Regeneration of Pulp-Dentin Using Nitric Oxide-releasing Biomimetic Nanomatrix Gel: A Preliminary Study

Dental pulp tissue exposed to mechanical trauma or cariogenic processes can result in infection of the root canal system and/or periapical tissues. Such endodontic infections are common and can be treated with root canal treatment. Successful disinfection and complete tissue regeneration are key goals in regenerative endodontics. Despite reported clinical successes, current regenerative endodontic procedures (REP) face limitations. To address these, a novel antibiotic and nitric oxide (NO) releasing biomimetic nanomatrix gel was developed and evaluated for its antibacterial efficacy against multispecies endodontic bacteria and animal models.

The gel, synthesized from peptide amphiphiles, encapsulated ciprofloxacin (CF) and metronidazole (MN) alongside NO. Antibacterial effects were assessed using bacterial viability assays on endodontic microorganisms, including clinical samples. Additionally, pulp-dentin regeneration was evaluated in the beagle’s tooth model.

Results demonstrated that the antibiotics and NO-releasing biomimetic nanomatrix gel had a concentration-dependent antibacterial effect, with NO alone also showing significant efficacy. In vivo studies further indicated that the gel promoted tooth revascularization and root canal maturation.

This research suggests that the optimal concentration of the NO-releasing nanomatrix gel holds promise as a root treatment material for REP. Future studies will focus on refining growth factor incorporation and conducting larger-scale trials to confirm its efficacy and establish protocols for human clinical application.