Effects of the nitric oxide releasing biomimetic nanomatrix gel on pulp-dentin regeneration: Pilot study

PLoS One. 2018 Oct 11;13(10):e0205534. doi: 10.1371/journal.pone.0205534. eCollection 2018.

Abstract

Successful disinfection alongside complete endodontic tissue regeneration and revascularization are the most desired clinical outcomes of regenerative endodontics. Despite reported clinical successes, significant limitations to the current regenerative endodontic procedure (REP) have been elucidated. To improve the current REP, an antibiotics and nitric oxide (NO) releasing biomimetic nanomatrix gel was developed. The study evaluates antibacterial effects of an antibiotics and NO releasing biomimetic nanomatrix gel on multispecies endodontic bacteria. Antibiotics, ciprofloxacin (CF) and metronidazole (MN) were mixed and encapsulated within the NO releasing biomimetic nanomatrix gel. The gel was synthesized and self-assembled from peptide amphiphiles containing various functional groups. Antibacterial effects of the antibiotics and NO releasing biomimetic nanomatrix gel were evaluated using bacterial viability assays involving endodontic microorganisms including clinical samples. Pulp-dentin regeneration was evaluated via animal-model experiments. The antibiotics and NO releasing biomimetic nanomatrix gel demonstrated a concentration dependent antibacterial effect. In addition, NO alone demonstrated a concentration dependent antibacterial effect on endodontic microorganism. An in vivo analysis demonstrated the antibiotics and NO releasing biomimetic nanomatrix gel promoted tooth revascularization with maturation of root canals. An optimal concentration of and NO releasing nanomatrix gel is suggested for its potential as a root treatment material for REP and an appropriate protocol for human trials. Further investigation is required to obtain a larger sample size and decide upon ideal growth factor incorporation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anti-Bacterial Agents / administration & dosage*
  • Biofilms / drug effects
  • Biomimetic Materials / chemical synthesis
  • Dental Pulp / diagnostic imaging
  • Dental Pulp / drug effects*
  • Dental Pulp / pathology
  • Dental Pulp / physiopathology
  • Dentin / diagnostic imaging
  • Dentin / drug effects*
  • Dentin / pathology
  • Dentin / physiopathology
  • Dogs
  • Drug Delivery Systems
  • Enterococcus faecalis / drug effects
  • Enterococcus faecalis / physiology
  • Gels* / chemical synthesis
  • Gram-Positive Bacterial Infections / diagnostic imaging
  • Gram-Positive Bacterial Infections / drug therapy
  • Gram-Positive Bacterial Infections / pathology
  • Gram-Positive Bacterial Infections / physiopathology
  • Humans
  • Nanostructures
  • Neovascularization, Physiologic / drug effects
  • Neovascularization, Physiologic / physiology
  • Nitric Oxide / administration & dosage*
  • Pilot Projects
  • Pulpitis / diagnostic imaging
  • Pulpitis / drug therapy
  • Pulpitis / pathology
  • Pulpitis / physiopathology
  • Regeneration / drug effects*
  • Regeneration / physiology
  • Treponema denticola / drug effects
  • Treponema denticola / physiology

Substances

  • Anti-Bacterial Agents
  • Gels
  • Nitric Oxide