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  • Title: Bactericidal activity of stabilized chlorine dioxide as an endodontic irrigant in a polymicrobial biofilm tooth model system.
    Author: Lundstrom JR, Williamson AE, Villhauer AL, Dawson DV, Drake DR.
    Journal: J Endod; 2010 Nov; 36(11):1874-8. PubMed ID: 20951304.
    Abstract:
    INTRODUCTION: The purpose of this study was to determine bactericidal efficacy of 0.04% stabilized chlorine dioxide, 3% sodium hypochlorite, 2% chlorhexidine gluconate, and sterile distilled water in a polymicrobial biofilm model. METHODS: Roots of 35 permanent bovine incisors had pulps extirpated, and their apical size and root length were standardized. Teeth were coated with mucin, inoculated with standardized suspensions of Streptococcus sanguinis, Actinomyces viscosus, Fusobacterium nucleatum, Peptostreptococcus micros, and Prevotella nigrescens and incubated anaerobically. Teeth were randomly divided into four groups and rinsed for 3 minutes with 15 mL of irrigant. Biofilms were harvested and spiral-plated on selective media. Numbers of bacteria in the harvested biofilms was determined via the standard spiral-plating methodology. Treatment groups were evaluated using the nonparametric Kruskal-Wallis procedure. Pair-wise comparisons among the four groups and five organisms were made using the Wilcoxon-Mann-Whitney procedure. Adjustments for multiple comparisons were made using the Holm method with p < 0.05. RESULTS: Results provide strong evidence of a significant difference in levels of bactericidal activity associated with the type of irrigant for all five bacterial species tested. Levels of bactericidal activity were significantly higher for the NaOCl group than for the stabilized chlorine dioxide (ClO₂) group for S. sanguinis, A. viscosus, and P. nigrescens. Results for F. nucleatum and P. micros were not significant after the adjustment for multiple comparisons. CONCLUSIONS: The triple-inoculation bovine tooth model system is a robust, consistent, and reproducible model system to study polymicrobial biofilms. It should be used with the knowledge expansion of biofilm structure and function as well as the development of antimicrobial protocols.
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