Abstract
Introduction
A novel 2-part varnish system containing chitosan nanoparticles (part 1) and chitosan-grafted
hydroxyapatite precursor nanocomplex (part 2) was developed to condition the root-end
dentin using the principle of biomineralization while rendering both antimicrobial
efficacy and bioactivity. This in vitro study aimed to characterize and assess the effectiveness of the chitosan nanoparticles
and chitosan-grafted hydroxyapatite precursor nanocomplex containing self-mineralizing
antibacterial tissue repair varnish to condition as well as seal root-end dentin during
endodontic microsurgery.
Methods
In phase 1, the antibacterial properties and cellular response of the varnish were
characterized. The antibacterial activity and cellular responses were evaluated using
Enterococcus faecalis and periodontal ligament (PDL) fibroblasts, respectively. In phase 2, a resected
root-end model was used to apply the 2-part varnish and examine the dentin-varnish
interface using transmission electron microscopy. The percentage of root end sealed
with time was determined using scanning electron microscopy (n = 6/time point). Statistical analysis was performed using 1-way analysis of variance
where applicable.
Results
The part 1 and 2 of the varnish displayed significant antibacterial activity and reduced
bacterial adherence/survival (P < .01). The attachment and spreading of PDL fibroblasts on the varnish-conditioned
dentin was enhanced compared with unconditioned dentin (P < .01). In the resected root-end model, the 2-part varnish displayed a biomineralized
varnish layer with close interaction with the subsurface dentin. Root-end coverage
with the biomineralized layer increased with incubation time (P < .01), reaching approximately 95% coverage after 24 hours.
Conclusions
The 2-part varnish system effectively conditioned/sealed the root end with a biomineralized
layer while reducing bacterial load and promoting PDL fibroblast attachment. This
therapeutic modification of root-end dentin could provide optimal conditions to enhance
healing and improve prognosis in teeth with root-end cracks after endodontic microsurgery.
Key Words
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Article info
Publication history
Published online: February 25, 2021
Identification
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© 2021 American Association of Endodontists.
