Abstract
This study was conducted to investigate the antimicrobial-biofilm activity of chitosan (Ch-NPs), silver nanoparticles (Ag-NPs), ozonated olive oil (O3-oil) either separately or combined together against endodontic pathogens. While testing the antimicrobial activity, Ch-NPs showed the least minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values exerting eightfold higher bactericidal activity than O3-oil against both Enterococcus faecalis and Streptococcus mutans as well as fourfold higher fungicidal activity against Candida albicans. Antimicrobial synergy test revealed synergism between O3-oil and Ch-NPs against the test pathogens (FIC index ≤ 0.5). Ch-NPs was superior at inhibiting immature single and mixed-species biofilm formations by 97 and 94%, respectively. Both of O3-oil and Ch-NPs had a complete anti-fibroblast adherent effect. The safety pattern results showed that O3-oil was the safest compound, followed by Ch-NPs. The double combination of Ch-NPs and O3-oil reduced the mature viable biofilm on premolars ex vivo model by 6-log reductions, with a fast kill rate, indicating potential use in treating root canals. Therefore, the double combination has the potential to eradicate mature mixed-species biofilms and hence it is potent, novel and safe.
Highlights
The primary goal of endodontic therapy is to eradicate microbial infection and promote periapical tissue healing
This study evaluated three test substances: an ozonated extra virgin olive oil (Novox R, MOSS S.r.l., Lesa – Novara, Italy) containing active oxygen in the form of peroxide ranged between 560–590 mmol-equiv/kg, prepared by introducing olive oil through a device generating ozone (Díaz et al, 2006); chitosan NPs (Ch-NPs) prepared by an ionotropic gelation technique (Sailaja et al, 2011) (NanoTech Egypt company for PhotoElectronics); and silver nanoparticles prepared by a chemical reduction method (Ratyakshi and Chauhan, 2009) (NanoTech Egypt company for Photo-Electronics)
Ch-NPs exerted 4- and 8-fold increases in the microbicidal activity compared to O3-oil against C. albicans, and both of E. faecalis and S. mutans, respectively
Summary
The primary goal of endodontic therapy is to eradicate microbial infection and promote periapical tissue healing. Endodontic infections are polymicrobial and made up of various microorganisms that differ between failed endodontic cases and primary endodontic infections (Nair, 2006; Tirali et al, 2017). Gram-negative, black-pigmented anaerobes are typically associated with primary endodontic infections, whereas Gram-positive streptococci and enterococci, Enterococcus faecalis and Streptococcus mutans, and Candida albicans are more common in failed or persistent endodontic infections (Peciuliene et al, 2000; Nair, 2006; Tirali et al, 2017). Biofilm-mediated infection is the primary cause of endodontic disease. Persistent and chronic endodontic infections depend in part on the density, diversity and resistance of bacterial biofilms to both host defense mechanisms and antimicrobial agents. Other contributing factors are the complexity of the root canal anatomy including the lateral canals, ramifications and tubular nature of the dentin that harbors bacterial colonies (Kishen, 2010; Siqueira et al, 2010)
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