonic irrigation; Photodynamic therapy; Photosensitizer; Root canal disinfection