Augmenting the Antibiofilm Efficacy of Advanced Noninvasive Light Activated Disinfection with Emulsified Oxidizer and Oxygen Carrier

In this study, we tested the hypothesis that the inclusion of an oxidizer and oxygen carrier in the photosensitization formulation would facilitate comprehensive disinfection of matured endodontic biofilm by light-activated disinfection (LAD). Photosensitizing formulations containing methylene blue (MB) and an oxygen carrier alone (perfluorodecahydronaphthalene) (PF1) or in combination with oxidizer (H2O2) (PF2) or their emulsions formed with triton-X100 (Bio-Rad Laboratories, Hercules, CA) in different proportions (PF3 and PF4) were tested for photochemical properties and damage to the biofilm structure using confocal laser scanning microscopy. Conventional chemomechanical preparation, LAD using MB in water, and LAD using MB in emulsion (PF4) were also conducted on 10-week-old Enterococcus faecalis biofilm within root canals. MB in emulsion (PF4) was overall the most effective photosensitizer formulation for photooxidation, generation of singlet oxygen (p = 0.001), and in disinfecting biofilm bacteria. Advanced noninvasive LAD using a photosensitizer formulation containing oxidizer and oxygen carrier disrupted the biofilm matrix and facilitated comprehensive inactivation of biofilm bacteria. This modified photosensitizer formulation will have potential advantages in endodontic disinfection.