Abstract
Objective: The purpose of this study was to evaluate, in vitro, the effectiveness of photodynamic therapy and sodium hypochlorite over root canal system infected with Enterococcus faecalis.Methods: The root canals of 45 single-rooted human extracted teeth were enlarged up to a file 60, autoclaved, inoculated with Enterococcus faecalis and incubated for 30 days. The samples were divided into five groups (G1 – n=5; G2-G5 – n=10) according to the protocol of decontamination: G1 (negative control) – no procedure was performed; G2 – distilled water; G3 – hotodynamictherapy (PDT); G4 – 2.5% sodium hypochlorite (NaOCl); and G5 – 2.5% NaOCl+PDT. Scanning electron microscopy (SEM) were performed to evaluate the effectiveness of proposed treatments. The assessment was made by images of each third at 5000x magnification for the canal wall and 10000x for the exposed tubule area. The presence of bacteria was scored by position ranks from 1 to 45, where the higher the value, the cleanliness of the sample. Data were subjected to one-way ANOVA followed by post-hoc Tukey test (α=0.05).Results: Group 4 (2.5% NaOCl) and 5 (2.5% NaOCl + PDT) had the highest mean of position ranks for all thirds of the root canal in the canal wall, which was statistically different from groups 1, 2 and 3 (p<0.05). Group 3 (PDT), group 4 (2.5% NaOCl) and 5 (2.5% NaOCl+PDT) had the highest mean of position ranks in the exposed tubule area, which was statistically different from groups 1 and 2 (p<0.05).Conclusion: the association of 2.5% sodium hypochlorite + photodynamic therapy can be considered an effective protocol for the elimination of Enterococcus faecalis.
Highlights
Microorganisms and their products are the main aetiological factor of pulpal and periapical pathologies [1,2]
Due to the anatomical complexity of the root canal system, organic tissues and some bacteria such as Enterococcus faecalis, which are located at depth in the dentinal tubules, as well as in isthmus and ramification areas, cannot always be reached [6]
In all thirds of root canals, group 4 (2.5% NaOCl) and 5 (2.5% NaOCl+photodynamic therapy (PDT)) had the highest mean of position ranks in the canal wall, which was statistically different from groups 1, 2 and 3 (p
Summary
Microorganisms and their products are the main aetiological factor of pulpal and periapical pathologies [1,2]. Enterococcus faecalis is an anaerobic facultative microorganism, which is highly resistant to conventional chemo-mechanical preparation and is usually found in cases of failure of root canal treatment [7]. This microorganism has several virulence factors and the ability to withstand prolonged periods of nutrient limitation, persisting as a pathogen in the root canal [8,9]. Sodium hypochlorite is the most commonly used root canal irrigant into root canal therapy, due its broad antimicrobial spectrum [10,11,12] and its ability to promote organic tissue dissolution [13,14]. Because of the adverse effects of this irrigant, researchers have developed alternative resources in order to promote decontamination of root canal system
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