Photoactivated Disinfection Technology Used In Root Canal Therapy Effectiveness Analysis

Objective: On the basis of conventional root canal therapy,photo-activated disinfection (PAD) technique was used twice before the rootcanal preparation and after root canal disinfection. Changes of the root canalbacteria quantity in patients were observed, and the statement of endodonticinter-appointment pain after root canal preparation was record. Furthermore,the change of alveolar bone density in teeth apical lesions area wasinvestigated by periapical X-ray films three months after PAD treatment. Weaimed to evaluate bactericidal and result and clinical effect of PAD technologyin root canal therapy.Methods: Twenty-nine patients with chronic single root canalinflammation were randomly divided into group A and group B. Generalsituation and medical history of patients was inquired before root canaltreatment. Chronic root apex inflammation was diagnosed by regular oralcavity examination and radiographic X-ray films. Fifteen patients in group Awere proceeding with PAD before root canal preparation and after root canaldisinfection when treated with conventional root canal therapy. Five times ofsampling were conducted before and after root canal preparation, after eachtime of PAD treatment and after root canal disinfection. Fourteen patients ingroup B were proceeding with conventional root canal treatment. Three timesof sampling were conducted before and after root canal preparation and afterroot canal disinfection. Uniform sampling method was utilized by using sterilepaper. Sample was uniformed and10-fold diluted, and then cultured (50μl) inblood agar plate under37℃aerobic conditions. Colony count was performed24h after the sample culture. The statements of endodontic inter-appointmentpain in all of the patients in both groups were inquired during the period ofroot canal treatment. Patients further consulated with doctor three months after the root canal filling was finished. Periapical film was photoed by X-ray withthe same proficient doctor. The change of alveolar bone density in teeth apicallesions area was investigated by Digora digital imaging system. Statisticalanalysis was performed to compare the difference of root canal bacteriaquantity, occurring rate and pain degree of endodontic inter-appointment painand alveolar bone density of teeth apical lesions area in two groups.Results: The photo-activated disinfection (PAD) technology made thequantity of bacteria in root canal decreased99.41%with statisticalsignificance (P<0.01), compared with the bacteria quantity before root canaldisinfection. In group A, the quantity of root canal bacteria decreased99.71%after the1st PAD treatment and root canal preparation, and the quantity of rootcanal bacteria decreased99.23%after root canal preparation in group B. Therewas no significant difference with the quantity of bacteria in the root canalbetween these two groups (P>0.05). The negative rate of root canal bacterialculture which were treated with conventional root canal therapy and twicePAD root canal disinfection group A was6.7%, while the negative rate ofgroup B after the conventional root canal therapy was50%. There wassignificant statistical differences between two groups (P<0.05). There was noincidence of endodontic inter-appointment pain (EIAP pain evaluated as gradeⅡ or Ⅲ) in group A, while The incidence rate of endodonticinter-appointment pain in group B was28.6%. Obviously, the incidence rateof endodontic inter-appointment pain in group B was much higher than groupA (P<0.05). Furthermore, the endodontic inter-appointment pain in group Bwas serious than that in group A (P<0.01). After3months of treatment, theteeth apical lesions area was smaller and the alveolar bone density wasincreased with varying degrees. However, there is no statistically differencebetween the two groups (P>0.05). In conclusion, the PAD technology in rootcanal therapy showed good clinical effect.Conclusions: The photo-activated disinfection (PAD) technology couldeffectively kill bacteria in root canal for chronic apical periodontitis patients,and alleviate endodontic inter-appointment pain. It reveals better clinical therapeutic effects, and provides a good basis for the root canal fillingtreatment.