Remineralization of Dentin with Cerium Oxide and Its Potential Use for Root Canal Disinfection

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Abstract

Objective

This study was to investigate a novel antibacterial biomimetic mineralization strategy for exploring its potential application for root canal disinfection when stabilized cerium oxide was used.

Material and Methods

A biomimetic mineralization solution (BMS) consisting of cerium nitrate and dextran was prepared. Single-layer collagen fibrils, collagen membranes, demineralized dentin, and root canal system were treated with the BMS for mineralization. The mineralized samples underwent comprehensive characterization using various techniques, including transmission electron microscopy (TEM), high-resolution TEM (HRTEM), Fourier transform infrared spectroscopy (FTIR), scanning transmission electron microscopy (STEM), selected-area electron diffraction (SAED), energy-dispersive X-ray spectroscopy (EDX), X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), and micro-CT. Additionally, the antimicrobial properties of the BMS and the remineralized dentin were also analyzed with broth microdilution method, live/dead staining, and SEM.

Results

Cerium ions in the BMS underwent a transformation into cerium oxide nanoparticles, which were deposited in the inter- and intra-fibrillar collagen spaces through a meticulous bottom-up process. XPS analysis disclosed the presence of both Ce (III) and Ce (IV) of the generated cerium oxides. A comprehensive examination utilizing SEM and micro-CT identified the presence of cerium oxide nanoparticles deposited within the dentinal tubules and lateral canals of the root canal system. The BMS and remineralized dentin exhibited substantial antibacterial efficacy against E. faecalis, as substantiated by assessments involving the broth dilution method and live/dead staining technique. The SEM findings revealed the cell morphological changes of deceased E. faecalis.

Conclusion

This study successfully demonstrated antibacterial biomimetic mineralization as well as sealing dentinal tubules and lateral branches of root canals using cerium nitrate and dextran. This novel biomimetic mineralization could be used as an alternative strategy for root canal disinfection.

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Most cited references 90

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Mechanism of photogenerated reactive oxygen species and correlation with the antibacterial properties of engineered metal-oxide nanoparticles.

Yang Li, Wen Wen Zhang, Junfeng Niu … (2012)

Oxidative stress induced by reactive oxygen species (ROS) is one of the most important antibacterial mechanisms of engineered nanoparticles (NPs). To elucidate the ROS generation mechanisms, we investigated the ROS production kinetics of seven selected metal-oxide NPs and their bulk counterparts under UV irradiation (365 nm). The results show that different metal oxides had distinct photogenerated ROS kinetics. Particularly, TiO(2) nanoparticles and ZnO nanoparticles generated three types of ROS (superoxide radical, hydroxyl radical, and singlet oxygen), whereas other metal oxides generated only one or two types or did not generate any type of ROS. Moreover, NPs yielded more ROS than their bulk counterparts likely due to larger surface areas of NPs providing more absorption sites for UV irradiation. The ROS generation mechanism was elucidated by comparing the electronic structures (i.e., band edge energy levels) of the metal oxides with the redox potentials of various ROS generation, which correctly interpreted the ROS generation of most metal oxides. To develop a quantitative relationship between oxidative stress and antibacterial activity of NPs, we examined the viability of E. coli cells in aqueous suspensions of NPs under UV irradiation, and a linear correlation was found between the average concentration of total ROS and the bacterial survival rates (R(2) = 0.84). Although some NPs (i.e., ZnO and CuO nanoparticles) released toxic ions that partially contributed to their antibacterial activity, this correlation quantitatively linked ROS production capability of NPs to their antibacterial activity as well as shed light on the applications of metal-oxide NPs as potential antibacterial agents.

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Alternative Antimicrobial Approach: Nano-Antimicrobial Materials

Nurit Beyth, Yael Houri-Haddad, Avi Domb … (2015)

Despite numerous existing potent antibiotics and other antimicrobial means, bacterial infections are still a major cause of morbidity and mortality. Moreover, the need to develop additional bactericidal means has significantly increased due to the growing concern regarding multidrug-resistant bacterial strains and biofilm associated infections. Consequently, attention has been especially devoted to new and emerging nanoparticle-based materials in the field of antimicrobial chemotherapy. The present review discusses the activities of nanoparticles as an antimicrobial means, their mode of action, nanoparticle effect on drug-resistant bacteria, and the risks attendant on their use as antibacterial agents. Factors contributing to nanoparticle performance in the clinical setting, their unique properties, and mechanism of action as antibacterial agents are discussed in detail.

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Properties and applications of calcium hydroxide in endodontics and dental traumatology.

Paul Dummer, Z Mohammadi (2011)

Calcium hydroxide has been included within several materials and antimicrobial formulations that are used in a number of treatment modalities in endodontics. These include, inter-appointment intracanal medicaments, pulp-capping agents and root canal sealers. Calcium hydroxide formulations are also used during treatment of root perforations, root fractures and root resorption and have a role in dental traumatology, for example, following tooth avulsion and luxation injuries. The purpose of this paper is to review the properties and clinical applications of calcium hydroxide in endodontics and dental traumatology including its antibacterial activity, antifungal activity, effect on bacterial biofilms, the synergism between calcium hydroxide and other agents, its effects on the properties of dentine, the diffusion of hydroxyl ions through dentine and its toxicity. Pure calcium hydroxide paste has a high pH (approximately 12.5-12.8) and is classified chemically as a strong base. Its main actions are achieved through the ionic dissociation of Ca(2+) and OH(-) ions and their effect on vital tissues, the induction of hard-tissue deposition and the antibacterial properties. The lethal effects of calcium hydroxide on bacterial cells are probably due to protein denaturation and damage to DNA and cytoplasmic membranes. It has a wide range of antimicrobial activity against common endodontic pathogens but is less effective against Enterococcus faecalis and Candida albicans. Calcium hydroxide is also an effective anti-endotoxin agent. However, its effect on microbial biofilms is controversial. © 2011 International Endodontic Journal.

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Author and article information

Journal

Journal ID (nlm-ta): Int J Nanomedicine

Journal ID (iso-abbrev): Int J Nanomedicine

Journal ID (publisher-id): ijn

Title: International Journal of Nanomedicine

Publisher: Dove

ISSN (Print): 1176-9114

ISSN (Electronic): 1178-2013

Publication date (Electronic): 30 December 2023

Publication date Collection: 2024

Volume: 19

Pages: 1-17

Affiliations

[1 ]Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University , Hangzhou, People’s Republic of China

[2 ]School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College , Beijing, People’s Republic of China

Author notes

Correspondence: Baiping Fu; Mingxing Li, Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Clinical Research Center for Oral Diseases of Zhejiang Province, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University , Hangzhou, People’s Republic of China, Email fbp@zju.edu.cn; 7315019@zju.edu.cn

Article

Publisher ID: 441060

DOI: 10.2147/IJN.S441060

PMC ID: 10763684

SO-VID: 1bc93704-b974-48cf-9d70-e73697bf49d5

License:

This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

History

Date received : 19 September 2023

Date accepted : 12 December 2023

Page count

Figures: 7, References: 90, Pages: 17

Remineralization of Dentin with Cerium Oxide and Its Potential Use for Root Canal Disinfection

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Abstract

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Material and Methods

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Bacterial extracellular vesicles

Most cited references 90

Mechanism of photogenerated reactive oxygen species and correlation with the antibacterial properties of engineered metal-oxide nanoparticles.

Alternative Antimicrobial Approach: Nano-Antimicrobial Materials

Properties and applications of calcium hydroxide in endodontics and dental traumatology.

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