Does supplemental photodynamic therapy optimize the disinfection of bacteria and endotoxins in one-visit and two-visit root canal therapy? a randomized clinical trial

Publication date: Available online 12 June 2017
Source:Photodiagnosis and Photodynamic Therapy
Author(s): Diego G.D. Rabello, Bruna J.M. Corazza, Luciana L. Ferreira, Mauro P. Santamaria, Ana P.M. Gomes, Frederico C. Martinho
Aimto evaluate the effectiveness of supplemental photodynamic therapy (PDT) in optimizing the removal of bacteria and endotoxins from primarily infected root canals after one-visit and two-visit treatments.MethodologyTwenty-four primarily infected root canals with apical periodontitis were selected and randomly divided into one-visit (n=12) and two-visit treatment groups (n=12). Chemo-mechanical preparation (CMP) was performed by using the single-file reciprocating technique+2.5% NaOCL and a final rinse with 17% EDTA. The photosensitizer agent (methylene blue 0.1mg/mL) was applied to root canals for 60seconds before application of laser with a potency of 60mW and energy density of 129J/cm² for 120seconds after CMP in the one-visit treatment and after 14-day inter-appointment medication with Ca(OH)2+Saline solution (SSL) in the two-visit treatment. Samples were collected before and after root canal procedures. Endotoxins were quantified by chromogenic limulus amebocyte lysate assay. Culture techniques were used to determine bacterial colony-forming unit counts.ResultsBacteria and endotoxins were detected in 100% of the initial samples, with median values of 1.97×10⁵ CFU/mL and 24.983EU/mL, respectively. The CMP using single-file reciprocating technique was effective in the reduction of bacteria and endotoxins (All, p<.05). The supplemental PDT was effective in reducing bacterial load in the one-visit (p<.05) but not in the two-visit treatment after use of Ca(OH)2 medication for 14days (p>.05). In the two-visit group, after 14days of inter-appointment medication with Ca(OH)2, a significant reduction in the median levels of endotoxins was found in comparison to CMP alone (from 1.041 to 0.094EU/mL) (p<.05). Despite the type of treatment, the supplemental PDT was not effective against endotoxins (p>.05).Conclusionsthe photodynamic therapy optimized the disinfection of bacteria from root canals in one-visit but not for two visit treatment modality with the accomplishment of calcium hydroxide medication. Despite the type of treatment, the supplemental PDT was not effective against endotoxins.



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