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17Perio TribuneNovember 29-December 5, 2010United Kingdom Edition Simply visit our website or call our freephone number below to order PAD Plus or to book a demonstration with one of our representatives www.dexceldental.co.uk 0800 013 2333 TREATMENT AREAS ? Endodontics ? Caries ? Periodontics ? Implants ? Trauma ? Dry socket * excluding VAT & delivery PHOTO ACTIVATED DISINFECTION TM A STEP FORWARD IN DENTAL DISINFECTION FROM DEXCEL DENTAL PAD Plus Photo Activated Disinfection system eliminates bacterial and fungal infections in the majority of dental procedures. This breakthrough in LED technology allows you to e ectively and e ciently eradicate 99.9% of all oral bacteria in one patient visit giving you increased pro tability and providing a less stressful patient experience. LED technology makes PAD affordable for all dental professionals PROVEN A4 Indesign.indd 1 13/5/10 11:17:18 The in vitro study of Soukos et al. (2006) ended with the con- clusion that “PDT may be devel- oped as an adjunctive procedure to kill residual bacteria in the root canal system after standard endodontic treatment.” Pinheiro et al. (2007) study was to “evaluate photodynamic therapy in deciduous teeth with necrotic pulp by means of fully quantifying viable bacteria, be- fore and after instrumentation and after the use of photody- namic therapy”. They concluded that “Photodynamic therapy is recommended as adjunct ther- apy for microbial reduction in deciduous teeth with necrotic pulp.” When using Methylen blue as PS, Fimple et al. (2008) con- cluded “that PDT can be an effective adjunct to standard endodontic antimicrobial treat- ment when the PDT parameters are optimised.“ The research group around Lim (2009), calling the PAD process “Light Activated Disin- fection” (LAD) used “biofilms of Enterococcus faecalis at two different stages of maturation” and extracted teeth. The results of the study showed “Sodium hypochlorite and improved LAD showed the ability to sig- nificantly inactivate bacteria in four-day-old biofilms when compared to the control and LAD (p < 0.05). Inactivation of bacteria from deeper dentine was higher in improved LAD than sodium hypochlorite. In four-week-old biofilms, a com- bination of chemomechanical disinfection and improved LAD produced significant bacterial killing compared to either ch- emomechanical disinfection or improved LAD alone.” Souza et al (2010) compared the efficacy of Methylen blue and Toluidine blue as an adju- vant in root canal disinfection. Their conclusions were “These in vitro results suggest that PDT with either MB or TB may not exert a significant supplemen- tal effect to instrumentation/ irrigation procedures with re- gard to intracanal disinfection. Further adjustments in the PDT protocol may be required to en- hance predictability in bacte- rial elimination before clinical use is recommended.” It may be noted that the culture media for E. faecalis may play a role in the different outcomes. Based on current knowl- edge and evidence the author suggests the implementation of PAD in root canal disinfec- tion once conventional protocol completed. Conclusion PAD is not at all a new con- cept. It has proven it s efficacy in action over almost the last hundred years. New microbio- logic knowledge is continuously compensated with advanced re- search in light emitting sources. Intensive work is committed into the identification process of correlating adequate PS to spe- cific bacterial infection, enhanc- ing dye penetration, adjusting light exposure time, etc. On the other side numerous new applications arise. Con- firming treatment efficacy is a demanding and highly time-, re- source-and finance-consuming process. Rewards are amazing taking under consideration the huge added benefits in regards of antibiotic resistance. DT ‘Confirming treat- ment efficacy is a demanding and highly time-, re- source-and finance- consuming process.’ Fig8 – Application of light source page 18DTà