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Comparação das técnicas de ativação sónica e laser na irrigação endodôntica para a erradicação de Enterococcus faecalis : um estudo in vitro
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Advisor(s)
Abstract(s)
Introdução: O avanço científico tem revelado o papel dos biofilmes bacterianos na capacidade de adesão às paredes do canal radicular, dificultando o tratamento das infeções endodônticas. Os principais desafios no tratamento endodôntico compreendem a anatomia radicular e a infeção microbiana. Após a conformação dos canais, a irrigação torna-se essencial, exercendo uma ação tanto mecânica quanto química. Atualmente, vários sistemas e protocolos de irrigação complementam a instrumentação, removendo tecido pulpar necrótico, a smear layer e as bactérias, assegurando o sucesso do tratamento endodôntico.
Objetivos: O objetivo foi implementar um estudo in vitro usando modelos 3D de dentes molares para determinar se as técnicas de irrigação com ativação sónica e ativação laser, são mais eficazes do que a irrigação passiva na desinfeção e limpeza dos canais radiculares.
Materiais e Métodos: O estudo foi dividido em duas fases, uma primeira fase de otimização de protocolos para quantificação e análise da formação de biofilme. E uma segunda fase para comparar os diferentes protocolos de irrigação na erradicação de biofilme de E. faecalis. No total foram utilizados 51 modelos 3D de molares inferiores (3DsurpreenDente tooth, Portugal) com 2 raízes e 3 canais (2 canais mesiais e 1 canal distal). Os canais foram preparados mecanicamente, esterilizados, e seguidamente inoculados para formação do biofilme de E. faecalis durante 21 dias. Os protocolos de irrigação foram aplicados e o biofilme remanescente foi recolhido dos canais radiculares e analisado através da contagem de UFCs/mL, qPCR, e microscopia de fluorescência.
Resultados: As 3 análises mostraram-se consistentes entre si. A ativação com laser revelou ser o método com maior redução da carga bacteriana, seguido da ativação sónica. Ambos os métodos de ativação demonstraram ser mais eficazes do que a irrigação manual convencional na remoção de E. faecalis.
Conclusão: Espera-se que os resultados obtidos ajudem a melhorar os procedimentos clínicos e, consequentemente, aumentar o sucesso dos tratamentos endodônticos.
Introduction: Scientific advances have uncovered the role of bacterial biofilms in their ability to adhere to the walls of the root canal, making the treatment of endodontic infections more demanding. The main challenges in endodontic treatment include root anatomy and microbial infection. After shaping the canals, irrigation becomes essential, providing both mechanical and chemical action. Currently, various irrigation systems and protocols complement instrumentation, removing necrotic pulp tissue, the smear layer, and bacteria, ensuring the success of endodontic treatment. Objectives: The aim was to conduct an in vitro study using 3D molar tooth models to determine whether irrigation techniques with sonic activation and laser activation are more effective than passive irrigation in disinfecting and cleaning root canals. Materials and Methods: The study was divided into two phases. The first phase focused on optimizing protocols for the quantification and analysis of biofilm formation. The second phase compared different irrigation protocols in the eradication of E. faecalis biofilm. In total, 51 3D models of lower molars (3DsurpreenDente tooth, Portugal) with 2 roots and 3 canals (2 mesial canals and 1 distal canal) were used. The canals were mechanically prepared, sterilized, and then inoculated for the formation of E. faecalis biofilm over 21 days. The irrigation protocols were applied, and the remaining biofilm was collected from the root canals and analyzed through CFU/mL counting, qPCR, and fluorescence microscopy. Results: The three analyses were consistent with each other. Laser activation proved to be the method with the greatest reduction in bacterial load, followed by sonic activation. Both activation methods were more effective than conventional manual irrigation in the removal of E. faecalis. Conclusion: The results obtained here are expected to help improve clinical procedures and, consequently, increase the success of endodontic treatments.
Introduction: Scientific advances have uncovered the role of bacterial biofilms in their ability to adhere to the walls of the root canal, making the treatment of endodontic infections more demanding. The main challenges in endodontic treatment include root anatomy and microbial infection. After shaping the canals, irrigation becomes essential, providing both mechanical and chemical action. Currently, various irrigation systems and protocols complement instrumentation, removing necrotic pulp tissue, the smear layer, and bacteria, ensuring the success of endodontic treatment. Objectives: The aim was to conduct an in vitro study using 3D molar tooth models to determine whether irrigation techniques with sonic activation and laser activation are more effective than passive irrigation in disinfecting and cleaning root canals. Materials and Methods: The study was divided into two phases. The first phase focused on optimizing protocols for the quantification and analysis of biofilm formation. The second phase compared different irrigation protocols in the eradication of E. faecalis biofilm. In total, 51 3D models of lower molars (3DsurpreenDente tooth, Portugal) with 2 roots and 3 canals (2 mesial canals and 1 distal canal) were used. The canals were mechanically prepared, sterilized, and then inoculated for the formation of E. faecalis biofilm over 21 days. The irrigation protocols were applied, and the remaining biofilm was collected from the root canals and analyzed through CFU/mL counting, qPCR, and fluorescence microscopy. Results: The three analyses were consistent with each other. Laser activation proved to be the method with the greatest reduction in bacterial load, followed by sonic activation. Both activation methods were more effective than conventional manual irrigation in the removal of E. faecalis. Conclusion: The results obtained here are expected to help improve clinical procedures and, consequently, increase the success of endodontic treatments.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Enterococcus faecalis Irrigação endodôntica Ativação sónica Ativação laser