Abstract
BACKGROUND:
 Enterococcus faecalis (E. faecalis) is the most commonly detected micro-organism in asymptomatic and persistent endodontic infections. Thorough disinfection of the root canal is more important than proper shaping for a successful endodontic treatment. This study is an attempt to implement nanoparticles which have proven anti-bacterial efficacy as irrigating solutions against E. faecalis.
 AIM:
 To compare and evaluate the anti-bacterial efficacy of 5% sodium hypochlorite (NaOCl), 0.2% chitosan nanoparticles solution (ChNP) and 0.01% silver nanoparticles solution (AgNP) against E.faecalis with and without diode laser activation.
 MATERIALS AND METHODS:
 70 single rooted mandibular premolars were included in this study. Access opening, working length determination and biomechanical preparation were standardized. Samples were embedded in putty material inside an eppendorf tube to simulate periodontal ligament and autoclaved followed by inoculation of E.faecalis (MTCC 439) and incubated at 37℃ for 7 days. The samples were divided into 7 groups (10 samples in each group). Group 1- No treatment (Negative control), group 2 - 5% NaOCl without activation (Positive control), group 3 - 5% NaOCl with diode laser activation, group 4- 0.01% AgNP without activation, group 5- 0.01% AgNP with diode laser activation, group 6- 0.2% ChNP without activation and group 7- 0.2% ChNP with diode laser activation. A final rinse of the respective irrigants and activation were performed, followed by counting the colony forming units. Statistical analysis used were one-way analysis of variance (ANOVA) followed by Tukey’s post-hoc tests. Results showed that diode laser in combination with 5% NaOCl and 0.2% ChNP had significant effects in the reduction of microbial colony counts of E. faecalis in comparison to other experimental groups.
 Keywords: Nanoparticles, Irrigation, LASER, Enterococcus faecalis
Highlights
Biofilm is a microbial sessile community which contains cells attached to a substratum, within a matrix of extracellular polysaccharides and it shows alterations in phenotype, growth and gene expression.[1]. E. faecalis present in the biofilms plays a significant role in the primary and persistent pathologies in the root canal system.[2]. This was attributed to multiple factors, especially its capacity to survive in environments of nutritional deprivation and when commensality with other bacteria is meagre.[3] the success of root canal treatment relies on the elimination of the microbial film, which can be challenging due to the invasion of the microorganism into the dentinal tubules and the anatomic complexities of the root canal
Antimicrobial delivery system through nanoparticles is one of the innovations to improve the characteristics of antibacterial agents used in root canal treatment.[6]. Nanomaterials are particles with external dimensions of 1–100 nm, large surface/area mass ratio and increased chemical reactivity, which enable them to interact to a greater extent with the International Journal of Medical and Biomedical Studies (IJMBS)
The lowest Colony Forming Units (CFU) were noted in Groups 3 and 7 (NaOCl + Laser and chitosan nanoparticles solution (ChNP) + Laser) and highest CFU were noted in Group 4 (AgNP) among experimental groups
Summary
Biofilm is a microbial sessile community which contains cells attached to a substratum, within a matrix of extracellular polysaccharides and it shows alterations in phenotype, growth and gene expression.[1]. Negatively charged surface of bacterial cells, resulting in enhanced antimicrobial activity.[7,8] Nanoparticles have been studied in the endodontic field in an attempt to reduce E. faecalis adherence to dentine, eliminate biofilms and enhance root canal disinfection of dentinal tubules.[6]. A primary component of crustacean exoskeletons procured by alkaline deacetylation from chitin is a cationic biopolymer,(9) which is known to remineralize the demineralized structure with its functional phosphate groups and combines with calcium ions for crystal nucleation, leading to the formation of a calcium phosphate layer It improves the resistance of the dentinal surface to degradation by collagenase.[10] chitosan presents with biocompatibility, chelating capacity and antimicrobial effects against a broad range of grampositive and gram-negative bacteria as well as fungi.[11].
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