Effectiveness of Oxidative Potential Water as an Irrigant in Pulpectomized Primary Teeth

Objective: The aim of this study was to evaluate the effectiveness of oxidative potential water (OPW) as an irrigating solution in reducing bacterial loading in necrotic pulpectomized primary teeth. Study design: Forty necrotic teeth were included, 20 irrigated with OPW (experimental group) and 20 with 1% NaOCl (control group); in both groups, 2 microbiological samples from within the canals were taken with a sterile paper point, the first before irrigation (immediately before opening the crown), and the second after instrumentation and final irrigation (before filling). All samples were evaluated by McFarland's scale. Results: After the samples were analyzed before and after irrigation in the control group, there was a significant decrease in bacterial load, as in the experimental group (P < 0.0001). When both groups were compared post irrigation, no significant difference was observed (P = 0.1519). Conclusion: The OPW was as effective as the NaOCl and is suggested as an alternative for irrigating after pulpectomy of necrotic primary teeth.

irrigating solution, oxidative potential water, primary teeth, pulpectomy

1. Cox ST Jr, Hembree JH Jr, McKnight JP. The bactericidal potential of various  endodontic  materials  for  primary  teeth.  Oral  Surg  Oral  Med Oral Pathol, 45: 947–54, 1978.

2. Fuks AB. Pulp therapy for the primary and young permanent dentition. Dent Clin North Am, 44: 571–96, 2000.

3. Pappen F, Bolzani L, Rodríguez S, Amaral MR, Tanumaru M. Efecto antimicrobiano de soluciones irrigadoras utilizadas en endodoncia. Rev Estomatol Herediana, 13: 9–11, 2003. 

4. Onçağ O, Hoşgör M, Hilmioğlu S, Zekioğlu O, Eronat C, Burhanoğlu D.  Comparison of antibacterial and toxic effects of various root canal irrigants. Int Endod J, 36: 423–32, 2003.

5. Ruiz-Esparza CL, Garrocho-Rangel A, Gonzalez-Amaro AM, Flores-Reyes H, Pozos-Guillen AJ. Reduction in bacterial loading using 2%chlorhexidine as an irrigant in pulpectomized deciduous teeth. A pre-liminary report. J Clin Pediatr Dent, 35: 265–70, 2010.

6. Razi RS. Pulp therapy in the primary dentition. NY State Dent J, 65: 18–22, 1999.

7. Hata G, Hayami S, Weine FS, Toda T. Effectiveness of oxidative poten-tial water as a root canal irrigant. Int Endod J, 34: 308–17, 2001.

8. Gaitán CI, Gonzalez AM, Cruz R, Flores HE, Pozos-Guillen AJ. Efecto antimicrobiano del agua potencialmente oxidativa. Rev Odontol Mex, 13: 224–8, 2009.

9. Thorn  RM,  Lee  SW,  Robinson  GM,  Greenman  J,  Reynolds  DM. Electrochemically activated solutions: evidence for antimicrobial effi-cacy and applications in healthcare environments. Eur J Clin Microbiol Infect Dis, 31: 64–53, 2012.

10. Yamada K, Yama M, Takaku Y, Kakizawa T, Kimizuka R, Okuda K, Kato  T.  Antimicrobial  activity  of  super-oxidised  water  against  oral microorganisms. Arc Oral Biol, 55: 397–400, 2010.

11. Hata  G.  Removal  of  smear  layer  in  the  root  canal  using  oxidative potential water. J Endod, 22: 643–5, 1996.

12. Carlsson J, Sundqvist G. Evaluation of methods of transport and culti-vation  of  bacterial  specimens  from  infected  dental  root  canals.  Oral Surg Oral Med Oral Pathol, 49: 451–4, 1980.

13. Manzur  A,  Gonzalez  AM,  Pozos  A,  Silva-Herzog  D,  Friedman  S. Bacterial  quantification  in  teeth  with  apical  periodontitis  related  to instrumentation  and  different  intracanal  medications:  A  randomized clinical trial. J Endod, 33: 114–8, 2007.

14. McFarland J. The nephelometer: an instrument for estimating the num-ber of bacteria in suspensions used for calculating the opsonic index and for vaccines. J Am Med Assoc, 49: 1176–8, 1907.

15. Zehnder M. Root canal irrigants. J Endod, 32: 389–98, 2006.

16. Gomes-Filho JE, Aurélio KG, Costa MM, Bernabé FE. Comparison of the biocompatibility of different root canal irrigants. J Appl Oral Sci, 16: 137–44, 2008.

17. Gomes BP, Lilley JD, Drucker DB. Associations of endodontic symp-toms  and  signs  with  particular  combinations  of  specific  bacteria.  Int Endod J, 29: 69–75, 1996.

18. Brook  I.  Microbiology  and  management  of  endodontic  infections  in children. J Clin Pediatr Dent, 28: 18–25, 2003.

19. Da Silva LA, Nelson-Filho P, Faria G, Souza-Gugelmin MC, Ito IY. Bacterial  profile  in  primary  teeth  with  necrotic  pulp  and  periapical lesions. Braz Dent J, 17: 144–8, 2006.

20. Ledezma-Rasillo G, Flores-Reyes H, Gonzalez-Amaro AM, Garrocho-Rangel A, Ruiz-Rodriguez MS, Pozos-Guillen AJ. Identification of cul-tivable microorganisms from primary teeth with necrotic pulps. J Clin Pediatr Dent, 34: 329–34, 2010.

21. Marais JT, Williams WP. Antimicrobial effectiveness of electrochemi-cally activated water as an endodontic irrigation solution. Int Endod J, 34: 23–43, 2001.

22. Gulabivala  K,  Stock  JR,  Lewsey  JD,  Ghori  S,  Ng  YL,  Spratt  DA. Effectiveness of electrochemically activated water as an irrigant in an infected tooth model. Int Endod J, 37: 624–31, 2004.

23. Rossi-Fedele G, Figueiredo JA, Steier L, Canullo L, Steier G, Roberts

A.  Evaluation  of  the  antimicrobial  effect  of  super-oxidized  water (Sterilox) and sodium hypochlorite against Enterococcus faecalis in a bovine root canal model. J Appl Sci, 18: 498–502, 2010.

24. Kiura H, Sano K, Morimatsu S, Nakano T, Morita C, Yamaguchi M, Maeda T, Katsuoka Y. Bacterial activity of electrolyzed acid water from solution containing sodium chloride at low concentration, in compari-son with that at high concentration. J Microbiol Methods, 49: 285–93, 2002.

25. Serper A, Calt S, Dogan AL, Guc D, Ozcelik B, Kuraner T. Comparison of the cytotoxic effects and smear layer removing capacity of oxidative potential water, NaOCl and EDTA. J Oral Sci, 43: 233–8, 2001.

26. Morita  C,  Nishida  T,  Ito  K.  Biological  toxicity  of  acid  electrolyzed functional water: Effect of oral administration on mouse digestive tract and changes in body weight. Arch Oral Biol, 56: 359–66, 2011.