Objectives: The aim of this study is to investigate the antimicrobial efficacy of antimicrobial photodynamic therapy (PDT) using natural photosensitizers (curcumin, riboflavin, and phycocyanin) and light-emitting diode (LED) irradiation against multispecies biofilms in an acrylic denture base model. Materials and Methods: Forty-five acrylic specimens were fabricated using heat-curing acrylic resin. The specimens were then infected with a mixed culture of bacterial and fungal species (including Streptococcus mutans, Streptococcus sanguinis, Candida albicans, and Candida glabrata) for 4 days. The acrylic discs were divided into nine groups, with each group containing five discs: control, 0.2% chlorhexidine, 5.25% sodium hypochlorite, curcumin, riboflavin, phycocyanin alone or along with LED. After treatment, the number of colony-forming units (CFUs) per milliliter was counted. In addition, the extent of biofilm degradation was assessed using the crystal violet staining method and scanning electron microscopy. Results: All experimental groups exhibited a significant reduction in colony numbers for both bacterial and fungal species compared to the control (p < 0.001). The PDT groups exhibited a statistically significant reduction in colony counts for both bacteria and fungi compared to the photosensitizer-only groups. Conclusions: The results of this in vitro study show that PDT with natural photosensitizers and LED devices can effectively reduce the viability and eradicate the biofilm of microorganisms responsible for causing denture infections.
Objectives: This study investigates the efficacy of antimicrobial photodynamic therapy (aPDT) using riboflavin and a blue diode laser (BDL), combined with shock wave-enhanced emission photoacoustic streaming (SWEEPS), against Enterococcus faecalis. Materials and Methods: A total of 48 extracted single-rooted human teeth were used. The root canals were instrumented, sealed at their apices, had the smear layer removed, and then underwent autoclave sterilization. Subsequently, each canal was inoculated with E. faecalis bacterial suspension and allowed to incubate for ten days. After confirming the presence of biofilms through scanning electron microscopy (SEM) in three teeth, the remaining teeth were randomly allocated into nine groups, each containing five teeth: control, 5.25% sodium hypochlorite (NaOCl), BDL, SWEEPS + normal saline, SWEEPS + NaOCl, riboflavin, riboflavin + SWEEPS, riboflavin + BDL, and riboflavin + BDL + SWEEPS. After the treatment, the numbers of colony-forming units (CFUs)/mL were calculated. The data were analysed using one-way ANOVA followed by Tukey’s test for comparisons. Results: All groups, with the exception of the BDL group, exhibited a significant reduction in E. faecalis CFU/mL when compared to the control group (p < 0.001). The difference in CFU/mL value between riboflavin + BDL + SWEEPS and riboflavin + SWEEPS was significant (p = 0.029), whereas there was no significant difference between riboflavin + BDL + SWEEPS and riboflavin + BDL (p = 0.397). Moreover, there was no statistically significant difference between the riboflavin + SWEEPS group and the riboflavin + BDL group (p = 0.893). Conclusions: The results demonstrated that combining the SWEEPS technique with riboflavin as a photosensitizer activated by BDL in aPDT effectively reduced the presence of E. faecalis in root canals.
Objectives: The synergistic effect of shock wave-enhanced emission photoacoustic streaming (SWEEPS) and antimicrobial photodynamic therapy (aPDT) in mandibular molar root canal disinfection remains underexplored, particularly against dual-species biofilms that better simulate clinical conditions. This study evaluates their combined antimicrobial efficacy against Enterococcus faecalis and Candida albicans biofilms and assesses potential tooth discoloration caused by riboflavin and nano-curcumin. Materials and Methods: The mesiobuccal canals of 57 extracted mandibular molars were inoculated with E. faecalis and C. albicans biofilms. The antimicrobial effects were assessed using riboflavin or nano-curcumin with a 450 nm diode laser (BDL), SWEEPS, or their combinations, compared to 5.25% NaOCl (positive control) and saline (negative control). Biofilm reduction was quantified by colony-forming units (CFUs/mL), and discoloration was evaluated using the ΔE metric in the CIE L*a*b* color space. Results: Both microorganisms showed a significant decrease in colony numbers in all experimental groups compared to the negative control (p < 0.001), except for E. faecalis, where no significant difference was observed between the riboflavin/nano-curcumin groups and the negative control. Combining riboflavin or nano-curcumin with SWEEPS or BDL significantly enhanced antimicrobial efficacy compared to individual treatments (p < 0.001). The combined photodynamic therapy and SWEEPS groups showed the lowest colony counts. The ΔE values were, on average, 1.81 for riboflavin and 1.09 for nano-curcumin. Conclusions: The combination of SWEEPS and aPDT effectively reduces E. faecalis and C. albicans biofilms in molars, supporting its potential as an adjunct in endodontic disinfection. Minimal discoloration further highlights its clinical applicability.