Aplicabilidade da terapia fotodinâmica antimicrobiana na eliminação do Enterococcus faecalis

Introducao: A endodontia e uma especialidade odontologica que visa promover a saude dentaria por meio da eliminacao de micro-organismos capazes de causar agressoes pulpares. A terapia fotodinâmica antimicrobiana, apresenta-se como uma alternativa coadjuvante ao tratamento endodontico convencional para eliminacao dos micro-organismos resistentes ao preparo-quimico-mecânico. Objetivo: Explorar a literatura dando enfoque ao mecanismo de acao e aplicabilidade da aPDT na eliminacao do Enterococcus faecalis . Material e metodo: Realizou-se uma revisao de literatura conduzida atraves do acesso as bases de dados eletronicos Medline/Pubmed e Scielo utilizando isoladamente ou em associacao as palavras-chaves “Photodynamic Therapy”, “ Enterococcus faecalis ” e “Endodontic”, no periodo de 2007 a 2017, totalizando 392 artigos. Resultados: A eliminacao de forma eficaz de bacterias, Enterococcus faecalis, sao vantagens atribuidas a terapia fotodinâmica, no entanto, a literatura evidencia a necessidade de utiliza-la associada a outras formas de tratamento. Conclusao: E necessaria a padronizacao dos protocolos para que se obtenha dados mais esclarecedores sobre a eficacia da terapia fotodinâmica na eliminacao do Enterococcus faecalis. Descritores: Endodontia; Fotoquimioterapia; Enterococcus faecalis. Referencias Siqueira JF, Rocas I. Clinical implications and microbiology of bacterial persistence after treatment procedures. J Endod 2008; 34(11):1291-301 e 3.  Fouad AF, Zerella J, Barry J, Spangberg LS. Molecular detection of Enterococcus species in root canals of therapy-resistant endodontic infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;99(1):112–18. Amaral RR, AmorimJCF, Nunes E, Soares JA, Silveira FF.  Terapia fotodinâmica na endodontia: revisao de literatura. RFO. 2010;15(2):207-11. Pfitzner A, Sigusch B W, Albrecht V, Glockmann E. Killing of periodontopathogenic bacteria by photodynamic therapy J Periodontol. 2004. 75(10):1343–49. Tortora GJ, Funke BR, Case CL. Microbiology an introduction. San Francisco: Pearson Benjamin Cummings; 2010. Asnaashari M, Godiny M, Azari-Marhabi S, Tabatabaei FS, Barati M. Comparison of the antibacterial effect of 810 nm diode laser and photodynamic therapy in reducing the microbial flora of root canal in endodontic retreatment in patients with periradicular lesions. J Lasers Med Sci. 2016;7(2):99-104. Asnaashari M, Safavi N. Application of low level lasers in Dentistry (Endodontic). J Lasers Med Sci. 2013;4(2):57-66. Maia Filho ET, Maia CCR, Bastos ACSC, Novais TMG. Efeito antimicrobiano in vitro de diferentes medicacoes endodonticas e propolis sobre Enterococcus faecalis . RGO. 2008;56(1):21-5. Pinheiro ET, Gomes BP, Ferraz CC, Teixeira FB, Zaia AA, Souza Filho FJ. Evaluation of root canal microorganisms isolated from teeth with endodontic failure and their antimicrobial susceptibility. Oral Microbiol Immunol. 2003;18(2):100-3. SchirrmeisterJF, LiebenowAL, Pelz K, WittmerA, Serr A, Hellwig E et al. New bacterial compositions in root-filled teeth with periradicular lesions. J Endod. 2009; 35(2):169-74. Amaral RR, Amorim JCF, Nunes E, Soares JA, Silveira FF. Terapia fotodinâmica na endodontia: revisao de literatura. RFO. 2010;15(2):207-11. Endo MS, Martinho FC, Zaia AA, Ferraz CC, Almeida JF, Gomes BP. Quantification of cultivable bacteria and endotoxin in post-treatment apical periodontitis before and after chemo-mechanical preparation. Eur J Clin Microbiol Infect Dis. 2012;31(10):2575-83. Zhang C, Hou BX, Zhao HY, Sun Z. Microbial diversity in failed endodontic root-filled teeth. Chin Med J (Engl). 2012;125(6):1163-68. Endo MS,   Ferraz  CC,   Zaia  AA,   Almeida  JF, Gomes BP. Quantitative and qualitative analysis of microorganisms in root-filled teeth with persistent infection: monitoring of the endodontic retreatment. Eur J Dent. 2013;7(3):302-9. Morrison D, Woodford N, Cookson B. Enterococci as emerging pathogens of humans. Soc Appl Bacteriol Symp Ser. 1997;26:89S-99S. Poeschl PW, Spusta L, Russmueller G, Seemann R, Hirschl A, Poeschl E et al. Antibiotic susceptibility and resistance of the odontogenic microbiological spectrum and its clinical impact on severe deep space head and neck infections. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010; 110(2):151-56. Skucaite N, Peciuliene V, Vitkauskiene A, Machiulskiene V. Susceptibility of endodontic pathogens to antibiotics in patients with symptomatic apical periodontitis. J Endod. 2010;36(10):1611-16. Endo MS, Signoretti FG, Kitayama VS, Marinho AC, Martinho FC, Gomes BPFA. Culture and molecular detection of Enterococcus faecalis from patients with failure endodontic treatment and antimicrobial susceptibility of clinical isolates. Braz Dent Sci. 2014; 17(3):83-91 Al-Ahmad A, Ameen H, Pelz K, Karygianni L, Wittmer A, Anderson AC, et al. Antibiotic resistance and capacity for biofilm formation of different bacteria isolated from endodontic infections associated with root-filled teeth. J Endod. 2014; 40(2):223-30. DiVito E, Lloyd A. ER:YAG laser for 3-dimensional debridement of canal systems: use of photon-induced photoacoustic streaming. Dent Today. 2012;31(11):122,124-27. Zhu X, Yin X, Chang JW, Wang Y, Cheung GS, Zhang C. Comparison of the Antibacterial Effect and Smear Layer Removal Using Photon-Initiated Photoacoustic Streaming Aided Irrigation Versus a Conventional Irrigation in Single-Rooted Canals: An  In Vitro  Study. Photomed Laser Surg.  2013;31(8):371-77.  Veerenda NR, Ghandana G, Sehawat S. Photodynamic therapy: review. Indian J Dent Adv. 2009; 1: 46-50. Seal G, Ng Y, Spratt D, Bhatti M, Gulabivala K. An in vitro comparison of the bactericidal efficacy of lethal photosensitization or sodium hyphochlorite irrigation on Streptococcus intermedius biofilms in root canals. Int Endod J. 2002;35(3):268-74. Soukos N, Chen P, Morris J, Ruggiero K, Abernethy A, Som S, et al. Photodynamic therapy for endodontic disinfection. J Endod. 2006; 32(10):979-84. Foschi F, Fontana C, Ruggiero K, Riahi R, Vera A, Doukas A, et al. Photodynamic inactivation of Enterococcus faecalis in   dental   root   canals   in vitro. Lasers Surg Med. 2007; 39(10):782-87. Fimple J, Fontana C, Foschi F, Ruggiero K, Song X, Pagonis T, et al. Photodynamic treatment of endodontic polymicrobial infection in vitro. J Endod. 2008; 34(6):728-34. George S, Kishen A. Augmenting the antibiofilm efficacy of advanced noninvasive light activated disinfection with emulsified oxidizer and oxygen carrier. J Endod. 2008;34(9):1119-23. George S, Kishen A. Photophysical, photochemical, and photobiological characterization of methylene blue formulations for light-activated root canal disinfection. J Biomed Opt. 2007;12(3):034029.  Meire MA, De Prijck K, Coenye T, Nelis HJ, De Moor RJ. Effectiveness of different laser systems to kill Enterococcus faecalis in aqueous suspension and in an infected tooth model. Int Endod J. 2009;42(4):351-59. Arneiro RA, Nakano RD, Antunes LA, Ferreira GB, Fontes K, Antunes LS. Efficacy of antimicrobial photodynamic therapy for root canals infected with Enterococcus faecalis. J Oral Sci. 2014;56(4):277-85. Garcez AS, Nunez SC, Hamblin MR, Ribeiro MS. Antimicrobial Effects of Photodynamic Therapy on Patients with Necrotic Pulps and Periapical Lesion. J Endod. 2008;34(2):138-42. Ahangari Z, Mojtahed Bidabadi M, Asnaashari M, Rahmati A, Tabatabaei FS. Comparison of the antimicrobial efficacy of calcium hydroxide and photodynamic therapy against  Enterococcus faecalis  and  Candida albicans  in teeth with periapical lesions; an in vivo study. J Lasers Med Sci. 2017;8(2):72-8. Johns DA, Shivashankar VY, Krishnamma S, Johns M. Use of photoactivated disinfection and platelet-rich fibrina in regenerative endodontics. J Conserv Dent. 2014; 17(5):487-90.