Antibacterial and cytotoxic evaluation of copper and zinc oxide nanoparticles as a potential disinfectant material of connections in implant provisional abutments: An in-vitro study

Cytotoxicity of green synthesized zinc oxide nanoparticles using Musa acuminata on Vero cells

Zinc oxide nanoparticles (ZnO NPs) have become a highly regarded substance in various industries especially biologically synthesized ZnO NPs due to their adherence to the principles of green chemistry. However, concerns have been raised regarding the potential cytotoxic effects of ZnO NPs on biological systems. This study aimed to investigate and compare the cytotoxicity of ZnO NPs that were synthesized through chemical (C-ZnO NPs) and green approach using Musa acuminata leaf aqueous extract (Ma-ZnO NPs) on Vero cells. Characterization of ZnO NPs through Uv-Vis, FESEM, EDX, XRD, FTIR and XPS confirmed the successful synthesis of C- and Ma-ZnO NPs. MTT and ROS assays revealed that C- and Ma-ZnO NPs induced a concentration- and time-dependent cytotoxic effect on Vero cells. Remarkably, Ma-ZnO NPs showed significantly higher cell viability compared to C-ZnO NPs. The corelation of ROS and vell viability suggest that elevated ROS levels can lead to cell damage and even cell death. Flow cytometry analysis indicated that Ma-ZnO NPs exposed cells had more viable cells and a smaller cell population in the late and early apoptotic stage. Furthermore, more cells were arrested in the G1 phase upon exposure to C-ZnO NPs, which is associated with oxidative stress and DNA damage caused by ROS generation, proving its higher cytotoxicity than Ma-ZnO NPs. Similarly, time-dependent cytotoxicity and morphological alterations were observed in C- and Ma-ZnO NPs treated cells, indicating cellular damage. Furthermore, fluorescence microscopy also demonstrated a time-dependent increase in ROS formation in cells exposed to C- and Ma-ZnO NPs. In conclusion, the findings suggest that green ZnO NPs possess a favourable biocompatibility profile, exhibiting reduced cytotoxicity compared to chemically synthesized ZnO NPs on Vero cells. These results emphasize the potential of green synthesis methods for the development of safer and environmentally friendly ZnO NPs.

Systematic Review of Zinc's Benefits and Biological Effects on Oral Health

BACKGROUND

This review was based on the following question: "What is the state-of-the-art regarding the effect of zinc exposure in the oral cavity on a population of adults and children, compared to dental products containing materials other than zinc, considering in vivo (clinical trials and observational studies) and in vitro studies?" according to a PICOS strategy format. This study aims to analyze zinc application in dental materials, with different compositions and chemical formulations, considering how mechanical and biological properties may influence its clinical applicability.

METHODS

In vivo (clinical trials: controlled clinical trials (CCTs) and randomized controlled trials (RCTs); and observational studies: case control and cohort studies) trials or in vitro studies published in English or Italian during the last 10 years on children and adult patients with zinc exposure were included by three different reviewers using the MEDLINE (via PubMed), Scopus, and Web of Science electronic databases.

RESULTS

Titles and abstracts were evaluated following the eligibility criteria. The full texts of eligible studies were then reviewed against the inclusion/exclusion criteria. Scientific and technical information of the 33 included studies were collected into evidence tables, reporting data on in vivo and in vitro studies. A narrative approach was adopted.

CONCLUSIONS

Antibacterial activity was found to be the most studied property of zinc, but further investigations are needed to establish adjuvant zinc therapies in patients with oral disease.

Antimicrobial Activity of Zinc against Periodontal Pathogens: A Systematic Review of In Vitro Studies

Background and Objectives: More than a billion people worldwide suffer from chronic periodontitis. The primary etiological factor of periodontal diseases is dental plaque and the bacteria it contains, particularly Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia, and Aggregatibacter actinomycetemcomitans. Zinc, owing to its antibacterial properties, can be employed in periodontology. The objective of this review was to analyze scientific literature that examines the effects of zinc on periopathogens. Materials and methods: A systematic review protocol of scientific literature was designed following PRISMA recommendations. Data search was conducted in PubMed, Web of Science, and ScienceDirect databases. Full-text articles in English that examine the effects of zinc on periopathogens and were published between 2011 and 2021 were included. Results: Fifteen articles were included in the analysis based on inclusion criteria. ZnO exhibited antibacterial activity against P. gingivalis and P. intermedia (p < 0.001). The minimum inhibitory concentration against P. gingivalis was 10 μg/mL. ZnO demonstrated a significant antibacterial effect, as evidenced by inhibition zones of 15.10 mm for S. oralis, 13.36 mm for P. gingivalis, 12.98 mm for S. sanguis, and 14.01 mm for P. intermedia. Zn (II)-based polymers inhibited the ragA and ragB genes of P. gingivalis. Titanium dental implants coated with ZnO effectively disrupted the cell walls of P. gingivalis and A. actinomycetemcomitans. ZnO inhibited the growth of P. gingivalis within 2 h and the growth of F. nucleatum and P. intermedia within 3 h. ZnO exhibited nontoxic effects, and concentrations up to 0.8 mg/L increased cell survival rates by up to 90%. Conclusions: The analysis of the literature confirms the antibacterial action of zinc against periodontal pathogenic bacteria. At low concentrations, these substances do not exhibit cytotoxic effects on fibroblasts.

Antibacterial Cu or Zn-MOFs Based on the 1,3,5-Tris-(styryl)benzene Tricarboxylate

Metal-organic frameworks (MOFs) are highly versatile materials. Here, two novel MOFs, branded as IEF-23 and IEF-24 and based on an antibacterial tricarboxylate linker and zinc or copper cations, and holding antibacterial properties, are presented. The materials were synthesized by the solvothermal route and fully characterized. The antibacterial activity of IEF-23 and IEF-24 was investigated against Staphylococcus epidermidis and Escherichia coli via the agar diffusion method. These bacteria are some of the most broadly propagated pathogens and are more prone to the development of antibacterial resistance. As such, they represent an archetype to evaluate the efficiency of novel antibacterial treatments. MOFs were active against both strains, exhibiting higher activity against Staphylococcus epidermidis. Thus, the potential of the developed MOFs as antibacterial agents was proved.

Study of the Antibacterial Capacity of a Biomaterial of Zeolites Saturated with Copper Ions (Cu2+) and Supported with Copper Oxide (CuO) Nanoparticles

In this work, copper (II) ions were saturated and copper oxide nanoparticles (CuO NPs) were supported in natural zeolite from Chile; this was achieved by making the adsorbent material come into contact with a copper ion precursor solution and using mechanical agitation, respectively. The kinetic and physicochemical process of the adsorption of copper ions in the zeolite was studied, as well as the effect of the addition of CuO NPs on the antibacterial properties. The results showed that the saturation of copper (II) ions in the zeolite is an efficient process, obtaining a 27 g L^-1 concentration of copper ions in a time of 30 min. The TEM images showed that a good dispersion of the CuO NPs was obtained via mechanical stirring. The material effectively inhibited the growth of Gram-negative and Gram-positive bacteria that have shown resistance to methicillin and carbapenem. Furthermore, the zeolite saturated with copper at the same concentration had a better bactericidal effect than the zeolite supported with CuO NPs. The results suggested that the ease of processing and low cost of copper (II) ion-saturated zeolitic material could potentially be used for dental biomedical applications, either directly or as a bactericidal additive for 3D printing filaments.

Cytotoxicity of PLGA-zinc oxide nanocomposite on human gingival fibroblasts

Background

Polylactic-co-glycolic acid and zinc oxide (PLGA-ZnO) nanocomposite has been investigated for its antibacterial properties, which could be beneficial for adding to wound dressings after periodontal surgery. However, its cytotoxicity against human gingival fibroblasts (HGFs) remains unclear and should be evaluated.

Methods

ZnO nanoparticles were synthesized using the hydrothermal method. These metallic nanoparticles were incorporated into the PLGA matrix by the solvent/non-solvent process. The nanomaterial was evaluated by field emission scanning electron microscopy (FESEM), Fourier transform infrared (FTIR), thermogravimetric analysis (TGA), and x-ray diffraction (XRD) analyses. HGF cells were acquired from the National Cell Bank and categorized into four groups: ZnO, PLGA, ZnO-PLGA, and control. The cells were exposed to different ZnO (1, 20, 40, 60, 80, and 100 µg/mL) and PLGA (0.2, 4, 8, 12, 16, and 20 µg/mL) concentrations for 24 and 48 hours. The cytotoxicity was tested using the MTT assay. The data were analyzed using SPSS 25, and P<0.05 was considered statistically significant.

Results

ZnO nanoparticles exhibited significant toxicity at≥40 µg/mL concentrations after 24 hours. Cell viability decreased significantly at all the tested concentrations after 48 hours of exposure. PLGA-ZnO cell viability in 24 hours was similar to the control group for all the concentrations up to 80 µg/mL.

Conclusion

ZnO nanoparticles could be toxic against HGF in high concentrations and with prolonged exposure. Therefore, incorporating ZnO nanoparticles into a biocompatible polymer such as PLGA could be a beneficial strategy for reducing their toxicity.

In Vitro and In Vivo Studies of Antibacterial Coatings on Titanium Alloy Implants for Veterinary Application

The aim of this work was the evaluation of biological properties of hybrid coatings modified with Ag, Cu, and Zn nanoparticles (NPs) applied on TPLO medical implants by the sol-gel process. The implant coatings enriched with various concentrations of metallic NPs were investigated in the in vitro bactericidal efficacy tests against Gram+ and Gram- bacteria and pathogenic yeast. Next, the designed materials were tested on human osteosarcoma cell lines. The cells adhesion, proliferation, viability, and differentiation were investigated. The cell growth wasevaluated using SEM, and the metallic ion release was measured. The results revealed that the NPs concentration in the hybrid layers decreased with the incubation time. In the last stage, the implants were tested in vivo on six canine patients. Three months after the operation, the radiological evaluation of the performed anastomosis was carried out as well as the histopathological evaluation of tissue regeneration. The strongest bactericidal efficacy was observed for the layers containing AgNPs. Along with an increased concentration of metallic additives, a growing toxic effect was clearly observed. The most pronounced toxic effect was especially evident with the AgNPs concentration exceeding 1 mol %. In all the operated patients, no deviations were found during the follow-up examinations in the postoperative period. The low dose of AgNPs in the hybrid layer facilitated the tissue healing process. It was proven that silver nanoparticles may accelerate the bone healing process. The correct tissue reparation was observed.

Metal and Metal Oxide Nanomaterials for Fighting Planktonic Bacteria and Biofilms: A Review Emphasizing on Mechanistic Aspects

The misuse and mismanagement of antibiotics have made the treatment of bacterial infections a challenge. This challenge is magnified when bacteria form biofilms, which can increase bacterial resistance up to 1000 times. It is desirable to develop anti-infective materials with antibacterial activity and no resistance to drugs. With the rapid development of nanotechnology, anti-infective strategies based on metal and metal oxide nanomaterials have been widely used in antibacterial and antibiofilm treatments. Here, this review expounds on the state-of-the-art applications of metal and metal oxide nanomaterials in bacterial infective diseases. A specific attention is given to the antibacterial mechanisms of metal and metal oxide nanomaterials, including disrupting cell membranes, damaging proteins, and nucleic acid. Moreover, a practical antibiofilm mechanism employing these metal and metal oxide nanomaterials is also introduced based on the composition of biofilm, including extracellular polymeric substance, quorum sensing, and bacteria. Finally, current challenges and future perspectives of metal and metal oxide nanomaterials in the anti-infective field are presented to facilitate their development and use.

Synthesis, Characterization, and In Vivo Toxicological Evaluation of Copper (II) Oxide Containing Herbometallic Siddha Nanocomplex “Thamira Parpam”

“Thamira parpam” (TP), a copper-based herbometallic oxide (copper (II) oxide) nanodrug has been used in Siddha medicine for centuries because of its anti-ulcerogenic property. However, the physicochemical properties and in vivo toxicity of TP still remain elusive. Rigorous clinical translation requires deciphering these vital properties. We have synthesized TP following a gold standard protocol in the traditional Siddha methodology. We assessed the size, phase, elemental constituents, and thermal stability of TP by SEM and TEM, XRD, EPR, and EDAX analyses, respectively. The results depicted the conversion of metallic copper into copper (II) oxide in the final stages of TP preparation and exhibited nanodimensions ranging between 10 and 50 nm. The XPS spectra revealed the presence of oxygen-deficient state and a carbonaceous coating was found on the surface of TP using TEM analysis. In vivo safety was studied in rat toxicity models by adopting OECD guidelines. Body weight changes, feed, and water intake were unaltered upon TP administration. Hematological, biochemical profiling, and histopathological findings also suggested its nontoxic nature with no abnormalities in major organs and its functions. Interestingly, we found that the metal toxicity could have been subdued because of the carbonaceous coating around the nanoparticle copper (II) oxide, confirming that the drug is safe at a low dose. Overall, our study has enlightened the safety of TP supporting the use of Siddha formulations.

Insight into the Antibacterial Activity of Selected Metal Nanoparticles and Alterations within the Antioxidant Defence System in Escherichia coli, Bacillus cereus and Staphylococcus epidermidis

The antimicrobial activity of nanoparticles (NPs) is a desirable feature of various products but can become problematic when NPs are released into different ecosystems, potentially endangering living microorganisms. Although there is an abundance of advanced studies on the toxicity and biological activity of NPs on microorganisms, the information regarding their detailed interactions with microbial cells and the induction of oxidative stress remains incomplete. Therefore, this work aimed to develop accurate oxidation stress profiles of Escherichia coli, Bacillus cereus and Staphylococcus epidermidis strains treated with commercial Ag-NPs, Cu-NPs, ZnO-NPs and TiO2-NPs. The methodology used included the following determinations: toxicological parameters, reactive oxygen species (ROS), antioxidant enzymes and dehydrogenases, reduced glutathione, oxidatively modified proteins and lipid peroxidation. The toxicological studies revealed that E. coli was most sensitive to NPs than B. cereus and S. epidermidis. Moreover, NPs induced the generation of specific ROS in bacterial cells, causing an increase in their concentration, which further resulted in alterations in the activity of the antioxidant defence system and protein oxidation. Significant changes in dehydrogenases activity and elevated lipid peroxidation indicated a negative effect of NPs on bacterial outer layers and respiratory activity. In general, NPs were characterised by very specific nano-bio effects, depending on their physicochemical properties and the species of microorganism.

Microgap and bacterial microleakage during the osseointegration period: An in vitro assessment of the cover screw and healing abutment in a platform-switched implant system

STATEMENT OF PROBLEM

Microgap and bacterial microleakage at the implant-prosthetic abutment interface are recognized concerns for implant-supported restorations, leading to inflammation of the peri-implant tissues, with deleterious consequences for crestal bone levels. However, little is known regarding the interface established between the implant and the healing abutment or cover screw placed for the osseointegration phase.

PURPOSE

The purpose of this in vitro study was to characterize the implant-cover screw and implant-healing abutment interfaces of a platform-switched implant system to determine the microgap and bacterial microleakage of the system and evaluate the biological response and functionality of an interface sealing agent.

MATERIAL AND METHODS

The interfacial microgaps of the implant-healing abutment and implant-cover screw interfaces were characterized by scanning electron microscopy (n=10), and bacterial microleakage was evaluated after colonization with Enterococcus faecalis in a 30-day follow-up (n=10). The sealing efficacy and irritation potential of a silicone-based sealer were determined by using the hen's egg test on chorioallantoic membrane assay. The 2-sample t test was performed to compare means between groups, and data presented with the Kaplan-Meier method were compared statistically by using the log-rank test (α=.05).

RESULTS

The interfacial microgap was less than 2.5 μm for both systems. Bacterial microleakage was noted in approximately 50% of the specimens, particularly at early time points, at both the healing abutment and cover screw interfaces. The silicone-based sealer prevented bacterial leakage in the experimental setting.

CONCLUSIONS

The implant-healing abutment and implant-cover screw interfaces of the tested system, despite the low microgap, allowed for bacterial microleakage after internal colonization. The use of a nonirritating silicone-based sealing agent effectively sealed the system.

Enhanced reduction of polymicrobial biofilms on the orthodontic brackets and enamel surface remineralization using zeolite-zinc oxide nanoparticles-based antimicrobial photodynamic therapy

The aim of this study was to evaluate the anti-biofilm and anti-metabolic activities of zeolite-zinc oxide nanoparticles (Zeo/ZnONPs)-based antimicrobial photodynamic therapy (aPDT) against pre-formed polymicrobial biofilms on the orthodontic brackets, as well as, assess the remineralization efficacy on polymicrobial biofilms induced enamel lesions. Following synthesis and characterization of Zeo/ZnONPs, cell cytotoxicity, hemolytic effect, and intracellular reactive oxygen species (ROS) production were determined. The anti-biofilm and anti-metabolic activities of aPDT using different concentrations of Zeo/ZnONPs were investigated. Microhardness tester and DIAGNOdent Pen were used to evaluate the changes of remineralization degree on the treated enamel slabs duration 1 and 3 months. No significant cytotoxicity and erythrocyte hemolysis were observed in treated cells with Zeo/ZnONPs. When irradiated, suggesting that the Zeo/ZnONPs were photoactivated, generating ROS and leading to reduce dose-dependently the cell viability and metabolic activity of polymicrobial biofilms. Also, the enamel surface microhardness value of exposed enamel showed a steady increase with the concentration of Zeo/ZnONPs. No statistically significant differences were shown between aPDT and sodium fluoride varnish as the control group. Overall, Zeo/ZnONPs-based aPDT with the greatest remineralization efficacy of enamel surface can be used as an anti-biofilm therapeutic method, which is involved with their potent ability to produce ROS.

Antibacterial Activity of Copper Nanoparticles (CuNPs) against a Resistant Calcium Hydroxide Multispecies Endodontic Biofilm

Endodontic treatment reduces the amount of bacteria by using antimicrobial agents to favor healing. However, disinfecting all of the canal system is difficult due to its anatomical complexity and may result in endodontic failure. Copper nanoparticles have antimicrobial activity against diverse microorganisms, especially to resistant strains, and offer a potential alternative for disinfection during endodontic therapy. This study evaluated the antibacterial action of copper nanoparticles (CuNPs) on an ex vivo multispecies biofilm using plaque count compared to the antibacterial activity of calcium hydroxide Ca(OH)₂. There were significant differences between the Ca(OH)₂ and CuNPs groups as an intracanal dressing compared with the CuNPs groups as an irrigation solution (p < 0.0001). An increase in the count of the group exposed to 7 days of Ca(OH)₂ was observed compared to the group exposed to Ca(OH)₂ for 1 day. These findings differ from what was observed with CuNPs in the same period of time. Antibacterial activity of CuNPs was observed on a multispecies biofilm, detecting an immediate action and over-time effect, gradually reaching their highest efficacy on day 7 after application. The latter raises the possibility of the emergence of Ca(OH)₂-resistant strains and supports the use of CuNPs as alternative intracanal medication.

The Adc regulon mediates zinc homeostasis in Streptococcus mutans

Zinc (Zn²⁺ ) is an essential divalent trace metal for living cells. Intracellular zinc homeostasis is critical to the survival and virulence of bacteria. Thus, the frequent fluctuations of salivary zinc, caused by the low physiological level and the frequent exogenous zinc introduction, present a serious challenge for bacteria colonizing the oral cavity. However, the regulation strategies to keep intracellular Zn²⁺ homeostasis in Streptococcus mutans, an important causative pathogen of dental caries, are unknown. Because zinc uptake is primarily mediated by an ATP-binding ABC transporter AdcABC in Streptococcus strains, we examined the function of AdcABC and transcription factor AdcR in S. mutans in this study. The results demonstrated that deletion of either adcA or adcCB gene impaired the growth but enhanced the extracellular polymeric matrix production in S. mutans, both of which could be relieved after excessive Zn²⁺ supplementation. Using RNA sequencing analysis, quantitative reverse transcription polymerase chain reaction examination, LacZ-reporter studies, and electrophoretic mobility shift assay, we showed that a MarR (multiple antibiotic resistance regulator) family transcription factor, AdcR, negatively regulates the expression of the genes adcR, adcC, adcB, and adcA by acting on the adcRCB and adcA promoters in response to Zn²⁺ concentration in their environmental niches. The deletion of adcR increases the sensitivity of S. mutans to excessive Zn²⁺ supply. Taken together, our findings suggest that Adc regulon, which consists of a Zn²⁺ uptake transporter AdcCBA and a Zn²⁺ -responsive repressor AdcR, plays a prominent role in the maintenance of intracellular zinc homeostasis of S. mutans.

Synergistic biocidal effects of metal oxide nanoparticles-assisted ultrasound irradiation: Antimicrobial sonodynamic therapy against Streptococcus mutans biofilms

BACKGROUND

Antimicrobial sonodynamic therapy (aSDT) is an adjunctive modality, which uses ultrasound irradiation to kill microbial cells by the activation of a sonosensitizer. The aim of this study was to evaluated the synergistic biocidal effects of zinc oxide nanoparticles (ZnO NPs) and titanium dioxide nanoparticles (TiO₂ NPs) as the metal oxide nanoparticles (MONPs)-assisted ultrasound irradiation against Streptococcus mutans biofilms.

MATERIALS AND METHODS

Following preparation and characterization of MONPs, cellular uptake and generation of intracellular reactive oxygen species (ROS) were assessed. After determination of the sub-significant reduction (SSR) doses of ZnO NPs, TiO₂ NPs, ZnO/TiO₂ NPs, and ultrasound intensity against S. mutans, anti-biofilm effects of aSDT were assessed using colorimetric assay, plate counting, and field emission scanning electron microscope (FESEM) analysis. Also, the metabolic activity of S. mutans and the expression levels of glucosyltransferase B (gtfB) as a main virulence factor of S. mutans were evaluated by XTT assay and quantitative real-time polymerase chain reaction following ZnO/TiO₂ NPs^SSR- mediated aSDT.

RESULTS

The finding of this study showed that an incubation time of 5 min was sufficient to achieve maximal uptake of MONPs. The ROS production following aSDT using ZnO NPs, TiO₂ NPs, and ZnO/TiO₂ NPs were ~ 4.1-, 5.6-, and 11.7-fold increase, respectively. The dose-dependent reduction in cell viability of S. mutans was revealed by increasing the concentrations of ZnO NPs, TiO₂ NPs, ZnO/TiO₂, as well as ultrasound intensities. According to the data, 1.5 µg/mL, 3.1 µg/mL, 25 µg/mL, and 0.75 W/cm² were considered as the SSR doses of ZnO/TiO₂ NPs, ZnO NPs, TiO₂ NPs, and ultrasound intensity, respectively (P>0.05). ZnO/TiO₂ NPs^SSR-mediated aSDT showed a significantly higher biofilm inhibitory activity than the other treatment groups (P<0.05). Based on the FE-SEM analysis, aSDT based on the ZnO/TiO₂ NPs^SSR had a strong anti-biofilm effect against preformed biofilms of S. mutans on the enamel slabs. Also, the metabolic activity of S. mutans and the expression levels of gtfB were significantly decreased to 85.5% and 12.3-fold, respectively following ZnO/TiO₂ NPs^SSR-mediated aSDT (P<0.05). No considerable difference was observed in anti-biofilm activity between ZnO/TiO₂ NPs^SSR- mediated aSDT and 0.2% CHX (P>0.05).

CONCLUSION

The results revealed anti-metabolic and anti-biofilm potential activities of ZnO/TiO₂ NPs-mediated aSDT against S. mutans with the highest cellular uptake and ROS generation.

Molecular characterization and antibacterial activity of oral antibiotics and copper nanoparticles against endodontic pathogens commonly related to health care-associated infections

OBJECTIVE

To carry out molecular characterization and determine the antibacterial activity of oral antibiotics and copper nanoparticles (Cu-NPs) against endodontic strains isolated from persistent infections.

MATERIALS AND METHODS

Root canal samples from 24 teeth in different patients with persistent endodontic infections were obtained. The isolated strains were identified by biochemical tests and 16S rDNA sequencing. Genotyping was achieved by molecular methods. The antibacterial activity of antibiotics and copper nanostructures was determined by using minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values. Furthermore, a time-kill kinetics assay was evaluated. Nonparametric tests (Kruskal-Wallis ANOVA) were performed (p value <0.05).

RESULTS

Twenty-one isolated strains were identified. Six isolates of Enterococcus faecalis were grouped into two clusters of three isolates each, two of which were clones. All were clarithromycin-resistant and erythromycin. Eight Pseudomonas putida presented two clusters, two Pseudomonas spp. were not clonal, and all were resistant to the tested antibiotics except tetracycline. Two of five strains of Cutibacterium acnes were clonal, and all were resistant only to metronidazole. The lowest MIC and MBC values were obtained with Cu-NPs. Time-kill kinetics using Cu-NPs showed a significant decrease in all tested species within 4 h and reached 100% in 2 h for C. acnes.

CONCLUSION

In this study, in relation to health care-associated infections, endodontic strains of each species isolated at least in one patient were polyclonal. In Pseudomonas spp., at least one clone was shared between patients. E. faecalis and C. acnes strains were susceptible to low Cu-NP concentrations, while Pseudomonas spp. strains were resistant.

CLINICAL RELEVANCE

Assessing and keeping track of the susceptibility of clinical strains to antimicrobial compounds is important for the clinical outcome. Based on our results, Cu-NPs could be an alternative for endodontic treatment, in order to avoid selection of resistant strains.

Metallic-nanoparticle release systems for biomedical implant surfaces: effectiveness and safety

The current focus of bioengineering for implant devices involves the development of functionalized surfaces, bioactive coatings, and metallic nanoparticles (mNPs) with a controlled release, together with strategies for the application of drugs in situ, aiming at reducing infection rates, with an improvement of clinical outcomes. Controversially, negative aspects, such as cytotoxicity, mNP incorporation, bioaccumulation, acquired autoimmunity, and systemic toxicity have gained attention at the same status of importance, concerning the release of mNPs from these surface systems. The balance between the promising prospects of system releasing mNPs and the undesirable long-term adverse reactions require further investigation. The scarcity of knowledge and the methods of analysis of nanoscale-based systems to control the sequence of migration, interaction, and nanoparticle incorporation with human tissues raise hesitation about their efficacy and safety. Looking ahead, this innovative approach requires additional scientific investigation for permitting an evolution of implants without counterpoints, while updating implant surface technologies to a new level of development. This critical review has explored the promising properties of metals at the nano-scale to promote broad-spectrum bacterial control, allowing for a decrease in using systemic antibiotics. Attempts have also been made to discuss the existing limitations and the future challenges regarding these technologies, besides the negative findings that are explored in the literature.