ArticleBMC oral health2026
The anti-biofilm effect of ozonated water and super-oxidized water applied with different activation procedures against Enterococcus faecalis biofilm.
Article in BMC oral health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe objective of this in vitro study was to assess the anti-biofilm efficacy of super-oxidized water and ozonated water, activated through various methods, against Enterococcus faecalis (E. faecalis) biofilms within the root canal system.
methodsSeventy-four single-root mandibular premolars were prepared, inoculated with E. faecalis, and incubated for 4 weeks to allow mature biofilm formation. Infected root canals were divided into 7 experimental groups (n = 10), including 3 main experimental groups consisting of activation methods (Standard needle irrigation-SNI, EndoActivator-EA, Erbium: yttrium-aluminum-garnet-Er: YAG laser), 2 sub-experimental groups consisting of irrigation solutions (Super-oxidized water, ozonated water) and a positive control group consisting of sodium hypochlorite (NaOCl). Biofilm was assessed using colony-forming units (CFU) on blood agar plates. The data were statistically evaluated using the Mann-Whitney U and Kruskal-Wallis tests, with the significance threshold set at 0.05.
resultsSuper-oxidized water showed significantly higher anti-biofilm efficacy than ozonated water across all activation methods (p < 0.05). EA combined with super-oxidized water was more effective than Er: YAG laser (p < 0.05). Ozonated water groups showed no significant differences between activation methods (p > 0.05). NaOCl exhibited significantly higher anti-biofilm activity compared to all other groups (p < 0.05).
conclusionsThe results demonstrated that neither super-oxidized water nor ozonated water was capable of achieving complete bacterial elimination within the root canal system following the application of SNI, EA, or Er: YAG laser techniques. In addition, it can be concluded that the activation of super-oxidized water with EA has a remarkable anti-biofilm effect. It was found that super-oxidized water was more effective in bacterial elimination than ozonated water in all activation methods.
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