Endodontic photodynamic therapy ex vivo.
Endodontic photodynamic therapy ex vivo.
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DOI：
10.1016/j.joen.2010.10.008
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发表时间：
2011-02
影响因子：
4.2
通讯作者：
Soukos NS
中科院分区：
文献类型：
--
作者：
Ng R;Singh F;Papamanou DA;Song X;Patel C;Holewa C;Patel N;Klepac-Ceraj V;Fontana CR;Kent R;Pagonis TC;Stashenko PP;Soukos NS
评估光动力疗法 (PDT) 对受感染的人类牙齿离体的抗菌作用。从 34 名受试者身上获得了 52 颗新拔出的牙齿，这些牙齿具有牙髓坏死和相关的根周射线可透性。 49 根管的 26 颗牙齿接受了 6% NaOCl 的化学机械清创 (CMD)，52 根管的 26 颗牙齿接受了 CMD 加 PDT。对于 PDT，将根管系统与浓度为 50 µg/ml 的亚甲基蓝 (MB) 孵育 5 分钟，然后暴露于 665 nm 能量通量为 30 J/cm2 的红光下。通过在基线冲洗根管并遵循单独的CMD或CMD+PDT对根管内容物进行取样，并连续稀释并在血琼脂上培养。通过计数菌落形成单位（CFU）来计算存活分数。在棋盘分析中，使用 DNA 探针对一组 39 种牙髓物种进行基线和单独 CMD 或 CMD+PDT 后根管物种的部分表征。治疗效果的 Mantel-Haenszel 卡方检验表明 CMD+PDT 优于 CMD（P=0.026）。相对于单独的 CMD，CMD+PDT 显着降低了阳性根管的频率 (P=0.0003)。 CMD+PDT 后，52 根根管中的 45 根 (86.5%) 没有 CFU，而用 CMD 治疗的 49 根根管中的 24 根 (49%) 没有 CFU（根管冲洗样本）。当牙齿或根管被视为独立实体时，CFU 减少量相似。对于所有物种来说，经 CMD+PDT 处理的根管的治疗后检测水平明显低于仅用 CMD 处理的根管。 CMD 组和 CMD+PDT 组分别有 17/22 (77.3%) 和 15/29 (51.7%) 的根管中检测到牙本质小管内的细菌种类 (P= 0.034)。数据表明，PDT 显着减少了根管系统内的残留细菌，并且如果通过技术改进进一步增强 PDT，则有望作为 CMD 的辅助手段。
To evaluate the anti-microbial effects of photodynamic therapy (PDT) on infected human teeth ex vivo. Fifty-two freshly extracted teeth with pulpal necrosis and associated periradicular radiolucencies were obtained from 34 subjects. Twenty-six teeth with 49 canals received chemomechanical debridement (CMD) with 6% NaOCl and twenty-six teeth with 52 canals received CMD plus PDT. For PDT, root canal systems were incubated with methylene blue (MB) at concentration of 50 µg/ml for 5 minutes followed by exposure to red light at 665 nm with an energy fluence of 30 J/cm2. The contents of root canals were sampled by flushing the canals at baseline and following CMD alone or CMD+PDT and were serially diluted and cultured on blood agar. Survival fractions were calculated by counting colony-forming units (CFU). Partial characterization of root canal species at baseline and following CMD alone or CMD+PDT was performed using DNA probes to a panel of 39 endodontic species in the checkerboard assay. The Mantel-Haenszel chi-square test for treatment effects demonstrated the better performance of CMD+PDT over CMD (P=0.026). CMD+PDT significantly reduced the frequency of positive canals relative to CMD alone (P=0.0003). Following CMD+PDT, 45 of 52 canals (86.5%) had no CFU as compared to 24 of 49 canals (49%) treated with CMD (canal flush samples). The CFU reductions were similar when teeth or canals were treated as independent entities. Post-treatment detection levels for all species were markedly lower for canals treated by CMD+PDT than were for those treated by CMD alone. Bacterial species within dentinal tubules were detected in 17/22 (77.3%) and 15/29 (51.7%) of canals in the CMD and CMD+PDT group, respectively (P= 0.034). Data indicate that PDT significantly reduces residual bacteria within the root canal system, and that PDT, if further enhanced by technical improvements, holds substantial promise as an adjunct to CMD.