Antibiofilm Efficacy of Silver Nanoparticles Alone or Mixed with Calcium Hydroxide as Intracanal Medicaments: An Ex-Vivo Analysis

Abstract

IntroductionThis study aimed to determine the most effective antibiofilm concentration of silver nanoparticles (AgNPs) alone or in combination with calcium hydroxide (Ca[OH]2) against Fusobacterium nucleatum biofilm. MethodsThe minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of AgNPs alone or with Ca(OH)2 were determined. Dentin slices were sterilized and inoculated with F. nucleatum for 3 weeks to establish a biofilm. Samples were randomly assigned to determine the MIC and MBC for AgNPs alone or mixed with Ca(OH)2. A higher concentration of AgNPs for both preparations was also used. Triple antibiotic paste, Ca(OH)2, and saline were used as controls. Specimens in each group were subdivided over 2 observation periods: 7 and 14 days. At the end of each period, specimens were analyzed with 3-(4,5-dimethylthiazole-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) to determine the metabolic activity. Also, samples from each group were assessed by scanning electron microscopy. ResultsThe MIC and MBC of AgNPs alone against F. nucleatum coincided at 0.04%. The combination of AgNPs + Ca(OH)2 exhibited a lower MIC and MBC of 0.03%. MTT analysis showed a significant reduction in bacterial viability in all groups compared with negative controls (P < .05). A more substantial reduction in bacterial cells was observed with increasing concentrations of AgNPs at both periods. The combination (AgNPs [0.06%] + Ca[OH]2) was the most potent against F. nucleatum. ConclusionsThe findings demonstrated that combining AgNPs with Ca(OH)2 was more effective on the F. nucleatum biofilm than either material alone, suggesting a combined effect.