The chemical irrigation of root canal has been usually performed by combined treatment with 3-10% sodium hypochlorite and 3% hydrogen peroxide (Oxydol) as the most useful procedure. It is, however, contraindicative for an acute apical inflammation and may give unexpected effects on soft tissues and clothes if it inadvertently comes into contact with them. The present study was scheduled to find out the utility of electrolyzed neutral water for sterilization of root canal as an alternative to chemical agents. It has been previously reported that neutral water shows excellent bactericidal effects with few side effects on vital tissues and environments.
The prepared canal walls of extracted single-rooted teeth were contaminated with
Staphylococcus aureus 209P or
Streptococcus mutans. The canals were then washed for one minute with neutral water or agents alternately using 10% sodium hypochlorite and Oxydol. The sterilization effects of them on the canal walls were evaluated in terms of the number of surviving bacteria. Both types of bacteria in the canal were thoroughly removed by the agents after one-minute washing using a syringe. When the canal was washed by syringe with the neutral water, some numbers of surviving bacteria remained in one sample out of three. As the water showed sufficient sterilization effect for exterminating the bacteria within a short time when they were mixed in a glass tube, the reduction of the effect in the canal might be due to the exhausted effective residual chloride of the water by its reaction with organic materials in the canal. The remaining number, however, statistically exhibited no significant difference from that of the agents. Ultrasonic washing with the neutral water could further reduce the number of surviving bacteria, and no
Staphylococcus aureus 209P were found in the canal after washing although only a small number of
Streptococcus mutans could still survive. The neutral water gel developed by the authors showed better sterilization effects because it contained higher concentration of residual chloride and could stay
in situ in the canal for longer time. When the gel was filled in the canal after washing with the neutral water, the sterilization effects reached completely 100% for the contaminated canal. It is expected that gel filled in the canal after washing until the next washing treatment may be able to inhibit the growth of existing bacteria as well as the invasion of new bacteria.
When the dentin specimen was dynamically immersed in the tested media, it tended to whiten and decrease in volume in sodium hypochlorite while no change was found in the neutral water and gel.
The foregoing results suggest that the combined use of neutral water and gel may be well applicable for sterilization of canal alternative to the chemical agents from the standpoints of effective sterilization ability and subsequent maintenance, biological safety and easy manipulation without concerning any side effects.
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