Is the chlorophyll derivative Zn(II)e 6 Me a good photosensitizer to be used in root canal disinfection?

Diogo, Patrícia; Mota, Marta; Fernandes, Chantal; Sequeira, Diana; Palma, Paulo J.; Caramelo, Francisco; Neves, Maria G. P. M. S.; Faustino, Maria A. F.; Gonçalves, Teresa; Santos, João Miguel

doi:10.1016/j.pdpdt.2018.04.009

Cited by 38 publications

(19 citation statements)

References 43 publications

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“…Recently, aPDT was applied in endodontics by our team with a focus on a semi-synthetic photosensitizer obtained from the cyanobacteria Spirulina maxima alga (i.e., a modified chlorophyll Zn(II)chlorin e 6 methyl ester [(Zn(II)e 6 Me]), with promising outcomes [10,16]. However, due to the disparity of root canal anatomies, as well as to the lower oxygen availability inside the root canal, researchers have been testing numerous approaches and methods to improve aPDT efficacy [17].…”

Section: Introductionmentioning

confidence: 99%

An Insight into Advanced Approaches for Photosensitizer Optimization in Endodontics—A Critical Review

Diogo

Faustino

Neves

et al. 2019

JFB

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Apical periodontitis is a biofilm-mediated disease; therefore, an antimicrobial approach is essential to cure or prevent its development. In the quest for efficient strategies to achieve this objective, antimicrobial photodynamic therapy (aPDT) has emerged as an alternative to classical endodontic irrigation solutions and antibiotics. The aim of the present critical review is to summarize the available evidence on photosensitizers (PSs) which has been confirmed in numerous studies from diverse areas combined with several antimicrobial strategies, as well as emerging options in order to optimize their properties and effects that might be translational and useful in the near future in basic endodontic research. Published data notably support the need for continuing the search for an ideal endodontic photosensitizer, that is, one which acts as an excellent antimicrobial agent without causing toxicity to the human host cells or presenting the risk of tooth discoloration. The current literature on experimental studies mainly relies on assessment of mixed disinfection protocols, combining approaches which are already available with aPDT as an adjunct therapy. In this review, several approaches concerning aPDT efficiency are appraised, such as the use of bacteriophages, biopolymers, drug and light delivery systems, efflux pump inhibitors, negative pressure systems, and peptides. The authors also analyzed their combination with other approaches for aPDT improvement, such as sonodynamic therapy. All of the aforementioned techniques have already been tested, and we highlight the biological challenges of each formulation, predicting that the collected information may encourage the development of other effective photoactive materials, in addition to being useful in endodontic basic research. Moreover, special attention is dedicated to studies on detailed conditions, aPDT features with a focus on PS enhancer strategies, and the respective final antimicrobial outcomes. From all the mentioned approaches, the two which are most widely discussed and which show the most promising outcomes for endodontic purposes are drug delivery systems (with strong development in nanoparticles) and PS solubilizers.

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Section: Introductionmentioning

confidence: 99%

An Insight into Advanced Approaches for Photosensitizer Optimization in Endodontics—A Critical Review

Diogo

Faustino

Neves

et al. 2019

JFB

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“…This technique presents several advantages when compared with the use of traditional antimicrobials, showing to be efficient independently of the antimicrobial resistance profile and to prevent further development of resistance even after several cycles of treatment [15][16][17]26]. This approach has been efficient to inactivate several microorganisms, such as gram-negative and gram-positive bacteria [18,19,21], fungi [15,[27][28][29], and viruses [15,30], and to degrade the matrix of microbial biofilms and kill the resident bacteria [16,31,32].…”

Section: Introductionmentioning

confidence: 99%

The Remarkable Effect of Potassium Iodide in Eosin and Rose Bengal Photodynamic Action against Salmonella Typhimurium and Staphylococcus aureus

et al. 2019

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Antimicrobial photodynamic therapy (aPDT) has been shown as a promising technique to inactivate foodborne bacteria, without inducing the development of bacterial resistance. Knowing that addition of inorganic salts, such as potassium iodide (KI), can modulate the photodynamic action of the photosensitizer (PS), we report in this study the antimicrobial effect of eosin (EOS) and rose bengal (RB) combined with KI against Salmonella enterica serovar Typhimurium and Staphylococcus aureus. Additionally, the possible development of bacterial resistance after this combined aPDT protocol was evaluated. The combination of EOS or RB, at all tested concentrations, with KI at 100 mM, was able to efficiently inactivate S. Typhimurium and S. aureus. This combined approach allows a reduction in the PS concentration up to 1000 times, even against one of the most common foodborne pathogenics, S. Typhimurium, a gram-negative bacterium which is not so prone to inactivation with xanthene dyes when used alone. The photoinactivation of S. Typhimurium and S. aureus by both xanthenes with KI did not induce the development of resistance. The low price of the xanthene dyes, the non-toxic nature of KI, and the possibility of reducing the PS concentration show that this technology has potential to be easily transposed to the food industry.

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“…Eradication of endodontic infection, elimination of microorganisms, and prevention of further infection are the main goals of endodontic treatment. With the available conventional treatment protocols, it is almost impossible to achieve these goals due to the presence of many factors, such as the complex anatomical structure of the endodontium, the biofilm lifestyle of bacteria, the increase of antibiotic-resistant strains, and the incapability of irrigants to penetrate the dentinal tubules at the apical portion of root canals [6][7][8].…”

Section: Introductionmentioning

confidence: 99%

“…In order to improve the antimicrobial capacities of conventional endodontic techniques, new approaches, instruments, and medications have been proposed. Photodynamic therapy (PDT) in the endodontic field has been proposed as an adjunctive modality to the conventional treatment protocols, especially for the management of refractory endodontic infections [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…Some authors have demonstrated better results of PDT through improving the evaluation methodology of the antibacterial effect [4]. Others attributed the reduced efficacy of PDT to the reduced penetration ability of PSs; therefore, they have suggested improving the pharmacological characteristics of PSs using semi-synthetic PSs (e.g., chlorophyll derivative [Zn(II)e6Me]) or nanoparticles containing PS (e.g., rose bengal-functionalized chitosan nanoparticle (CSRBnps)) [8,16].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Photodynamic Therapy Using a Diode Laser 635 nm as an Adjunct to Conventional Chemo-Mechanical Endodontic Procedures against Enterococcus faecalis Biofilm: Ex-Vivo Study

et al. 2020

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The study aimed to evaluate the antimicrobial effect of photodynamic therapy (PDT) with the use of Toluidine Blue (TB) on extracted teeth infected with biofilms of Enterococcus faecalis. Fifty-four extracted teeth with single-roots and single canals were mechanically shaped, autoclaved, and contaminated with E. faecalis. They were randomly divided into six groups: two groups were negative and positive control groups, two groups were subjected to mechanical instrumentation and PDT with different pre-irradiation times and irradiation times, and two groups were subjected to chemo-mechanical endodontic treatment and PDT with different pre-irradiation times and irradiation times. In PDT groups, after the application of TB, the canals were irradiated with a diode laser of wavelength 635 nm, with a fiber diameter of 200 μm and 100 mW of power in continuous mode. The bacterial load was evaluated using a BioTimer Assay protocol. The greatest reduction of bacterial load was observed in groups of combined PDT with chemo-mechanical treatment. The reductions of bacterial load in groups of combined PDT with chemo-mechanical treatment, and in the positive control group, were significant (p < 0.01) when compared to that of the negative control group. Photodynamic therapy as an adjunctive modality may improve the disinfection capacity of conventional endodontic treatment against E. faecalis.

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Is the chlorophyll derivative Zn(II)e 6 Me a good photosensitizer to be used in root canal disinfection?

Cited by 38 publications

References 43 publications

An Insight into Advanced Approaches for Photosensitizer Optimization in Endodontics—A Critical Review

An Insight into Advanced Approaches for Photosensitizer Optimization in Endodontics—A Critical Review

The Remarkable Effect of Potassium Iodide in Eosin and Rose Bengal Photodynamic Action against Salmonella Typhimurium and Staphylococcus aureus

Evaluation of Photodynamic Therapy Using a Diode Laser 635 nm as an Adjunct to Conventional Chemo-Mechanical Endodontic Procedures against Enterococcus faecalis Biofilm: Ex-Vivo Study

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