The comparison of intracanal medicaments, diode laser and photodynamic therapy on removing the biofilm of Enterococcus faecalis and Candida albicans in the root canal system (ex-vivo study).

Abstract

Long term success in endodontic therapy is attributed to removal and debridement of intracanal microorganisms. The aim of this study was to compare the antimicrobial effects of calcium hydroxide (Ca(OH)2), triple antibiotic paste (TAP), photodynamic therapy(PDT), toluidine blue(TOL), light emitting diode (LED) and 940 nm diode laser (DL) on the biofilm of Enterococcus faecalis and Candida albicans in the root canal system of ex-vivo human teeth. 84 intact, uniradicular, extracted human premolar teeth were prepared and the apical foramina were sealed with glass ionomer. The samples were transformed to microtubes containing sterile BHI and were sterilized. After incubation of E. faecalis and C. albicans into the canals, the samples were kept in an incubator for 8 weeks to form the biofilm. Then the samples were randomly divided into 7 groups of 12, including: control and groups treated with Ca(OH)2,TAP, TOl, LED, PDT, and DL. Then the samples were fixed, gold coated and observed under scanning electron microscope (SEM). Significant reductions in biofilm thickness were noted in TAP,PDT and LED (P < 0.05). The greatest reduction in biofilm thickness was seen in TAP; however, the differences between TAP and PDT and LED were not significant (P > 0.05). Since one of the main purposes in root canal therapy is to eliminate the bacteria, this study showed that the application of TAP, PDT, and LED exposure lead to least biofilm thickness.