Effectiveness of electrochemically activated water as an irrigant in an infected tooth model.
OBJECTIVE
To test the effectiveness of electrochemically activated aqueous solutions in the debridement of Enterococcus faecalis biofilms in root canals of extracted teeth.


METHODS
Extracted, human, single-rooted teeth (198) assembled into 11 sets (n = 18) with matching anatomical characteristics were randomly assigned to eight experimental groups. After decoronation, the root canals were prepared to a standard size. Enterococcus faecalis biofilms were grown in the root canals of autoclaved, individually mounted teeth over 48 h. Electrolysed saline collected as anolyte at the anode and catholyte at the cathode were the test agents. The four ultrasonication and four without ultrasonication irrigant groups included: neutral anolyte (NA) (pH 6.5), acidic anolyte (AA) (pH 3.0), catholyte (C) (pH 11.5) and C alternated with neutral anolyte (C/NA). Phosphate-buffered saline (PBS) with and without ultrasonication formed negative and NaOCl (3%) positive control groups. After irrigation, root canal samples were serially diluted, cultured and enumerated. The data were analysed as ratios of residual colony-forming units (CFUs) in PBS versus the test irrigants and using multivariate regression.


RESULTS
The NA and NA (ultrasonicated, U), C/NA and AA (U) groups had significantly (alpha = 0.05) less and C (U) and C/NA (U) significantly (alpha = 0.05) more bacteria (CFUs mL(-1)) compared with their respective PBS controls. Ultrasonicated C/NA had significantly (alpha = 0.05) higher CFU counts than the nonultrasonicated solution. Other comparisons between ultrasonic and nonultrasonic groups were not significant. Of the nonultrasonicated groups, C/NA and NA were most effective, whilst of the ultrasonicated groups, AA and NA were most effective. None of these was as effective as 3% NaOCl.


CONCLUSIONS
All but two groups (AA and C) were significantly different from their PBS controls. There was a significant difference between the C/NA groups with and without ultrasonication but not between other combinations. NA (U) and AA (U) were the most effective test solutions but NaOCl (3%) gave by far the highest bacterial kills.
Unit of Endodontology, Eastman Dental Institute for Oral Health Care Sciences, University College London, London, UK. k.gulabivala@eastman.ucl.ac.uk
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Gulabivala
C J R
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Stock
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Lewsey
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Ghori
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Spratt
D015169:Colony Count, Microbial; D003786:Dental Pulp Cavity / Q000382:microbiology*; D003788:Dental Pulp Diseases / Q000188:drug therapy; D004563:Electrochemistry; D013293:Enterococcus faecalis / Q000187:drug effects*; D016908:Gram-Positive Bacterial Infections / Q000188:drug therapy; D006801:Humans; D008954:Models, Biological; D011897:Random Allocation; D012044:Regression Analysis; D012388:Root Canal Irrigants / Q000494:pharmacology*; D014465:Ultrasonics; D014867:Water / Q000494:pharmacology*
D012388:Root Canal Irrigants; D014867:Water