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Estudo comparativo da ação microbiana do hipoclorito de sódio recorrendo a terapia fotodinâmica contra enteroccocus faecalis
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Introdução: Os irrigantes convencionais, como o Hipoclorito de Sódio, não são totalmente eficazes na eliminação bacteriana. O insucesso do tratamento endodôntico deve-se à presença de bactérias no interior do canal. Atualmente, têm surgido novos métodos para melhorar a taxa de sucesso do tratamento endodôntico, a Terapia Fotodinâmica tem sido estudado como coadjuvante ao tratamento convencional na eliminação dos microrganismos. Objetivo: Verificar a capacidade bactericida da Terapia Fotodinâmica como coajduvante do tratamento endodôntico quando comparado com tratamento endodôntico convencional com soluções de Hipoclorito de Sódio a 5% e a 2,5%. Materiais e métodos: Preparação de 56 dentes monorradiculares: 30 dentes de estudo e 12 dentes controlo. Inoculação com a estripe de Enterococcus faecalis de referência (ATCC 29212). Realizaram-se quatro protocolos de desinfeção testando a eliminação de E. faecalis. No Grupo 1, avaliou-se a capacidade de desinfeção do Hipoclorito de Sódio a 5%. No Grupo 2, avaliou-se a capacidade de desinfeção do Hipoclorito de sódio a 2,5%. No Grupo 3, avaliou-se a capacidade de desinfeção do Hipoclorito de Sódio a 5% complementado com a Terapia Fotodinâmica. No Grupo 4, avaliou-se a capacidade de desinfeção do Hipoclorito de Sódio a 2,5% complementado com a Terapia Fotodinâmica. A eliminação de E. faecalis foi verificada através de métodos de cultura bacteriológica. Resultados: Todos os grupos apresentaram efeito antibacteriano. No entanto, nenhum erradicou por completo a E. faecalis. O grupo 1 e o grupo 3 apresentaram os resultados mais eficázes. O grupo 2 apresentou os valores mais baixos de atividade bactericida. Conclusão: A Terapia Fotodinâmica mostrou ser um bom complemento de soluções de Hipoclorito de Sódio em baixas concentrações. Porém, a Terapia Fotodinâmica como complemento do Hipoclorito de Sódio a 5% não apresentou melhoria. O Hipoclorito de Sódio na concentração de 5% continua a ser o método mais eficaz na eliminação de E. faecalis.
Introduction: The conventional irrigants, as Sodium Hypochlorite, are not totally effective in eliminating the bacteria. The unsuccessful result in endodontic treatment is due to the presence of bacteria inside the root canal. Nowadays, there are new methods to improve the success rate of endodontic treatments, the Photodynamic Therapy has been studied as a valid adjuvant to the conventional treatment on the microorganisms elimination. Objective: Verify the effectiveness of the Photodynamic Therapy as adjuvant to the endodontic treatment when compared to the conventional endodontic treatment with solutions of Sodium Hypochlorite 5% and 2,5%. Materials and Methods: Preparation of 56 monorradicular teeth: 30 study teeth and 12 control teeth. Inoculation with Enterococcus faecalis reference (ATCC 29212). Four disinfection protocols were design testing the elimination of E. faecalis. In Group 1, it was evaluated the antibacterial efficacy of Sodium Hypochlorite 5%. In Group 2, it was evaluated the antibacterial efficacy of Sodium Hypochlorite 2,5%. In Group 3, it was evaluated the antibacterial efficacy of Sodium Hypochlorite 5% complemented with the Photodynamic Therapy. In Group 4, it was evaluated the antibacterial efficacy of Sodium Hypochlorite 2,5% complemented with the Photodynamic Therapy. The elimination of E. faecalis was verified through bacterial growth methods. Results: All the groups had antimicrobial effect. However, none completely eradicated E. faecalis. The group 1 and group 3 had more effective results. The group 2 had the lower antibacterial activity values. Conclusion: The Photodynamic Therapy showed to be a good complement with low Sodium Hypochlorite concentrations. Yet, the Photodynamic Therapy as a Sodium Hypochlorite 5% complement did not show any improvements. The Sodium Hypochlorite at a concentration of 5% still is the most effective method in the elimination of E. faecalis.
Introduction: The conventional irrigants, as Sodium Hypochlorite, are not totally effective in eliminating the bacteria. The unsuccessful result in endodontic treatment is due to the presence of bacteria inside the root canal. Nowadays, there are new methods to improve the success rate of endodontic treatments, the Photodynamic Therapy has been studied as a valid adjuvant to the conventional treatment on the microorganisms elimination. Objective: Verify the effectiveness of the Photodynamic Therapy as adjuvant to the endodontic treatment when compared to the conventional endodontic treatment with solutions of Sodium Hypochlorite 5% and 2,5%. Materials and Methods: Preparation of 56 monorradicular teeth: 30 study teeth and 12 control teeth. Inoculation with Enterococcus faecalis reference (ATCC 29212). Four disinfection protocols were design testing the elimination of E. faecalis. In Group 1, it was evaluated the antibacterial efficacy of Sodium Hypochlorite 5%. In Group 2, it was evaluated the antibacterial efficacy of Sodium Hypochlorite 2,5%. In Group 3, it was evaluated the antibacterial efficacy of Sodium Hypochlorite 5% complemented with the Photodynamic Therapy. In Group 4, it was evaluated the antibacterial efficacy of Sodium Hypochlorite 2,5% complemented with the Photodynamic Therapy. The elimination of E. faecalis was verified through bacterial growth methods. Results: All the groups had antimicrobial effect. However, none completely eradicated E. faecalis. The group 1 and group 3 had more effective results. The group 2 had the lower antibacterial activity values. Conclusion: The Photodynamic Therapy showed to be a good complement with low Sodium Hypochlorite concentrations. Yet, the Photodynamic Therapy as a Sodium Hypochlorite 5% complement did not show any improvements. The Sodium Hypochlorite at a concentration of 5% still is the most effective method in the elimination of E. faecalis.
Descrição
Tese de mestrado, Medicina Dentária, Universidade de Lisboa, Faculdade de Medicina Dentária, 2015
Palavras-chave
Tratamento endodôntico Terapia fotodinâmica Teses de mestrado - 2015