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Abstract
Root canal treatment (RCT), or endodontic treatment, is a dental procedure for the treatment of infected and inflamed pulp and for protection from future bacterial contamination. Although endodontic treatment is a common dental procedure, failure occurs in ~20% of cases, caused by the remaining bacteria left in the root canal or endodontic failure with secondary leakage and infection. The most frequent bacteria, isolated from the infected root canals in cases of secondary infections or endodontic failure, is Enterococcus faecalis, from the oral microbiota. E. faecalis bacteria remain in the root canals or dental tubules due to the technical complexity of the root canal preparations with limitations of the disinfection agents to reach all tooth morphological structures during RCT. These secondary infections often require the dentist to prescribe antibiotic treatment, which stimulates the development of antibiotic resistance in the bacterial infections. New endodontic materials should reduce the incidence of secondary infections by application of non-antibiotic antimicrobial agents. Silver nanoparticles (AgNPs) have proven to be an effective antimicrobial agent due to their unique properties, such as large surface-to-volume ratio, different ways of antibacterial action and importantly, low cytotoxicity. Here, we explore how AgNPs can be used in root canal therapy to eliminate bacteria in the root canal after the RCT-treatment and, thus, reduce the incidence of endodontic failure. The project aims to develop novel silver nanoparticle applications for root canal treatment.
AgNPs’ morphology was investigated by scanning (SEM) and transmission electron microscopy (TEM) and confirmed the square shape of the AgNP and their ~50 nm size. The antimicrobial properties of these AgNPs were tested with both solid and liquid media and demonstrated dose-dependent action against E. faecalis. Based on our results of the antimicrobial action of AgNPs, we developed a dental root canal model which close to in-vivo replica the application of AgNPs in endodontic treatment. Bacterial growth of E. faecalis was confirmed throughout the root canal in our dental models by immunocytochemical staining. These results showed that supplementation of AgNPs in the dental model slowed down the growth of E. faecalis compared to dental models without AgNPs.
Thus, our new results demonstrated the effective antimicrobial action against E.faecalis, by application of AgNPs to the dental models and the suggest that AgNPs provides promising translational potential as antimicrobial agent with quality of patient-care improvements and long-term cost-efficiency in the clinical endodontics.
Keywords: silver nanoparticles, endodontic treatment, root canal treatment, Enterococcus faecalis, antibiotic resistance.
Acknowledgments: The project was supported in part by the HORIZON-MSCA-SE-2021 project ARGO (#101086441).
