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Investigation of Endodontic Disinfection by Combination of Laser and Nanobubble Technology
Haosu Ci1, BingCheng Xin2, Andrew W Hubbard3
1Department of Bioscience Research, College of Dentistry, University of Tennessee Health Science Center, Memphis, Tennessee; Department of Oral Medicine, Binzhou Medical University Hospital, Binzhou & School of Stomatology, Binzhou Medical University, Yantai, Shandong, China.
Introduction:
To investigate the combined use of laser, nanobubble water (NB-H2O), and calcium hydroxide (Ca(OH)2) for endodontic disinfection, particularly in regenerative endodontic cases where maximum effectiveness is needed.
Methods:
The canal of human teeth were prepared, sterilized, and inoculated with Enterococcus faecalis (E. faecalis). Teeth were assigned to 4 groups for 2 rounds of disinfection with Er,Cr: YSGG laser (Biolase). Group I - control, no disinfection, Group II - 6.25% NaOCl, Group III - 1.25% NaOCl, and Group IV - 1.25% NaOCl/NB-H2O. Ca(OH)2 was placed in the canal for ∼10 days between the 2 disinfection rounds. Teeth were evaluated by scanning electron microscopy for biofilm removal and confocal laser scanning microscopy to detect live/dead bacteria in the dentinal tubules.
Results:
Scanning electron microscopy analysis of the canal disinfection indicated that the NB-H2O group (1.25% NaOCl/NB-H2O) appeared to enhance the removal of biofilm/smear layer. However, it was not consistently more effective than other groups in killing the bacteria in the dentinal tubules. The combined use of low-concentration NaOCl, laser, NB-H2O and Ca(OH)2 largely reduced E. faecalis but did not achieve complete eradication from the canal or in the dentinal tubules.
Conclusions:
Our comprehensive disinfection protocol reduced the bacteria in the dentinal tubules to a level potentially suited for regenerative endodontic therapy.
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