Research Article
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Antibiofilm Effect of Different Irrigation Solutions Activated with KTP Laser

Year 2022, Volume: 25 Issue: Suppl/2, 19 - 25, 29.12.2022

Zuhal Elmalı , Recai Zan

https://doi.org/10.7126/cumudj.1205797

Abstract

Objectives: The aim of this study was to evaluate the antimicrobial efficacy of Potassium Titanium Phosphate (KTP) laser-activated irrigation solutions on intraradicular Enterococcus faecalis biofilms in invitro conditions by using a scanning electron microscope.
Materials and Methods: 120 single-root, single canal permanent mandibular premolar human teeth were used. Sterilization and disinfection of the teeth were performed. E. faecalis biofilms were obtained after 4 weeks by re-inoculation procedures. Each group was divided into 6 groups consisting of 20 roots and root canal disinfection protocols were applied using irrigation solutions with 5.25% NaOCl, saline, super-oxidized water solution, 8ppm ozonated water, 2% CHX, 17% EDTA, all activated by KTP laser. It was smear-planted to a solid medium which split as before and after the disinfection applications for the aim of Counting Microorganism colonies from root canals and data were evaluated statistically. In this statistical evaluation one way ANOVA and Tukey tests were used. Before and after the irrigation procedures for presence and elimination of biofilm the root canals were processed for scanning electron microscopy and biofilm was examined on the standard images.
Results: As a result of the statistical comparison performed among all groups, while NaOCl ensures the highest amount of elimination as a positive control group, the lowest amount of bacterial elimination was detected in the SF group that applied as the negative control group (P<0,05). None of the experimental groups achieved the whole elimination of E. faecalis biofilm. While there was no statistically significant difference between SPO and aqueous ozone groups that indicated the strongest antibiofilm effect (P>0,05), EDTA showed the lowest antibiofilm effect (P<0,05).

Conclusion: The use of 5.25% NaOCl solution activated by KTP laser, which shows the highest antibiofilm efficiency among the study groups, in clinical applications is very effective in terms of biofilm elimination in root canal treatments and is especially promising in the success of long-follow-up treatments. However, the KTP laser activation procedures of super-oxidized water solution and 8ppm ozonated water may be insufficient as a safe disinfection method.

Keywords

Biofilm laser-activated irrigation E. faecalis KTP laser

Supporting Institution

the Scientific Research Project Fund of Sivas Cumhuriyet University

Project Number

DİŞ-170

References

  • Berutti E, Marini R, Angeretti A. Penetration ability of different irrigants into dentinal tubules. J Endod 1997;23(12):725-727.
  • Sundqvist G, Figdor D, Persson S, Sjogren U. Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;85(1):86-93.
  • Siqueira JF, Rocas IN, De Uzeda M, Colombo AP, Santos KR. Comparison of 16S rDNA-based PCR and checkerboard DNA-DNA hybridisation for detection of selected endodontic pathogens. J Med Microbiol 2002;51(12):1090-1096.
  • Dummett CO, Kopel HM. Pediatric endodontics, In Ingle JI, Bakland LK (eds). Endodontics. 5th ed. London: BC Decker Inc Hamilton, 861-902.
  • Klinke T, Klimm W, Gutknecht N. Antibacterial effects of Nd:YAG laser irradiation within root canal dentin. J Clin Laser Med Surg 1997;15(1):29-31.
  • Mohammadi Z. Laser applications in endodontics: an update review. Int Dent J, 2009;59(1):35-46.
  • Moritz A, Schoop U, Goharkhay K, Jakolitsch S, Kluger W, Wernisch J, Sperr W. The bactericidal effect of Nd:YAG, Ho:YAG, and Er:YAG laser irradiation in the root canal: an in vitro comparison. J Clin Laser Med Surg 1999;17(4):161-164.
  • Pinheiro ET, Gomes BP, Ferraz CC, Sousa EL, Teixeira FB, Souza-Filho FJ. Microorganisms from canals of root-filled teeth with periapical lesions. Int Endod J 2003;36: 1-11.
  • Peciuliene V, Reynaud AH, Balciuniene I, Haapasalo M. Isolation of yeasts and enteric bacteria in root-filled teeth with chronic apical periodontitis. Int Endod J 2001;34: 429-434.
  • Gomes BP, Lilley JD, Drucker DB. Variations in the susceptibilities of components of the endodontic microflora to biomechanical procedures. Int Endod J 1996;29: 235-241.
  • Prabhakar J, Senthilkumar M, Priya MS, Mahalakshmi K, Sehgal PK, Sukumaran VG. Evaluation of antimicrobial efficacy of herbal alternatives (Triphala and green tea polyphenols), MTAD, and 5% sodium hypochlorite against Enterococcus faecalis biofilm formed on tooth substrate: an in vitro study. J Endod 2010;36(1):83-86.
  • Bryce G, O'Donnell D, Ready D, Ng YL, Pratten J, Gulabivala K. Contemporary root canal irrigants are able to disrupt and eradicate single- and dual-species biofilms. J Endod 2009;35(9):1243-1248.
  • Schoop U, Goharkhay K, Klimscha J, Zagler M, Wernisch J, Georgopoulos A, Sperr W, Moritz A. The use of the erbium, chromium:yttrium-scandium-gallium-garnet laser in endodontic treatment: the results of an in vitro study. J Am Dent Assoc 2007;138(7):949-955.
  • Roper MJ, White JM, Goodis HE, Gekelman D. Two-dimensional changes and surface characteristics from an erbium laser used for root canal preparation. Lasers Surg Med 2010;42(5):379-383.
  • Yanez MJ, Barbosa SE. Changes in particle area measurements due to SEM accelerating voltage and magnification. Microsc Res Tech 2003;61(5):463-468.
  • Piccolomini R, D'arcangelo C, D'ercole S. Bacteriologic evaluation of the effect of Nd:YAG laser irradiation in experimental infected root canals. J Endod 2002;28:276‐278.
  • Folwaczny M, Mehl A, Jordan C, Hickel R. Antibacterial effects of pulsed Nd:YAG laser radiation at different energy settings in root canals. J Endod 2002;28:24‐29.
  • Gutknecht N, Moritz A, Conrads G, Sievert T, Lampert F. Bactericidal effect of the Nd:YAG laser in in vitro root canals. J Clin Laser Med Surg 1996;14:77‐80.
  • Moritz A, Schoop U, Goharkay K, Jakolitsch S, Kluger W, Wernish J, Sperr W. The bactericidal effect of Nd:YAG, Ho:YAG ve Er:YAG lazer irridation in the root canal: an in vitro comparison. J Clin Med Surg 1999;17:161-164.
  • Seltzer S, endodontology, Lee and Febiger, Philadelphia s. 1988;260-266.
  • Gulabivala K Pb, Evans G, Yuan-Ling Ng. Effects of mechanical and chemicalprocedures on root canal surfaces. Endodontic Topics 10:103–122.
  • Retamozo B, Shabahang S, Johnson N, Aprecio RM, Torabinejad M. Minimum contact time and concentration of sodium hypochlorite required to eliminate Enterococcus faecalis. J Endod 2010;36(3):520-523.
  • Sohrabi K, Sooratgar A, Zolfagharnasab K, Kharazifard MJ, Afkhami F. Antibacterial Activity of Diode Laser and Sodium Hypochlorite in Enterococcus Faecalis-Contaminated Root Canals. Iran Endod J 2016;11(1):8-12.
  • Giardino L, Ambu E, Savoldi E, Rimondini R, Cassanelli C, Debbia EA. Comparative evaluation of antimicrobial efficacy of sodium hypochlorite, MTAD, and Tetraclean against Enterococcus faecalis biofilm. J Endod 2007;33(7):852-855.
  • Abdullah M, Ng YL, Gulabivala K, Moles DR, Spratt DA. Susceptibilties of two Enterococcus faecalis phenotypes to root canal medications. J Endod 2005;31(1):30-36.
  • Lin YH, Mickel AK, Chogle S. Effectiveness of selected materials against Enterococcus faecalis: part 3. The antibacterial effect of calcium hydroxide and chlorhexidine on Enterococcus faecalis. J Endod 2003;29(9):565-566.
  • Cheng X, Chen B, Qiu J, He W, Lv H, Qu T, Yu Q, Tian Y. Bactericidal effect of Er:YAG laser combined with sodium hypochlorite irrigation against Enterococcus faecalis deep inside dentinal tubules in experimentally infected root canals. J Med Microbiol 2016;65(2):176-187.
  • Ohara P, Torabinejad M, Kettering JD. Antibacterial effects of various endodontic irrigants on selected anaerobic bacteria. Endod Dent Traumatol 1993;9(3):95-100.
  • Ballal NV, Mala K, Bhat KS. Evaluation of decalcifying effect of maleic acid and EDTA on root canal dentin using energy dispersive spectrometer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112(2):e78-84.
  • Zhang R, Chen M, Lu Y, Guo X, Qiao F, Wu L. Antibacterial and residual antimicrobial activities against Enterococcus faecalis biofilm: A comparison between EDTA, chlorhexidine, cetrimide, MTAD and QMix. Sci Rep 2015;5(1):1-5.
  • Kaushik N, Rehani U, Agarwal A, Kaushik M, Adlakha V. Antimicrobial Efficacy of Endodontic Irrigants against Enterococcus Faecalis and Escherichia Coli: An in vitro study. Int J Clin Pediatr Dent 2013;6(3):178-182.
  • Dunavant TR, Regan JD, Glickman GN, Solomon ES, Honeyman AL. Comparative evaluation of endodontic irrigants against Enterococcus faecalis biofilms. J Endod 2006;32(6):527-531.
  • Arias-Moliz MT, Ferrer-Luque CM, Espigares-Garcia M, Baca P. Enterococcus faecalis biofilms eradication by root canal irrigants. J Endod 2009;35(5):711-714.
  • Estrela C, Estrela CR, Decurcio DA, Hollanda AC, Silva JA. Antimicrobial efficacy of ozonated water, gaseous ozone, sodium hypochlorite and chlorhexidine in infected human root canals. Int Endod J 2007;40(2):85-93.
  • Perçin D, Esen Ş: New disinfectants and problems in practice. Ankem 2009;23(2):89-93.
  • Gunaydin M, Esen S, Karadag A, Unal N, Yanik K, Odabasi H, Birinci A. In vitro antimicrobial activity of Medilox(R) super-oxidized water. Ann Clin Microbiol Antimicrob 2014;13:29.
  • Turkmen C, Gunday M, Karacorlu M, Basaran B. Effect of CO2, Nd:YAG, and ArF excimer lasers on dentin morphology and pulp chamber temperature: an in vitro study. J Endod 2000;26(11):644-648.
  • Fabricius L, Dahlen G, Sundqvist G, Happonen RP, Moller AJ. Influence of residual bacteria on periapical tissue healing after chemomechanical treatment and root filling of experimentally infected monkey teeth. Eur J Oral Sci 2006;114(4):278-285.

KTP Lazer ile Aktive Edilen Farklı İrrigasyon Solüsyonlarının Antibiyofilm Etkisi

Year 2022, Volume: 25 Issue: Suppl/2, 19 - 25, 29.12.2022

Zuhal Elmalı , Recai Zan

https://doi.org/10.7126/cumudj.1205797

Abstract

Amaç: Bu çalışmanın amacı, Potasyum Titanyum Fosfat (KTP) lazer ile aktive edilen irrigasyon solüsyonlarının intraradiküler Enterococcus faecalis biyofilmleri üzerindeki antimikrobiyal etkinliğinin taramalı elektron mikroskobu kullanarak in vitro koşullarda değerlendirilmesidir.
Gereç ve Yöntem: Bu çalışmada 120 tek kök tek kanallı daimi mandibular küçük azı insan dişleri kullanıldı. Dişlerin sterilizasyon ve dezenfeksiyon işlemleri yapıldı. E. faecalis biyofilmleri re-inokülasyon prosedürleri ile elde edildi. Her grup 20 kökten oluşan 6 gruba ayrıldı ve tamamı KTP lazer ile aktive edilen %5,25’lik NaOCl, serum fizyolojik, süper okside su solüsyonu, 8ppm ozonlu su, %2’lik CHX, %17’lik EDTA ile irrigasyon protokolleri uygulandı. Kök kanallarından Mikroorganizma kolonilerinin sayımı amacıyla dezenfeksiyon uygulamaları öncesi ve sonrası olarak ayrılan katı besiyerine smear ekilmiş ve veriler istatistiksel olarak değerlendirilmiştir. Bu istatistiksel değerlendirmede tek yönlü ANOVA ve Tukey testleri kullanılmıştır. Biyofilm varlığı ve ortadan kaldırılması için irrigasyon işlemlerinden önce ve sonra kök kanalları taramalı elektron mikroskobu için işlendi ve standart görüntüler üzerinde biyofilm incelendi.
Bulgular: Tüm gruplar arasında yapılan istatistiksel karşılaştırmalar sonucunda NaOCl pozitif kontrol grubu olarak en yüksek miktarda eliminasyonu sağlarken, en düşük bakteri eliminasyonu negatif kontrol grubu olarak uygulanan SF grubunda tespit edilmiştir (p<0,05). Deney gruplarının hiçbiri, E. faecalis biyofilminin tamamen ortadan kaldırılmasını sağlamadı. Antibiyofilm etkinliği açısından en güçlü etkiyi gösteren SPO ile ozonlu su grupları arasında istatistiksel olarak anlamlı bir fark bulunmaz iken (p>0,05); en düşük antibiofilm etkiyi EDTA grubu göstermiştir (p<0,05).
Sonuçlar: Çalışma grupları arasında en yüksek antibiyofilm etkinliği gösteren KTP lazer ile aktive ettiğimiz % 5,25’ lik NaOCl solüsyonunun klinik uygulamalarda kullanılmasının kök kanal tedavilerinde biyofilm eliminasyonu açısından oldukça etkili ve özellikle uzun takipli tedavilerin başarısında umut vericidir. Ancak süper oksitlenmiş su solüsyonu ve 8ppm ozonlu suyun KTP lazer aktivasyon prosedürleri güvenli bir dezenfeksiyon yöntemi olarak yetersiz kalabilir.

Keywords

Biyofilm Lazer ile Aktive Edilen İrrigasyon E. Faecalis KTP Lazer

Project Number

DİŞ-170

References

  • Berutti E, Marini R, Angeretti A. Penetration ability of different irrigants into dentinal tubules. J Endod 1997;23(12):725-727.
  • Sundqvist G, Figdor D, Persson S, Sjogren U. Microbiologic analysis of teeth with failed endodontic treatment and the outcome of conservative re-treatment. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1998;85(1):86-93.
  • Siqueira JF, Rocas IN, De Uzeda M, Colombo AP, Santos KR. Comparison of 16S rDNA-based PCR and checkerboard DNA-DNA hybridisation for detection of selected endodontic pathogens. J Med Microbiol 2002;51(12):1090-1096.
  • Dummett CO, Kopel HM. Pediatric endodontics, In Ingle JI, Bakland LK (eds). Endodontics. 5th ed. London: BC Decker Inc Hamilton, 861-902.
  • Klinke T, Klimm W, Gutknecht N. Antibacterial effects of Nd:YAG laser irradiation within root canal dentin. J Clin Laser Med Surg 1997;15(1):29-31.
  • Mohammadi Z. Laser applications in endodontics: an update review. Int Dent J, 2009;59(1):35-46.
  • Moritz A, Schoop U, Goharkhay K, Jakolitsch S, Kluger W, Wernisch J, Sperr W. The bactericidal effect of Nd:YAG, Ho:YAG, and Er:YAG laser irradiation in the root canal: an in vitro comparison. J Clin Laser Med Surg 1999;17(4):161-164.
  • Pinheiro ET, Gomes BP, Ferraz CC, Sousa EL, Teixeira FB, Souza-Filho FJ. Microorganisms from canals of root-filled teeth with periapical lesions. Int Endod J 2003;36: 1-11.
  • Peciuliene V, Reynaud AH, Balciuniene I, Haapasalo M. Isolation of yeasts and enteric bacteria in root-filled teeth with chronic apical periodontitis. Int Endod J 2001;34: 429-434.
  • Gomes BP, Lilley JD, Drucker DB. Variations in the susceptibilities of components of the endodontic microflora to biomechanical procedures. Int Endod J 1996;29: 235-241.
  • Prabhakar J, Senthilkumar M, Priya MS, Mahalakshmi K, Sehgal PK, Sukumaran VG. Evaluation of antimicrobial efficacy of herbal alternatives (Triphala and green tea polyphenols), MTAD, and 5% sodium hypochlorite against Enterococcus faecalis biofilm formed on tooth substrate: an in vitro study. J Endod 2010;36(1):83-86.
  • Bryce G, O'Donnell D, Ready D, Ng YL, Pratten J, Gulabivala K. Contemporary root canal irrigants are able to disrupt and eradicate single- and dual-species biofilms. J Endod 2009;35(9):1243-1248.
  • Schoop U, Goharkhay K, Klimscha J, Zagler M, Wernisch J, Georgopoulos A, Sperr W, Moritz A. The use of the erbium, chromium:yttrium-scandium-gallium-garnet laser in endodontic treatment: the results of an in vitro study. J Am Dent Assoc 2007;138(7):949-955.
  • Roper MJ, White JM, Goodis HE, Gekelman D. Two-dimensional changes and surface characteristics from an erbium laser used for root canal preparation. Lasers Surg Med 2010;42(5):379-383.
  • Yanez MJ, Barbosa SE. Changes in particle area measurements due to SEM accelerating voltage and magnification. Microsc Res Tech 2003;61(5):463-468.
  • Piccolomini R, D'arcangelo C, D'ercole S. Bacteriologic evaluation of the effect of Nd:YAG laser irradiation in experimental infected root canals. J Endod 2002;28:276‐278.
  • Folwaczny M, Mehl A, Jordan C, Hickel R. Antibacterial effects of pulsed Nd:YAG laser radiation at different energy settings in root canals. J Endod 2002;28:24‐29.
  • Gutknecht N, Moritz A, Conrads G, Sievert T, Lampert F. Bactericidal effect of the Nd:YAG laser in in vitro root canals. J Clin Laser Med Surg 1996;14:77‐80.
  • Moritz A, Schoop U, Goharkay K, Jakolitsch S, Kluger W, Wernish J, Sperr W. The bactericidal effect of Nd:YAG, Ho:YAG ve Er:YAG lazer irridation in the root canal: an in vitro comparison. J Clin Med Surg 1999;17:161-164.
  • Seltzer S, endodontology, Lee and Febiger, Philadelphia s. 1988;260-266.
  • Gulabivala K Pb, Evans G, Yuan-Ling Ng. Effects of mechanical and chemicalprocedures on root canal surfaces. Endodontic Topics 10:103–122.
  • Retamozo B, Shabahang S, Johnson N, Aprecio RM, Torabinejad M. Minimum contact time and concentration of sodium hypochlorite required to eliminate Enterococcus faecalis. J Endod 2010;36(3):520-523.
  • Sohrabi K, Sooratgar A, Zolfagharnasab K, Kharazifard MJ, Afkhami F. Antibacterial Activity of Diode Laser and Sodium Hypochlorite in Enterococcus Faecalis-Contaminated Root Canals. Iran Endod J 2016;11(1):8-12.
  • Giardino L, Ambu E, Savoldi E, Rimondini R, Cassanelli C, Debbia EA. Comparative evaluation of antimicrobial efficacy of sodium hypochlorite, MTAD, and Tetraclean against Enterococcus faecalis biofilm. J Endod 2007;33(7):852-855.
  • Abdullah M, Ng YL, Gulabivala K, Moles DR, Spratt DA. Susceptibilties of two Enterococcus faecalis phenotypes to root canal medications. J Endod 2005;31(1):30-36.
  • Lin YH, Mickel AK, Chogle S. Effectiveness of selected materials against Enterococcus faecalis: part 3. The antibacterial effect of calcium hydroxide and chlorhexidine on Enterococcus faecalis. J Endod 2003;29(9):565-566.
  • Cheng X, Chen B, Qiu J, He W, Lv H, Qu T, Yu Q, Tian Y. Bactericidal effect of Er:YAG laser combined with sodium hypochlorite irrigation against Enterococcus faecalis deep inside dentinal tubules in experimentally infected root canals. J Med Microbiol 2016;65(2):176-187.
  • Ohara P, Torabinejad M, Kettering JD. Antibacterial effects of various endodontic irrigants on selected anaerobic bacteria. Endod Dent Traumatol 1993;9(3):95-100.
  • Ballal NV, Mala K, Bhat KS. Evaluation of decalcifying effect of maleic acid and EDTA on root canal dentin using energy dispersive spectrometer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2011;112(2):e78-84.
  • Zhang R, Chen M, Lu Y, Guo X, Qiao F, Wu L. Antibacterial and residual antimicrobial activities against Enterococcus faecalis biofilm: A comparison between EDTA, chlorhexidine, cetrimide, MTAD and QMix. Sci Rep 2015;5(1):1-5.
  • Kaushik N, Rehani U, Agarwal A, Kaushik M, Adlakha V. Antimicrobial Efficacy of Endodontic Irrigants against Enterococcus Faecalis and Escherichia Coli: An in vitro study. Int J Clin Pediatr Dent 2013;6(3):178-182.
  • Dunavant TR, Regan JD, Glickman GN, Solomon ES, Honeyman AL. Comparative evaluation of endodontic irrigants against Enterococcus faecalis biofilms. J Endod 2006;32(6):527-531.
  • Arias-Moliz MT, Ferrer-Luque CM, Espigares-Garcia M, Baca P. Enterococcus faecalis biofilms eradication by root canal irrigants. J Endod 2009;35(5):711-714.
  • Estrela C, Estrela CR, Decurcio DA, Hollanda AC, Silva JA. Antimicrobial efficacy of ozonated water, gaseous ozone, sodium hypochlorite and chlorhexidine in infected human root canals. Int Endod J 2007;40(2):85-93.
  • Perçin D, Esen Ş: New disinfectants and problems in practice. Ankem 2009;23(2):89-93.
  • Gunaydin M, Esen S, Karadag A, Unal N, Yanik K, Odabasi H, Birinci A. In vitro antimicrobial activity of Medilox(R) super-oxidized water. Ann Clin Microbiol Antimicrob 2014;13:29.
  • Turkmen C, Gunday M, Karacorlu M, Basaran B. Effect of CO2, Nd:YAG, and ArF excimer lasers on dentin morphology and pulp chamber temperature: an in vitro study. J Endod 2000;26(11):644-648.
  • Fabricius L, Dahlen G, Sundqvist G, Happonen RP, Moller AJ. Influence of residual bacteria on periapical tissue healing after chemomechanical treatment and root filling of experimentally infected monkey teeth. Eur J Oral Sci 2006;114(4):278-285.
There are 38 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research Articles
Authors

Zuhal Elmalı 0000-0001-6054-0058

Recai Zan 0000-0002-2781-355X

Project Number DİŞ-170
Publication Date December 29, 2022
Submission Date November 16, 2022
Published in Issue Year 2022Volume: 25 Issue: Suppl/2

Cite

EndNote Elmalı Z, Zan R (December 1, 2022) Antibiofilm Effect of Different Irrigation Solutions Activated with KTP Laser. Cumhuriyet Dental Journal 25 Suppl/2 19–25.
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