14 Photodynamic Therapy for Root Canal Disinfection |
247 |
|
|
|
|
a |
b |
c |
Fig. 14.5 Representative image of the light-scattering intensity of each group. Image J software transforms the black-white image in a false color image according to the light intensity between values minimum of 0 for no light and 256 for maximum light intensity. (a) G3, irradiation
Conclusion
Elimination of bacterial bioÞlm from the infected root canal system remains to be the primary focus in the management of endodontic disease. Current research is directed to potentiate the antibioÞlm efÞcacy of PDT by developing newer photosensitizers, by altering the photosensitizer formulation, and by combining the advantages of photodynamic effect with bioactive antimicrobial microparticles [56, 60, 84] and nanoparticles [48, 61, 74]. The key to the successful application of these newer antibacterial strategies for the
with the larger laser tip; (b) G4, irradiation with the smaller laser tip; and (c) G5, irradiation with the laser optical Þber/diffuser (Adapted with permission from Garcez et al. [67])
treatment of root canal bioÞlms is to address all the tissue-speciÞc issues in entirety rather than focusing only on the antibacterial aspect. Further research is mandatory to improve the antibioÞlm efÞcacy of PDT in the presence of tissue inhibitors, to optimize light delivery within the root canal, and to optimize new photosensitizers and/or formulations for application within the root canal. A standardized protocol for photosensitization and light activation is paramount for endodontic disinfection using PDT.
248 |
A. Kishen and A. Shrestha |
|
|
Table 14.2 Laser parameters of studies showing positive outcomes of photodynamic therapy toward elimination of Enterococcus faecalis from infected root canals
|
Laser |
Diameter |
Power |
Power |
Energy |
Duration of |
|
Authors |
wavelength |
of Þber |
output |
density |
ßuence |
irradiation |
Photosensitizer |
et al. |
(nm) |
in μm |
(in mW) |
(mW/cm2) |
(in J/cm2) |
(in min) |
(concentration in μg/mL) |
Bago et al. |
660 |
320 |
100 |
− |
− |
1 |
(a) Phenothiazine chloride |
[70] |
|
|
|
|
|
|
(103 μg/mL) |
|
|
|
|
|
|
|
(b) TBO (155 μg/mL) |
Vaziri |
625 |
− |
− |
200 |
12 |
1 |
TBO (15 μg/mL) |
et al. [71] |
|
|
|
|
|
|
|
Foschi |
665 |
500 |
− |
100 |
60 |
5 |
MB (6.25 μg/mL) |
et al. [65] |
|
|
|
|
|
|
|
Soukos |
665 |
500 |
1,000 |
100 |
30 |
5 |
MB (25 μg/mL) |
et al. [34] |
|
|
|
|
|
|
|
Rios et al. |
628 |
− |
− |
− |
− |
0.5 |
TBO (−) |
[73] |
|
|
|
|
|
|
|
Pagonis |
665 |
250 |
1,000 |
100 |
60 |
10 |
MB (6.25 μg/mL) |
et al. [74] |
|
|
|
|
|
|
|
Fonseca |
660 |
600 |
50 |
− |
400 |
5 |
TBO (−) |
et al. [75] |
|
|
|
|
|
|
|
Bergmans |
635 |
300 |
100 |
− |
− |
1.5 |
TBO |
et al. [76] |
|
|
|
|
|
|
(12.5 × 103 μg/mL) |
Poggio |
628 |
− |
1,000 |
− |
− |
0.5 |
(a) TBO (100 μg/mL) |
et al. [77] |
|
|
|
|
|
1.5 |
(b) TBO (100 μg/mL) |
Nagayoshi |
805 |
400 |
5,000 |
− |
− |
2 |
Indocyanine green |
et al. [78] |
|
|
|
|
|
|
(12.5 × 103 μg/mL) |
Schlafer |
628 |
4 × 103 |
1,000 |
− |
− |
0.5 |
TBO (100 μg/mL) |
et al. [79] |
|
|
|
|
|
|
|
Garcez |
660 |
200 |
40 |
− |
− |
4 |
Conjugate between |
et al. [37] |
|
|
|
|
|
|
polyethylenimine and chlorin |
|
|
|
|
|
|
|
(~19 μg/mL) |
Adapted and modiÞed with permission from Siddiqui et al. [69]
MB methylene blue, TBO toluidine blue
Table 14.3 Laser parameters of studies that reported photodynamic therapy to be ineffective toward elimination of Enterococcus faecalis from infected root canals
|
Laser |
|
Power |
|
Energy |
Duration of |
Photosensitizer |
Authors |
wavelength |
Diameter of |
output |
Power density |
ßuence |
irradiation |
(concentration in |
et al. |
(nm) |
Þber in μm |
(in mW) |
(mW/cm2) |
(in J/cm2) |
(in min) |
μg/mL) |
Nunes |
660 |
216 |
90 |
− |
− |
5 |
MB (100 μg/mL) |
et al. [72] |
|
|
|
|
|
|
|
Hecker |
635 |
− |
200 |
− |
− |
6 |
TBO (−) |
et al. [80] |
|
|
|
|
|
|
|
Souza |
660 |
300 |
40 |
− |
− |
4 |
(a) MB (−) |
et al. [81] |
|
|
|
|
|
|
(b) TBO (−) |
Cheng |
660 |
2,000 |
200 |
− |
− |
1 |
MB (10 μg/ml) |
et al. [83] |
|
|
|
|
|
|
|
Adapted and modiÞed with permission from Siddiqui et al. [69]
MB methylene blue, TBO toluidine blue
14 Photodynamic Therapy for Root Canal Disinfection |
249 |
|
|
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