A new study published in the journal of Nature Scientific Reports found that “matching transformation system” (MA-T) has a strong disinfection ability and superior biocompatibility, suggesting it could serve as a promising alternative to traditional irrigants like sodium hypochlorite (NaOCl).

Apical periodontitis arises primarily from bacterial invasion and biofilm formation inside the root canal system. Conventional treatment relies heavily on mechanical cleaning combined with chemical irrigation. However, widely used agents such as NaOCl can damage periapical tissues and exhibit cytotoxic effects on surrounding cells. MA-T, a recently developed chlorine dioxide-based solution, has now been evaluated for its antibacterial performance and cytocompatibility.

The study examined MA-T’s antibacterial activity against both mono-species biofilms (including Enterococcus faecalis, Parvimonas micra, and Fusobacterium nucleatum) and polymicrobial biofilms derived from human plaque samples. Furthermore, an in vitro infected root canal model using E. faecalis simulated real clinical conditions. Researchers assessed bacterial viability using colony counting and confocal laser scanning microscopy (CLSM), while crystal violet (CV) staining quantified biofilm mass.

To ensure biocompatibility, rat osteoblasts and human periodontal ligament fibroblasts were exposed to MA-T and NaOCl, and cell health was measured via ATP level assays and morphological observations under microscopy.

MA-T completely eliminated planktonic bacteria across all tested species. Biofilm viability dropped dramatically (up to a 99% reduction) according to both CFU data and CLSM imaging. Although MA-T significantly reduced bacterial numbers within biofilms, the total mass of the biofilm matrix (as shown by CV staining) remained relatively stable over time, suggesting that MA-T primarily kills bacteria without dissolving the biofilm structure itself.

In the E. faecalis-infected canal system, MA-T achieved a substantial decrease in bacterial load comparable to or exceeding that of NaOCl. The cells treated with MA-T maintained higher ATP levels and displayed normal morphology, while NaOCl-treated cells showed significant ATP depletion and membrane distortion, indicating cytotoxic damage.

Overall, this research suggests that MA-T offers powerful antibacterial performance with superior biocompatibility, positioning it as a strong alternative for root canal irrigation. Future clinical trials are imperative which could revolutionize this innovation in endodontic disinfection to ensure effective sterilization while preserving the health of surrounding tissues.

Reference:

Shimaoka, T., Maezono, H., Ono, S., Asahi, Y., Kawanishi, Y., Klanliang, K., Takahashi, Y., & Hayashi, M. (2025). Application of on-demand aqueous chlorine dioxide solution for non-surgical root canal treatment. Scientific Reports, 15(1), 36215. https://doi.org/10.1038/s41598-025-20131-5