Antibacterial and Antibiofilm Efficacy of Antimicrobial Photodynamic Therapy Against Intracanal Enterococcus faecalis: An In Vitro Comparative Study with Traditional Endodontic Irrigation Solutions
AbstractObjectives: Enterococcus faecalis (E. faecalis), an infecting microorganism of the root canals, is difficult to eliminate during endodontic therapy. In this study, the effect of root canal disinfection with sodium hypochlorite (NaOCl) and chlorhexidine (CHX) was evaluated on planktonic and biofilm forms of E. faecalis in comparison with antimicrobial photodynamic therapy (aPDT) as an alternative strategy for root canal disinfection.Materials and Methods: In this study, E. faecalis (ATCC 29212) was used. The experimental procedures included aPDT with curcumin (CUR) and indocyanine green (ICG) as photosensitizers, irrigation with 5.25% NaOCl, 0.2% and 2.0% CHX solutions as traditional endodontic irrigating solutions, and the control group. The antibacterial and anti-biofilm potentials were assessed by counting the colony forming units and also using the crystal violet assay, respectively.Results: According to the results, E. faecalis biofilm was disrupted by 65.3%, 81.0% and 92.6% using 0.2% CHX, 2.0% CHX, and 5.25% NaOCl, respectively (P<0.05). In addition, CUR- and ICG-mediated aPDT displayed a significant reduction in E. faecalis count (90.2% and 82.5%, respectively) and its biofilm (83.6% and 75.2%, respectively) in comparison to the control group (P<0.05).Conclusions: APDT has a high potential for elimination of E. faecalis and is almost equivalent to NaOCl and CHX. It can be used as an adjucnt to conventional endodontic irrigating solutions.
- Plotino G, Cortese T, Grande NM, Leonardi DP, Di Giorgio G, Testarelli L, et al. New Technologies to Improve Root Canal Disinfection. Braz Dent J. 2016 Feb;27(1):3-8.
- 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 Feb;32(2):93-8.
- Ma J, Tong Z, Ling J, Liu H, Wei X. The effects of sodium hypochlorite and chlorhexidine irrigants on the antibacterial activities of alkaline media against Enterococcus faecalis. Arch Oral Biol. 2015 Jul;60(7):1075-81.
- Kim SW, Shin DH. Antibacterial effect of urushiol on E. faecalis as a root canal irrigant. Restor Dent Endod. 2017 Feb;42(1):54-59.
- Violich DR, Chandler NP. The smear layer in endodontics - a review. Int Endod J. 2010 Jan;43(1):2-15.
- Frough-Reyhani M, Ghasemi N, Soroush-Barhaghi M, Amini M, Gholizadeh Y. Antimicrobial efficacy of different concentration of sodium hypochlorite on the biofilm of Enterococcus faecalis at different stages of development. J Clin Exp Dent. 2016 Dec;8(5):e480-4.
- Chiniforush N, Pourhajibagher M, Shahabi S, Bahador A. Clinical approach of high technology techniques for control and elimination of endodontic microbiota. J Lasers Med Sci. 2015;6(4):139-50.
- Chiniforush N, Pourhajibagher M, Shahabi S, Kosarieh E, Bahador A. Can antimicrobial photodynamic therapy (aPDT) enhance the endodontic treatment? J Lasers Med Sci. 2016;7(2):76-85.
- Pourhajibagher M, Chiniforush N, Ghorbanzadeh R, Bahador A. Photo-activated disinfection based on indocyanine green against cell viability and biofilm formation of Porphyromonas gingivalis. Photodiagnosis Photodyn Ther. 2017 Mar;17:61-4.
- Pourhajibagher M, Chiniforush N, Parker S, Shahabi S, Ghorbanzadeh R, Kharazifard MJ, et al. Evaluation of antimicrobial photodynamic therapy with indocyanine green and curcumin on human gingival fibroblast cells: An in vitro photocytotoxicity investigation. Photodiagnosis Photodyn Ther. 2016 Sep;15:8-13.
- Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. Twenty-fourth informational supplement M100-S24, Wayne: NCCLS. 2014;34:62-4.
- Miles AA, Misra SS, Irwin JO. The estimation of the bactericidal power of the blood. J Hyg (Lond). 1938 Nov;38(6):732-49.
- Pourhajibagher M, Chiniforush N, Shahabi S, Ghorbanzadeh R, Bahador A. Sub-lethal doses of photodynamic therapy affect biofilm formation ability and metabolic activity of Enterococcus faecalis. Photodiagnosis Photodyn Ther. 2016 Sep;15:159-66.
- O'Toole GA. Microtiter dish biofilm formation assay. J Vis Exp. 2011;47:1-2.
- Borzini L, Condò R, De Dominicis P, Casaglia A, Cerroni L. Root canal irrigation: Chemical agents and plant extracts against Enterococcus faecalis. Open Dent J. 2016;10:692-703.
- Zand V, Lotfi M, Soroush MH, Abdollahi AA, Sadeghi M, Mojadadi A. Antibacterial efficacy of different concentrations of sodium hypochlorite gel and solution on Enterococcus faecalis biofilm. Iran Endod J. 2016;11(4):315-9.
- Bidar M, Naderinasab M, Talati A, Ghazvini K, Asgari S, Hadizadeh B, et al. The effects of different concentrations of chlorhexidine gluconate on the antimicrobial properties of mineral trioxide aggregate and calcium enrich mixture. Dent Res J (Isfahan). 2012 Jul;9(4):466-71.
- Bukhary S, Balto H. Antibacterial efficacy of octenisept, alexidine, chlorhexidine, and sodium hypochlorite against Enterococcus faecalis biofilms. J Endod. 2017 Apr;43(4):643-647.
- Donyavi Z, Ghahari P, Esmaeilzadeh M, Kharazifard M, Yousefi-Mashouf R. Antibacterial efficacy of calcium hydroxide and chlorhexidine mixture for treatment of teeth with primary endodontic lesions: A randomized clinical trial. Iran Endod J. 2016;11(4):255-60.
- Ercan E, Ozekinci T, Atakul F, Gül K. Antibacterial activity of 2% chlorhexidine gluconate and 5.25% sodium hypochlorite in infected root canal: in vivo study. J Endod. 2004 Feb;30(2):84-7.
- Mittal R, Singla MG, Garg A, Gupta S, Dahiya V. Comparative evaluation of the antimicrobial efficacy of MTAD, oxytetracycline, sodium hypochlorite and chlorhexidine against Enterococcus faecalis: An ex-vivo study. 2012 May;2:70-4.
- Bansal S, Tewari S. Ex vivo evaluation of dye penetration associated with various dentine bonding agents in conjunction with different irrigation solutions used within the pulp chamber. Int Endod J. 2008 Nov;41(11):950-7.
- Darrag AM. Antimicrobial efficacy of endodontic irrigation solutions against planktonic microorganisms and dual-species biofilm. Tanta Dent J. 2013 Dec;10(3):129-37.
- Ghorbanzadeh S, Arab Loodaricheh S, Samizade S, Zadsirjan S. Irrigants in endodontic treatment. Int J Contemp Dent Med Rev.2015;7:1-7.
- Chiniforush N, Pourhajibagher M, Parker S, Shahabi S, Bahador A. The in vitro effect of antimicrobial photodynamic therapy with indocyanine green on Enterococcus faecalis: Influence of a washing vs non-washing procedure. Photodiagnosis Photodyn Ther. 2016 Dec;16:119-23.