国际口腔医学杂志

国际口腔医学杂志 ›› 2024, Vol. 51 ›› Issue (5): 565-571.doi: 10.7518/gjkq.2024081

• 牙体牙髓病学专栏 • 上一篇    下一篇

光热治疗辅助根管冲洗治疗根尖周炎的研究进展

赖思悦(),李博磊,程磊()   

  1. 口腔疾病防治全国重点实验室 国家口腔医学中心 国家口腔疾病临床医学研究中心四川大学华西口腔医院牙体牙髓病科 成都 610041
  • 收稿日期:2024-02-05 修回日期:2024-06-01 出版日期:2024-09-01 发布日期:2024-09-14
  • 通讯作者: 程磊
  • 作者简介:赖思悦，硕士，Email：laisiyuee@163.com
  • 基金资助:
    国家自然科学基金青年基金(82301058)

Research progress on photothermal therapy-assisted root canal irrigation in the treatment of apical periodontitis

Siyue Lai(),Bolei Li,Lei Cheng()   

  1. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Dept. of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
  • Received:2024-02-05 Revised:2024-06-01 Online:2024-09-01 Published:2024-09-14
  • Contact: Lei Cheng
  • Supported by:
    Young Scientists Fund of National Natural Science Foundation of China(82301058)

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摘要：

根尖周炎是由微生物感染引发的根尖周炎症，根管微生物既能直接破坏根尖区牙槽骨，也能刺激根尖周组织产生炎症，进而刺激牙槽骨吸收。根管治疗的首要目标是控制感染，终极目标是促进根尖周病变愈合。根管冲洗是根管治疗中的重要步骤，理想的根管冲洗剂应符合上述两大目标并且细胞毒性较小。光热治疗（PTT） 是一种新型的抑菌方法，可以利用光热材料将光能转变为热能以控制感染，并且能调节组织修复过程，促进成骨过程并抑制破骨吸收。PTT还能与光动力治疗（PDT）形成协同抗菌效应。PTT应用于根管冲洗，有希望实现根管治疗的两大目标。本文总结了PTT对感染根管中常见微生物的抗菌作用和对根尖区骨修复的作用及其机制，并且初步探讨了PTT和PDT的协同效应，为PTT在根管冲洗中的进一步应用提供了一定的理论依据。

关键词: 光热治疗, 光热材料, 根管冲洗, 抗菌, 骨修复, 光动力治疗

Abstract:

Apical periodontitis is an inflammation of the periapical area triggered by microbial infection. Root canal microorganisms can directly destroy the alveolar bone in the apical region as well as stimulate inflammation in the periapical tissues, thereby stimulating alveolar bone resorption. Root canal therapy primarily aims to control infection and promote healing of periapical lesions. Root canal irrigation is an important step in root canal therapy, and the ideal root canal irrigation agent should meet these two goals and be less cytotoxic. Photothermal therapy (PTT) is a new antimicrobial method, which uses photothermal agents to convert light energy into heat to control infection, promote bone formation, and inhibit bone resorption. In addition, PTT can form a good synergy with photodynamic therapy (PDT). When being applied to root canal irrigation, PTT could achieve the two goals of root canal therapy. Thus, this article summarized the antibacterial effect of PTT on common microorganisms in infected root canals and its effect and mechanism on bone repair in the apical region. The synergistic effect of PTT and PDT was also initially discussed, which provides a basis for the further application of PTT in root canal irrigation.

Key words: photothermal therapy, photothermal agents, root canal irrigation, antimicrobial, bone remodeling, photodynamic therapy

中图分类号: 

  • R781.05
1 Burns LE, Kim J, Wu YX, et al. Outcomes of primary root canal therapy: an updated systematic review of longitudinal clinical studies published between 2003 and 2020[J]. Int Endod J, 2022, 55(7): 714-731.
2 MEHAA Mostafa, El-Shrief YAI, Anous WIO, et al. Postoperative pain following endodontic irrigation using 1.3% versus 5.25% sodium hypochlorite in mandibular molars with necrotic pulps: a randomi-zed double-blind clinical trial[J]. Int Endod J, 2020, 53(2): 154-166.
3 Ballal NV, Das S, Rao BSS, et al. Chemical, cytotoxic and genotoxic analysis of etidronate in sodium hypochlorite solution[J]. Int Endod J, 2019, 52(8): 1228-1234.
4 Luo XT, Wan QX, Cheng L, et al. Mechanisms of bone remodeling and therapeutic strategies in chro-nic apical periodontitis[J]. Front Cell Infect Micro-biol, 2022, 12: 908859.
5 Chen Y, Gao YJ, Chen Y, et al. Nanomaterials-based photothermal therapy and its potentials in antibac-terial treatment[J]. J Control Release, 2020, 328: 251-262.
6 Bermúdez-Jiménez C, Niño-Martínez N, Patiño-Marín N, et al. Effective control of biofilms by photothermal therapy using a gold nanorod hydrogel[J]. J Biomed Mater Res B Appl Biomater, 2020, 108(2): 333-342.
7 Xin YT, Yu YJ, Su MH, et al. In situ-activated photothermal nanoplatform for on-demand NO gas delivery and enhanced colorectal cancer treatment[J]. J Control Release, 2023, 359: 69-84.
8 Naskar A, Kim KS. Friends against the foe: synergistic photothermal and photodynamic therapy agai-nst bacterial infections[J]. Pharmaceutics, 2023, 15(4): 1116.
9 赵苑汐, 苏勤. 根管再治疗中根管充填物去除辅助技术的应用与发展[J]. 国际口腔医学杂志, 2023, 50(5): 581-586.
Zhao YX, Su Q. Application and development of supplementary techniques in removing the remai-ning filling materials of root canal retreatment[J]. Int J Stomatol, 2023, 50(5): 581-586.
10 苏征, 杨子, 安婷, 等. 激光活化技术对细菌生物膜的清除效果[J]. 口腔医学研究, 2023, 39(7): 607-612.
Su Z, Yang Z, An T, et al. Antibiofilm activity of irrigation protocols activated by lasers in vitro [J]. J Oral Sci Res, 2023, 39(7): 607-612.
11 Duan XC, Zhang QY, Jiang Y, et al. Semiconduc-ting polymer nanoparticles with intramolecular motion-induced photothermy for tumor phototheranostics and tooth root canal therapy[J]. Adv Mater, 2022, 34(17): e2200179.
12 Liu GH, Xiong QS, Xu YQ, et al. Magnetically se-parable MXene@Fe3O4/Au/PDA nanosheets with photothermal-magnetolytic coupling antibacterial performance[J]. Appl Surf Sci, 2022, 590: 153125.
13 Wu F, Zheng HL, Wang WZ, et al. Rapid eradication of antibiotic-resistant bacteria and biofilms by MXene and near-infrared light through photothermal ablation[J]. Sci China Mater, 2021, 64(3): 748-758.
14 Drews DJ, Nguyen AD, Diederich A, et al. The interaction of two widely used endodontic irrigants, chlorhexidine and sodium hypochlorite, and its impact on the disinfection protocol during root canal treatment[J]. Antibiotics, 2023, 12(3): 589.
15 Wang YH, Xiao SL, Ma DF, et al. Minimizing concentration of sodium hypochlorite in root canal irrigation by combination of ultrasonic irrigation with photodynamic treatment[J]. Photochem Photobiol, 2015, 91(4): 937-941.
16 Huang Y, Li D, Wang DL, et al. A NIR-Ⅱ emissive polymer AIEgen for imaging-guided photothermal elimination of bacterial infection[J]. Biomaterials, 2022, 286: 121579.
17 Park L, Kim HS, Jang W, et al. Antibacterial evaluation of zirconia coated with plasma-based graphene oxide with photothermal properties[J]. Int J Mol Sci, 2023, 24(10): 8888.
18 Tian YJ, Li Y, Liu JL, et al. Photothermal therapy with regulated Nrf2/NF‑κB signaling pathway for treating bacteria-induced periodontitis[J]. Bioact Mater, 2022, 9: 428-445.
19 Qu XY, Guo Y, Xie CX, et al. Photoactivated MXene nanosheets for integrated bone-soft tissue therapy: effect and potential mechanism[J]. ACS Nano, 2023, 17(8): 7229-7240.
20 Liang YP, Zhao X, Hu TL, et al. Adhesive hemosta-tic conducting injectable composite hydrogels with sustained drug release and photothermal antibacte-rial activity to promote full-thickness skin regeneration during wound healing[J]. Small, 2019, 15(12): e1900046.
21 Cen R, Wang RQ, Cheung GSP. Periodontal blood flow protects the alveolar bone from thermal injury during thermoplasticized obturation: a finite element analysis study[J]. J Endod, 2018, 44(1): 139-144.
22 Siqueira JF Jr, Rôças IN. Present status and future directions: microbiology of endodontic infections[J]. Int Endod J, 2022, 55(): 512-530.
23 Ossmann A, Kranz S, Andre G, et al. Photodynamic killing of Enterococcus faecalis in dentinal tubules using mTHPC incorporated in liposomes and invasomes[J]. Clin Oral Investig, 2015, 19(2): 373-384.
24 Cao J, Sun Q, Shen AG, et al. Nano Au@Cu2- x S with near-infrared photothermal and peroxidase catalytic activities redefines efficient antibiofilm-oriented root canal therapy[J]. Chem Eng J, 2021, 422: 130090.
25 Gomes BPFA, Bronzato JD, Almeida-Gomes RF, et al. Identification of Fusobacterium nucleatum in primary and secondary endodontic infections and its association with clinical features by using two different methods[J]. Clin Oral Investig, 2021, 25(11): 6249-6258.
26 Bouillaguet S, Manoil D, Girard M, et al. Root microbiota in primary and secondary apical periodontitis[J]. Front Microbiol, 2018, 9: 2374.
27 Gao YC, Kang K, Luo B, et al. Graphene oxide and mineralized collagen-functionalized dental implant abutment with effective soft tissue seal and romotely repeatable photodisinfection[J]. Regen Biomater, 2022, 9: rbac024.
28 Korona-Glowniak I, Piatek D, Fornal E, et al. Patterns of oral microbiota in patients with apical perio-dontitis[J]. J Clin Med, 2021, 10(12): 2707.
29 Lu SX, Li RY, Chai MZ, et al. Nanostructured Cu-doped TiO2 with photothermal effect for prevention of implant-associated infection[J]. Colloids Surf B Biointerfaces, 2022, 217: 112695.
30 Lu XW, Qu YX, Zhu TT, et al. Applications of photothermally mediated nanohybrids for white spot lesions in orthodontics[J]. Colloids Surf B Biointerfaces, 2023, 225: 113274.
31 Cao H, Qi Z, Jiang H, et al. Detection of Porphyromonas endodontalis, Porphyromonas gingivalis and Prevotella intermedia in primary endodontic infections in a Chinese population[J]. Int Endod J, 2012, 45(8): 773-781.
32 Persoon IF, Crielaard W, Özok AR. Prevalence and nature of fungi in root canal infections: a systematic review and meta-analysis[J]. Int Endod J, 2017, 50(11): 1055-1066.
33 dos Santos KF, Sousa MS, Valverde JVP, et al. Fractal analysis and mathematical models for the investigation of photothermal inactivation of Candida albicans using carbon nanotubes[J]. Colloids Surf B Biointerfaces, 2019, 180: 393-400.
34 Zhao Y, Zhao JJ, Guo JX, et al. Transdermal photothermal sterilization and abscess elimination research of BSA-CuS nanoparticles in vivo [J]. Chem Med Chem, 2022, 17(3): e202100570.
35 Yoo YJ, Kim AR, Perinpanayagam H, et al. Candida albicans virulence factors and pathogenicity for endodontic infections[J]. Microorganisms, 2020, 8(9): 1300.
36 Ji X, Yang HY, Liu W, et al. Multifunctional parachute-like nanomotors for enhanced skin penetration and synergistic antifungal therapy[J]. ACS Nano, 2021, 15(9): 14218-14228.
37 Li Y, Ling JQ, Jiang QZ. Inflammasomes in alveolar bone loss[J]. Front Immunol, 2021, 12: 691013.
38 Hang K, Ye CY, Chen EM, et al. Role of the heat shock protein family in bone metabolism[J]. Cell Stress Chaperones, 2018, 23(6): 1153-1164.
39 Li CH, Sunderic K, Nicoll SB, et al. Downregulation of heat shock protein 70 impairs osteogenic and chondrogenic differentiation in human mesenchymal stem cells[J]. Sci Rep, 2018, 8(1): 553.
40 Zhang XD, Li Q, Li LF, et al. Bioinspired mild photothermal effect-reinforced multifunctional fiber scaffolds promote bone regeneration[J]. ACS Nano, 2023, 17(7): 6466-6479.
41 Tong LP, Liao Q, Zhao YT, et al. Near-infrared light control of bone regeneration with biodegradable pho-tothermal osteoimplant[J]. Biomaterials, 2019, 193: 1-11.
42 Cui D, Kong N, Ding L, et al. Ultrathin 2D titanium carbide MXene (Ti3C2t x ) nanoflakes activate WNT/HIF-1α‑mediated metabolism reprogramming for periodontal regeneration[J]. Adv Healthc Mater, 2021, 10(22): e2101215.
43 Zeng YX, Pan ZX, Yuan JP, et al. Inhibiting osteolytic breast cancer bone metastasis by bone-targeted nanoagent via remodeling the bone tumor microenvironment combined with NIR‑Ⅱ photothermal therapy[J]. Small, 2023, 19(38): e2301003.
44 袁为, 徐宁, 秦爱丽, 等. 抗菌光动力疗法应用于乳前牙治疗对髓腔内微生物的影响[J]. 中国微生态学杂志, 2022, 34(9): 1042-1046.
Yuan W, Xu N, Qin AL, et al. Effect of antibacterial photodynamic therapy on microorganisms in pulp cavities of deciduous anterior teeth[J]. Chin J Microecol, 2022, 34(9): 1042-1046.
45 de Miranda RG, Colombo APV. Clinical and microbiological effectiveness of photodynamic therapy on primary endodontic infections: a 6-month randomi-zed clinical trial[J]. Clin Oral Investig, 2018, 22(4): 1751-1761.
46 Bai LY, Shi EY, Li YN, et al. Oxyhemoglobin-based nanophotosensitizer for specific and synergistic photothermal and photodynamic therapies against Porphyromonas gingivalis oral infection[J]. ACS Biomater Sci Eng, 2023, 9(1): 485-497.
47 Zhu CY, Shen SW, Zhang SH, et al. Autophagy in bone remodeling: a regulator of oxidative stress[J]. Front Endocrinol, 2022, 13: 898634.
48 Li YZ, Liu CD, Cheng XT, et al. PDA-BPs integra-ted mussel-inspired multifunctional hydrogel coa-ting on PPENK implants for anti-tumor therapy, antibacterial infection and bone regeneration[J]. Bioact Mater, 2023, 27: 546-559.
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