title: The efficacy of photon-initiated photoacoustic streaming and sonic-activated irrigation combined with QMiX solution or sodium hypochlorite against intracanal E. faecalis biofilm.
abstract: The aim of the study was to assess the antibacterial efficacy of photon-initiated photoacoustic streaming (PIPS) using an Er:YAG laser and sonic-activated irrigation combined with QMiX irrigant or sodium hypochlorite against Enterococcus faecalis intracanal biofilm. Root canals of 91 human extracted single-canal teeth were instrumented, sterilized, contaminated with E. faecalis and incubated for 15 days. The infected teeth were then randomly distributed into six experimental groups: G1: PIPS/Er:YAG laser (wavelength 2940 nm, pulse energy 20 mJ, 15 Hz, pulse duration 50 μs, energy density 2.06 J/cm(2), 3 × 20 s) with the QMiX irrigant; G2: PIPS/Er:YAG laser-activated 2.5 % NaOCl; G3 sonic-activated irrigation (EndoActivator system) for 60 s with the QMiX irrigant; G4 sonic-activated irrigation for 60 s with 2.5 % NaOCl; G5 30-gauge needle irrigation with the QMiX irrigant; G6 30-gauge needle irrigation with 2.5 % NaOCl. The positive control group was rinsed with sterile saline solution. The root canals were sampled by flushing with saline solution at baseline and after the treatments, serially diluted and cultured. The number of bacteria in each canal was determined by plate count. The presence and the absence of E. faecalis in root canals were demonstrated by polymerase chain reaction (PCR), and the pattern of the bacteria colonization was visualized by scanning electron microscopy. There was significant reduction in the bacterial population for all groups (p < 0.001). The best antibacterial efficacy was recorded after sonic-activated irrigation with both NaOCl (99.999 %) and QMiX (99.999 %) and after PIPS with QMiX (99.999 %), which were more effective than conventional irrigation with NaOCl (99.998 %) and the PIPS with the NaOCl (99.966 %). Also, the PIPS with QMiX solution provided the highest number of sterile samples (five). There was no difference in the bacteria reduction between the active irrigation techniques, regardless of the irrigant used. Although the laser activation did not improve the antimicrobial action of the NaOCl nor QMiX, the fact that it generated the greatest number of sterile samples warrants further investigation.
authors.affiliation: Student of the School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: M
authors.initials: M
authors.lastname: Balić
authors.affiliation: Student of the School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: R
authors.initials: R
authors.lastname: Lucić
authors.affiliation: Student of the School of Dental Medicine, University of Zagreb, Zagreb, Croatia.
authors.forename: K
authors.initials: K
authors.lastname: Mehadžić
authors.affiliation: Department of Endodontics and Restorative Dentistry School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10 000, Zagreb, Croatia. bago@sfzg.hr.
authors.forename: I
authors.initials: I
authors.lastname: Bago
authors.affiliation: Department of Endodontics and Restorative Dentistry School of Dental Medicine, University of Zagreb, Gunduliceva 5, 10 000, Zagreb, Croatia.
authors.forename: I
authors.initials: I
authors.lastname: Anić
authors.affiliation: Department of Materials, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, 10 000, Zagreb, Croatia.
authors.forename: S
authors.initials: S
authors.lastname: Jakovljević
authors.affiliation: Microbiology Department, University Hospitals of Morecambe Bay, Lancaster, UK.
authors.forename: V
authors.initials: V
authors.lastname: Plečko
mesh_terms: D001645:Biguanides / Q000494:pharmacology*; D018441:Biofilms / Q000187:drug effects* / Q000528:radiation effects; D003786:Dental Pulp Cavity / Q000382:microbiology*; D004347:Drug Interactions; D013293:Enterococcus faecalis / Q000187:drug effects / Q000502:physiology* / Q000528:radiation effects; D006801:Humans; D053844:Lasers, Solid-State; D017785:Photons; D011108:Polymers / Q000494:pharmacology*; D012388:Root Canal Irrigants / Q000494:pharmacology; D012973:Sodium Hypochlorite / Q000494:pharmacology*; D012996:Solutions; D000069453:Ultrasonic Waves
chemical_list: D001645:Biguanides; D011108:Polymers; C557698:QMix root canal irrigant; D012388:Root Canal Irrigants; D012996:Solutions; D012973:Sodium Hypochlorite
keywords: Enterococcus faecalis; Laser-activated irrigation; PIPS; Sonic irrigation