Manual and Rotary Instrumentation Ability to Reduce Enterococcus faecalis Associated with Photodynamic Therapy in Deciduous Molars

Abstract

This aim of this study was to assess the ability of manual or rotary instrumentation associated with photodynamic therapy (PDT) to reduce Enterococcus faecalis using three combinations of light/photosensitizers: toluidine blue O/laser, fuchsin/halogen light and fuchsin/LED. Twenty deciduous molars were selected and contaminated with Enterococcus faecalis (McFarland 0.5 scale). Working length determination was performed by visual method. The teeth were randomly divided into two groups: G1 (n=10): manual instrumentation (Kerr-type files) and G2 (n=10): rotary instrumentation (ProTaper system). The bacteria were collected three times using sterile paper cones compatible with the anatomic diameter of the root canal for 30 s before and after instrumentation and after PDT. The samples were diluted in peptone water, seeded on blood agar plates and incubated in an oven at 37 °C for colony-forming units counting. The decrease of E. faecalis counts after instrumentation and after PDT was compared using the Wilcoxon test, t-test and Kruskal Wallis test. A significant reduction of E. faecalis occurred after manual and rotary instrumentation and after PDT using the three combinations of light/ photosensitizer (p<0.05). It may be concluded that both rotary and manual instrumentation reduced E. faecalis. Fuchsin with halogen light or LED irradiation and toluidine blue O with laser irradiation can be used to reduce E. faecalis in root canals of primary molars. PDT can be used as an adjuvant to conventional endodontic treatment.

Assessment of Extruded Debris in Primary Molars Comparing Manual and Reciprocating Instrumentation

“…In a previous study [10], the authors used the small 21:06 CRT file of 21 mm in length, of the WaveOne system and it was observed that it was effective for disinfecting and modeling the root systems of primary molars [7,9].…”

“…The WaveOne system allows greater flow of irrigating solution by removing smaller amounts of dentin from the channel walls [6], thus reducing the extrusion of debris and reducing the risk of damaging or frustrating the instrument in irregular channels as presented the primary teeth [5][6][7]. This method has also been shown to be more effective in disinfecting the radial channels of deciduous molars [8][9][10].…”

“…The WaveOne system stands out also because it requires less work time compared to other techniques [9,10]. In pediatric dentistry, the use of techniques that reduce office work time by improving the quality of care and patient well-being are extremely important.…”

Usage of Rotary Instruments in Root Canal Therapy of Deciduous Teeth - Review

“…4,15,16 Comparing rotary instruments with manual instruments in terms of intracavitary microorganism elimination demonstrated that both systems significantly reduced the number of microorganisms and that there was no statistical difference between them. [17][18][19] Conventional stainless steel files were reported to remove more dentin tissue, especially in the coronal region. Although the difference between them and rotary instruments was not significant, stainless steel files were indicated to provide more efficient cleaning.…”

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

“…Many authors demonstrated the positive effect of PDT on E. faecalis reduction on extracted human teeth when it was accompanied by various protocols [25][26][27][28][29]. Some authors demonstrated that the effect of PDT in combination with various antimicrobial irrigants (NaOCl and EDTA) was more pronounced against E. faecalis, while the effect of irrigants alone was greater against Streptococcus mutans [25].…”