Comparative Analysis of Antimicrobial Efficacy of Electrolyzed Water with Sodium Hypochlorite Solution against Root Canal Pathogen: A Scoping Review

Authors

  • Siti Nazihah Abd Rahman Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan Campus, Bandar Indera Mahkota, Pahang, Malaysia
  • Siti Nabilah Aini @ Jaini Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan Campus, Bandar Indera Mahkota, Pahang, Malaysia
  • Sobrina Mohamed Khazin Restorative Dentistry Department, Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan Campus, Bandar Indera Mahkota, Pahang, Malaysia
  • Mohd. Hafiz Arzmi Fundamental Dental and Medical Science Department, Kulliyyah of Dentistry, International Islamic University Malaysia, Kuantan Campus, Bandar Indera Mahkota, Pahang, Malaysia

DOI:

https://doi.org/10.22452/adum.vol31no3

Keywords:

antibacterial, electrolyte solution, enterococcus faecalis, root canal irrigant, sodium hypochlorite

Abstract

Electrolyzed water (EW) has been introduced as a surface disinfectant due to its antimicrobial properties without cytotoxic effects to oral tissues contrary to sodium hypochlorite (NaOCl), which is cytotoxic and can be detrimental if extruded beyond the root canal. This scoping review aimed to compare antimicrobial efficacy of EW with NaOCl on root canal pathogens and to assess effect of concentration and exposure time on antimicrobial efficacy. The review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews protocol guidelines. Electronic databases were searched for eligible articles published between 2011-2021 in PubMed, PLOS, Science Direct, and Google Scholar. Joanna Briggs Institute Critical Appraisal Tool was used for quality assessment. Of the 784 articles recovered, only 8 were eligible based on inclusion criteria. The included studies assessed several types of EW, which showed antimicrobial potential against E. faecalis in vitro in suspension and biofilm forms. EW demonstrated antimicrobial efficacy comparable with NaOCl in 5 of 8 studies. Only one study found that higher concentration and exposure time increased antimicrobial efficacy of EW; other studies showed otherwise. It can be concluded that EW can be a potential alternative solution for NaOCl as an endodontic irrigant.

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References

Loroño, G., Zaldivar JR, Arias A, Cisneros R, Dorado S, Jimenez‐Octavio JR. Positive and negative pressure irrigation in oval root canals with apical ramifications: a computational fluid dynamics evaluation in micro‐CT scanned real teeth. Int Endod J. 2020;53:671–9.

Peters OA, Schönenberger K, Laib A. Effects of four Ni–Ti preparation techniques on root canal geometry assessed by micro computed tomography. Int Endod J. 2001;34:221–30.

Pai A. Factors influencing the occurrence and progress of sodium hypochlorite accident: A narrative and update review. J Conserv Dent. 2023;26:3.

Xu H, Ye Z, Zhang A, Lin F, Fu J, Fok ASL. Effects of concentration of sodium hypochlorite as an endodontic irrigant on the mechanical and structural properties of root dentine: A laboratory study. Int Endod J. 2022;55:1091–1025.

Coelho A, Amaro I, Rascão B, Marcelino I, Paula A, Saraiva J, Gianrico S, MM Ferreira, Carlos Miguel M, E Carrilho. Effect of cavity disinfectants on dentin bond strength and clinical success of composite restorations-a systematic review of in vitro, in situ and clinical studies. Int J Mol Sci. 2021;22:353.

Ibrahim NZ, Abdullah M. Antimicrobial evaluation of sodium hypochlorite and ozonated water on E. faecalis biofilm. Annals of Dentistry University Malaya. 2008;15:20–6.

Boutsioukis C, Psimma Z, Kastrinakis E. The effect of flow rate and agitation technique on irrigant extrusion ex vivo. Int Endod J. 2014;47:487–96.

Basrani BR, Malkhassian G. Update on irrigation disinfection [Internet]. American Association of Endodontics. 2021 [cited 2024 Jan 17]. Available from: https://www.aae.org/specialty/update-on-irrigation-disinfection.

Baruwa AO, Martins JNR, Maravic T, Mazzitelli C, Mazzoni A, Ginjeira A. Effect of endodontic irrigating solutions on radicular dentine structure and matrix metalloproteinases—a comprehensive Review. Dent J (Basel). 2022;10.

Chen KK, Wu JH, Wei SI, Du JK. Influence of the acidity of electrolyzed water on the microhardness of inner layer dentin. J Dent Sci. 2019;14:419–25.

Hsieh S-C, Teng N-C, Chu CC, Chu Y-T, Chen C-H, Chang L, Chieh YH, Ching-Shuan Huang, Grace Yinh-Wen H, JC Yang. The antibacterial efficacy and in vivo toxicity of sodium hypochlorite and electrolyzed oxidizing (EO) water-based endodontic irrigating solutions. Materials. 2020;13:260.

Cárdenas AM, Bijit VC, Francesco F Di, Schwarz F, Cafferata EA, Vernal R. Electrolyzed water for the microbiologic control in the pandemic dental setting : a systematic review. BMC Oral Health. 2022;22:579

Tricco A, Lillie E, Zarin W, O’Brien K, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169:467–73.

Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, Pau S, Lesley A Stewart. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Syst Rev. 2015;4:1.

Cumpston M, Li T, Page MJ, Chandler J, Welch VA, Higgins JP, James Thomas. Updated guidance for trusted systematic reviews: a new edition of the Cochrane Handbook for Systematic Reviews of Interventions. Cochrane Database Systematic Reviews. 2019;10:ED000142

Tufanaru C, Munn Z, Aromataris E, Campbell J, Hopp L. Systematic reviews of effectiveness. Joanna Briggs Institute reviewer’s manual. 2017;3.

Zan R, Alacam T, Hubbezoglu I, Tunc T, Sumer Z, Alici O. Antibacterial efficacy of super-oxidized water on Enterococcus faecalis biofilms in root canal. Jundishapur J Microbiol. 2016;9:e30000

Lata S, Mohanty SK, Pradhan PK, Patri G, Sinha SP, Agrawal P. Anti bacterial effectiveness of electro-chemically activated (ECA) water as a root canal irrigant- an in-vitro comparative study. Journal of Clinical and Diagnostic Research. 2016;10:ZC138–42.

Mena-mendivil ED, Flores-treviño JJ, Rodríguez-delgado I, Garza-ramos MA De, Torre-martínez HH, Martínez- GI. Antimicrobial effect of Microdacyn 60, OxOral, and sodium hypochlorite 5.25% in anaerobic bacteria. Journal of Pharmacognosy and Phytotherapy. 2013;5:178–82

Akbulut MB, Eldeniz AÜ. In vitro antimicrobial activity of different electrochemically-activated solutions on enterococcus faecalis. Eur Oral Res. 2019;53:44–50.

Cheng X, Tian Y, Zhao C, Qu T, Ma C, Liu X, Qing Yu. Bactericidal effect of strong acid electrolyzed water against flow Enterococcus faecalis biofilms. J Endod. 2016;42:1120–5

Okamura T, Tamura M, Suguro H, Ohtsu M, Omagari D, Yoshino A, Bunnai O, Masatake A. Bactericidal and cytotoxic effects of acid-electrolyzed functional water. J Oral Sci. 2019;61:512–5.

Saucedo AH, Antonio M, Guerra C, Javier F, Padilla V, Haydeé D, Sandra Laura AR. Comparison of OxOral® and NaOCl irrigants efficiency in Enterococcus faecalis elimination. Revista Odontológica Mexicana. 2017;21:e233–6.

Lata S, Mohanty SK, Pradhan PK, Patri G, Sinha SP, Agrawal P. Anti bacterial effectiveness of electro-chemically activated (ECA) water as a root canal irrigant- an in-vitro comparative study. Journal of Clinical and Diagnostic Research. 2016;10:ZC138–42..

Akbulut MB, Eldeniz AÜ. In vitro antimicrobial activity of different electrochemically-activated solutions on enterococcus faecalis. Eur Oral Res. 2019;53:44–50.

Cheng X, Tian Y, Zhao C, Qu T, Ma C, Liu X, Yu Q. Bactericidal effect of strong acid electrolyzed water against flow Enterococcus faecalis biofilms. J Endod [Internet]. 2016;42:1120–5. Available from: http://dx.doi.org/10.1016/j.joen.2016.04.009

Mena-mendivil ED, Flores-treviño JJ, Rodríguez-delgado I, Garza-ramos MA De, Torre-martínez HH, Martínez- GI. Antimicrobial effect of Microdacyn 60, OxOral, and sodium hypochlorite 5.25% in anaerobic bacteria. Journal of Pharmacognosy and Phytotherapy. 2013;5:178–82

Zan R, Alacam T, Hubbezoglu I, Tunc T, Sumer Z, Alici O. Antibacterial efficacy of super-oxidized water on Enterococcus faecalis biofilms in root canal. Jundishapur J Microbiol. 2016;9:e30000

Saucedo AH, Antonio M, Guerra C, Javier F, Padilla V, Haydeé D, Sandra Laura AR. Comparison of OxOral® and NaOCl irrigants efficiency in Enterococcus faecalis elimination. Revista Odontológica Mexicana [Internet]. 2017;21:e233–6. Available from: http://dx.doi.org/10.1016/j.rodmex.2018.01.013.

Okamura T, Tamura M, Suguro H, Ohtsu M, Omagari D, Yoshino A, Bunnai O, Masatake A. Bactericidal and cytotoxic effects of acid-electrolyzed functional water. J Oral Sci. 2019;61:512–5.

Hsieh S-C, Teng N-C, Chu CC, Chu Y-T, Chen C-H, Chang L, Hsu CY, Huang CS, Hsiao GY-W, Yang J-C. The antibacterial efficacy and in vivo toxicity of sodium hypochlorite and electrolyzed oxidizing (EO) water-based endodontic irrigating solutions. Materials. 2020;13:260.

Thorn R, Lee S, Robinson G, Greenman J, Reynolds D. Electrochemically activated solutions: evidence for antimicrobial efficacy and applications in healthcare environments. European Journal of Clinical Microbiology & Infectious Diseases. 2012;31:641–53.

Zhao L, Li S, Yang H. Recent advances on research of electrolyzed water and its applications. Curr Opin Food Sci. 2021;41:180–8.

Cui X, Shang Y, Shi Z, Xin H, Cao W. Physicochemical properties and bactericidal efficiency of neutral and acidic electrolyzed water under different storage conditions. J Food Eng. 2009;91:582–6.

Sampson M, Muir A. Not all super-oxidized waters are the same. J Hosp Infect. 2002;52:228–9.

Landa-Solis C, González-Espinosa D, Guzmán-Soriano B, Snyder M, Reyes-Terán G, Torres K, et al. MicrocynTM: a novel super-oxidized water with neutral pH and disinfectant activity. Journal of Hospital Infection. 2005;61:291–9.

Zeng X, Ye G, Tang W, Ouyang T, Tian L, Ni Y,Li P. Fungicidal efficiency of electrolyzed oxidizing water on Candida albicans and its biochemical mechanism. J Biosci Bioeng. 2011;112:86–91.

Huang Y, Hung Y, Hsu S, Huang Y, Hwang D. Application of electrolyzed water in the food industry. Food Control. 2008;19:329–45.

Nair PNR. On the causes of persistent apical periodontitis: a review. Int Endod J. 2006;39:249–81

Teles AM, Pina C, Manso MC, Cabeda JMB. A review of microbiological root canal sampling: updating an emerging picture. Archives of Oral Research. 2013;9:41–59.

Yanik K, Karadag A, Unal N, Odabasi H, Esen S, Gunaydin M. An ınvestigation into the in-vitro effectiveness of electrolyzed water against various microorganisms. Int J Clin Exp Med. 2015;8:11463–9.

Gunaydin M, Esen S, Karadag A, Unal N, Yanik K, Odabasi H, Asuman B. In vitro antimicrobial activity of Medilox® super-oxidized water. Ann Clin Microbiol Antimicrob [Internet]. 2014;13:29. Available from: http://ann-clinmicrob.biomedcentral.com/articles/10.1186/1476-0711-13-29

Lucio-Sauceda DG, Urrutia-Baca VH, Gomez-Flores R, De La Garza-Ramos MA, Tamez-Guerra P, Orozco-Flores A. Antimicrobial and anti-biofilm effect of an electrolyzed superoxidized solution at neutral-pH against Helicobacter pylori. Biomed Res Int [Internet]. 2019;2019:1–9. Available from: https://www.hindawi.com/journals/bmri/2019/6154867/

Okajima M, Kanzaki M, Ishibashi Y, Wada Y, Hino F, Kitahara Y, Shimokawa K, Ishii F. In vitro bactericidal activity against periodontopathic bacteria by electrolyzed ion-reduced water. Drug Discov Ther. 2011;5:306–10.

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

Ileri C, Sezen Y, Dimoglo A. Investigation of the efficacy of electrolyzed acid water on the standard strains of some pathogenic microorganisms. Mikrobiyol Bul. 2006;40:317–24.

Salisbury A-M, Percival SL. The efficacy of an electrolysed water formulation on biofilms. Adv Exp Med Biol. 2018. p. 1–8.

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Published

2024-03-18

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Section

Review Article