A comprehensive review on role of nanoparticle enhanced endodontic sealers on antimicrobial properties

This review synthesizes research on mechanisms by which nanoparticles enhance antimicrobial efficacy of endodontic sealers and clinical outcomes to address persistent microbial biofilms in root canal therapy. The review was to assess the mechanisms of antimicrobial activity of nanoparticles in sealers, benchmark the efficacy against Enterococcus faecalis biofilms, compare the physicochemical and biological properties, report on clinical outcomes, and studies performed in vivo. It focused on the nanoparticle types, antimicrobial assays, and penetration depth, material characterization, cytotoxicity, and clinical indicators. Findings indicate that nanoparticles, especially silver, chitosan, and zinc oxide, significantly enhance antimicrobial activity through ion release, biofilm disruption, and improved dentinal tubule penetration, generally maintaining or improving sealer physicochemical properties. Cytotoxicity profiles are acceptable at optimized concentrations, although long-term biocompatibility is still to be fully determined. Although clinical evidence is limited, available studies suggest that endodontic sealers modified with nanoparticles provide better sealing and help reduce bacterial levels. The antimicrobial effect is further enhanced when nanoparticles are combined with antibiotics or designed to release active agents slowly over time. Overall, research indicates that nanoparticles can improve the performance of endodontic sealers in several ways. However, challenges remain in translating these findings into clinical practice, and there is a lack of standardized methods across studies. These findings highlight the promising role of nanoparticle-based sealers in improving endodontic treatment outcomes, while also emphasizing the need for well-designed clinical trials to confirm results observed in laboratory studies.