Artículos de revistas
Does supplemental photodynamic therapy optimize the disinfection of bacteria and endotoxins in one-visit and two-visit root canal therapy? A randomized clinical trial
Photodiagnosis and Photodynamic Therapy, v. 19, p. 205-211.
Universidade Estadual Paulista (UNESP)
School of Dentistry
Aim To evaluate the effectiveness of supplemental photodynamic therapy (PDT) in optimizing the removal of bacteria and endotoxins from primarily infected root canals after one-visit and two-visit treatments. Methodology Twenty-four primarily infected root canals with apical periodontitis were selected and randomly divided into one-visit (n = 12) and two-visit treatment groups (n = 12). Chemo-mechanical preparation (CMP) was performed by using the single-file reciprocating technique + 2.5% NaOCL and a final rinse with 17% EDTA. The photosensitizer agent (methylene blue 0.1 mg/mL) was applied to root canals for 60 s before application of laser with a potency of 60 mW and energy density of 129 J/cm2 for 120 s after CMP in the one-visit treatment and after 14-day inter-appointment medication with Ca(OH)2 + Saline solution (SSL) in the two-visit treatment. Samples were collected before and after root canal procedures. Endotoxins were quantified by chromogenic limulus amebocyte lysate assay. Culture techniques were used to determine bacterial colony-forming unit counts. Results Bacteria and endotoxins were detected in 100% of the initial samples, with median values of 1.97 × 105 CFU/mL and 24.983 EU/mL, respectively. The CMP using single-file reciprocating technique was effective in the reduction of bacteria and endotoxins (All, p < 0.05). The supplemental PDT was effective in reducing bacterial load in the one-visit (p < 0.05) but not in the two-visit treatment after use of Ca(OH)2 medication for 14 days (p > 0.05). In the two-visit group, after 14 days of inter-appointment medication with Ca(OH)2, a significant reduction in the median levels of endotoxins was found in comparison to CMP alone (from 1.041 to 0.094 EU/mL) (p < 0.05). Despite the type of treatment, the supplemental PDT was not effective against endotoxins (p > 0.05). Conclusions The photodynamic therapy optimized the disinfection of bacteria from root canals in one-visit but not for two visit treatment modality with the accomplishment of calcium hydroxide medication. Despite the type of treatment, the supplemental PDT was not effective against endotoxins.