Evaluation of Antimicrobial Efficacy and Postoperative Pain After Using Silver Nanoparticles and Chitosan Nanoparticles Against Enterococcus Faecalis and Candida Albicans Biofilm

Study Overview
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Brief Summary
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Silver nanoparticles possess unique physicochemical and biological properties in addition to their antibacterial capabilities. Similarly, zinc oxide nanoparticles have demonstrated antibacterial effects against a wide range of bacteria, including heat and pressure resistant spores. Given these characteristics, it would be valuable to evaluate and compare a new irrigation solution containing nanosilver and nanozinc-oxide particles with sodium hypochlorite. Furthermore, Chitosan Nanoparticles are expected to exhibit enhanced antibacterial activity compared to regular-sized Chitosan due to their ability to penetrate and disrupt microbial cell membranes. Consequently, the current study aims to assess and compare the antibacterial activity of Silver Nanoparticles and Chitosan Nanoparticles, as well as their impact on post-operative pain.

Official Title
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Evaluation of Antimicrobial Efficacy and Postoperative Pain After Using Silver Nanoparticles and Chitosan Nanoparticles Against Enterococcus Faecalis and Candida Albicans Biofilm (An in Vitro - in Vivo Study)

Conditions
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Endodontic Disease

Intervention / Treatment
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* Drug: Silver Nanoparticles Irrigant
* Drug: Chitosan Nanoparticles Irrigant


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Medically stable healthy patients (category: American society of anesthesiologists class I). The patient ranges in age from 20 to 40. No sexual orientation Necrotic pulp evaluated by thermal or electrical pulp testing. Enough crown structure to provide adequate isolation. One root and one canal. Patients' desire to engage in this research. Patients' comprehension of the visual analogue scale (VAS). Patients' ability to sign informed consent. Exclusion Criteria: Endodontic treatment for the tooth previously. Teeth with poor conditions for using rubber dams. Vital pulp tissue was observed throughout the treatment. Patients who have a medical condition. Teeth with open apices that are immature Women who are pregnant or breastfeeding. Psychologically disturbed patients. Patients having a history of allergy to any of the research drugs were barred from participation. A periodontally affected tooth with grade 2 or 3 mobility.

Ages Eligible for Study
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Minimum Age: 20 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Silver Nanoparticles Irrigant<br> | Drug: Silver Nanoparticles Irrigant<br>* Nanosilver irrigant solution<br>|
| Experimental: Chitosan Nanoparticle Irrigant<br> | Drug: Chitosan Nanoparticles Irrigant<br>* Chitosan nanoparticles irrigant solution<br>|
| Active Comparator: 2.6% NaOCl and 17% EDTA sol<br> | Drug: Silver Nanoparticles Irrigant<br>* Nanosilver irrigant solution<br>Drug: Chitosan Nanoparticles Irrigant<br>* Chitosan nanoparticles irrigant solution<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Postoperative Pain Assessment | Each patient was given a pain scale chart (VAS scale) before every endodontic operation to record his or her pain level. The VAS is a 10-point scale with values ranging from 0 to 10, with 0 representing No pain, (1-3) representing mild pain, (4-6) representing moderate pain, and (7-10) representing worst imaginable pain. At 6, 12, 24, 48, and 72 hours, each patient was instructed to use the VAS scale (0-10) to rate the presence and severity of discomfort after obturation. | 6, 12, 24, 48, and 72 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Antimicrobial Activity Assessment | A sterile paper point was placed in each root canal to a level roughly 1 mm short of the apex, depending on working length radiographs, to get a sample from the root canal. The samples were suspended in a suspension of 25 microliters, which was pipetted onto a BHI agar plate. The colonies were counted using a Reichert-Jung colony counter after 1 hour, 24 hours, 7 days, and 30 days of incubation at 37oC in an anaerobic jar. | 1 hour, 24 hours, 7 days, and 30 days |