Evaluation of repair of apical periodontitis induced in rats after adjuvant treatment with antimicrobial photodynamic therapy, probiotic therapy and associations
Endodontics; Apical periodontitis; Antimicrobial Photodynamic Therapy; Probiotics; Rats.
Apical periodontitis (AP) is a biofilm-mediated disease, therefore an antimicrobial approach is essential to cure or prevent its development. Achieving maximum reduction of intracanal microbial load is the main objective of conventional endodontic treatment, through the action of chemical-mechanical preparation (CMP). However, such therapy has its limitations and may sometimes not achieve a satisfactory standard of control and elimination of the infection and, in this sense, adjuvant therapies have been suggested. The objective of this study was to evaluate, in vivo, the effect of Lactobacillus casei and Antimicrobial Photodynamic Therapy (APDT) as an adjuvant to conventional endodontic treatment on the apical tissues of teeth of rats with experimentally induced apical periodontitis by biochemical analysis and bone loss. This is a preclinical, in vivo, randomized, early, placebo-controlled trial consisting of 30 male Wistar rats randomly divided into 5 groups of six animals, two controls and three experimental groups: 1) CN; 2) PA; 3) PA + Prob + PQM; 4) PA + PQM + TFDA; 5) PA + Prob + PQM + TFDA. PA was induced by pulp exposure in all animals. Daily, Lactobacillus casei 109 CFU was administered to the GProb and GProb+TFDA groups through gavage for 30 days, the other groups received saline solution as placebo. TFDA was performed with 0.01% methylene blue for 5 minutes of pre-irradiation, then the laser with a wavelength of 660 nm was applied for 90 seconds, totaling 9 J. After 30 days for the control groups and 60 days for the other groups, the animals were euthanized. The biochemical results showed that calcium and alkaline phosphatase levels remained within normal parameters in all groups. Regarding µCT, the axial analysis showed that the GProbTFDA group presented a significant increase in the BV/TV ratio and a decrease in the percentages of total porosity and open pores in relation to GPA (p<0.05), and the sagittal analysis revealed no significant difference between the GProbTFDA experimental groups (0.094 + 0.005) in relation to GPA (0.1164 + 0.066), (p>0.05). Therefore, as an adjuvant, antimicrobial photodynamic therapy in association with probiotic therapy demonstrated more effective anti-bone loss activity when compared to the other groups against apical periodontitis.