Efficiency of Newly Introduced Root Canal Irrigants Based on Nano Particles (In Vitro Study)

Abstract

Irrigation is a pivotal step in the cleaning of the root canal complex and the eradication of resistant bacterial biofilm as well as elimination of toxins within the root dentin. Ensuring the cleanliness of root canal comes at a cost of altering the physical and mechanical properties of the dentinal microstructure. Sodium hypochlorite, though an efficient antibacterial irrigant and an organic tissue dissolver, is suggested to change the nature of dentin especially the calcium phosphorous ratio. Nanotechnology is considered a new emerging wave in developing materials that can aid in the antibacterial activity of irrigants. Nanoparticles in suspension especially chitosan and silver nano particles have been suggested as effective irrigations for the endodontic procedure of cleaning the infected root canal system. This study aims to test the efficacy of newly introduced nano particles irrigations in comparison with the golden standard irrigation regarding their antibacterial effect and the altering of dentin composition within the root canal dentin. A total of sixty five single rooted human teeth were collected after being freshly extracted. Each tooth was accessed and prepared using one shape rotary files and then manual step back technique was performed at the apical portion to a size of 40#. The teeth were then divided into: antibacterial test group (45 teeth) and dentin composition test group (20 teeth). For Evaluation of Antibacterial effect: A number of 45 prepared tooth was inoculated with E.faecalis bacteria for 21 days to develop biofilm, which was confirmed using Scanning electron microscope. After that, the teeth were divided into 5 groups according to the irrigant used: Group A sodium hypochlorite 5.25% (10 teeth), Group B Silver Nano Particles 80 ml suspension 2% (10 teeth), Group C chitosan nano particles 80 ml suspension 2% (10 teeth), Group D positive Control (10 teeth) and Group D negative control (5 teeth). Each tooth was irrigated with the specified irrigant for a time of 2 minutes while being activated by manual agitation protocol using k files (10-15#). Each tooth was then irrigated with saline solution and a paper point sample was collected from each saline solution. For evaluation of antibacterial effect; Each paper point collected was tested for bacterial evaluation using colony forming unit test. Colony forming unit Tests were statistically measured using one way analysis of variance (ANOVA) test, followed by Tukey’s post hoc test.