The Evaluation of SWEEPS Plus Antimicrobial Photodynamic Therapy with Indocyanine Green in Eliminating Enterococcus faecalis Biofilm from Infected Root Canals: An In Vitro Study

Abstract

Objectives: This study aimed to assess the efficacy of shockwave-enhanced emission photoacoustic streaming (SWEEPS) plus antimicrobial photodynamic therapy (aPDT) using indocyanine green (ICG) for the elimination of Enterococcus faecalis biofilm from infected root canals. Materials and Methods: thirty sound human single-canal teeth were chosen and standardized to have 12 mm of root length. The root canals were shaped and prepared by means of ProTaper rotary files. After sterilization of the teeth, the canals were inoculated with E. faecalis for 2 weeks. The teeth were then randomly divided into six groups (n = five) of control, ICG, ICG + 808 nm diode laser, ICG + SWEEPS, ICG + 808 nm diode laser + SWEEPS, and 5.25% sodium hypochlorite (NaOCl). Following treatment, the number of colony-forming units (CFUs)/mL were calculated for each group. Statistical analysis was carried out using one-way ANOVA. For multiple comparisons, Tukey’s test was used as the post hoc test. Results: NaOCl alone showed the highest efficacy (p < 0.001). The ICG + 808 nm diode laser + SWEEPS group displayed significantly lower amounts of bacteria than either the ICG + 808 nm diode laser or SWEEPS (p < 0.001). There was a statistically significant difference detected between the ICG + 808 nm diode laser and ICG + SWEEPS (p = 0.035). Conclusions: SWEEPS can effectively increase the photosensitizer distribution in the root canal space, and its application along with irrigants can bring about promising results.

In Vitro Assessment of SWEEPS and Antimicrobial Photodynamic Therapy Alone or in Combination for Eradicating Enterococcus faecalis Biofilm in Root Canals

“…No such concern arises when using riboflavin. Furthermore, the inhibitory effect of NaOCl was notably nine times more effective than that of the ICG + DL + SWEEPS group [35]. Curcumin's limited use in clinical settings is due to its poor solubility and instability, whereas riboflavin is a water-soluble vitamin, making it more suitable for clinical use.…”

“…In prior studies, researchers have explored the effectiveness of aPDT combined with the SWEEPS technique against E. faecalis biofilm. These investigations involved the use of indocyanine green (ICG) and 808 nm DL [35], as well as curcumin/nano-curcumin and LED [39]. An important distinction in this study lies in the choice of photosensitizer and the light source employed.…”

“…In the next step, the insides of the root canals were dried with a paper cone. The teeth were transferred to a microtube filled with 1 mL of BHI broth and vortexed for 1 min [35]. Subsequently, 10 µL of the suspension was subjected to a series of 5 serial dilutions, and 10 µL from each dilution was cultured on BHI agar (Ibresco, Tehran, Iran), and incubated at 37 • C. The number of bacterial colonies was counted after 24 h [36].…”

Biofilm Removal from In Vitro Narrow Geometries Using Single and Dual Pulse Er:YAG Laser Photoacoustic Irrigation

“…The objective of this work was to fabricate two different narrow confined geometries and compare the efficiency of two laser pulse modalities for biofilm removal. We hypothesized that Er:YAG-AutoSWEEPS photoacoustic irrigation would better reach inaccessible sites and increase fluid flow rate in narrow geometries which would in turn increase the cleaning of Enterococcus faecalis biofilms, the main causative agent of persistent bacterial infection in oral cavity [ 36 , 37 , 38 , 39 ]. Biofilms were grown on titanium disks of different dimensions for 3 days to reach maturity.…”