Publication: ANTIMICROBIAL EFFICACY, MECHANISM OF ACTION AND BIOCOMPATIBILITY OF α-MANGOSTIN NANOEMULSION AS AN ENDODONTIC IRRIGANT: AN IN VITRO STUDY
Date
2023
Authors
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Publisher
International Medical University
Abstract
α-Mangostin has been explored by many researchers, and it is effective against bacteria and other
microbes such as fungi and mycobacteria. Enterococcus faecalis (E. faecalis), Staphylococcus
epidermidis (S. epidermidis), and Candida albicans (C. albicans) are the most prevalent biofilms
that induce endodontic flare-ups and secondary infections. This research aimed to formulate and
characterize palm oil-in-water based α-Mangostin nanoemulsion (PO-AMNE) endodontic irrigant
and test its antimicrobial effectiveness against E. faecalis, S. epidermidis, and C. albicans biofilms
with smear layer removal capability. In addition, it was tested for cytotoxicity in Immortalized
Oral Kerantinocytes-OKF-6 cells. The optimization of the 0.2% PO-AMNE irrigant was
performed using the Box-Behnken statistical design. The optimized 0.2% PO-AMNE irrigant was
found to have a particle size of 340.9 nm with 0.246 PDI of the dispersed droplets and zeta potential
(mV) of -27.2±0.7 mV. The MIC/mL values showed that 0.2% PO-AMNE (1.22±0.02) was
comparable to 2% CHX (1.33±0.01) and 3.25% NaOCl (2.2±0.09) had the least inhibition for E.
faecalis. 3.25% NaOCL showed the maximum inhibition on S. epidermidis (0.26±0.05), whereas
0.2% PO-AMNE (1.25±0.0) was comparable to 2% CHX (1.86±0.07). For C. albicans, 2% CHX
(8.12±0.12) showed the least inhibition as compared to 0.2% PO-AMNE (1.23±0.02) and 3.25%
NaOCl (0.59±0.02). The 0.2% PO-AMNE irrigant was then evaluated for antimicrobial efficacy
using colony-forming units (CFU) against E. faecalis, S. epidermidis, and C. albicans biofilms.
The 0.2% PO-AMNE was comparable to 3.25% NaOCl and 2% CHX in inhibiting the growth of
biofilms. The 0.2% PO-AMNE irrigant was investigated for smear layer removal, and 0.2% POAMNE
and 17% EDTA demonstrated comparable efficacy in removing the smear layer with a
mean score of p<0.001. Finally, in Immortalized Oral Keratinocytes-OKF-6 cells, 0.2% POAMNE
was less cytotoxic compared to 17% EDTA, 3.25% NaOCl, and 2% CHX. The cell viability percentage of 0.2% PO-AMNE after 60 minutes was 32.51%, whereas there was a
decrease in the cell viability percentages for 3.25% NaOCl, CHX, and 17% EDTA cell survival of
6.47%, 4.30%, and 4.15%, respectively. Overall, the formulated 0.2% PO-AMNE irrigant may
potentially combat endodontic infection-related microbial biofilms.
Keywords: α-Mangostin, palm-oil, nanoemulsion, root canal irrigants, antimicrobial, antifungal,
smear layer, OKF-6 cells.
Description
Keywords
Palm Oil, Fungi, Root Canal Irrigants, Endodontics, Smear Layer