Endodontic Regeneration of Micro/Nanoparticles-based Delivery System ofthe Triple Antibiotic Drug: A SystematicReview

Abstract

Improved physicochemical properties of antimicrobial nanoparticles have attracted significant attention as an
improved antimicrobial agent, especially in the multifaceted setting of the oral cavity. The present systematic
review assesses the existing evidence regarding nanoparticle-based delivery systems loaded with triple antibiotic
paste (TAP) that can be applied in the field of regenerative endodontics, in other words, in the treatment of root canal
infections. The systematic review was carried out through a comprehensive search of the literature published in
2016–2021 in English in PubMed Central, Google Scholar, and in MEDLINE. Appropriate information regarding
TAP, endodontic regeneration, and antimicrobial activity of the micro- and nanoparticle systems was retrieved
and reviewed descriptively. Among 39 identified articles, 19 articles were found to be relevant after the screening
process, and nine articles met the inclusion criteria to be included in the quantitative synthesis. The result reveals
that biodegradable micro- and nanoparticle-based delivery systems retain the antibacterial effect of TAP and allow
to control and release the compound locally and at low concentrations to promote regenerative effects where it
is delivered. All in all, the included studies indicated that nanoparticulate systems have similar or even better
efficacies in the management of root canal infections as compared to traditional antimicrobial methods, but the
clinical evidence on the utilization of TAP-loaded local drug delivery systems is still limited, which explains the
necessity of well-designed clinical trials to facilitate the standardization of the procedures in clinical practice.