Highly targeted electrochemical disruption of microbes with minimal disruption to pulp cells.

Introduction: Pulpitis results from the infiltration of mixed populations of bacteria which trigger inflammation in the dental pulp, causing significant disruption to these tissues. Clinically, pulpitis frequently leads to devitalization or extraction, as disinfection of the dental pulp while maintaining its vitality is extremely difficult. Here we describe the use of an electrocatalytic titanium dioxide (TiO)-based apparatus adapted from water purification technology, which can efficiently deliver anti-microbial oxidants (e.g., hydroxyl radicals) when low voltages are applied. As these oxidants are also potentially harmful to pulp cells, oxidant exposure protocols that disrupt oral bacteria, yet are innocuous to dental pulp cells must be established.

Methods: Stem cells from Human Exfoliated Deciduous teeth (SHEDs) and mixed salivary bacteria were exposed to apparatus generated oxidants for time points of 15, 100 or 300 s. SHED apoptosis, necrosis, and vitality post exposure were analyzed by florescent marker staining and flow cytometry. Destruction of mixed salivary bacteria was analyzed by post exposure counts of adherent bacterial cells.

Results: When applied to SHEDs the apparatus generated oxidants do not significantly induce apoptosis or necrosis at any exposure time. SHED cell vitality is not decreased with apparatus exposure. Exposure to apparatus generated oxidants destroys mixed salivary bacteria, with significant destruction seen at 15 s and maximal destruction achieved at 100 s.

Conclusions: This technology has the potential to be useful in the disinfection of deep lesions and pulp tissues, efficiently producing oxidants which eliminate bacteria but do not harm native pulp cells after relatively brief exposures.

Clinical Significance: Incomplete disinfection of inflamed dental pulp is a significant cause of pulp destruction, leading to devitalization or extraction. Novel technology which enhances the disinfection of the pulp may provide clinicians with treatments options that preserve pulp vitality and tooth structure.