Comparison of final disinfection protocols using antimicrobial photodynamic therapy and different irrigants after single-file reciprocating instrumentation against intracanal bacterial biofilm - An in vitro study

Photodiagnosis Photodyn Ther. 2018 Dec:24:153-157. doi: 10.1016/j.pdpdt.2018.10.006. Epub 2018 Oct 9.

Abstract

Background: The aim of the study was to compare the efficacy of antimicrobial photodynamic therapy (aPDT) with irrigation protocols that include sodium hypochlorite (NaOCl), ethylenediaminotetraacetic acid (EDTA) or QMiX (combined irrigant: EDTA, chlorhexidine, detergent) solution after single-file reciprocating root canal instrumentation.

Methods: The study sample included 68 extracted mandibular human single canal teeth. The canals were inoculated with bacterial suspension made of wild strain of Enterococcus faecalis. After 17 days of incubation, the samples were assigned to experimental groups according to the final disinfection protocol and a control group. The root canals in all groups were, firstly, instrumented with Wave One Gold reciprocating system. Then the canals were disinfected as follows: Group 1. 2.5% NaOCl and EDTA followed by the application of the aPDT; Group 2. 2.5% NaOCl, EDTA and 2.5% NaOCl; Group 3. 2.5% NaOCl and QMIX solution; Group 4. 2.5% NaOCl and EDTA. In the control group, the canals were irrigated with saline solution. Microbiological samples were collected at baseline, after single-file instrumentation and after the final disinfection protocols. The samples were plated onto Mitis Salivarius agar plates for incubation. The colony forming units (CFUs) were counted, and the final number was determined based on the dilution factor.

Results: Reciprocating single-file instrumentation reduced CFUs significantly in all groups (p<0.05). No significant difference between Group 1 and Group 2 was observed (p=0.178). Irrigation with the QMiX was more efficient than the aPDT (p=0.02).

Conclusions: The aPDT used after irrigation with NaOCl and EDTA demonstrated similar antimicrobial efficacy as conventional irrigation with NaOCl.

Keywords: Antimicrobial photodynamic therapy; Irrigation; Photodynamic therapy; QMIX; Sodium hypochlorite.

MeSH terms

  • Biguanides / pharmacology
  • Biofilms / drug effects*
  • Combined Modality Therapy
  • Edetic Acid / pharmacology
  • Enterococcus faecalis / drug effects*
  • Humans
  • Phenothiazines / pharmacology
  • Photochemotherapy / methods*
  • Photosensitizing Agents / pharmacology
  • Polymers / pharmacology
  • Random Allocation
  • Root Canal Irrigants / pharmacology*
  • Root Canal Preparation / methods*
  • Sodium Hypochlorite / pharmacology

Substances

  • Biguanides
  • Phenothiazines
  • Photosensitizing Agents
  • Polymers
  • QMix root canal irrigant
  • Root Canal Irrigants
  • Edetic Acid
  • Sodium Hypochlorite
  • phenothiazine