A Novel Self-Mineralizing Antibacterial Tissue Repair (SMART
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A novel two-part varnish system containing chitosan nanoparticles (CS) ( part-1) and chitosan-grafted hydroxyapatite precursor nanocomplex (CS-HA) ( part-2) was developed to condition the root-end dentin utilizing the principle of biomineralization while rendering both antimicrobial efficacy and bioactivity.

This in vitro study aimed to characterize and assess the effectiveness of the CS and CS-HA containing self-mineralizing antibacterial tissue repair (SMART) varnish to condition as well as seal root-end dentin during endodontic microsurgery.

Phase-I- Characterized the antibacterial properties and cellular response of the varnish. Antibacterial activity and cellular responses were evaluated utilizing Enterococcus faecalis and periodontal ligament fibroblasts, respectively. Phase-II- A resected root-end model was used to apply the two-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.

--Part-1 and -2 of the varnish displayed significant antibacterial activity and reduced bacterial adherence/survival.

--The attachment and spreading of PDL fibroblasts on the varnish-conditioned dentin were enhanced compared to unconditioned dentin.

--In resected root-end model, the two-part varnish displayed a biomineralized varnish layer with close interaction with the subsurface dentin.

-- Root-end coverage with biomineralized layer increased with incubation time, reaching approximately 95% coverage after 24 hours.

In particular, the two-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 following endodontic microsurgery.

Journal of Endodontics
Source: https://doi.org/10.1016/j.joen.2021.02.008