الفهرس 
Efficacy of antimicrobial photodynamic therapy of toluidine blue combined with hydrogen peroxide or silver nano particles against enterococcus faecalis biofilms: an in vitro study
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Abstract
Objective: to assess antibacterial effect of Photodynamic Therapy using Nano Silver
Particles (AgNps) or Toluidine blue O (TBO) with Hydrogen Peroxide (H2O2) and 635 nm
diode laser with output power 100 mw against E. faecalis biofilms compared to calcium
hydroxide paste Ca(OH)2 as intracanal medicament .
Materials and Methods
One hundred and fifty-four extracted single rooted human teeth with a single canal were
decoronated with high-speed diamond wheel stone under water-cooling to facilitate access
to the root. Final length was 15mm ± 1. Then instrumented by Protaper universal system up
to F3 then until size 50# taper 4% to the working length. The files were used in outward
brushing mode at 300rpm/2.6nm torque . With the use of each file , the canal was irrigated
with 5.25 % NaOCL.
E. faecalis Biofilms were generated based on a previously established protocol. four teeth
were used to check the biofilm formation by Confocal laser scanning microscopy ”CLSM”
and act as a control (no treatment) .Then the remaining teeth were randomly divided into
three main lines of treatments ; Line1, PDT using TBO as photosensitizer , line 2, PDT
using AgNPs as photosensitizer and line 3 ,Ca(OH)2 . The antibacterial efficacy of the three
lines of treatment was evaluated by colony forming units, and relative intensity of live/dead
bacteria, using Confocal Laser Scanning Microscopy. Data of the study were analyzed by
statistical analysis with P= 0.05.
Results: E. faecalis reduction was significantly better in all the experimental groups than
in the control group (p value < 0.001). However, the highest bacterial reduction was
obtained with the combined effect of PDT and H2O2 and Ca(OH)2 .
Conclusion: the combination of PDT (TBO and AgNps activated by 635 nm diode laser
with output power 100 mw ) with H2O2 and Ca(OH)2 exert highest percentage of E.
Faecalis reduction in infected root canals.