Destruction of bacterials, periimplantitis, infections, root channel infections – Photo Dynamic Therapy

Indication		Joule cm2	Frequency	Treeatments
Destruction of bacterials		8 - 10	cw	1
	X	Apply toluidine blue or tolonium chloride and irradiate the cavity/root  channel directly with the laser using a special dental applicator,  fiber optic.

For disinfection, the laser is used in combination with  special drugs, for the so called Photo Dynamic Therapy (PDT) or in this case Photo Dynamic Disinfection (PDD).

The PDT became available for use in both caries and infections of the soft tissue, endodontics.

Principle of function:

1. The photosensitiser molecules attach to the membrane of the bacteria.
2. Irradiation with light at a specific wavelength (670-690 nm) matched to the peak absorption of the photosensitiser leads to the production of singlet oxygen, which causes the bacterial cell wall to rupture, killing the bacteria.

How to perform the PDT/PDD

The PDT is fast, secure and easy to perform:

1. Connect the tip of the laser probe to a the thin optical fiber, this can be a reusable or disposable hand piece.  
2. After completion of canal preparation, the canal is inoculated with the photosensitiser solution which is left in situ for a fixed period of time (60 seconds). Apply a 12.7mg/l solution of the tolonium chloride (pharmaceutical grade of the vital stain, Toluidene blue O) to the prepared tooth.
3. Irradiate with the laser in the root canal for 120 seconds.  

Aftercare: Place a non-setting calcium hydroxide paste (e.g. UltraCal) into the canal, cotton wool pledget (Roeko, Germany) in the pulp chamber and dress the tooth with IRM (Dentsply, DeTrey) in the case of posterior teeth or Chemfil Superior (Dentsply, DeTrey) in the case of anterior teeth.

This PDT system has been evaluated in the laboratory and destruction rate of bacterial is in the order of 109, achieved under conditions comparable to those found clinically

PDT will destroy common bacteria associated with endodontic infections such as:

Fusobacterium nucleatum
Prevotella intermedi
Streptococcus intermedius
Peptostreptococcus micros.
Enterococcus faecalis which is regarded as one of the contaminants associated with canals which have recurrent infections.

 

	Apply the photosensitizer and insert the laser tip into the centre of the cavity, directly on the surface.
	Apply the photosensitizer and inserting the laser tip into the centre of the root canal.
	Apply the photosensitizer and insert the laser tip into the centre of the pocket.
	Remove the mucosa around the implant (micro surgery) and clean the wound. Apply the photosensitizer internal and external, let it take effect for 60 seconds and irradiate with laser 150 seconds.
Handylaser sprint for PDD               Click her for dental applicators

 

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