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Real-time optical detection of endodontic infection using bacterial autofluorescence

 Eun-Song Lee  ;  Elbert de Josselin de Jong  ;  Euiseong Kim  ;  Baek-Il Kim 
 JOURNAL OF DENTISTRY, Vol.136 : 104600, 2023-09 
Journal Title
Issue Date
Diagnostic systems ; Endodontic infection ; Optical detection ; Quantitative light-induced fluorescence ; Red fluorescence
Objectives: For successful root canal treatment (RCT), it is essential to objectively assess the presence and activity of bacteria in the root canal system. However, current methods rely on subjective observations of root canal exudates. This study aimed to confirm whether real-time optical detection using bacterial autofluorescence can evaluate endodontic infection status by assessing the red fluorescence (RF) detected from root canal exudates.

Methods: During RCT, endodontic paper points were used to collect root canal exudates scored using conventional organoleptic tests to assess the severity of root canal infections. RF on the paper points was assessed using quantitative light-induced fluorescence (QLF) technology. RF intensity and area from the paper points were quantified, and their correlations with infection severity were assessed using their organoleptic scores. The oral microbiome composition of RF samples was compared with non-red fluorescent (non-RF) samples.

Results: The RF detection rate was nil and >98% in the non-infectious and severe groups. The RF intensity and area significantly increased with infection severity (p<0.001) and showed strong correlations with organoleptic scores (r=0.72, 0.82, respectively). The diagnostic accuracy for detecting root canal infection using RF intensity was good to excellent (AUC = 0.81-0.95) and increased with infection severity. The microbial diversity of the RF samples was significantly lower than that of the non-RF samples. Gram-negative anaerobic bacteria such as Prevotella and Porphyromonas were more predominant in RF samples.

Conclusions: Optical detection using bacterial autofluorescence can objectively evaluate endodontic infection status in real-time by assessing the RF of endodontic root canal exudates.

Clinical significance: This real-time optical technology can be utilised to detect endodontic bacterial infection without conventional incubation, allowing clinicians to determine the endpoint of chemomechanical debridement and increase the positive outcomes of RCTs.
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Appears in Collections:
2. College of Dentistry (치과대학) > Dept. of Conservative Dentistry (보존과학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Preventive Dentistry and Public Oral Health (예방치과학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Others (기타) > 1. Journal Papers
Yonsei Authors
Kim, Baek Il(김백일) ORCID logo https://orcid.org/0000-0001-8234-2327
Kim, Eui Seong(김의성) ORCID logo https://orcid.org/0000-0003-2126-4761
Lee, Eun Song(이은송) ORCID logo https://orcid.org/0000-0002-2949-4783
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