This
study was designed to examine the in vitro bactericidal activity of
hydrogen peroxide against Legionella. We tested hydrogen peroxide
(Peroxy Ag+) at 600 ppm to evaluate Legionella survival in a simulated
dental treatment water system equipped with Water Hygienization Equipment
(W.H.E.) device that was artificially contaminated. When Legionella
pneumophila serogroup (sg) 1 was exposed to Peroxy Ag+ for 60 min
we obtained a two decimal log reduction. High antimicrobial efficacy
was obtained with extended periods of exposure: four decimal log reduction
at 75 min and five decimal log reduction at 15 h of exposure. Involving
a simulation device (Peroxy Ag+ is flushed into the simulation dental
unit waterlines (DUWL)) we obtained an average reduction of 85% of
Legionella load. The product is effective in reducing the number of
Legionella cells after 75 min of contact time (99.997%) in the simulator
device under test conditions. The Peroxy Ag+ treatment is safe for
continuous use in the dental water supply system (i.e., it is safe
for patient contact), so it could be used as a preventive option,
and it may be useful in long-term treatments, alone or coupled with
a daily or periodic shock treatment.