AUTHOR=Elshinawy Mohamed I. , Al-Madboly Lamiaa A. , Ghoneim Walaa M. , El-Deeb Nehal M. 

TITLE=Synergistic Effect of Newly Introduced Root Canal Medicaments; Ozonated Olive Oil and Chitosan Nanoparticles, Against Persistent Endodontic Pathogens

JOURNAL=Frontiers in Microbiology

VOLUME=9

YEAR=2018

URL=https://www.frontiersin.org/journals/microbiology/articles/10.3389/fmicb.2018.01371

DOI=10.3389/fmicb.2018.01371

ISSN=1664-302X

ABSTRACT=<p>This study was conducted to investigate the antimicrobial-biofilm activity of chitosan (Ch-NPs), silver nanoparticles (Ag-NPs), ozonated olive oil (O<sub>3</sub>-oil) either separately or combined together against endodontic pathogens. While testing the antimicrobial activity, Ch-NPs showed the least minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values exerting eightfold higher bactericidal activity than O<sub>3</sub>-oil against both <italic>Enterococcus faecalis</italic> and <italic>Streptococcus mutans</italic> as well as fourfold higher fungicidal activity against <italic>Candida albicans</italic>. Antimicrobial synergy test revealed synergism between O<sub>3</sub>-oil and Ch-NPs against the test pathogens (FIC index ≤ 0.5). Ch-NPs was superior at inhibiting immature single and mixed-species biofilm formations by 97 and 94%, respectively. Both of O<sub>3</sub>-oil and Ch-NPs had a complete anti-fibroblast adherent effect. The safety pattern results showed that O<sub>3</sub>-oil was the safest compound, followed by Ch-NPs. The double combination of Ch-NPs and O<sub>3</sub>-oil reduced the mature viable biofilm on premolars <italic>ex vivo</italic> model by 6-log reductions, with a fast kill rate, indicating potential use in treating root canals. Therefore, the double combination has the potential to eradicate mature mixed-species biofilms and hence it is potent, novel and safe.</p>