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Spectrophotometric analysis of crown discoloration following the use of silver nanoparticles combined with calcium hydroxide as intracanal medicament.

ABSTRACT: Optimal antibacterial efficacy of intracanal medicaments containing silver nanoparticles (Ag-NPs) has been well documented. However, concerns remain regarding the effect of Ag-NPs on tooth color. This study aimed to assess the effects of calcium hydroxide (CH) mixed with Ag-NPs as intracanal medicaments on tooth color. The effect of location of application of medicament on the degree of discoloration was evaluated as well.Fifty extracted single-rooted, single-canal human teeth with straight roots, no caries, no cracks or fractures were collected and accessed. After cleaning and shaping of the root canals, the teeth were randomly divided into two experimental groups (n=20) with CH and CH plus Ag-NPs as intracanal medicaments and a control group of saline (n=10). Experimental groups were randomly divided into two equal subgroups of A, where medicament was applied below the cemento enamel junction (CEJ) and B where the medicament was applied to the root canal and pulp chamber. Color change (ΔE) was assessed using a spectrophotometer in CIELAB system at five time points of beforemedicaments application (T0), immediately medicaments placement (T1), one week (T2), one month (T3) and three months (T4) after the application of medicaments. Data were analyzed using two-way and three-way ANOVA.Color change in Ag-NPs plus CH and CH groups was not significantly different at any time point (P=0.23). Increased exposure time in both groups did not increase the ΔE (P >0.05). Significant differences were noted in ΔE between subgroups A and B (P<0.05).Addition of Ag-NPs to CH caused no significant change in tooth color compared to the application of CH alone. However, its use must be limited to the root canal space only. Key words:Silver nanoparticles, color change, calcium hydroxide, spectrophotometry, intracanal medicament.

SUBMITTER: Afkhami F

PROVIDER: S-EPMC5549580 | biostudies-other | 2017 Jul

REPOSITORIES: biostudies-other

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Project description:BackgroundEnterococcus faecalis and Candida albicans are frequently found in persistent endodontic infection and could remain in dentinal tubules despite intracanal medication with calcium hydroxide (Ca(OH)2), a commonly used medication. Thus, an effective and safe antimicrobial medication against such refractory infection is necessary in endodontic retreatment, so we aimed to test the efficacy of chitosan paste against these microorganisms compared with Ca(OH)2 in root canals of extracted human teeth.MethodsThirty-six sterilized human root samples prepared from extracted premolars and upper maxillary incisors were infected with E. faecalis for 14 days, while 32 were infected with C. albicans for 48 h, for mature biofilm formation. The samples were assigned to 6 groups of intracanal medications: Group 1: no medication (negative control); Group 2: 20% Polyethylene glycol (PEG); Group 3: 20% Propylene glycol (PG); Group 4: Ca(OH)2; Group 5: Chitosan + PEG; and Group 6: Chitosan + PG. After 7 days, intracanal surface dentin was harvested using Protaper next, resuspended, serially diluted and spread on Brain-Heart-Infusion agar (for E. faecalis) and Yeast Extract-Peptone-Dextrose agar (for C. albicans) for colony count. Antimicrobial efficacy was determined as percentage of remaining colony forming unit (CFUs) relative to negative control and analyzed using One-way ANOVA and post-hoc Games-Howell test. The significance level was set at 0.05.ResultsFor E. faecalis, chitosan + PG had significantly higher antibacterial activity than Ca(OH)2 (P = 0.039). Chitosan + PEG and chitosan + PG medication significantly reduced viable bacteria compared with negative control, PEG and PG (P = 0.001, 0.003, 0.024, respectively for chitosan + PEG; P = 0.002, 0.003, 0.014, respectively for chitosan + PG). For C.albicans, chitosan + PEG and chitosan + PG were not significantly different from Ca(OH)2. However, Chitosan + PEG and chitosan + PG, but not Ca(OH)2, showed a significantly lower level of remaining CFUs compared with negative control (P = 0.013 and 0.005, respectively).ConclusionChitosan paste showed better efficacy in reducing viable E. faecalis biofilm when compared to Ca(OH)2 after 7-day intracanal medication in this in vitro root canal model. It could also significantly reduce viable C. albicans, but was not significantly different from Ca(OH)2.

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Spectrophotometric analysis of crown discoloration following the use of silver nanoparticles combined with calcium hydroxide as intracanal medicament.

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