{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T04:47:06Z","timestamp":1776919626966,"version":"3.51.2"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T00:00:00Z","timestamp":1776902400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Persistent\n                      <jats:italic>Enterococcus faecalis<\/jats:italic>\n                      infection remains a primary cause of endodontic treatment failure, necessitating the development of more effective disinfection protocols. This retrospective case-control study compared the antimicrobial efficacy of semiconductor laser irradiation combined with sodium hypochlorite irrigation vs. sodium hypochlorite irrigation alone for the elimination of\n                      <jats:italic>E. faecalis<\/jats:italic>\n                      from infected root canals.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 102 patients with chronic apical periodontitis and confirmed\n                      <jats:italic>E. faecalis<\/jats:italic>\n                      infection who underwent root canal treatment between May 2024 and June 2025 were retrospectively enrolled. Treatment outcomes were evaluated at short-term 6-month follow-up using clinical and radiographic criteria. Patients were divided into two groups: the laser group (\n                      <jats:italic>n<\/jats:italic>\n                      = 51), which received 810 nm semiconductor laser irradiation combined with 3% sodium hypochlorite irrigation, and the control group (\n                      <jats:italic>n<\/jats:italic>\n                      = 51), which received 3% sodium hypochlorite irrigation alone. Microbiological samples were collected before treatment (S1), immediately after chemomechanical preparation (S2), and after final disinfection (S3). Bacterial counts were determined using colony-forming unit (CFU) analysis, and\n                      <jats:italic>E. faecalis<\/jats:italic>\n                      was identified through polymerase chain reaction (PCR). While quantitative real-time PCR (qPCR) offers advantages in specificity and sensitivity, CFU analysis was employed in this retrospective study as it represents the clinically accessible standard method during the study period. Treatment outcomes were evaluated at 6-month follow-up using clinical and radiographic criteria.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Both groups demonstrated significant reductions in bacterial load from S1 to S3 (\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). However, the laser group exhibited significantly greater bacterial reduction rates compared to the control group (98.7 vs. 89.4%,\n                      <jats:italic>p<\/jats:italic>\n                      &amp;lt; 0.001). The complete elimination rate of\n                      <jats:italic>E. faecalis<\/jats:italic>\n                      at S3 was significantly higher in the laser group (92.2%) compared to the control group (74.5%;\n                      <jats:italic>p<\/jats:italic>\n                      = 0.018). At the short-term 6-month follow-up, the laser group showed superior healing rates (90.2 vs. 76.5%,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.043). Multivariate logistic regression identified laser treatment (\n                      <jats:italic>OR<\/jats:italic>\n                      = 3.42, 95% CI: 1.28\u20139.15,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.014), initial bacterial load (\n                      <jats:italic>OR<\/jats:italic>\n                      = 0.67, 95% CI: 0.49\u20130.91,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.011), and tooth type (\n                      <jats:italic>OR<\/jats:italic>\n                      = 2.18, 95% CI: 1.05\u20134.52,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.036) as significant predictors of\n                      <jats:italic>E. faecalis<\/jats:italic>\n                      elimination.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Semiconductor laser irradiation combined with sodium hypochlorite irrigation demonstrates significantly superior antimicrobial efficacy against\n                      <jats:italic>E. faecalis<\/jats:italic>\n                      compared to conventional irrigation alone, resulting in improved short-term clinical outcomes in the treatment of infected root canals. However, as\n                      <jats:italic>E. faecalis<\/jats:italic>\n                      represents only one component of the complex endodontic microbiota, future studies employing comprehensive microbiological analysis including qPCR and anaerobic culture are warranted to validate these findings across the polymicrobial infection spectrum. Long-term follow-up studies are warranted to confirm the stability of these results.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1803478","type":"journal-article","created":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T04:22:29Z","timestamp":1776918149000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparative efficacy of semiconductor laser and sodium hypochlorite irrigation for elimination of Enterococcus faecalis in root canals"],"prefix":"10.3389","volume":"13","author":[{"given":"Jiamin","family":"Lu","sequence":"first","affiliation":[{"name":"Department of Endodontics, Changzhou Stomatological Hospital","place":["Changzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rui","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Stomatology, Changzhou Hospital of Traditional Chinese Medicine","place":["Changzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Changzhou Stomatological Hospital","place":["Changzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Min","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Changzhou Stomatological Hospital","place":["Changzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,23]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"512","DOI":"10.1111\/iej.13677","article-title":"Present status and future directions: microbiology of endodontic infections","volume":"55","author":"Siqueira JF","year":"2022","journal-title":"Int Endod J."},{"key":"B2","doi-asserted-by":"publisher","first-page":"365204","DOI":"10.1088\/1361-6463\/ac7423","article-title":"Antibacterial effects of liquid discharge cold plasma on Enterococcus faecalis planktonic cultures and biofilms: an in vitro study of root canal treatment","volume":"55","author":"Wen","year":"2022","journal-title":"J Phys D Appl Phys."},{"key":"B3","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1016\/j.cden.2016.08.009","article-title":"Endodontic treatment outcomes","volume":"61","author":"Chugal","year":"2017","journal-title":"Dent Clin North Am."},{"key":"B4","doi-asserted-by":"publisher","first-page":"382","DOI":"10.1016\/j.joen.2023.01.005","article-title":"Impact of case difficulty, endodontic mishaps, and instrumentation method on endodontic treatment outcome and quality of life: a four-year follow-up study","volume":"49","author":"Johnsen","year":"2023","journal-title":"J Endod."},{"key":"B5","doi-asserted-by":"publisher","first-page":"191","DOI":"10.29196\/jubpas.v30i2.4256","article-title":"Enterococcus faecalis: a mini-review","volume":"30","author":"Jaafar","year":"2022","journal-title":"J Univ Babylon Pure Appl Sci."},{"key":"B6","doi-asserted-by":"publisher","first-page":"fnac082","DOI":"10.1093\/femsle\/fnac082","article-title":"Enterococcus faecalis V583 cell membrane protein expression to alkaline stress","volume":"369","author":"Cathro","year":"2022","journal-title":"FEMS Microbiol Lett."},{"key":"B7","doi-asserted-by":"publisher","first-page":"1667","DOI":"10.1016\/j.archoralbio.2013.08.013","article-title":"Survival of Enterococcus faecalis during alkaline stress: changes in morphology, ultrastructure, physiochemical properties of the cell wall and specific gene transcripts","volume":"58","author":"Ran","year":"2013","journal-title":"Arch Oral Biol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1111\/iej.13656","article-title":"A critical analysis of research methods and experimental models to study the root canal microbiome","volume":"55","author":"Siqueira JF","year":"2022","journal-title":"Int Endod J."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1138","DOI":"10.1016\/j.dental.2024.05.014","article-title":"Effects of endodontic root canal irrigants on tooth dentin revealed by infrared spectroscopy: a systematic literature review","volume":"40","author":"Elfarraj","year":"2024","journal-title":"Dent Mater."},{"key":"B10","doi-asserted-by":"publisher","first-page":"16","DOI":"10.1016\/j.joen.2016.09.023","article-title":"Sodium hypochlorite accident: a systematic review","volume":"43","author":"Guivarc'h","year":"2017","journal-title":"J Endod"},{"key":"B11","doi-asserted-by":"publisher","first-page":"e636","DOI":"10.1097\/SCS.0000000000010407","article-title":"Sodium hypochlorite accidents in endodontic practice: clinical evidence and state of the art","volume":"35","author":"Fiorillo","year":"2024","journal-title":"J Craniofac Surg."},{"key":"B12","doi-asserted-by":"publisher","first-page":"101756","DOI":"10.1016\/j.pdpdt.2020.101756","article-title":"Comparison between antimicrobial photodynamic therapy and low-level laser therapy on non-surgical periodontal treatment: a clinical study","volume":"31","author":"Freire","year":"2020","journal-title":"Photodiagnosis Photodyn Ther."},{"key":"B13","doi-asserted-by":"publisher","first-page":"420","DOI":"10.3390\/dj12120420","article-title":"Laser technology in dentistry: from clinical applications to future innovations","volume":"12","author":"Sachelarie","year":"2024","journal-title":"Dent J (Basel)."},{"key":"B14","doi-asserted-by":"publisher","first-page":"650","DOI":"10.3390\/photonics10060650","article-title":"Therapeutic and adverse effects of lasers in dentistry: a systematic review","volume":"10","author":"Malcangi","year":"2023","journal-title":"Photonics."},{"key":"B15","doi-asserted-by":"publisher","first-page":"103014","DOI":"10.1016\/j.pdpdt.2022.103014","article-title":"Antimicrobial photodynamic therapy in endodontic reintervention: a systematic review and meta-analysis","volume":"39","author":"Nunes","year":"2022","journal-title":"Photodiagnosis Photodyn Ther."},{"key":"B16","doi-asserted-by":"publisher","first-page":"5105","DOI":"10.1007\/s00784-022-04558-y","article-title":"Is the quality of root canal filling obtained by cone-beam computed tomography associated with periapical lesions? A systematic review and meta-analysis","volume":"26","author":"Dos Santos","year":"2022","journal-title":"Clin Oral Investig."},{"key":"B17","doi-asserted-by":"publisher","first-page":"3226","DOI":"10.3390\/ijms23063226","article-title":"Use of photodynamic therapy associated with antimicrobial peptides for bacterial control: a systematic review and meta-analysis","volume":"23","author":"Dias","year":"2022","journal-title":"Int J Mol Sci."},{"key":"B18","doi-asserted-by":"publisher","first-page":"101","DOI":"10.3390\/dj13030101","article-title":"Enhancing root canal disinfection with Er:YAG laser: a systematic review","volume":"13","author":"Fiegler-Rudol","year":"2025","journal-title":"Dent J (Basel)."},{"key":"B19","doi-asserted-by":"publisher","first-page":"101611","DOI":"10.1016\/j.pdpdt.2019.101611","article-title":"Evaluation of the outcome of various laser therapy applications in root canal disinfection: a systematic review","volume":"29","author":"Bordea","year":"2020","journal-title":"Photodiagnosis Photodyn Ther."},{"key":"B20","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1016\/j.joen.2020.05.020","article-title":"The apical root canal system of teeth with posttreatment apical periodontitis: correlating microbiologic, tomographic, and histopathologic findings","volume":"46","author":"Siqueira JF","year":"2020","journal-title":"J Endod."},{"key":"B21","doi-asserted-by":"publisher","first-page":"501","DOI":"10.1111\/iej.12753","article-title":"What happens to unprepared root canal walls: a correlative analysis using micro-computed tomography and histology\/scanning electron microscopy","volume":"51","author":"Siqueira JF","year":"2018","journal-title":"Int Endod J."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1301","DOI":"10.1186\/s12903-025-06573-3","article-title":"Antibacterial efficacy of quaternary ammonium compounds (QACs) against Enterococcus faecalis in endodontic infections: a systematic review and meta-analysis","volume":"25","author":"Bapat","year":"2025","journal-title":"BMC Oral Health."},{"key":"B23","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1089\/photob.2021.0073","article-title":"In vivo efficacy of diode laser as a monotherapy in root canal disinfection: a systematic review and meta-analysis","volume":"40","author":"Dawasaz","year":"2022","journal-title":"Photobiomodul Photomed Laser Surg."},{"key":"B24","doi-asserted-by":"publisher","first-page":"233","DOI":"10.1016\/j.pdpdt.2015.07.171","article-title":"A comparison of the antibacterial activity of the two methods of photodynamic therapy (using diode laser 810 nm and LED lamp 630 nm) against Enterococcus faecalis in extracted human anterior teeth","volume":"13","author":"Asnaashari","year":"2016","journal-title":"Photodiagnosis Photodyn Ther."},{"key":"B25","doi-asserted-by":"publisher","first-page":"1607","DOI":"10.1007\/s00784-011-0664-2","article-title":"Long-term outcome of primary non-surgical root canal treatment","volume":"16","author":"Lee","year":"2012","journal-title":"Clin Oral Investig."},{"key":"B26","doi-asserted-by":"publisher","first-page":"447","DOI":"10.3390\/medicina56090447","article-title":"Long-term prognosis of endodontic microsurgery\u2014a systematic review and meta-analysis","volume":"56","author":"Pinto","year":"2020","journal-title":"Medicina (Kaunas)."},{"key":"B27","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1111\/j.1365-2591.2011.01872.x","article-title":"A prospective study of the factors affecting outcomes of nonsurgical root canal treatment: part 1: periapical health","volume":"44","author":"Ng","year":"2011","journal-title":"Int Endod J."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12903-023-03624-5","article-title":"Micro computed tomography (Micro-CT) characterization of root and root canal morphology of mandibular first premolars: a systematic review and meta-analysis","volume":"24","author":"Karobari","year":"2024","journal-title":"BMC Oral Health."},{"key":"B29","doi-asserted-by":"publisher","first-page":"e70175","DOI":"10.1002\/cre2.70175","article-title":"Evaluation of root canal cleaning and irrigant penetration using different irrigation protocols: a combined SEM and single-tooth micro-CT study","volume":"11","author":"Iandolo","year":"2025","journal-title":"Clin Exp Dent Res."},{"key":"B30","doi-asserted-by":"publisher","first-page":"296","DOI":"10.3390\/bioengineering10030296","article-title":"Current applications and future directions of lasers in endodontics: a narrative review","volume":"10","author":"Huang","year":"2023","journal-title":"Bioengineering (Basel)."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1803478\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,23]],"date-time":"2026-04-23T04:22:29Z","timestamp":1776918149000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1803478\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,23]]},"references-count":30,"alternative-id":["10.3389\/fmed.2026.1803478"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1803478","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,23]]},"article-number":"1803478"}}