Efeito do laser diodo de alta potência na redução bacteriana em canais radiculares infectados por Enterococcus faecalis
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Data
2018-03-29
Autores
Mançanares, Ariel Zogbi Barbosa [UNESP]
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Editor
Universidade Estadual Paulista (Unesp)
Resumo
O sucesso do tratamento endodôntico depende da eliminação de microrganismos do sistema de canais radiculares. As soluções irrigadoras e métodos mecânicos são incapazes de eliminar completamente as bactérias, que penetram profundamente nos túbulos dentinários e sistema de canais radiculares. Novos métodos de descontaminação intracanal, como o laser, têm sido estudados. Este estudo ex vivo foi realizado para avaliar o efeito antibacteriano de um laser diodo de alta potência, a irrigação convencional e combinação destas técnicas em dentes contaminados com biofilme de Enterococcus faecalis. Sessenta e cinco dentes unirradiculados com canal único foram selecionados, suas coroas foram removidas e as raizes padronizadas em 15mm e foram preparados com limas manuais e Reciproc R50. Posteriormente foram preparados para o estudo microbiológico. Seus forames apicais foram selados com resina fotopolimerizável e a superfícies externa radicular foi impermeabilizada com adesivo epoxi e os espécimes foram fixados em placas de 24-poços e esterilizados com óxido de etileno. Cinquenta e cinco foram contaminados com E. faecalis. Após 21 dias de incubação, os espécimes foram divididos em três grupos experimentais (n = 15): NaOCl, Solução salina + laser (SS+laser), e NaOCl + laser; e dois grupos controle (n = 10): Controle positivo (C+) e controle negativo (C-). No grupo NaOCl os espécimes foram irrigados com 5 mL de hipoclorito de sódio-NaOCl a 2,5%; no grupo SS+laser, foram irrigados com 5 mL de solução salina e posteriormente irradiados com laser diodo de alta potência 808 nm com 1,5 W em três aplicações de 5 x 5 s; no grupo NaOCl + laser, foram irrigados com 5 mL de NaOCl a 2,5% e posteriormente irradiados com laser da mesma maneira que no grupo anterior. Foram realizadas três coletas microbiológicas (C1- 21 dias após contaminação, C2- imediatamente póstratamento e C3- após 7 dias do tratamento). Após diluição decimal seriada e plaqueamento, foi realizada a contagem de unidades formadoras de colônias (UFC mL-1). Na C1, todos os grupos experimentais apresentaram contaminação bacteriana; Na C2, os grupos NaOCl e NaOCl + laser não apresentaram crescimento bacteriano, diferente do grupo SS + laser que apresentou crescimento bacteriano, porém houve uma redução significativa quando comparado ao grupo C+; Na C3, após sete dias do tratamento, todos os grupos apresentaram crescimento bacteriano. NaOCl e NaOCl + laser foram mais eficazes na redução bacteriana em comparação ao grupo de SS + laser (p<0,05) e estes não apresentaram diferença estatística entre si (p>0,05). Nos parâmetros estudados, conclui-se que o laser diodo de alta potência não demonstra efeito significante em relação ao NaOCl na redução bacteriana intracanal. Novos protocolos de irradiação com laser devem ser estudados frente ao E. faecalis.
The success of the endodontic treatment depends on the elimination of microorganisms from the root canal system. The irrigant solutions and mechanical methods are incapable of eliminating bacteria, which penetrate deeply into the dentinal tubules and root canal systems. New methods of intracanal decontamination, like lasers, have been studied. This ex vivo study was done to evaluate the antibacterial effect of a high-power diode laser, conventional irrigation and the combination of these techniques in teeth contaminated with Enterococcus faecalis biofilm. Sixty-five uniradicular teeth with single canal were selected, their crowns were removed, and roots were standardized with 15 mm and were prepared with manual files and Reciproc R50. Afterwards, they were prepared for microbiological study. Their apical foramen was sealed with light cured resin and their root external surfaces were sealed with Epoxi adhesive and the specimens were attached to 24-well microplates and sterilized with ethylene oxide. Fifty-five specimens were contaminates with E. faecalis. After 21 days of incubation, the specimens were divided into three experimental groups (n = 15): NaOCl, Saline + laser (SS+laser), and NaOCl + laser; and two control groups (n = 10): Positive control (C+) and negative control (C-). In the NaOCl group, the specimens were irrigated with 5 mL of 2,5% sodium hypochlorite – NaOCl; in the SS+laser group, they were irrigated with 5 mL of saline and then irradiated with highpower diode laser with 808 nm and 1,5W, in three applications of 5 x 5 s; In the NaOCl + laser group, they were irrigated with 5 mL of 2,5% NaOCl and then irradiated with laser in the same protocol as the previous group. Three microbiological samples were collected (C1- 21 days after inoculation, C2- immediately after treatment and C3- after 7 days of treatment). After decimal dilution and plating, counting of colony forming units (CFU mL-1) was done. In the C1, all experimental groups showed bacterial contamination; in the C2, the NaOCl and NaOCl + laser didn’t show bacterial growth, differing from the SS + laser group, that showed bacterial growth, but also showed significant bacterial reduction when compared to the C+ group; in the C3, seven days after treatment, all groups showed bacterial growth. NaOCl and NaOCl + laser were more efficient in bacterial reduction when compared to the SS + laser group (p<0,05) and they didn’t show statistical difference between them (p>0,05). In the studied parameters, it was concluded that the high-power diode laser didn’t show significant effect when compared to NaOCl in intracanal bacterial reduction. New laser irradiation protocols should be studied against E. faecalis.
The success of the endodontic treatment depends on the elimination of microorganisms from the root canal system. The irrigant solutions and mechanical methods are incapable of eliminating bacteria, which penetrate deeply into the dentinal tubules and root canal systems. New methods of intracanal decontamination, like lasers, have been studied. This ex vivo study was done to evaluate the antibacterial effect of a high-power diode laser, conventional irrigation and the combination of these techniques in teeth contaminated with Enterococcus faecalis biofilm. Sixty-five uniradicular teeth with single canal were selected, their crowns were removed, and roots were standardized with 15 mm and were prepared with manual files and Reciproc R50. Afterwards, they were prepared for microbiological study. Their apical foramen was sealed with light cured resin and their root external surfaces were sealed with Epoxi adhesive and the specimens were attached to 24-well microplates and sterilized with ethylene oxide. Fifty-five specimens were contaminates with E. faecalis. After 21 days of incubation, the specimens were divided into three experimental groups (n = 15): NaOCl, Saline + laser (SS+laser), and NaOCl + laser; and two control groups (n = 10): Positive control (C+) and negative control (C-). In the NaOCl group, the specimens were irrigated with 5 mL of 2,5% sodium hypochlorite – NaOCl; in the SS+laser group, they were irrigated with 5 mL of saline and then irradiated with highpower diode laser with 808 nm and 1,5W, in three applications of 5 x 5 s; In the NaOCl + laser group, they were irrigated with 5 mL of 2,5% NaOCl and then irradiated with laser in the same protocol as the previous group. Three microbiological samples were collected (C1- 21 days after inoculation, C2- immediately after treatment and C3- after 7 days of treatment). After decimal dilution and plating, counting of colony forming units (CFU mL-1) was done. In the C1, all experimental groups showed bacterial contamination; in the C2, the NaOCl and NaOCl + laser didn’t show bacterial growth, differing from the SS + laser group, that showed bacterial growth, but also showed significant bacterial reduction when compared to the C+ group; in the C3, seven days after treatment, all groups showed bacterial growth. NaOCl and NaOCl + laser were more efficient in bacterial reduction when compared to the SS + laser group (p<0,05) and they didn’t show statistical difference between them (p>0,05). In the studied parameters, it was concluded that the high-power diode laser didn’t show significant effect when compared to NaOCl in intracanal bacterial reduction. New laser irradiation protocols should be studied against E. faecalis.
Descrição
Palavras-chave
Lasers semicondutores, Endodontia, Enterococcus faecalis, Lasers, Endodontics