Case Report: Single visit photo-activated disinfection in regenerative endodontics

Abstract

Background: Root canal disinfection is considered critical for achieving successful regenerative endodontic procedures. Photo-activated disinfection is a novel disinfection method that can help to achieve the goal of regenerative endodontics. This article reports the clinical and radiographic results after single visit regenerative endodontics using photo-activated disinfection. Methods: An 8.5-year-old girl complained of fractured upper right central incisor. Pulp necrosis was diagnosed on the basis of clinical findings. The root canal was irrigated with sodium hypochlorite solution (1.5%) followed by saline. Then, the canal was dried with paper points. A combination of a photosensitizer solution and low power laser light were applied. EDTA solution was used as a final irrigant. Bleeding was induced, followed by placement of collagen resorbable matrix and white mineral trioxide aggregate. Two days later, the tooth was sealed and restored with permanent filling. Results: Clinical findings revealed no pain on percussion or palpation tests. Radiographic examination revealed an increase in root length, an increase of apical root thickness and apical closure at the 12-month follow-up period. Conclusion: Regenerative endodontics using photo-activated disinfection achieved successful outcomes in the necrotic immature permanent tooth.

What the future holds for regenerative endodontics: novel antimicrobials and regenerative strategies

“…Curcumin possesses a wide spectrum of bioactive and therapeutic properties such as antibacterial, antifungal, and antiviral properties (Praditya et al, 2019;Rai et al, 2008). Antioxidant and antiinflammatory activities are also documented in the literature (Hewlings and Kalman, 2017;Rai et al, 2020;Sinjari et al, 2019).…”

“…The antimicrobial action of curcumins is attributed to their ability to damage the bacterial cell membrane through the suppression of bacterial cytokinesis, the induction of filamentation, and the inhibition of the FtsZ assembly dynamics in the Z-ring (Rai et al, 2008). Inhibition of cellular proliferation and alterations of gene expression are also reported to be behind the bactericidal mechanisms of curcumins (Rai et al, 2008;Rai et al, 2020;Tyagi et al, 2015).…”

“…However, to date, this is scarcely documented in vivo. Successful clinical and radiographic outcomes, in terms of thickening of dentinal walls and apical closure, following the adjunct use of tolonium chloride photosensitiser followed by platelet-rich fibrin (Johns et al, 2014) or collagen resorbable matrix (Abdel Hafiz Abdel Rahim et al, 2019) are reported.…”

Regenerative Endodontics as the Future Treatment of Immature Permanent Teeth

“…It was successfully used in root canal disinfection of mature teeth [59][60][61][62]. Attempts are being made to use it in REP [62,63]. It is based on activating a photosensitizer (tolonium chloride or toluidine blue) with a low-power laser light at an appropriate wavelength.…”

“…If necessary, the treatment may be repeated several times during one visit. It also has the advantage of performing the entire REP in a single visit, which minimizes the risk of contamination during subsequent tooth opening [62][63][64]. However, it requires appropriate instrumentation.…”