Anti-inflammatory and antimicrobial efficacy of electrospun nanofiber films for intracanal drug delivery

Abstract

In an effort to combat the effects of endodontic infection, root canal treatment aims to remove endodontic bacteria. Nevertheless, endodontic treatment failure may occur due to microbial persistence and reinfection. Guidelines on dental infection management recommend triple antibiotic paste (TAP), a mixture of ciprofloxacin, metronidazole and minocycline, as an intra-canal medication for the eradication of endodontic bacteria1. Although the antimicrobial efficacy of the previous mentioned conventional remedy is generally recognized, they may produce some complications such as bacterial resistance, tissue irritation, stem cell toxicity and teeth discoloration due to its acidic nature. These limitations gave prominence to the use of nanoparticle-based irrigants, such as silver (Ag) or zinc oxide (ZnO) nanoparticles (NPs), both having a similar mode of bactericidal action. Equally important to eliminating endodontic microbial infection is the management of inflammation caused by bacterial infections. Ketoprofen is one of the most widely used nonsteroidal anti-inflammatory agents (NSAIDs) administered orally for the management of inflammation and postoperative endodontic pain4. To this extent, In the current study a rapidly dissolving electrospun film was developed for the intracanal co-administration of an antimicrobial (ZnO NPs) and an anti-inflammatory (ketoprofen) agent.

In the current study, polymeric fast-disintegrating films were successfully developed to address the antimicrobial and anti-inflammatory requirements for root canal treatment. The electrospun films showed good in vitro anti-inflammatory action on LPS-stimulated RAW 264.7 cells and adequate antimicrobial efficacy against E. faecalis, one of the most frequent species present in post-treatment disease. The antimicrobial efficacy of the nanofiber films was verified not only in vitro but also ex vivo in a human tooth model experimentally infected with E. faecalis. The combination of anti-inflammatory and antimicrobial activity to be exerted directly at the site of action shows a very appealing application for the treatment of periradicular infections and endodontic lesions.

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ORCID for Orestis L. Katsamenis: orcid.org/0000-0003-4367-4147

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