Antimicrobial photodynamic therapy combined with conventional endodontic treatment to eliminate root canal biofilm infection
Aguinaldo S. Garcez DDS
Center for Lasers and Applications, IPEN-CNEN/SP, São Paulo, SP, Brazil
Search for more papers by this authorMartha S. Ribeiro PhD
Center for Lasers and Applications, IPEN-CNEN/SP, São Paulo, SP, Brazil
Search for more papers by this authorGeorge P. Tegos PhD
Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
Department of Dermatology, Harvard Medical School, Boston, Massachusetts
Search for more papers by this authorSilvia C. Núñez DDS
Center for Lasers and Applications, IPEN-CNEN/SP, São Paulo, SP, Brazil
Search for more papers by this authorAntonio O.C. Jorge PhD
School of Dentistry, Universidade de Taubaté, Taubaté, São Paulo, SP, Brazil
Search for more papers by this authorCorresponding Author
Michael R. Hamblin PhD
Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
Department of Dermatology, Harvard Medical School, Boston, Massachusetts
Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts
BAR414, Wellman Center for Photomedicine, Massachusetts General Hospital, 40 Blossom Street, Boston, MA 02114.Search for more papers by this authorAguinaldo S. Garcez DDS
Center for Lasers and Applications, IPEN-CNEN/SP, São Paulo, SP, Brazil
Search for more papers by this authorMartha S. Ribeiro PhD
Center for Lasers and Applications, IPEN-CNEN/SP, São Paulo, SP, Brazil
Search for more papers by this authorGeorge P. Tegos PhD
Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
Department of Dermatology, Harvard Medical School, Boston, Massachusetts
Search for more papers by this authorSilvia C. Núñez DDS
Center for Lasers and Applications, IPEN-CNEN/SP, São Paulo, SP, Brazil
Search for more papers by this authorAntonio O.C. Jorge PhD
School of Dentistry, Universidade de Taubaté, Taubaté, São Paulo, SP, Brazil
Search for more papers by this authorCorresponding Author
Michael R. Hamblin PhD
Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts
Department of Dermatology, Harvard Medical School, Boston, Massachusetts
Harvard-MIT Division of Health Sciences and Technology, Cambridge, Massachusetts
BAR414, Wellman Center for Photomedicine, Massachusetts General Hospital, 40 Blossom Street, Boston, MA 02114.Search for more papers by this authorAbstract
Background and 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.
Study Design/Materials and 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-µ 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. Lasers Surg. Med. © 2006 Wiley-Liss, Inc.
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