The purposes of this study were firstly to investigate the any formation of precipitate after interaction between ALX and NaOCL and secondarily to analyze the PCA formation by using time of flight secondary ion mass (TOF-SIM) spectrometry. Mass spectrometry analysis was performed for the mixture of 0.5% ALX and 5.25% NaOCl. As controls, 2.5% CHX with 5.25% NaOCl and 1% PCA solutions were used. Any formation of precipitates in 10 tested solutions was evaluated by naked eye. Results of mass spectrum showed that the typical peak of PCA was not detected in mixed solution of ALX and NaOCl, whereas CHX/NaOCl mixture showed the same peak that found in the PCA spectrum. Precipitate formation was only observed in CHX/NaOCL mixture. The present TOF-SIM spectrometry results indicated that ALX can be a useful root canal irrigant combined with NaOCl during canal instrumentation. Further study is necessary to confirm the antimicrobial effect of ALX against endodontic pathogen before its clinical application as an endodontic irrigant.

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In order to examine the immunoresponse of host cells to Enterococcus faecalis, this in vitro study monitored the production of Interleukin-2 (IL-2), Interleukin-4 (IL-4) and Transforming growth factor-β1 (TGF-β1) in human lymphocytes. Lymphocytes were activated with PHA in the presence or abscence of sonicated extracts of E. Faecalis (SEF) and further incubated for 72 hours. The level of each cytokine was measured by ELISA. Data were analyzed with Kruskal-Wallis test and Mann-Whitney U test (P < 0.05). PHA-activated group did exhibit higher level of IL-2 and IL-4 than untreated control group. The levels of expression of both cytokines were significantly decreased following the treatment of high (25 µg/ml) and medium concentration (12.5 µg/ml) of SEF (P <0 .05) than those of PHA activated group. But low concentration (5 µg/ml) of SEF showed the similar level of IL-2 and IL-4 production as those of PHA activated group. TGF-β1 was unaffected by SEF treatment. These results suggested that E. faecalis may suppress IL-2 and IL-4 production by lymphocytes and this could be one of possible factors why E. faecalis are found frequently in the teeth with failed endodontic treatment.

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