Evaluation of the biocompatibility of silver nanoparticles, ascertaining their safety in the field of endodontic therapy

Abstract

The success of endodontic therapy relies on the complete elimination of bacteria from the root canals. Primary root canal infections consist of polymicrobial groups, which can efficiently eradicate through root canal treatment. However, conventional root canal treatment cannot remove persistent bacterial species from the root canals. Although significant numbers of studies that focus on developing antimicrobial agents to overcome this problem exist, most of these attempts failed to achieve desired outcomes due to the rapid degradation and fast release of antibacterial agents, causing low efficiency and safety concerns. Antimicrobials such as sodium hypochlorite and ethylenediaminetetraacetic acid are commonly used in endodontic treatment. They carry the disadvantage of antibiotic resistance. Thus nanoparticles (NPs) have been introduced in dentistry as an alternative to such materials. The dominant microorganism, or sometimes the only species present in the root canal of teeth with resistant peri-radicular lesions, is Enterococcus faecalis (E. faecalis). This bacterium is capable of tolerating starvation, high pH, and salt concentration. Its ability to penetrate dentinal tubules and create resistant species to antibiotics has made it very difficult to eradicate root canals. One of the essential characteristics of this bacterium is biofilm formation. NPs can reach the untouched portion of root canals such as cul de sacs, isthmi, fins and can implement the ideal action of irrigant such as antibacterial action. Higher-end evidence-based support is needed to ascertain the application of NPs in the field of endodontics. Hence, our systematic review encompasses, encloses, and enumerates the use of silver NPs in routine endodontic procedures.

Keywords

• biocompatibility
• endodontic irrigants
• intracanal medicaments
• silver nanoparticles