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We investigated the photodynamic effects of methylene blue (MB) on multi-species root canal biofilms comprising Actinomyces israelii, Fusobacterium nucleatum subspecies nucleatum, Porphyromonas gingivalis and Prevotella intermedia in experimentally infected root canals of extracted human teeth in vitro. The four test microorganisms were detected in root canals using DNA probes. Scanning electron microscopy (SEM) showed the presence of biofilms in root canals prior to therapy. Root canal systems were incubated with MB (25 µg/ml) for 10 minutes followed by exposure to red light at 665 nm with an energy fluence of 30 J/cm 2 . Light was delivered from a diode laser via a 250 µm diameter polymethyl methacrylate optical fiber that uniformly distributed light at 360°. Photodynamic therapy (PDT) achieved up to 80% reduction of colony-forming unit counts. We conclude that PDT can be an effective adjunct to standard endodontic antimicrobial treatment when the PDT parameters are optimized.

Diagnosis using CBCT revealed a lower healed and healing rate for primary root canal treatment than periapical radiographs, particularly in roots of molars. There was a 14 times increase in failure rate when teeth with no pre-operative periapical radiolucencies were assessed with CBCT compared with periapical radiographs at 1year.

Aim To compare using scanning electron microscopy (SEM) root canal walls following instrumentation in vitro with two different rotary NiTi instruments. The hypothesis was that no difference should be observable between the experimental groups in terms of debris on canal walls and surface morphology. Methodology Twenty-four single-rooted human teeth were selected. Two types of NiTi instruments were used, Mtwo (Sweden & Martina, Padova, Italy) and ProTaper (Dentsply Maillefer, Ballaigues, Switzerland). Irrigation for both groups was performed after each instrument change with 5% NaOCl, 3% H 2 O 2 and 17% EDTA solutions. Three different areas (coronal, middle and apical thirds) of the root canal were evaluated using SEM. The canal wall of each sample was assessed and compared using a predefined scale of four parameters, namely, smear layer, pulpal debris, inorganic dentine debris, surface profile. Data were analysed statistically using the Kruskal-Wallis test (anova). Results A statistically significant difference (P < 0.01) was found between the apical third and the middle and coronal thirds for both groups. No difference was observable between instrumentation groups. In the apical third canal walls were often contaminated by inorganic debris and by smear layer. In the apical third, the surface profile was affected by uninstrumented regions, comprising dentine depressions and grooves in which predentine was still visible. Conclusion Both instruments produced a clean and debris-free dentine surfaces in the coronal and middle thirds, but were unable to produce a dentine surfaces free from smear layer and debris in the apical third. The presence of deep grooves and depression on dentine walls in the apical third may well explain the presence of less-instrumented areas.

Objective-To study the in vitro effects of poly(lactic-co-glycolic acid) (PLGA) nanoparticles loaded with the photosensitizer methylene blue (MB) and light against Enterococcus faecalis (ATCC 29212).Materials and Methods-The uptake and distribution of nanoparticles in E. faecalis in suspension was investigated by transmission electron microscopy (TEM) after incubation with PLGA complexed with colloidal gold particles for 2.5, 5 and 10 minutes. E. faecalis species were sensitized in planktonic phase and in experimentally infected root canals of human extracted teeth with MB-loaded nanoparticles for 10 minutes followed by exposure to red light at 665 nm.Results-The nanoparticles were found to be concentrated mainly on the cell walls of microorganisms at all three time points. The synergism of light and MB-loaded nanoparticles led to approximately 2 and 1 log 10 reduction of colony-forming units in planktonic phase and root canals, respectively. In both cases, mean log 10 CFU levels were significantly lower than controls and MBloaded nanoparticles without light.Conclusion-The utilization of PLGA nanoparticles encapsulated with photoactive drugs may be a promising adjunct in antimicrobial endodontic treatment.

The results of this study support the need to determine the optimum MB concentration and light parameters to maximize bacterial killing in root canals.

T. denticola was associated with symptomatic endodontic disease in the presence of apical bone resorption. E. faecalis was associated with treatment failures. We suggest that these species may play critical roles in endodontic pathology.