Effect of fiber insertion depth on antibacterial efficacy of photodynamic therapy against Enterococcus faecalis in rootcanals

This in vitro study evaluated the effect of fiber insertion depth on antimicrobial efficacy of antimicrobial photodynamic therapy (aPDT) using a photosensitizer (PS; toluidine blue) and a red light-emitting diode (LED) in root canals infected with Enterococcus faecalis. Single-rooted extracted teeth were prepared with nickel-titanium-instruments, sterilized, contaminated with E. faecalis, and incubated for 72 h. Roots were randomly divided into four experimental groups: PS only, LED only, aPDT with LED in the apical third, aPDT with LED in the coronal third, as well as into infection and sterile controls (each n = 10). Samples were taken by collecting standardized dentine shavings from the root canal walls. After serial dilution and culturing on blood agar, colony-forming units (CFU) were counted. Both aPDT groups showed a CFU reduction of 1-2 log(10) steps compared with the infection control, whereas the effect of fiber insertion depth was negligible (< 0.5 log(10) steps). CFU reduction of approximately 0.5 log(10) steps for PS alone was detected compared with the infection control, but PS alone was less effective than both aPDT groups. No antibacterial effect was detected for LED alone. aPDT reduced E. faecalis within the root canal, whereas fiber insertion depth had a negligible influence on antimicrobial effectiveness of aPDT. The insertion depth of the light-emitting diode may not influence the antibacterial efficacy of photodynamic therapy against E. faecalis in straight root canals.