Abstract
In recent years, the use and research in nanomaterials have increased considerably. In dentistry, nanomaterials have been investigated in all their specialties like dental prosthesis, implantology, dental operative, periodontics, and endodontics. The nanomaterials are investigated in the areas of dentistry due to their application in the improvement of the physical and chemical properties of conventional materials, as well as the use of the antimicrobial activity of nanomaterials such as silver nanoparticles. Recently, silver nanoparticles (AgNPs) have been studied for their use as an endodontic irrigator due to their high antimicrobial activity. But little is known about the possible mechanisms of the adaptation to AgNPs by endodontic bacteria. These mechanisms may be intrinsic (such as efflux pumps, downregulation of porins, and chromosomal resistance genes) or extrinsic (such as point and adaptive mutations and plasmids with resistance genes) adaptation systems. In addition to this, it has been reported that coselection or coregulation of metal resistance mechanisms, as in the case of nanoparticles, is accompanied by increased resistance to various antibiotics. For these reasons, the objective of this article is to do a review of the literature on the possible mechanisms used by endodontic bacteria to generate resistance to silver nanoparticles and the possible side effects of these mechanisms.
Highlights
With the emergence of nanotechnology, silver nanoparticles (AgNPs) have been widely used in dentistry, mainly because of their antibacterial properties [1]
Silver nanoparticles are studied in dental prostheses where they are incorporated into polymers used as tissue conditioners and as denture bases to prevent the emergence of denture stomatitis
AgNPs maintain their antibacterial efficacy in the presence of dentin [6], and they are used as an alternative to root canal irrigation owing to their biocompatibility, especially in lower concentrations [7]
Summary
With the emergence of nanotechnology, silver nanoparticles (AgNPs) have been widely used in dentistry, mainly because of their antibacterial properties [1]. AgNPs have been incorporated into different materials (root canal sealer, cements, and gutta-percha) to prevent the recolonization of bacteria and have been studied as irrigating solutions and intracanal medication against bacterial biofilms [5]. This is due to the advantages that AgNPs offer in comparison to sodium hypochlorite (NaOCl). Not all mechanisms are well known, AgNPs can interact simultaneously with multiple targets in the microbial cell, like the cell membrane of both gram-positive and gram-negative bacteria [10, 11], enzymes, proteins [12], lipids [13], DNA, and plasmids [14], making it difficult for bacteria to generate resistance. A secondary search was conducted using the references or concepts mentioned in the selected articles in order to obtain more information
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