Effect of gaseous ozone on Enterococcus faecalis biofilm-an in vitro study

Clin Oral Investig. 2016 Sep;20(7):1733-9. doi: 10.1007/s00784-015-1667-1. Epub 2015 Dec 4.

Abstract

Objectives: The aim of this study was to evaluate the antimicrobial effect of gaseous ozone compared to conventional methods against Enterococcus faecalis.

Materials and methods: One hundred twenty-five teeth were infected by E. faecalis and were incubated for 72 h to form biofilm. Teeth were distributed among five groups. In the first group, ozone was used; in the second group, teeth were rinsed with 20 % ethylenediaminetetraacetic acid (EDTA); in the third group, with 3 % sodium hypochlorite (NaOCl). Group 4 combined 20 % EDTA with ozone. NaOCl and ozone were combined in group 5. After treatment, the samples with paper points were taken, followed by dentin samples taken with K-file, and cultured for 24 h. Then bacterial colonies were counted.

Results: All treatments reduced significantly (p < 0.05) the bacteria. Paper points' samples showed 85.38 % reduction after ozone. The highest reduction was observed in NaOCl group (99.98 %). EDTA reduced bacteria by 80.64 %. Combination of NaOCl and ozone eradicated 99.95 % of the bacteria. Combination of EDTA and ozone reduced E. faecalis up to 91.33 %. The dentin chips showed the following: the highest CFU counts were observed in EDTA group, followed by ozone and NaOCl group. The lowest CFU counts were found in NaOCl-ozone group and EDTA-ozone group.

Conclusions: Ozone reduced E. faecalis, even organised in a biofilm, however, lower than NaOCl. No treatment reduced totally the bacteria.

Clinical relevance: Used as an adjuvant, ozone can increase the efficacy of conventional rinsing like EDTA and presents an alternative treatment when NaOCl cannot be used e.g. in teeth with a wide-open apical foramen.

Keywords: Disinfection methods; Endodontics; Enterococcus faecalis; Ozone; Root canal treatment.

MeSH terms

  • Bacterial Adhesion / drug effects
  • Biofilms / drug effects*
  • Colony Count, Microbial
  • Edetic Acid / chemistry
  • Enterococcus faecalis / drug effects*
  • Humans
  • In Vitro Techniques
  • Ozone / chemistry*
  • Sodium Hypochlorite / chemistry
  • Tooth / microbiology*

Substances

  • Ozone
  • Edetic Acid
  • Sodium Hypochlorite