Purpose: This study investigated the synergistic effects of reduced graphene oxide (RGO) on the antibacterial activity of three calcium hydroxide-based intracanal medicaments with different vehicles.
Methods: Multispecies biofilms were cultured in a bovine root canal model. Intracanal medicaments containing nonaqueous vehicles, including N-methyl-2-pyrrolidone (NMP; CleaniCal), propylene glycol (PG; UltraCal XS), and polyethylene glycol (PEG; Calcipex II), were placed in the model. The synergistic effects of RGO were evaluated by analyzing colony-forming units, extracellular deoxyribonucleic acid (eDNA) levels, and findings from confocal laser-scanning microscopy (CLSM) and scanning electron microscopy. To evaluate the cytotoxicity of each vehicle, a 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was performed. To determine whether RGO altered the physicochemical properties of the medicaments, flowability and pH were measured. A P-value of <0.05 was considered to indicate statistical significance.
Results: In the CleaniCal group, bacterial viability, eDNA levels, and extracellular polymeric substrate (EPS) were significantly lower in the presence of RGO. However, only bacterial viability significantly differed in the other groups. PEG resulted in the highest cell viability among the vehicles. Furthermore, there was no significant difference in flowability or pH in relation to the inclusion of RGO.
Conclusion: The results suggest that RGO enhances the antibacterial effect of intracanal medicaments containing NMP.
Keywords: biofilm; calcium hydroxide; intracanal medicament; reduced graphene oxide.