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Assessment of New Technology Such as Devices and Materials

(PR059) An Innovative Injectable, Retrievable and Sustainable Drug Delivery System for Endodontic Therapy

Thursday, April 3, 2025
1:00 PM – 4:00 PM EST

    Presenter(s)

  • Abdel H. Mahmoud, D.D.S.

    PhD studet
    Stony Brook University School of Dental Medicine
    Stony brook, New York, United States

    • Co-Author(s)

  • Aaron Sloutski, Ph.D.

    Postdoctoral fellow
    University of Alabama College of Dentistry UAB
    HUNTINGTON, New York, United States

  • SW

    Stephen G. Walker, Ph.D., M.Sc., B.Sc.

    Associate Professor
    Stony Brook University School of Dental Medicine
    Stony Brook, New York, United States

  • Thomas Manders, D.D.S.

    Director, Division of Endodontics
    Stony Brook University School of Dental Medicine
    Stony Brook, New York, United States

  • Marcia Simon, Ph.D.

    Professor and Director for Graduate Studies
    Stony Brook University School of Dental Medicine
    Stony Brook, New York, United States

  • Jerome J. Cymerman, D.M.D.

    Associate Clinical Professor
    Stony Brook University School of Dental Medicine
    East Setauket, New York, United States

  • Miriam Rafailovich, Ph.D.

    Distinguished Professor
    Stony Brook University School of Dental Medicine
    Stony Brook, New York, United States

Objective: Endodontic treatment failures due to Enterococcus faecalis remains a significant challenge. Calcium hydroxide, a commonly used intracanal medicament, has many limitations, including low flowability, difficulty in full retrieval, and limited efficacy against E. faecalis. This study aims to assess a mixture of calcium hydroxide and salicylic acid (CASA), encapsulated in thermo-reversible F127-DMA hydrogel, as an injectable, retrievable intracanal medicament with antibacterial activity against fibrinogen modified E. faecalis and Streptococcus mutans.

Methods: CASA was prepared by mixing calcium hydroxide and salicylic acid and incorporated into F127-DMA at different concentrations (w/w). The mixture was UV-crosslinked using lithium phenyl(2,4,6-trimethylbenzoyl) phosphonate (LAP). Chemical properties were analyzed using XRD, Raman spectroscopy, FTIR, and XRF, while injectability and retrievability were assessed using a plastic root canal model and rheology. In vitro antibacterial efficacy against E. faecalis and Streptococcus mutans biofilms was tested using bovine extracted teeth.

Results: Encapsulation of CASA in F127-DMA reduced the viscosity by three orders of magnitude compared to the paste form, facilitating injection and retrieval. Furthermore, XRD, Raman, and FTIR analyses confirmed the formation of calcium salicylate and successful integration of CASA into F127-DMA. No significant cytotoxicity was observed in DPSCs, and doubling time was not significantly different to control. F127-DMA/CASA exhibited complete eradication of E. faecalis in planktonic form and the biofilm model showed a three-log reduction in bacterial count and no significant difference to the endodontic gold standard of Ca(OH)2.

Conclusion: F127-DMA/CASA exhibits superior flowability, retrievability, optimal pH, biocompatibility and antibacterial efficacy which highlights its therapeutic potential as a significant improvement over calcium hydroxide.