Nano-Antimicrobials in endodontics

Abstract

A root canal system exhibits a challenging environmental condition about the availability of nutrients and oxygen. Usually, chemical antimicrobials (topical) are used within the root canals in combination with mechanical instrumentation to achieve "microbe-free" root canals before obturating the root canal with an inert filling material. Antimicrobial resistance (AMR) has emerged as one of the primary public health problems of the 21st century. It threatens the effective prevention and treatment of an ever-increasing range of infections caused by bacteria, viruses, parasites, and fungi which is no longer susceptible to the currently used antibiotics. One of the important requirements of endodontic treatment is the ability to eliminate microorganisms from the root canal system and prevent re-entry of microbes. This antimicrobial effect is achieved by a combination of chemical and mechanical disinfection. Due to increasing antimicrobial resistance, the efficacy of traditionally used irrigants has been decreased. Owing to the limitation of currently used antibiotics it paves way for nano antimicrobial-based irrigants.It has been emphasized that the addition of antibacterial nanoparticles in root canal sealers would upsurge the direct (based on the direct antibacterial assay) and diffusible antibacterial effects (based on a membrane-restricted antibacterial assay) of the root canal sealers. Additionally, nanoparticles when incorporated into intracanal medicament have shown added benefits.Nanoparticle-based photosensitizers have been considered to potentiate the antimicrobial efficacy of photodynamic therapy (PDT). The antibacterial nanoparticle-based treatment has the potential to improve antibacterial/ antibiofilm efficacy. They have distinct advantages when applied in endodontics. The whole concept of nanotechnology in health care should be accepted with positive zeal for future development. This review paper describes the scope of nano antimicrobials in endodontics as irrigants, intracanal medicaments, and their role in photodynamic therapy, sealers, and obturating materials.