Antibacterial effect of the lasers and photodynamic therapy against Enterococcus faecalis in the root canal system
Efeito antibacteriano dos lasers e terapia fotodinâmica contra Enterococcus faecalis no sistema de canais radiculares
Poly, Ane; Brasil, Juliana Fernandes Waldmann; Marroig, Paula Carvalho; Blei, Vânia; Risso, Patrícia de Andrade
Rev. odontol. UNESP, vol.39, n4, p.233-239, 2010
Abstract
The chemomechanical disinfection is crucial to the success of endodontic treatment. In this regard, methodologies are developed to ensure maximum disinfection of root canal system. The objective of this literature review was to evaluate the ability of lasers and photodynamic therapy (PDT) in eliminating Enterococcus faecalis, which is strongly associated with failure of endodontic therapy. The search for articles was performed in two ways: through the online study guides in the Journal of Endodontics and, through databases: BBO, PubMed/MEDLINE and OVID. In parallel, we performed cross-searching, given the references of selected articles. Inclusion criteria were: a) the time periods between April 2000 and February 2010; b) articles that evaluate antimicrobial effect of lasers and PDT on E. faecalis. After a complete reading of selected articles, were included: 15 articles that evaluated the antibacterial capacity of the laser, 10 of PDT and 5 that compared laser and PDT. Based on this review, concluded that: neither of the two techniques was 100% effective against E. faecalis, but were able to reduce their presence; PDT apparently showed more effective than laser in controlling this infection. Thus, therapies can be considered promising allied to conventional treatment in the control of endodontic infection by E. faecalis, which is characterized as complementary therapies.
Keywords
Enterococcus faecalis, lasers, photodynamic therapy
Resumo
O preparo químico-mecânico (PQM) é crucial para o sucesso do tratamento endodôntico. Neste sentido, metodologias são desenvolvidas a fim de garantir a máxima desinfecção do sistema de canais radiculares. Assim, o objetivo desta revisão de literatura foi avaliar a capacidade dos lasers e da terapia fotodinâmica (PDT) em eliminar o Enterococcus faecalis, fortemente associado ao fracasso da terapia endodôntica. A busca pelos artigos foi realizada de duas formas: por meio dos guias de estudo on line do Journal of Endodontics e por meio das bases de dados: BBO, PUBMED/MEDLINE e OVID. Paralelamente, foi realizada busca cruzada, considerando as referências bibliográficas dos artigos selecionados. Os critérios de inclusão foram: a) os períodos de tempo entre abril de 2000 e fevereiro de 2010; b) artigos que avaliassem o efeito antimicrobiano dos lasers e PDT sobre o E. faecalis. Após a leitura completa dos artigos selecionados, incluíram-se: 15 artigos que avaliaram a capacidade antibacteriana do laser, 10 artigos relativos à PDT e 5 artigos que compararam o laser e a PDT. Baseado nesta revisão, concluiu-se que nenhuma das duas técnicas foi 100% eficaz contra o E. faecalis, mas que foram capazes de reduzir sua presença; a PDT se mostrou aparentemente mais eficaz que o laser no controle desta infecção. Desta forma, as terapias podem ser consideradas aliadas promissoras ao tratamento convencional no controle da infecção endodôntica por E. faecalis, caracterizando-se como terapias complementares.
Palavras-chave
Enterococcus faecalis, lasers, terapia fotodinâmica
References
1. Sjogren U, Figdor D, Persson S, Sundqvist G. Influence of infection at the time of root filling on the outcome of endodontic treatment of teeth with apical periodontitis. Int Endod J. 1997; 30: 297-306.
2. Stuart CH, Schwartz SA, Beeson TJ, Owatz CB. Enterococcus faecalis: Its role in root canal treatment failure and current concepts in retreatment. J Endod. 2006; 32: 93-8.
3. Gomes BPFA, Pinheiro ET, Sousa ELR, Jacinto RC, Zaia AA, Ferraz CCR, et al. Enterococcus faecalis in dental root canals detected by culture and by polymerase chain reaction analysis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 102: 247-53.
4. Zoletti GO, Siqueira JF, Santos KRN. Identification of Enterococcus faecalis in root-filled teeth with or without periradicular lesions by culture dependent and independent approaches. J Endod. 2006; 32: 722-6.
5. George S, Kishen A, Song P. The role of environmental changes on monospecies biofilm formation on root canal wall by Enterococcus faecalis. J Endod. 2005; 31: 867-72.
6. Duggan jm, Sedgley cm. Biofilm formation of oral and endodontic Enterococcus faecalis. J Endod. 2007; 33: 815-8.
7. Salah R, Dar-Odeh N, Hammad OA, Shehabi AA. Prevalence of putative virulence factors and antimicrobial susceptibility of Enterococcus faecalis isolates from pacients with dental diseases. BMC Oral Health. 2008; 8(17): 1-7.
8. Oliveira DP, Barbizam JVB, Trope M, Teixeira FB, Hil C. In vitro antibacterial efficacy of endodontic irrigants against Enterococcus faecalis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007; 103: 702-6.
9. Foschi F, Fontana CR, Ruggiero K, Riahi R, Vera A, Doukas AG, et al. Photodynamic inactivation of Enterococcus faecalis in dental root canals in vitro. Lasers Surg Med. 2007; 39: 782-7.
10. George S, Kishen A. Influence of photosensitizer solvent on the mechanisms of photoactivated killing of Enterococcus faecalis. Photochem Photobiol. 2008; 84: 734-40.
11. Rosa FCS. Eficácia da instrumentação associada à terapia fotodinâmica antimicrobiana e medicação intracanal na eliminação de biofilmes e na neutralização de endotoxinas em canais radiculares [tese doutorado]. São José dos Campos: Faculdade de Odontologia da UNESP; 2008.
12. Maiman TH. Stimulated optical radiation in ruby. Nature. 1960; 187: 493-4.
13. Weichman JA, Johnson FM. Laser use in endodontics. A preliminary investigation. Oral Surg. 1971; 31: 416-20.
14. Weichman JA, Johnson FM, Nitta LK. Laser use in endodontics. Part II. Oral Surg. 1972; 34: 828-30.
15. Benedicenti S, Resch A, Speicato A. Applications of laser light in root canal disinfection. Aust Dent Pract. 2008; 4: 176-84.
16. Cecchini SCM. Desinfecção da dentina radicular pela irradiação dos lasers de Nd:Yag, Ho:Yag e Er:Yag: um modelo in vitro [tese doutorado]. São Paulo: Faculdade de Odontologia da USP; 2001.
17. Kimura Y, Wilder-Smith P, Matsumoto K. Lasers in endodontics: a review. Int Endod J. 2000; 33: 173-85.
18. Schoop U, Barylyak A, Goharkhay K, Beer F, Wernisch J, Georgopoulos A, et al. The impact of an erbium, chromium: yttrium-scandiumgallium- garnet laser with radial-firing tips on endodontic treatment. Lasers Med Sci. 2009;24(1):59-65.
19. Bergmans L, Moisiadis P, Teughels W, Van Meerbeek B, Quirynen M, Lambrechts P. Bactericidal effect of Nd:YAG laser irradiation on some endodontic pathogens ex vivo. Int Endod J. 2006; 39: 547-57.
20. Garcez AS, Ribeiro MS, Tegos GP, Núñez SC, Jorge AOC, Hamblin Mr. Antimicrobial photodynamic therapy combined with conventional endodontic treatment to eliminate root canal biofilm infection. Lasers Surg Med. 2007; 39: 59-66.
21. Microbiology in endodontics: an online study guide. J Endod. 2008; 34(5S): e151-64.
22. Lasers in endodontics: an online study guide. J Endod. 2008; 34(5S): e33-6.
23. Gutknecht N, Van Gogswaardt D, Conrads G, Apel C, Schubert C, Lampert F. Diode laser radiation and its bactericidal effect in root canal wall dentin. J Clin Laser Med Surg. 2000; 18: 57-60.
24. Schoop U, Moritz A, Kluger W, Patruta S, Goharkhay K, Sperr W, et al. The Er:YAG laser in endodontics: results of an in vitro study. Lasers Surg Med. 2002; 30: 360-4.
25. Ribeiro AC. Terapia endodôntica associada à radiação do canal radicular com laser de diodo: avaliação térmica, morfológica, microbiológica e da infiltração marginal apical [tese doutorado]. São Paulo: Faculdade de Odontologia da USP; 2006.
26. Jha D, Guerrero A, Ngo T, Helfer A, Hasselgren G. Inability of laser and rotary instrumentation to eliminate root canal infection. J Am Dent Assoc. 2006; 137: 67-70.
27. Eldeniz AU, Ozer F, Hadimli HH, Erganis O. Bactericidal efficacy of Er,Cr:YSGG laser irradiation against Enterococcus faecalis compared with NaOCl irrigation: an ex vivo pilot study. Int Endod J. 2007; 40: 112-9.
28. Wang Q, Zhang C, Yin X. Evaluation of the bactericidal effect of Er,Cr:YSG, and Nd:YAG lasers in experimentally infected root canals. J Endod. 2007; 33: 830-2.
29. Gordon W, Atabakhsh VA, Meza F, Doms A, Nissan R, Rizoiu I, et al. The antimicrobial efficacy of the erbium, chromium:yttriumscandium- gallium-garnet laser with radial emitting tips on root canal dentin walls infected with Enterococcus. J Am Dent Assoc. 2007; 134: 992-1002.
30. De Souza EB, Cai S, Simionato MR, Lage-Marques JL. High-power diode laser in the disinfection in depth of the root canal dentin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008; 106: 68-72.
31. Benedicenti S, Cassanelli C, Signore A, Ravera G, Angiero F. Decontamination of root canals with the gallium-aluminum-arsenide laser: an in vitro study. Photomed Laser Surg. 2008; 26: 367-70.
32. Noiri Y, Katsumoto T, Azakami H, Ebisu S. Effects of Er:YAG Laser Irradiation on biofilm-forming bacteria associated with endodontic pathogens in vitro. J Endod. 2008; 34: 826-9.
33. Kustarci a, Sümer z, Altunbas d, Kosum s. Bactericidal effect of KTP laser irradiation against Enterococcus faecalis compared with gaseous ozone: an ex vivo study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009; 107: e73-e79.
34. Noetzel J, Nonhoff J, Bitter K, Wagner J, Neumann K, Kielbassa AM. Efficacy of calcium hydroxide, Er:YAG laser or gaseous ozone against Enterococcus faecalis in root canals. Am J Dent. 2009; 22: 14-8.
35. Usacheva MN, Teichert MC, Biel MA. The role of the methylene blue and toluidine blue monomers and dimers in the photoinactivation of bacteria. J Photochem Photobiol B, Biol. 2003; 71: 87-98.
36. Garcez AS, Núñez SC, Lage-Marques JL, Jorge AOC, Ribeiro MS. Efficiency of NaOCl and laser-assisted photosensitization on the reduction of Enterococcus faecalis in vitro. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006; 102: e93-e98.
37. Bonsor SJ, Nichol R, Reid TMS, Pearson GJ. Photo-activated disinfection in endodontics. Br Dent J. 2006; 200: 337-41.
38. Cavalheiro FM. Avaliação da redução microbiana em condutos radiculares contaminados comparando três técnicas de irradiação com laser de baixa potência associado a fotossensibilizador [dissertação mestrado]. São Paulo: Faculdade de Odontologia da USP; 2007.
39. Garcez A, Núñez S, Hamblin M, Ribeiro M. Antimicrobial effects of photodynamic therapy on patients with necrotic pulps and periapical lesion. J Endod. 2008; 34: 138-42.
40. Fonseca M, Tessare JP, Pallota R, Ferreira Filho H, Denardin O, Rapoport A, et al. Photodynamic therapy for root canals infected with Enterococcus faecalis. Photomed Laser Surg. 2008; 26: 209-13.
41. Souza LC. Efeitos antibacterianos da terapia fotodinâmica usando dois diferentes fotossensibilizadores em canais radiculares contaminados com Enterococcus faecalis: estudo in vitro [dissertação mestrado]. Rio de Janeiro: Faculdade de Odontologia da UNESA; 2009.
42. Souza LC, Brito PRR, Oliveira JCM, Alves FRF, Moreira EJL, Sampaio-Filho HR, et al. Photodynamic therapy with two different photosensitizers as a supplement to instrumentation/irrigation procedures in promoting intracanal reduction of Enterococcus faecalis. J Endod. 2010; 36: 292-6.
43. Soukos N, Chen P, Morris J, Ruggiero K, Abernethy A, Som S, et al. Photodynamic therapy for endodontic disinfection. J Endod. 2006; 32: 979-84.
44. Bergmans L, Moisiadis P, Huybrechts B, Van Meerbeek B, Quirynen M, Lambrechts P. Effect of photo-activated disinfection on endodontic pathogens ex vivo. Int Endod J. 2008; 41: 227-39.
45. Meire MA, De Prijck K, Coenye T, Nelis HJ, De Moor RJG. Effectiveness of different laser systems to kill Enterococcus faecalis in aqueous suspension and in na infected tooth model. Int Endod J. 2009; 42: 351-9.
46. Lim Z, Cheng JL, Lim TW, Teo EG, Wong J, George S, et al. Light activated disinfection: an alternative endodontic disinfection strategy. Aust Dent J 2009; 54: 108-14.