An artificial intelligence grading system of apical periodontitis in cone-beam computed tomography data.

OBJECTIVES: In order to assist junior doctors in better diagnosing apical periodontitis (AP), an artificial intelligence AP grading system was developed based on deep learning (DL) and its reliability and accuracy were evaluated. METHODS: One hundred and twenty cone-beam computed tomography (CBCT) images were selected to construct a classification dataset with four categories, which were divided by CBCT periapical index (CBCTPAI), including normal periapical tissue, CBCTPAI 1-2, CBCTPAI 3-5, and young permanent teeth. Three classic algorithms (ResNet50/101/152) as well as one self-invented algorithm (PAINet) were compared with each other. PAINet were also compared with two recent Transformer-based models and three attention models. Their performance was evaluated by accuracy, precision, recall, balanced F score (F1-score), and the area under the macro-average receiver operating curve (AUC). Reliability was evaluated by Cohen's kappa to compare the consistency of model predicted labels with expert opinions. RESULTS: PAINet performed best among the four algorithms. The accuracy, precision, recall, F1-score, and AUC on the test set were 0.9333, 0.9415, 0.9333, 0.9336, and 0.9972, respectively. Cohen's kappa was 0.911, which represented almost perfect consistency. CONCLUSIONS: PAINet can accurately distinguish between normal periapical tissues, CBCTPAI 1-2, CBCTPAI 3-5, and young permanent teeth. Its results were highly consistent with expert opinions. It can help junior doctors diagnose and score AP, reducing the burden. It can also be promoted in areas where experts are lacking to provide professional diagnostic opinions.

Ultrasonic-Assisted Method for the Preparation of Carbon Nanotube-Graphene/Polydimethylsiloxane Composites with Integrated Thermal Conductivity, Electromagnetic Interference Shielding, and Mechanical Performances.

Due to the rapid development of the miniaturization and portability of electronic devices, the demand for polymer composites with high thermal conductivity and mechanical flexibility has significantly increased. A carbon nanotube (CNT)-graphene (Gr)/polydimethylsiloxane (PDMS) composite with excellent thermal conductivity and mechanical flexibility is prepared by ultrasonic-assisted forced infiltration (UAFI). When the mass ratio of CNT and Gr reaches 3:1, the thermal conductivity of the CNT-Gr(3:1)/PDMS composite is 4.641 W/(m·K), which is 1619% higher than that of a pure PDMS matrix. In addition, the CNT-Gr(3:1)/PDMS composite also has excellent mechanical properties. The tensile strength and elongation at break of CNT-Gr(3:1)/PDMS composites are 3.29 MPa and 29.40%, respectively. The CNT-Gr/PDMS composite also shows good performance in terms of electromagnetic shielding and thermal stability. The PDMS composites have great potential in the thermal management of electronic devices.

The accuracy of using guided endodontics in access cavity preparation and the temperature changes of root surface: An in vitro study.

BACKGROUND: Guided endodontics is a successful technique that has been gradually applied to endodontic therapy in recent years without being affected by the operator's experience. However, the guided bur produces excessive heat during continuous rotation and friction with root canal walls, it is not clear whether the degree of temperature increase may lead to the periodontal ligament and alveolar bone damage. METHODS: A total of 58 teeth were used, of which 40 teeth were not grouped, all used to evaluate the accuracy. 40 single-rooted premolars were scanned using CBCT and an intra-oral scanner, and 3D-printed guided plates were made with the pre-designed access. A custom-made guided bur was used to prepare the access cavities. The postoperative CBCT data and pre-designed pathways were matched to evaluate the deviation between the planned and virtual paths. The other 18 teeth were randomly divided into three groups (ET20 and ProTaper F3 as the control group, guided endodontics as the test group), with 6 teeth in each group. The temperature changes on the root surfaces were inspected with a thermocouple thermometer. RESULTS: The average deviation on the tip and the base of the bur was 0.30 mm and 0.28 mm (mesial/distal), and 0.28 mm and 0.25 mm (buccal/lingual). The average angle deviation was 3.62°. The mean root surface temperature rise of the guided endodontics group was the lowest (5.07 °C) (P < 0.05). CONCLUSIONS: The access cavity preparation performed with guided endodontics has feasible accuracy and low-temperature rise on the root surfaces. Due to the limitations of the study, whether it has high reliability and safety in clinical applications needs to be further studied in vivo.

Root dentine thickness of danger zone in mesial roots of mandibular first molars.

BACKGROUND: Better understanding of the danger zone anatomy in mesial roots (MRs) of mandibular first molars (MFMs) may serve to decrease the risk of mishaps. This study aimed to measure the minimal distal dentine thicknesses of danger zone in MRs of MFMs in a native Chinese population using cone-beam computed tomography (CBCT). METHODS: CBCT images of 1792 MFMs from 898 Chinese patients were analyzed. The minimal distal dentine thicknesses of the mesiobuccal (MB) and mesiolingual (ML) canals below the furcation 1, 2, 3, 4, 5 mm were measured. The association between the minimal distal dentine thicknesses and the root lengths, patient's age and gender, side were assessed. RESULTS: The minimal distal dentine thicknesses of MB and ML canals are located 3 ∼ 4 mm below the furcation for both men and women. There are no differences between MB and ML canals, while the minimal distal dentine thicknesses of MB and ML canals were higher in men than women (P < 0.05), except at 1 and 3 mm of ML canals (P > 0.05). The minimal distal dentine thicknesses of MB and ML canals increased with age in both men and women at each location (P < 0.05). The minimum distal dentine thickness at every location were significantly different between long teeth and short teeth both in men and women (P < 0.05), with short teeth having the smallest mean values. There are no significant differences between two sides (P > 0.05). CONCLUSIONS: The minimal distal dentine thicknesses of MRs in MSMs have close correlation with root length, patient's age and gender.

Comparative Outcomes of Block and Cancellous Iliac Bone Grafting in Older Unilateral Alveolar Cleft Patients.

OBJECTIVE: To compare osseous outcomes of block and cancellous iliac bone grafting in older unilateral alveolar cleft patients. DESIGN: Retrospective and observational follow-up study. SETTING: Cleft Lip and Palate Centre, Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, China. PATIENTS: Forty-five nonsyndromic patients with unilateral complete alveolar cleft were enrolled in this study (25 patients in block bone graft group and 20 patients in cancellous bone graft group). INTERVENTIONS: In cancellous bone graft group, the alveolar cleft was filled with iliac cancellous bone particulate. In group of block bone graft, the harvested bone block was trimmed and fixed in alveolar defect. MAIN OUTCOME MEASURES: A novel method was proposed to investigate the volume and density of residual bone graft at 1-week, 3- and 6-month, 1- and 2-year postoperatively based on cone beam computed tomography scans. RESULTS: No difference in bone graft volume was found between 2 groups at 1-week and 3-month postoperatively; however, the residual volume of block bone graft group was significantly larger than that of cancellous bone graft group at 6-month, 1- and 2-year postoperatively. The bone density of block bone graft group was lower at 1-week and 3-month postoperatively but was comparable at 6-month, 1- and 2-year postoperatively. Our method was reliable and accurate to identify the range of residual bone graft when the boundary of grafted bone could not be identified clearly. CONCLUSION: Block bone graft could achieve comparable bone density and retain a greater amount of residual bone comparing to cancellous bone graft.

Highly stretchable and ultrathin nanopaper composites for epidermal strain sensors.

Multifunctional electronics are attracting great interest with the increasing demand and fast development of wearable electronic devices. Here, we describe an epidermal strain sensor based on an all-carbon conductive network made from multi-walled carbon nanotubes (MWCNTs) impregnated with poly(dimethyl siloxane) (PDMS) matrix through a vacuum filtration process. An ultrasonication treatment was performed to complete the penetration of PDMS resin in seconds. The entangled and overlapped MWCNT network largely enhances the electrical conductivity (1430 S m-1), uniformity (remaining stable on different layers), reliable sensing range (up to 80% strain), and cyclic stability of the strain sensor. The homogeneous dispersion of MWCNTs within the PDMS matrix leads to a strong interaction between the two phases and greatly improves the mechanical stability (ca. 160% strain at fracture). The flexible, reversible and ultrathin (<100 µm) film can be directly attached on human skin as epidermal strain sensors for high accuracy and real-time human motion detection.

Microfluidic-Based Single-Cell Study: Current Status and Future Perspective.

Investigation of cell behavior under different environments and manual operations can give information in specific cellular processes. Among all cell-based analysis, single-cell study occupies a peculiar position, while it can avoid the interaction effect within cell groups and provide more precise information. Microfluidic devices have played an increasingly important role in the field of single-cell study owing to their advantages: high efficiency, easy operation, and low cost. In this review, the applications of polymer-based microfluidics on cell manipulation, cell treatment, and cell analysis at single-cell level are detailed summarized. Moreover, three mainly types of manufacturing methods, i.e., replication, photodefining, and soft lithography methods for polymer-based microfluidics are also discussed.

Evaluation of the relationship between maxillary posterior teeth and the maxillary sinus floor using cone-beam computed tomography.

BACKGROUND: Maxillary posterior teeth have close anatomical proximity to the maxillary sinus floor (MSF), and the race, gender, age, side and presence/absence of adjacent teeth may influence the mean distances between the root apices and the MSF. This study aimed to evaluate both the relationship between the maxillary posterior teeth and MSF, and the influence of adjacent teeth loss on the distance between the maxillary posterior roots and MSF. METHODS: Cone-beam computed tomography images were collected from 1011 Chinese patients. The relationship between the maxillary posterior teeth and the MSF was divided into three types: Type OS (the root apex extending below/outside the MSF), Type CO (the root apex contacting with the MSF), Type IS (the root apex extending above/inside the MSF). The minimum vertical distances between the maxillary posterior roots apices and the MSF were recorded. The correlations of the distances with gender and age were analyzed. The distances between the maxillary posterior root apices and the MSF with different types of adjacent teeth loss was evaluated. RESULTS: Type OS was the most common relationship of all posterior root apices (P<0.05). Type IS was highest in the palatal roots (PRs) of the maxillary first molars (MFMs) and the mesiobuccal roots (MBRs) of the maxillary second molars (MSMs) (24.8% and 21.6%) (P<0.05). The frequency of Type IS decreased with age except the premolar roots and PRs of the MSMs (P<0.05). The MBRs of the MSMs had the lowest distances to the MSF (0.8 ± 2.5 mm), followed by the distobuccal roots of the MSMs (1.3 ± 2.7 mm) and the PRs of the MFMs (1.4 ± 3.4 mm) (P<0.05). Age was an important influencing factor to the mean distances while gender had little effects. The distance between the maxillary second premolar root apices and the MSF decreased with the absence of adjacent teeth (P<0.05). CONCLUSIONS: The maxillary molars showed greater proximity to the MSF than premolars. Age had significant impacts on the relationship between maxillary posterior roots and MSF. The absence of maxillary first molars will influence the proximity of maxillary second premolar root apices to MSF.

Quantitative evaluation of artifact expression in conebeam computed tomography of mesoporous calcium silicate nanoparticles as a promising root canal sealer.

OBJECTIVES: We aimed to quantitatively compare the area and volume of artifacts in cone beam computed tomography produced by mesoporous calcium silicate nanoparticles (MCSNs), AH Plus sealer, and iRoot SP sealer when used as root canal sealers. METHODS: We prepared 40 single-rooted mandibular premolars and divided them into an MCSN sealer group, an AH Plus sealer group, an iRoot SP sealer group, and a no-sealer (control) group. We filled the canals with gutta-percha using the single-cone method and subjected them to conebeam computed tomography before and after the placement of root fillings using the same exposure parameters. We evaluated the images to quantify the areas of hyperdense and hypodense artifacts and non-affected teeth and reconstructed 3-dimensional image models of the materials to study volume distortion artifacts. RESULTS: The MCSN sealer group produced a significantly smaller hyperdense and volume distortion artifacts than the AH Plus and iRoot SP groups (P < .01), but the area and volume of hypodense artifacts did not differ significantly among the groups (P > .05). CONCLUSIONS: When used as a root canal sealer, MCSNs generate a significantly smaller area and volume of hyperdense artifacts than AH Plus and iRoot SP sealers. By significantly reducing the generation of high-density artifacts, MCSNs may facilitate the evaluation of root canal filling quality and the diagnosis of root canal abnormalities.

Mesoporous Calcium-Silicate Nanoparticles Loaded with Prussian Blue Promotes Enterococcus Faecalis Ferroptosis-Like Death by Regulating Bacterial Redox Pathway ROS/GSH.

Background: Mesoporous calcium-silicate nanoparticles (MCSNs) are advanced biomaterials that have been used to control drug delivery for many years. Ultrasmall Prussian blue nanoparticles (UPBNPs) showed high peroxidase and catalase-like activities. This study evaluated the antibacterial and antibiofilm properties, mechanism and cytotoxicity of UPBNPs-MCSNs composites synthesized by both as precursors. Methods: UPBNPs-MCSNs were prepared and characterized. The antibacterial effect of UPBNPs-MCSNs was evaluated by the MTT assay and CFU counting method, and their biosafety was tested by CCK8. Then explore the antibacterial mechanism, including TEM observation of bacterial morphology, and detection of bacterial ROS, LPO and GSH levels. The antibiofilm activity of UPBNPs-MCSNs was tested by E. faecalis biofilm model in human roots. The roots were pretreated with materials and cultured with E. faecalis, and the survival of E. faecalis on the root canal wall was observed by SEM and CLSM. Results: The results showed that UPBNPs-MCSNs had potent antibacterial and antibiofilm activities. They can aggregate on the dentin surface and significantly inhibit E. faecalis adhesion and colonization. Their antibacterial activity is as effective as NaClO and calcium hydroxide (CH), can significantly prolong the time of bacterial colonization than CH, but have lower cytotoxicity to normal cells. We found that UPBNPs-MCSNs trigger a like classic ferroptosis pathway in bacteria. UPBNPs-MCSNs can induce bacteria to produce ROS and LPO, and reduce GSH level. Moreover, we observed that the metal ions chelator and the antioxidant could block their antibacterial activity. Conclusion: These results reveal that UPBNPS-MCSNs have high antibacterial and antibiofilm, and can mediate the bacterial redox pathway ROS/GSH like the classical pathway of ferroptosis, providing a theoretical basis for them to develop into a safe and effective novel root canal disinfectant.

Prevalence and correlation of C-shaped root canals of mandibular premolars and molars in Eastern Chinese individuals.

The aim of this study was to investigate the prevalence, correlation, and differences of C-shaped root canals (CSRCs) morphology in permanent mandibular premolars and molars in Eastern Chinese individuals using cone-beam computed tomography (CBCT). A total of 8000 mandibular first premolars (MFPs), mandibular second premolars (MSPs), mandibular first molars (MFMs), and mandibular second molars (MSMs) CBCT images from 1000 patients (692 females and 308 males) were collected. The prevalence, correlation, bilateral/unilateral presence, the morphology of CSRCs, level of canal bifurcation, gender differences, and location of radicular grooves (RGs) were evaluated. The prevalence of CSRCs in MFPs, MSPs, MFMs and MSMs were 10.25%, 0.25%, 0.55% and 47.05%, respectively. The prevalence of CSRCs in MFPs of males was higher than that in females, while the prevalence of CSRCs in MSMs of females was higher than that in males (P < 0.05). The bilateral symmetry presence of CSRCs in MSMs was significant but not in MFPs, MSPs, and MFMs. RGs were predominantly found on the mesiolingual (ML) surface of premolars and the lingual surface of molars. There was a high prevalence of CSRCs in MFPs and MSMs in the Eastern Chinese population, but there was no correlation. The prevalence of CSRCs in MFPs and MSMs differ significantly by gender (P < 0.05).

The clinical treatment of complicated root canal therapy with the aid of a dental operating microscope.

OBJECTIVES: To evaluate the clinical application of the dental operating microscope (DOM) in the management of complicated root canal therapy. METHODS: 345 teeth with 546 root canals which could not be successfully managed by conventional methods received therapy under the DOM with ultrasonic instruments by the same endodontists. The aetiology of the canals included calcification, broken instrument, missed canal and canal perforation. The teeth and canals successfully managed were then calculated. RESULTS: 406 canals were successfully managed with a rate of 74.4%; 246 teeth were successfully managed with a rate of 71.3%. The rates in each category of the complicated root canals were: 74.0% for calcified canals, 72.3% for canals blocked by broken instruments, 82.5% for missed canals and 72.7% for canal perforations. CONCLUSIONS: The clinical application of the DOM is an effective way of managing complicated root canal therapy.

Study on the fabrication and characterization of tip-loaded dissolving microneedles for transdermal drug delivery.

In order to increase the utilization rate of drug carried by microneedles and reduce waste, a two-step casting method was proposed to fabricate tip-loaded dissolving microneedles in this paper. The tip-loaded dissolving microneedles, also named layered microneedles, was consisted of two layers. The tip layer of the microneedles carried model drug, while the backing layer was fabricated with pure dissolving material. Polyvinyl alcohol, polyvinylpyrrolidone and hyaluronic acid were used as the base materials to fabricate the dissolving layers of the microneedle patches. Rhodamine B was chosen as the model drug to show the layered structure of tip-loaded microneedles. The material formulation and fabricating conditions of the tip-loaded dissolving microneedles and their transdermal insulin delivery efficiency were systematically studied. Nanoindentation testing showed that the tips of all three kinds of dissolving microneedles can bear the maximum loading of 50 mN with no damages, indicated sufficient mechanical strength for smooth skin puncturing as the minimum pressure required was 10 mN only. Moreover, our fabricated tip-loaded dissolving microneedles can greatly reduce the drug waste cause by unused backing layer in normal microneedles and realize a 30% enhancement of drug delivery efficiency after puncture treatment.

The Antibiofilm Activity and Mechanism of Nanosilver- and Nanozinc-Incorporated Mesoporous Calcium-Silicate Nanoparticles.

BACKGROUND: Mesoporous calcium-silicate nanoparticles (MCSNs) have good prospects in the medical field due to their great physicochemical characteristics, antibacterial activity and drug delivery capacity. This study was to analyze the antibiofilm activity and mechanisms of silver (Ag) and zinc (Zn) incorporated MCSNs (Ag/Zn-MCSNs) with different percentages of Ag and Zn. METHODS: Ag/Zn(1:9, molar ratio)-MCSNs and Ag/Zn(9:1, molar ratio)-MCSNs were prepared and characterized. Endocytosis of nanoparticles by Enterococcus faecalis (E. faecalis) treated with Ag/Zn-MCSNs was observed using TEM to explore the antibacterial mechanisms. The antibiofilm activity of Ag/Zn-MCSNs with different ratios of Ag and Zn was tested by E. faecalis biofilm model in human roots. The human roots pretreated by different Ag/Zn-MCSNs were cultured with E. faecalis. Then, SEM and CLSM were used to observe the survival of E. faecalis on the root canal wall. Cytotoxicity of the nanoparticles was tested by CCK8 kits. RESULTS: The Ag/Zn-MCSNs release Ag+ and destroy the cell membranes to kill bacteria. The MCSNs containing Ag showed antibacterial activity against E. faecalis biofilms in different degrees, and they can adhere to dentin surfaces to get a continuous antibacterial effect. However, MTA, MCSNs and Zn-MCSNs could not disrupt the bacterial biofilms obviously. MCSNs, Ag/Zn(1:1, molar ratio)-MCSNs and Ag/Zn(1:9)-MCSNs showed no obvious cytotoxicity, while Ag-MCSNs and Ag/Zn(9:1)-MCSNs showed cytotoxicity. Zn-MCSNs can slightly promote cell proliferation. CONCLUSION: Ag/Zn-MCSNs have good antibiofilm activity. They might achieve an appropriate balance between the antibacterial activity and cytotoxicity by adjusting the ratio of Ag and Zn. Ag/Zn-MCSNs are expected to be a new type of root canal disinfectant or sealer for root canal treatment.

Biomimetic Moth-eye Nanofabrication: Enhanced Antireflection with Superior Self-cleaning Characteristic.

Sub-wavelength antireflection moth-eye structures were fabricated with Nickel mold using Roll-to-Plate (R2P) ultraviolet nanoimprint lithography (UV-NIL) on transparent polycarbonate (PC) substrates. Samples with well replicated patterns established an average reflection of 1.21% in the visible light range, 380 to 760 nm, at normal incidence. An excellent antireflection property of a wide range of incidence angles was shown with the average reflection below 4% at 50°. Compared with the unpatterned ultraviolet-curable resin coating, the resulting sub-wavelength moth-eye structure also exhibited increased hydrophobicity in addition to antireflection. This R2P method is especially suitable for large-area product preparation and the biomimetic moth-eye structure with multiple performances can be applied to optical devices such as display screens, solar cells, or light emitting diodes.

Root and canal morphology of maxillary second molars by cone-beam computed tomography in a native Chinese population.

Objective To evaluate the root and root canal morphology of the maxillary second molars (MSMs) in a native Chinese population by cone-beam computed tomography. Methods Cone-beam computed tomography images of 2412 MSMs from 1294 Chinese patients were analyzed to determine the number and morphology of the roots, the root canal morphology, the bilateral symmetry, and the correlations of these parameters with sex and age. Results The percentage of fused roots increased with age, while the percentage of fused roots in women was higher than that in men. The percentage of second mesiobuccal (MB2) canals in MSMs with three separate roots was higher in men than women. Patients aged 31 to 40 years showed a higher prevalence of MB2 canals, while those aged ≥51 years showed the lowest prevalence of MB2 canals among both men and women. There was a significant difference in bilateral symmetry of MSMs between men and women. Conclusion Root fusion of MSMs increased with age, while the root canal morphology was more complex in patients of intermediate ages.

Effects of nanosilver and nanozinc incorporated mesoporous calcium-silicate nanoparticles on the mechanical properties of dentin.

Mesoporous calcium-silicate nanoparticles (MCSNs) are advanced biomaterials for drug delivery and mineralization induction. They can load silver and exhibit significantly antibacterial effects. However, the effects of MCSNs and silver-loaded MCSNs on dentin are unknown. The silver (Ag) and/or zinc (Zn) incorporated MCSNs (Ag-Zn-MCSNs) were prepared by a template method, and their characterizations were tested. Then the nanoparticles were filled into root canals and their effects on the dentin were investigated. Ag-Zn-MCSNs showed characteristics of mesoporous materials and sustained release of ions over time. Ag-Zn-MCSNs adhered well to the root canal walls and infiltrated into the dentinal tubules after ultrasound activation. Ag-Zn-MCSNs showed no significantly negative effects on either the flexural strength or the modulus of elasticity of dentin, while CH decreased the flexural strength of dentin significantly (P<0.05). These findings suggested that Ag and Zn can be incorporated into MCSNs using a template method, and the Ag-Zn-MCSNs may be developed into a new disinfectant for the root canal and dentinal tubules.

Ag-loaded mesoporous bioactive glasses against Enterococcus faecalis biofilm in root canal of human teeth.

Ag-loaded mesoporous bioactive glass (Ag-MBG) powders were synthesized and characterized. The ions release of Ag-MBGs in Tris-HCl and the pH stability of simulated body fluids after immersing Ag-MBGs were tested. Root canals were inoculated with Enterococcus faecalis for 4 weeks, and the antibacterial activity of MBGs, Ag-MBGs and calcium hydroxide against E. faecalis biofilm were evaluated. Results showed that Ag-MBGs possessed highly ordered mesoporous structure with silver nanoparticles deposited in the mesopores, which enabled a sustained Ag ions released. The biofilms treated with Ag-MBGs showed a significant structural disruption compared with MBGs. These results indicated that Ag-MBGs possess a potent antibacterial effect against E.faecalis biofilm in root canal, and the antibacterial activity was induced by the release of Ag ions from Ag-MBGs.

Evaluation of the antibacterial efficacy of silver nanoparticles against Enterococcus faecalis biofilm.

INTRODUCTION: The purpose of this study was to evaluate the antibacterial efficacy of silver nanoparticles (AgNPs) as an irrigant or medicament against Enterococcus faecalis biofilms formed on root dentin. METHODS: Dentin sections were inoculated with E. faecalis for 4 weeks to establish a standard monospecies biofilm model. These biofilms were tested in 2 stages. In stage 1, the biofilms were irrigated with 0.1% AgNP solution, 2% sodium hypochlorite, and sterile saline for 2 minutes, respectively. In stage 2, the biofilms were treated with AgNP gel (0.02% and 0.01%) and calcium hydroxide for 7 days. The ultrastructure of one half of the specimens from each group was evaluated by using scanning electron microscopy, whereas the structure and distribution of viable bacteria of the other half of the specimens were assessed with confocal laser scanning microscopy combined with viability staining. RESULTS: Syringe irrigation with 0.1% AgNP solution did not disrupt the biofilm structure, and the proportion of viable bacteria in the biofilm structures was not different from that of the saline group (P > .05) but was less than that of the control group (P < .05). The biofilms treated with 0.02% AgNP gel as medicament significantly disrupted the structural integrity of the biofilm and resulted in the least number of post-treatment residual viable E. faecalis cells compared with 0.01% AgNP gel and calcium hydroxide groups (P < .05). CONCLUSIONS: The findings from this study suggested that the antibiofilm efficacy of AgNPs depends on the mode of application. AgNPs as a medicament and not as an irrigant showed potential to eliminate residual bacterial biofilms during root canal disinfection.

Effects of adsorbed and templated nanosilver in mesoporous calcium-silicate nanoparticles on inhibition of bacteria colonization of dentin.

Mesoporous calcium-silicate nanoparticles (MCSNs) are advanced biomaterials for controlled drug delivery and mineralization induction. Nanosilver-incorporated MCSNs (Ag-MCSNs) were prepared in the present study using both the adsorption and template methods. Both versions of Ag-MCSNs showed characteristic morphology of mesoporous materials and exhibited sustained release of ions over time. In antibacterial testing against planktonic Enterococcus faecalis, Ag-MCSNs showed significantly better antibacterial effects when compared with MCSNs (P<0.05). The Ag-MCSNs aggregated on the dentin surface of root canal walls and infiltrated into dentinal tubules after ultrasound activation, significantly inhibiting the adherence and colonization of E. faecalis on dentin (P<0.05). Despite this, Ag-MCSNs with templated nanosilver showed much lower cytotoxicity than Ag-MCSNs with adsorbed nanosilver (P<0.05). The results of the present study indicated that nanosilver could be incorporated into MCSNs using the template method. The templated nanosilver could release silver ions and inhibit the growth and colonization of E. faecalis both in the planktonic form and as biofilms on dentin surfaces as absorbed nanosilver. Templated Ag-MCSNs may be developed into a new intracanal disinfectant for root canal disinfection due to their antibacterial ability and low cytotoxicity, and as controlled release devices for other bioactive molecules to produce multifunctional biomaterials.