Antimicrobial action of ozonated water and photodynamic therapy with sonic activation in root canals infected with Enterococcus faecalis

Analysis of antimicrobial efficacy of sodium hypochlorite and ozonated water against biofilm in oval canals

“…Several microorganisms and their byproducts are involved in the etiology of endodontic infections, including E. faecalis, which can invade dentinal tubules, shows strong adhesion to collagen, and is resistant to irrigating solutions commonly used during root canal instrumentation 15 . Given the great ability of this microorganism to survive root canal disinfection, biofilms of E. faecalis have been widely used in research settings 6 , 12 , 14 , 16 , 17 . However, because more than 150 species can colonize the root canal system 2 , the present study used mature multispecies biofilms containing E. faecalis , C. albicans , and S. aureus, microorganisms that are equally resistant and contribute to persistent intracanal infection, as done in previous studies using multispecies biofilms 15 , 18 .…”

“…In addition, it is important to highlight the biofilm formation time of 21 days, as used in previous studies 12 , 15 , 17 , 18 . In contrast, there are studies with younger biofilms, such as the one conducted by Hubbezoglu et al 6 , who waited 24 hours for biofilm formation.…”

“…Agitation potentiates the effects of the irrigant, which can be agitated by PUI 3 , 16 , 21 , 22 , continuous ultrasonic irrigation 12 , sonic agitation using the EA system 17 , 21 , and manual dynamic activation 21 . In the current study, the irrigants were agitated by PUI, a technique with some limitations such as the Irrisonic tip working until 2 mm short of the working length.…”

“…The S1 and S2 samples were collected with sterile paper points, as previously described 15 , 17 , 18 . However, a limitation of this method is that microorganisms can be collected only from the main canal and the most superficial dentin layer, in addition to not being able to identify disinfection by root canal thirds 23 .…”

“…The current study used both culture and molecular (qPCR) methods to analyze the level of disinfection achieved with different irrigants and agitation methods, as was done in the study by Moraes et al 12 , differing only in that they used monospecies biofilms of E. faecalis. Although the culture method was used in many other studies 3 , 6 , 15 , 17 , 18 , Siqueira and Rôças 23 report several limitations of the method, including the assessment of species prevalence only, without quantification, and the low sensitivity of culture for anaerobic species, which may lead to false-negative results. The real-time qPCR method overcomes these limitations by showing better sensitivity and specificity than the culture method and by producing quantitative results.…”