Antibacterial Efficacy of Chitosan Nanoparticle Based Intracanal Medicament Compared with Conventional Intracanal Medicament for Root Canal Disinfection - A Systematic Review

Authors

  • Atluri Manoj
  • Manish Ranjan
  • Sanyukta Singh
  • C. Ragavendran

DOI:

https://doi.org/10.52783/jns.v14.2416

Keywords:

Chitosan nanoparticles, intracanal medicament, root canal disinfection, antibacterial efficacy, endodontics

Abstract

Background: Root canal disinfection is crucial for the success of endodontic treatment, with intracanal medicaments playing a significant role in eliminating microbial infections. Conventional medicaments such as calcium hydroxide and chlorhexidine are widely used, but their limitations have led to the exploration of novel formulations. Chitosan nanoparticles, due to their antimicrobial properties and biocompatibility, have emerged as promising alternatives.

Objective: This systematic review aims to evaluate the antibacterial efficacy of chitosan nanoparticle-based intracanal medicaments in comparison to conventional intracanal medicaments for root canal disinfection.

Methods: A comprehensive literature search was conducted in PubMed, SCOPUS, and Web of Science databases, following PRISMA guidelines. Studies assessing the antibacterial effectiveness of chitosan nanoparticle-based intracanal medicaments against Enterococcus faecalis and other endodontic pathogens were included. Data extraction and risk of bias assessment were performed independently by two reviewers.

Results: Seven in vitro studies met the inclusion criteria. The reviewed studies utilized various formulations of chitosan nanoparticles, including combinations with calcium hydroxide, chlorhexidine, and propolis. Antimicrobial assessments were conducted using colony-forming unit (CFU) analysis, scanning electron microscopy (SEM), and spectrophotometry. Five studies demonstrated enhanced antibacterial efficacy with chitosan nanoparticle-based medicaments compared to conventional agents, while two studies showed comparable but not superior effects.

Conclusion: Chitosan nanoparticle-based intracanal medicaments exhibit significant antibacterial potential and may serve as effective alternatives to conventional medicaments. Their ability to enhance antimicrobial activity and provide controlled drug release suggests promising clinical applications. However, further standardized in vivo studies are required to validate their efficacy and long-term benefits.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

References

Del Carpio-Perochena A, Kishen A, Felitti R, Bhagirath AY, Medapati MR, Lai C, Cunha RS. Antibacterial properties of chitosan nanoparticles and propolis associated with calcium hydroxide against singleand multispecies bioflms: An In Vitro and In Situ Study. J Endod.2017;43(8):1332–6.

Parolia A, Kumar H, Ramamurthy S, Davamani F, Pau A. Effectiveness of chitosan-propolis nanoparticle against Enterococcus faecalis biofilms in root canal. BMC Oral Health. 2020 Nov 25;20(1):339.

Ge J, Li M, Fan J, Celia C, Xie Y, Chang Q, Deng X. Synthesis, characterization, and antibacterial activity of chitosan-chelated silver nanoparticles. J Biomater Sci Polym Ed. 2024 Jan;35(1):45-62.

Ratih DN, Mulyawati E, Fajrianti H. Antibacterial efficacy, calcium ion release, and pH using calcium hydroxide with three vehicles. J Conserv Dent. 2022 Sep-Oct;25(5):515-520.

Wong J, Zou T, Lee AHC, Zhang C. The Potential Translational Applications of Nanoparticles in Endodontics. Int J Nanomedicine. 2021 Mar 9;16:2087-2106.

Prabhakar A, Taur S, Hadakar S, Sugandhan S. Comparison of Antibacterial Efficacy of Calcium Hydroxide Paste, 2% Chlorhexidine Gel and Turmeric Extract as an Intracanal Medicament and their Effect on Microhardness of Root Dentin: An in vitro Study. Int J Clin Pediatr Dent. 2013 Sep;6(3):171-7.

S R S, Singh S, Hindlekar A, Desai N, Vyavahare N. Comparative Evaluation of Antimicrobial Efficacy of Various Antibiotic Pastes and Calcium Hydroxide Using Chitosan as a Carrier Against Enterococcus faecalis: An In Vitro Study. Cureus. 2023 Aug 15;15(8):e43541.

Parakh K, Shetty RM, Shetty S, Desai V, Shetty S, Al Jadaa A, Jain S, Vannala V. Antimicrobial Properties and Substantivity of Gentamicin, Amoxicillin and Metronidazole (GAM) Antibiotic Solution with Chitosan as a Root Canal Irrigant - A Preliminary Study. J Pharm Bioallied Sci. 2023 Jul;15(Suppl 1):S341-S345.

Moradi S, Moushekhian S, Najafi E, Sedigh HS, Navabi S. Efficacy of propolis and triple antibiotic paste as intra-canal medicaments for revascularisation of immature teeth in dogs: a comparative study. Eur Arch Paediatr Dent. 2023 Jun;24(3):321-326.

Teja KV, Janani K, Srivastava KC, Shrivastava D, Natoli V, Di Blasio M, Cicciu M, Minervini G. Comparative evaluation of antimicrobial efficacy of different combinations of calcium hydroxide against Enterococcus faecalis. BMC Oral Health. 2023 Nov 11;23(1):849.

Prabhakar A, Taur S, Hadakar S, Sugandhan S. Comparison of Antibacterial Efficacy of Calcium Hydroxide Paste, 2% Chlorhexidine Gel and Turmeric Extract as an Intracanal Medicament and their Effect on Microhardness of Root Dentin: An in vitro Study. Int J Clin Pediatr Dent. 2013 Sep;6(3):171-7.

Harshitha VS, Ranjini MA, Nadig RR. Antibacterial efficacy of nisin, calcium hydroxide, and triple antibiotic paste in combination with chitosan as an intracanal medicament against Enterococcus faecalis - An in vitro study. J Conserv Dent. 2022 Sep-Oct;25(5):504-509.

Lakshmi, and Nanobiomedicine Lab, Department of Pharmacology, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Chennai. 2021. “Anticariogenic Activity of Silver Nanoparticles Synthesized Using Fresh Leaves Extract of Kalanchoe Pinnata.” International Journal of Dentistry and Oral Science, July, 2985–87.

Nasim, Iffat, Zohra Jabin, S. Rajesh Kumar, and V. Vishnupriya. 2022. “Green Synthesis of Calcium Hydroxide-Coated Silver Nanoparticles Using Andrographis Paniculata and Ocimum Sanctum Linn. Leaf Extracts: An Antimicrobial and Cytotoxic Activity.” Journal of Conservative Dentistry: JCD 25 (4): 369–74

Kamath, Ajith K., Iffat Nasim, N. P. Muralidharan, and Ravalika N. Kothuri. 2022. “Anti-Microbial Efficacy of Vanilla Planifolia Leaf Extract against Common Oral Micro-Biomes: A Comparative Study of Two Different Antibiotic Sensitivity Tests.” Journal of Oral and Maxillofacial Pathology: JOMFP 26 (3): 330–34.

Choudhari, Sahil, Jogikalmat Krithikadatta, Ipsitha Vejendla, Swathi, and Mukesh Doble. 2023. “Microbial Interactions in Oral Biofilm: Evaluating Therapeutic Interventions and the Emergence of Resistance: A Narrative Review.” Cureus, October.

Deepika, Burra Anand, Jaiganesh Ramamurthy, Smiline Girija, and Nadathur Duraisamy Jayakumar. 2022. “Evaluation of the Antimicrobial Effect of Ocimum Sanctum L. Oral Gel against Anaerobic Oral Microbes: An in Vitro Study.” World Journal of Dentistry 13 (S1): S23–27.

Janani, Krishnamachari, Kavalipurapu Venkata Teja, P. Ajitha, and Raghu Sandhya. 2020. “Evaluation of Tissue Inflammatory Response of Four Intracanal Medicament - An Animal Study.” Journal of Conservative Dentistry: JCD 23 (3): 216–20.

Downloads

Published

2025-03-21

How to Cite

1.
Manoj A, Ranjan M, Singh S, C. Ragavendran. Antibacterial Efficacy of Chitosan Nanoparticle Based Intracanal Medicament Compared with Conventional Intracanal Medicament for Root Canal Disinfection - A Systematic Review. J Neonatal Surg [Internet]. 2025Mar.21 [cited 2025Sep.20];14(7S):366-72. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/2416