The Effect of Antimicrobial Photodynamic Therapy on the Success of Root Canal Treatment

Summary

The decontamination of the root canal system from pathological microflora is essential for the success of endodontic treatment. Mechanical instrumentation and irrigation solutions, known as the chemomechanical process, are typically used for this purpose. However, due to the complex anatomy of teeth, residual microorganisms can remain, potentially affecting treatment success and weakening dentin walls. This has led to the development of more effective irrigation and disinfection systems.

Antimicrobial photodynamic therapy (aPDT) has emerged as a promising adjunct to traditional methods. aPDT is used to eliminate resistant microorganisms in various medical fields, including dentistry, and has been shown to effectively destroy oral bacteria in both planktonic and biofilm forms. However, aPDT is not a replacement for traditional endodontic procedures but can be used as an adjunct in root canal disinfection.

aPDT works through the presence of a photosensitizer, a radiation source with a sufficient wavelength, and oxygen, producing reactive oxygen species (ROS) that have a bactericidal effect. Methylene blue (MB) is a common photosensitizer, but it can cause tooth discoloration and is difficult to remove. Alternatives to MB are being sought.

Different activation techniques, such as passive ultrasonic irrigation (PUI) and sonic activation systems (SAS), have been developed to enhance the effectiveness of irrigation solutions. Studies have shown that PUI and SAS have similar effectiveness in traditional endodontic irrigation. Enterococcus faecalis is a particularly resistant bacterium involved in endodontic infections. While MB's effectiveness against E. faecalis is documented, there is a lack of studies comparing its effectiveness with ultrasonic and sonic systems in necrotic and periapical lesion teeth. There is also limited research on the discoloration potential and postoperative pain of MB when used with various activation systems. The study hypothesizes that there will be no significant difference in lesion healing, postoperative pain, and discoloration potential with different activation systems using aPDT.

Conditions

• Antimicrobial Photodynamic Therapy

Interventions

PROCEDURE

Standard Needle Irrigation (SNI)

Standard Needle Irrigation (SNI): Utilizes standard needle irrigation techniques for activating the antimicrobial solution within the root canal.

PROCEDURE

Passive Ultrasonic Irrigation (PUI

Passive Ultrasonic Irrigation (PUI): Employs ultrasonic energy to enhance the activation and effectiveness of the antimicrobial solution in the root canal.

PROCEDURE

EndoActivator (EA)

EndoActivator (EA): Uses a sonic activation device to facilitate the distribution and activation of the antimicrobial solution in the root canal.

PROCEDURE

EDDY

EDDY: Involves the use of a sonic activation device that operates at high frequency to activate the antimicrobial solution within the root canal. These descriptions focus on the general method and purpose of each intervention without delving into the specific procedural details already covered in the arm/group descriptions.

Sponsors & Collaborators

• Saglik Bilimleri Universitesi

  lead OTHER

Principal Investigators

• Özge Hür Şahin, DDS · University of Health Sciences Gülhane

• Zeliha Uğur Aydın, Assoc. Prof. · University of Health Sciences Gülhane

Study Design

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

15 Years

Max Age

65 Years

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2023-06-20

Primary Completion

2024-03-15

Completion

2024-07-14

Countries

• Turkey (Türkiye)

Study Locations