Document Type : Final File


1 Pharmaceutical Sciences Research Center, The Institute of Pharmaceutical Sciences (TIPS), Tehran University of Medical Sciences, Tehran 1417614411, Islamic Republic of Iran

2 Laboratory of Organic Compound Research, Department of Organic Chemistry, College of Chemistry, University of Kashan, P.O. Box 87317-51167, Kashan, Islamic Republic of Iran

3 Dental Research Center, Dentistry Research Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran


Root canal disinfection is one of the main factors governing success of endodontic therapy. Antimicrobial photodynamic therapy (aPDT) is presented as a promising antimicrobial therapy that can eliminate microbiota present in infected root canal systems. In this study, a series of experiments investigated the effects of aPDT on cell viability and biofilm degradation ability of endopathogenic microbiota. Enterococcus faecalis and Pseudomonas aeruginosa strains as the versatile pathogenic microbiota in endodontic infections were used as the tested strains. Curcumin (CUR) and light-emitting diode (LED) were used as the photosensitizer and light source, respectively. The antimicrobial and anti-biofilm effects of CUR-aPDT were assessed by colony forming unit (CFU), and crystal violet assays. CUR-aPDT significantly decreased the CFU/mL count of E. faecalis and P. aeruginosa compared to the control group (P<0.05). The killing percentage of aPDT was achieved 95.0% for E. faecalis and 81.1% for P. aeruginosa. In addition, the biofilm degradation ability of E. faecalis and P. aeruginosa significantly decreased to 41.2% and 30.2%, respectively (P<0.05). According to the results, neither CUR nor LED showed the antimicrobial and anti-biofilm effects when used alone. In conclusion, the results of this study indicated that CUR-aPDT has an appreciable effect on endopathogenic microbiota upon photoactivation.


Main Subjects

  1. da Frota M.F., Guerreiro-Tanomaru J.M., Tanomaru-Filho M., Bagnato V.S., Espir C.G. and Berbert F.L. Photodynamic Therapy in Root Canals Contaminated with Enterococcus Faecalis using Curcumin as Photosensitizer. Lasers Med. Sci. 30(7): 1867-1872 (2015).
  2. Lee H.J., Kang S.M., Jeong S.H., Chung K.H. and Kim B. Antibacterial Photodynamic Therapy with Curcumin and Curcuma xanthorrhiza Extract against Streptococcus mutans. Photodiagnosis Photodyn. Ther. 20: 116-119 (2017).
  3. Araújo N.C., de Menezes R.F., Carneiro V.S.M., Dos Santos-Neto A.P., Fontana C.R., Bagnato V.S., Harvey C.M. and Gerbi M.E.M. Photodynamic Inactivation of Cariogenic Pathogens Using Curcumin as Photosensitizer. Photomed. Laser Surg. 35(5): 259-263 (2017).
  4. Gholibegloo E., Karbasi A., Pourhajibagher M., Chiniforush N., Ramazani A., Akbari T., Bahador A. and Khoobi M. Carnosine-Graphene Oxide Conjugates Decorated with Hydroxyapatite as Promising Nanocarrier for ICG Loading with Enhanced Antibacterial Effects in Photodynamic Therapy against Streptococcus mutans. J. Photochem. Photobiol. B. 181: 14-22 (2018).
  5. Sousa B.C., Gomes F.A., Ferreira C.M., Rocha M.M.N.P., Barros E.B. and Albuquerque DS. Persistent Extra-Radicular Bacterial Biofilm in Endodontically Treated Human Teeth: Scanning Electron Microscopy Analysis After Apical Surgery. Microsc. Res. Tech. 80(6): 662-667 (2017).
  6. Neelakantan P., Romero M., Vera J., Daood U., Khan A.U., Yan A. and Cheung G.S.P. Biofilms in Endodontics- Current Status and Future Directions. Int. J. Mol. Sci. 17: 1748-1769 (2017).
  7. Suwannakul S., Yuakyaung S. and Chaisomboon N. Effect of Purified Curcuminoids on Enterococcus Faecalis and its Biofilm. Int J Clin Prev Dent. 10(2): 71–78 (2014).
  8. Leite D.P, Paolillo F.R, Parmesano T.N, Fontana C.R. and Bagnato V.S. Effects of Photodynamic Therapy with Blue Light and Curcumin as Mouth Rinse for Oral Disinfection: A Randomized Controlled Trial. Photomed. Laser Surg. 32(11): 627-632 (2014).
  9. Mamone L., Di Venosa G., Gándara L., Sáenz D., Vallecorsa P., Schickinger S., Rossetti M.V., Batlle A., Buzzola F. and Casas A. Photodynamic Inactivation of Gram-Positive Bacteria Employing Natural Resources, J. Photochem. Photobiol B. 133: 80-89 (2014).
  10. Johnson G.A., Muthukrishnan N. and Pellois J.P. Photoinactivation of Gram Positive and Gram Negative Bacteria with the Antimicrobial Peptide (KLAKLAK)(2) Conjugated to the Hydrophilic Photosensitizer Eosin Y. Bioconjug. Chem. 24(1): 114-123 (2013).
  11. Tsai T., Chien H.F., Wang T.H., Huang C.T., Ker Y.B. and Chen C.T. Chitosan Augments Photodynamic Inactivation of Gram-Positive and Gram-Negative Bacteria. Antimicrob. Agents Chemother.55(5): 1883-1890 (2011).
  12. Huang L., Dai T. and  Hamblin M.R. Antimicrobial Photodynamic Inactivation and Photodynamic Therapy for Infections. Methods Mol. Biol. 635: 155–173 (2010).
  13. Lačević A., Foschi F., Pojskić L., Pojskić N., Bajrović K. and Izard J. Correlation of Periodontal Pathogens in Concurrent Endodontic-Periodontal Diseases, Arch. Oral. and Dent. Res. 2: 1-4 (2015).
  14. Brown L., Wolf J.M.,  Prados-Rosales R. and Casadevall A. Through the Wall: Extracellular Vesicles in Gram-Positive Bacteria, Mycobacteria and Fungi, Nat. Rev. Microbiol. 13: 620-630 (2015).
  15. Cieplik F., Tabenski L., Buchalla W. and Maisch T. Antimicrobial Photodynamic Therapy for Inactivation of Biofilms Formed by Oral Key Pathogens. Front Microbiol. 5: 1-17 (2014).
2.     Murad C.F., Sassone L.M., Faveri M., Hirata R.Jr., Figueiredo L. and Feres M. Microbial Diversity in Persistent Root Canal Infections Investigated by Checkerboard DNA-DNA Hybridization. J. Endod. 40(7): 899-906 (2014).
3.     Wang Q.Q., Zhang C.F., Chu C.H. and Zhu X.F. Prevalence of Enterococcus Faecalis in Saliva and Filled Root Canals of Teeth Associated with Apical Periodontitis. Int. J. Oral Sci. 4(1): 19-23 (2012).
4.     Jhajharia K., Parolia A., Shetty K.V. and Mehta L. Biofilm in Endodontics Review, J. Int. Soc. Prev. Community. Dent. 5: 1-12 (2015). 
5.     Narayanan L.L. and Vaishnavi C. Endodontic Microbiology. J. Conserv. Dent. 13(4): 233-239 (2010).
6.     Tennert C., Fuhrmann M., Wittmer A., Karygianni L., Altenburger M.J., Pelz K., Hellwig E. and Al-Ahmad A. New Bacterial Composition in Primary and Persistent/Secondary Endodontic Infections with Respect to Clinical and Radiographic Findings. J. Endod. 40(5): 670-677 (2014).
7.     Rôças I.N., Provenzano J.C., Neves M.A. and Siqueira J.F.Jr. Disinfecting Effects of Rotary Instrumentation with Either 2.5% Sodium Hypochlorite or 2% Chlorhexidine as the Main Irrigant: A Randomized Clinical Study. J. Endod. 42(6): 943-947 (2016).
8.     Prabhakar A. R., Hadakar S. G. and Raju O. S. Comparative Evaluation of pH and Antibacterial Effect of Various Calcium Hydroxide Combinations on E. Faecalis and its Effect on Root Strength: An in Vitro Study. Contemp Clin Den. 3(1): 42-47 (2012).
9.     Monteiro J.S.C., de Oliveira S.C.P.S., Pires Santos G.M., Sampaio F.J. P., Soares L.G. P. and Pinheiro A.L.B. Effectiveness of Antimicrobial Photodynamic Therapy (AmPDT) on Staphylococcus aureus using Phenothiazine Compound with Red Laser. Lasers Med. Sci. 32: 29-370 (2017).
10.  Singh S., Nagpal R., Manuja N. and Tyagi S.P. Photodynamic Therapy: An Adjunct to Conventional Root Canal Disinfection Strategies. Aust. Endod. J. 41(2): 54-71 (2015).
11.  Siddiqui S.H., Awan K.H. and Javed F. Bactericidal Efficacy of Photodynamic Therapy against Enterococcus Faecalis in Infected Root Canals: A Systematic Literature Review. Photodiagnosis Photodyn. Ther. 10(4): 632-643 (2013).
12.  Tonon C.C., Paschoal M.A., Correia M., Spolidório D.M., Bagnato V.S., Giusti J.S. and Santos-Pinto L. Comparative Effects of Photodynamic Therapy Mediated by Curcumin  on Standard and Clinical Isolate of Streptococcus mutans. J .Contemp. Dent. Pract. 16(1): 1-6 (2015).
27.  de Melo W.C., Avci P., de Oliveira M.N., Gupta A., Vecchio D., Sadasivam M., Chandran R., Huang Y.Y., Yin R., Perussi L.R., Tegos G.P., Perussi J.R., Dai T. and Hamblin M.R. Photodynamic Inactivation of Biofilm: Taking a Lightly Colored Approach to Stubborn Infection. Expert Rev. Anti Infect. Ther. 11(7): 669-693 (2013).
28.  Wikene K.O., Hegge A.B., Bruzell E. and Tønnesen H.H. Formulation and Characterization  of Lyophilized Curcumin Solid Dispersions for Antimicrobial Photodynamic Therapy (aPDT): Studies on Curcumin and Curcuminoids LII. Drug Dev. Ind. Pharm. 41(6): 969-977 (2015).