{"id":61203,"date":"2024-09-30T10:56:28","date_gmt":"2024-09-30T10:56:28","guid":{"rendered":"https:\/\/biomedpharmajournal.org\/?p=61203"},"modified":"2024-10-09T18:27:18","modified_gmt":"2024-10-09T18:27:18","slug":"antimicrobial-activity-of-metal-oxide-nanoparticles","status":"publish","type":"post","link":"https:\/\/biomedpharmajournal.org\/staging\/vol17no3\/antimicrobial-activity-of-metal-oxide-nanoparticles\/","title":{"rendered":"Antimicrobial Activity of Metal Oxide Nanoparticles"},"content":{"rendered":"\n<p class=\"wp-block-paragraph\"><strong>Introduction<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Human body biology is associated with a variety of microbial symbionts and their genomes. The microbial population rapidly colonizes both the inside and outside of our bodies, developing an organ that is essential to our physiology and general health. There are about 1000 different types of bacteria in the mouth, making the populations incredibly complicated. They are second in complexity in the body, after the colon, according to estimates<sup>1<\/sup>. One of the body&#8217;s most varied micro biomes is in the human mouth<sup>2<\/sup>. Viruses, protozoa, archaea, fungus, and bacteria make up the oral microbiome<sup>3<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">With an elevated risk of infection during various operations, the oral cavity is the home to a multitude of bacteria which is significant in the dental profession. Normal microflora typically comprises of a modest number of mutans microorganisms (most notably <em>Streptococcus mutans<\/em> and <em>Streptococcus sobrinus<\/em>) and non-mutans streptococci (such as <em>Streptococcus salivarius, Streptococcus sanguis<\/em>, etc.). Any disruption to the microbial ecosystem could make it easier for more pathogenic microbes to enter the environment, including <em>Escherichia coli, S. aureus, Aggregatibacter actinomycetemcomitans, Porphyromonas gingivalis,<\/em> and others<sup>4<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">A significant worldwide problem is the rise in bacterial resistance to one or more antibiotics<sup>5 <\/sup>. Newly, Nanomaterials have emerged as a weapon against bacteria resistant to many drugs. These nanoparticles can be employed as nanomedicines to combat resistant bacteria by working alone or in concert with other antibacterial substances. In order to improve physical and chemical characteristics and therapeutic efficacy, nanomaterials are often employed as drug delivery vehicles. A highly researched class of nanomaterials against bacteria resistant to many drugs are metal and MONPs. Metals such as gold, silver, titanium, copper, zinc and aluminum as well as metal oxides including silver, copper, magnesium, calcium and zinc oxide can be used to create these nanoparticles<sup>6<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Materials with unique features at the nano scale, or between 1 and 100 nanometers, gave rise to the field of nanotechnology, which was first described by Norio Taniguchi in 1974 and began to take shape in the 1980s. The incorporation of nanoscale features into material components including those intended for dental use is made possible by nanotechnology<a href=\"#_7._Yao_C,\"><sup>7<\/sup><\/a>. Innovative methods in dentistry make use of nanoparticles that have therapeutic properties on their own or employ nanotechnology to improve the results of current treatments<sup>8<\/sup>. The primary advantages of nanomaterials in dentistry are their efficient and broad antibacterial properties, which come with a low cost of production for the nanoparticles and a minimal chance of bacterial resistance developing<sup>9<\/sup>. The current article aims to provide an overview of the antibacterial properties of metal oxide-containing nanoparticles used in dentistry.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Microbiology\nof Root canal Infections<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Aerobes and facultative anaerobes initially predominate in the bacterial ecology of the root canal<sup>10,11 <\/sup>The ecology of the root canal system changes as the condition worsens. These alterations may be connected to the oxygen tension during root canal openings for therapeutic purposes, the application of root canal irrigants, and pH variations in the root canal as a result of different materials being inserted. Due to genetic population shifts, this leads to phenotypic changes<sup>12,13,14<\/sup>. An endodontic infection may be primary or secondary. Apical periodontitis, or inflammation of the supporting tissues, is the ultimate result of microbial byproducts or microbial invasion, which typically causes pulp inflammation and root canal infection as its primary infection. Infections that return in teeth after root canal therapy can be classified as secondary infections, post-treatment infections, emergent or acquired reinfections, or persistent residual infections<sup>15<\/sup>. Polymicrobial infections cause primary endodontic infections<sup>14,16<\/sup>. The most common species among them include <em>Eubacterium<\/em>, <em>Camphylobacter<\/em>, <em>Fusobacterium<\/em>, <em>Treponema<\/em>, <em>Prophyromonas, Prevotella, <\/em>and<em> Bacteroides.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Treatment failure is thought to be mostly caused by bacteria that continue to exist in the root canal system after treatment<sup>17,18,19<\/sup>. After root canal therapy, the diversity and number of bacterial species in primary infections can change, as well as the proportions of different bacteria. Microbial flora in secondary infections often adapt to harsh conditions such as broad pH ranges and nutrient-limited environments. The microbial phenotypes of primary infections and subsequent infections differ significantly, with gram-positive bacteria predominating in the latter<sup>18,19,20<\/sup>.&nbsp; Research has indicated that specific species, including <em>Enterococci, Streptococci, Lactobacilli, Actinomyces<\/em>, and fungus (like <em>Candida<\/em>), are more common in teeth that have had post-treatment infections. Specifically, it was found that a significant percentage of <em>Enterococcus faecalis<\/em> was present in patients with persistent apical periodontitis<sup>21,22<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Mechanism\nof Action of Metal Oxide (MO) Nanoparticles<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Breakdown of the Cell Membrane Caused by Electrostatic Interaction<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The negatively charged surfaces of bacteria interact with positively charged nanoparticles through the law of attraction between negative and positive charges, causing NPs to accumulate on the surface of bacterial cells. Because of the efficient bonding between these positively charged NPs and the cell membrane, the structure of the cell wall is disrupted, which makes the cell more permeable and makes it easier for NPs to enter the bacteria and cause cellular content escape. Those nanoparticles impact DNA replication, division, and respiration by attaching to mesosomes<sup>23,24<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Generation of Reactive Oxygen\nSpecies<\/strong> <strong>(ROS)<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">When nanoparticles penetrate a microorganism&#8217;s cell membrane, they release ROS, which puts the cell under stress due to oxidation and initiates the bacterium&#8217;s attack. The attack results in reduced respiration and ATP synthesis, which damages the cell membrane. Active redox reactions and the pro-oxidant functional group on the metal oxide nanoparticles&nbsp;interface allow a metal oxide to produce ROS<sup>25<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Enzyme and Protein Malfunction<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">By initiating the oxidative process of the amino acid chain, NPs promote the creation of carbonyls, which are naturally protein bound and result in protein breakdown, the deactivation of numerous enzymes, and disruption of catalytic activity<sup>26,27<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Genotoxicity\nand Inhibition of Signal Transduction<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Through their electrical properties, nanoparticles interact with amino acid molecules, impairing signal transduction and negatively affecting chromosomal and plasmid transcription processes<sup>28,29,30<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Effective\nPhysiochemical Properties of MONPs on Antimicrobial Activity<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Chemical Composition of MONPs<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The antibacterial ability of metal oxides is impacted by the kind of metal ion particles and the composition of their molecules. Metal ions including Ca2+, Mg2+, Cu2+, Zn2+, Co2+, Fe2+, and Ni2+ are required for various metabolic processes in the majority of surviving bacterial strains, but at larger quantities, they may be toxic. Ag+ and Hg+, two unnecessary metal ions, demonstrated a significantly higher antibacterial action at remarkably low quantities<sup>31<\/sup>.<sup> <\/sup>The ability of metal ions to bind selectively to ligand atoms found in biomolecules and cellular constituents may contribute to their antibacterial action. Hard soft acid base theory is the foundation for the interaction between ligand atoms and metal ions (HSAB principle). According to the HSAB principle, hard acids join with hard bases, while soft acids join with soft bases<sup>32<\/sup>.&nbsp; An excellent affinity of divalent copper for biological molecules is shown by the Irving Williams series of ligand affinity for the essential first-row transition divalent metal ions. This shows that at higher concentrations, divalent copper may be most dangerous<sup>33<\/sup>. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>MONPs Size and Surface Properties<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Particle size has a major impact on how MONPs interact with bacterial cells and other biological systems. Because of their increased surface to volume ratios and noticeably higher particle numbers per mass, nanoparticles demonstrated stronger antibacterial activity than microscaled (bulk) particles. Numerous reports have documented the size-dependent interaction between bacteria and MO nanostructures. Under normal lighting conditions, the Zinc Oxide Nanoparticles (ZnONPs) considerably inhibit gram-positive as well as gram-negative bacteria in comparison to the bulk particles<sup>34,35,36<\/sup>. The zeta potential of MONPs describes their surface charge characteristics. The Point of Zero Charge (PZC) is the pH at which the surface charge is neutral. MONPs can exhibit positive, negative, or neutral charges. NPs with the highest positive charge show the greatest antibacterial activity, followed by those with neutral, then negative charges. When the pH is below the PZC, the oxide surface is positively charged; when above, it is negatively charged.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Concentration\nof MONPs:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">With increasing concentration in the media, MONPs exhibit increased antibacterial activity<sup>37<\/sup>. Greater MONP concentrations may be associated with a greater surface area, this eventually promotes stronger contact with bacterial cells and increased antibacterial activity. The Minimum Inhibitory Concentration (MIC) is the most often used metric in microbiology to quantify the in vitro antibacterial activity assessment of MONP<sup>38<\/sup>. The MIC of an antimicrobial drug is the concentration at which, following overnight incubation, bacteria cannot grow visibly<sup>39<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">T<strong>he shape dependent\nantibacterial characteristics of MONPs: <\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Each form of nanoparticle has unique\nphysicochemical properties, such as surface characteristics, solubility, and\nthe potential to produce ROS in certain metal oxides, which influence their\nantibacterial activity. Studies show that different forms of MO-NPs exhibit\nvarying antibacterial properties. For instance, ZnO nanopyramids have significantly\ngreater antibacterial activity against Methicillin-Resistant Staphylococcus\naureus (MRSA) compared to nanoplates and nanospheres<sup>40<\/sup>. Another\nstudy found that spherical ZnO NPs possess higher antibacterial power than\nrod-shaped ZnO NPs<sup>34<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>&nbsp;Various MONPs\nin Endodontics:<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>&nbsp;Iron Oxide (IO NP)<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The\nbiological and medical fields find application for iron compound (FeO<sub>2<\/sub>)\nnanoparticles. Iron oxide, a sustainable and biocompatible\nmaterial that can be made on a big scale at a low cost by simple chemical\nsynthesis techniques, is now included in FDA-approved formulations for chronic\ntreatment. <\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Despite the fact the NaOCl is considered the &#8220;gold standard&#8221; for endodontic irrigants<sup>41<\/sup>, it have been observed that 40% to 60% of root canals still contain live bacteria even after irrigation<sup>42<\/sup>. Similar antibacterial activity to NaOCl has also been demonstrated for chlorhexidine<sup>43<\/sup>. But only the surface layers of the dentin exhibit antibacterial activity and both irrigants have shown decreased efficiency in disinfecting dentinal tubules<sup>44<\/sup>. IO NP\/H<sub>2<\/sub>O<sub>2<\/sub> had strong antibacterial activity that was notably superior to chlorhexidine and sodium hypochloride in the treatment of dentinal tubule infections caused by <em>E. faecalis<\/em>, especially in the central and peripheral zones. Because of IO NP&#8217;s innate &#8220;peroxidase-like activity,&#8221; which activates H<sub>2<\/sub>O<sub>2<\/sub>, a high degree of disinfection can be made possible, which catalyses the production of free radicals on the spot, which quickly destroys bacteria<sup>45<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Silver Oxide<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The most extensively studied antibacterial for endodontic infections is silver nanoparticles. While retaining the physicochemical characteristics of the produced sealers, it was discovered that adding 10 weight percent Ag with SiO<sub>2<\/sub> decreased the viability of <em>E. faecalis <\/em>during both immediate and longitudinal study<sup>46<\/sup>. It was discovered to help regulate the growth of bacteria in the intracanal environment and to be just as effective against<em> E. faecalis <\/em>and <em>Staphylococcus aureus <\/em>as 5.25% NaOCl<sup>47<\/sup>. Nevertheless, extended exposure to bacteria is necessary for their successful eradication, which has been described as a good substitute for an intracanal medication but not as an irrigant<sup>48<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Copper Oxide<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Copper is a cheap, readily available metal that can be affordably manufactured into nanoparticles. Either copper metal ions or oxidized cupric ions produced from copper nanoparticles (sizes ranging from 1 to 100 nm) have antimicrobial action. It is simple to mix and link copper nanoparticles with polymers, ceramics and other metals. In certain combinations, they exhibit physiochemical stability as well<sup>49<\/sup>. Copper is a common metal in dental and medical research because of its low toxicity and antibacterial properties<sup>50<\/sup>. According to reports, Copper Oxide Nanoparticles (CuO NPs) exhibit antibacterial properties and prevent the formation of biofilms<sup>51<\/sup>. Copper nanoparticles&#8217; high surface area to volume ratio amplifies their antibacterial activity<sup>52<\/sup>. Furthermore, dose dependence is shown in the antibacterial activity of copper oxide nanoparticles<sup>53<\/sup>. The antibacterial properties of these nanoparticles have been well studied, yet it is unclear how precisely copper nanoparticles work against microorganisms<sup>54,55,56<\/sup>. These nanoparticles are effective against both gram positive and gram negative bacteria because they have the ability to enter bacterial cell membranes and damage the organism&#8217;s vital enzymes. They possess some antifungal properties as well<sup>57<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">In caries prevention, copper nanoparticles have the ability to inhibit <em>S. mutans<\/em> from growing and colonizing on the surface of tooth roots, hence preventing root caries<sup>58<\/sup>. Composites with distinct physio chemical properties can be created by simply incorporating copper oxide nanoparticles into polymers. Copper oxide nanoparticles can be used to dental adhesive to prevent early or carious white spot lesions because they are antibacterial without compromising shear bond strength<sup>59,60<\/sup>. In soft denture liners CuO NPs were added, and this resulted in a considerable reduction in oral pathogen colonization and plaque development, particularly <em>C. albicans<\/em> accumulation<sup>61<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Zirconium Oxide<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Because of its metallic and optical characteristics that are comparable to those of teeth, zirconia has found extensive application in dentistry. Zirconium oxide (ZrO<sub>2<\/sub>) has been known as a high-performance ceramic material due to its superior properties, high strength, resistance to corrosion, and toughness. Because of its insolubility in water, it has been demonstrated to eliminate bacterial colonization with little cytotoxic effects<sup>62,63<\/sup>. Because zirconia-based NPs are so effective against some infections like <em>E. faecalis<\/em>, they are commonly used as a type of antimicrobial in endodontics<sup>64<\/sup>.&nbsp; The most used agent for pulp capping, whether direct or indirect, and root end filing is mineral trioxide aggregate (MTA). Portland cement is the main ingredient in MTA. Zirconia nanoparticles (NPs) can be added to Portland cement as an effective radio opacifier without having a detrimental effect on the cement&#8217;s biocompatibility. According to ISO\/ADA guidelines, both groups of micro- and nano-sized zirconia oxide particles showed improved radiopacity capabilities when examined<sup>63<\/sup>. In caries-affected dentine, an investigation on aluminum zirconate nanoparticles in etch and rinse adhesive revealed that 10 weight percent&nbsp;of the nanoparticles in the adhesive had the lowest survival rate of <em>S. mutans<\/em><sup>65<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Titanium dioxide<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Very stable particles with photocatalytic properties are titanium dioxide nanoparticles. Because ROS are produced, it results in oxidative stress. Because of its lipid peroxidation property, the cell membrane is disrupted and there is increased membrane fluidity even for the types of fungus that are resistant to fluconazole, it is also a potent antifungal<sup>5,66,67<\/sup>.&nbsp; Because of its excellent aesthetics and simplicity of use, Dental resin composite is a useful restoration technique for teeth that have decayed<sup>68,69,70<\/sup>, its perfect finishing and enhanced resistance to wear make it an excellent choice. However, it should be mentioned that in the case of a long-term dental resin repair, the bacteria will persist in growing and forming oral biofilms on the surface of the resin, particularly in the gap that are polymerization shrinkage produced. These biofilms will then continuously deteriorate the surrounding dental tissue and the current resin composite, leading to secondary caries and treatment failure<sup>71,72<\/sup>. &nbsp;Photo catalytic activity of synthesized anatase-phase Strontium Nitrogen Titanium dioxide (Sr, N, TiO<sub>2<\/sub>) was increased by mixing &nbsp;with Nano Hydroxyapatite (nHA) fillers as reinforcing fillers to create a novel multifunctional Direct Resin Composite. It possesses antimicrobial and mineralizing properties because Sr, N, TiO<sub>2<\/sub> and nHA combine. The mutans strain of <em>Streptococcus<\/em> (<em>S. mutans<\/em>) was the target of the maximum antibacterial rate of 98.96%, which helped the resin composite&nbsp;survive longer in the clinical environment. Consequently, they conclude that the Direct resin composite&nbsp;in conjunction with nHA &amp; Sr, N, TiO<sub>2<\/sub> fillers will probably be the most effective filler for filling dental cavities<sup>73<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Zinc Oxide <\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Although most living things require zinc as a trace metal for numerous metabolic functions, excessive amounts of zinc can be toxic. Because ZnO NPs are less harmful to humans than CuO NPs and AgO NPs and can be synthesized at a cheap cost, they are frequently utilized in cosmetic items, medicine and wound healing to treat fungal infections and acne. They also display a broad spectrum of antibacterial activity<sup>74<\/sup>.It has been discovered that ZnO NPs possess antibacterial qualities. Modest amounts of ZnO NPs had no effect on the mechanical properties of dental resin composites, but they did prevent <em>S. mutans<\/em> from growing and adhering to the material<sup>75<\/sup>. When ZnO NPs were added into Glass Ionomer Cement, it considerably increase antibacterial activities against <em>S. mutans <\/em>without affecting mechanical properties<sup>76<\/sup>. According to the study, ZnO NP doped with magnesium and silver has a stronger antibacterial effect than ZnO NP against <em>S. mutans<\/em>. Synthesized NP exhibits antibacterial activity against bacteria when its cell walls are compromised. These results in the distortion of constructional proteins, inactivation of enzymes, disruption of electron transport chains, deformation of nucleic acids, and facilitation of oxidative stress caused by reactive oxygen species. According to a number of studies, adding ZnO NPs to dental adhesive systems greatly enhanced their antimicrobial capabilities without having a negative impact on the bond strength<sup>77,78,79<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">One method that is most frequently utilized to treat endodontic infections is endodontic treatment<sup>80,81<\/sup>. Complete eradication of dental infections is not possible because to the polymicrobial character of endodontic infections, which involve a variety of bacteria and germs such as <em>E. faecalis, S. mutans<\/em> and <em>S. anginosus, F.<\/em> <em>nucleatum<\/em>, and <em>S. aureus<\/em><sup>82,83<\/sup>.&nbsp; An excellent filling material for root canals should not shrink, fill the channels easily, stick to the walls easily, or harm the periapical tissue or permanent tooth germ. Additionally, two important considerations while selecting the best among them are their antibacterial and biocompatible qualities<sup>84,85<\/sup>.&nbsp; The micro leakage and antibacterial properties of zinc oxide eugenol (ZOE), epoxy resin sealer (AH26), silver ZnO nano powders, and ZnO nanopowders were investigated. Shayani Rad reports that the nano ZnO sealer demonstrated better antibacterial properties against <em>E. faecalis<\/em>, <em>E. coli<\/em>, <em>C. albicans<\/em>, <em>S. mutans<\/em>, and <em>S. aureus<\/em> than two widely used endodontic sealers, AH26 (resin-based) and Pulpdent (ZnO based)<sup>86,87<\/sup>.&nbsp; These nanoparticles enhance alkalinization and antibacterial activity against Escherichia faecalis when coupled with calcium hydroxide nanoparticles and chlorhexidine as an intracanal medication. After being coated with ZnO NPs and pre-treated with argon plasma, flawless gutta percha cones displayed antibacterial action against S. aureus and <em>E. faecalis<\/em>. As a result, there is less chance of reinfection and endodontic failure and an effective hermetic seal is created<sup>88<\/sup>. Calcium silicate cement containing 1 wt%&nbsp;ZnO NPs can decrease pro-inflammatory cytokines and increase antibacterial activity without &nbsp;altering its physical characteristics<sup>89<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>&nbsp;Magnesium\noxide<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The caries process includes demineralization of hydroxyapatite due to acid attack<sup>90,91<\/sup>. Alkaline nanoparticles could therefore be a substitute for preventing dental cavities. About 0.5% of enamel and 1% of dentine are made of the alkaline metal magnesium<sup>92,93<\/sup>. &nbsp;According to a study, having enough serum magnesium levels can slow down the onset and development of tooth caries by releasing magnesium ions<sup>94<\/sup>.&nbsp; Glass ionomer cement treated with magnesium oxide nanoparticles exhibited strong antibacterial and biofilm activity against cariogenic bacteria<sup>95<\/sup>. Limited&nbsp;studies reported the use of magnesium nanoparticles to prevent dental cavities. Tooth decay and magnesium exhibit both substantial<sup>94<\/sup> and nonsignificant relationships<sup>96<\/sup>. According to the study, ZnO NP doped with magnesium and silver has a stronger antibacterial effect than ZnO NP against <em>S. mutans<\/em>. Synthesized NP exhibits antibacterial activity against bacteria when its cell walls are compromised. This results in the distortion of constructional proteins, inactivation of enzymes, disruption of electron transport chains, deformation of nucleic acids, and facilitation of oxidative stress caused by reactive oxygen species<sup>97,98<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Cobalt oxide<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">One of the transition metal oxides, cobalt oxide (CO), is a black powder having magnetic and antibacterial properties<sup>99<\/sup>. They were added to Pit and Fissure Sealant (PFS) in order to address important clinical issues related with PFS, including microleakage and secondary caries. An investigation on antibacterial potential of Minocycline (MNC) with CO, a pH-dependent cobalt oxide nanoparticle integrated with MNC, by characterizing and testing it against <em>Streptococcus sobrinus<\/em>. They discovered that 2.5% MNC with CO doped PFS demonstrated strong anti-biofilm capabilities without sacrificing mechanical characteristics<sup>100<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conclusion<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Due to their\nexcellent mechanical, chemical, biological, and physical properties,\nnanomaterials (NMs) have recently become more and more prominent in\ntechnological advancements. These qualities have allowed performance to rise\nabove that of its conventional counterparts. Nanomaterials can be used to fight\nendodontic and caries-related bacteria, lessen the formation of biofilms, and\nprevent the demineralization of the tooth structure. These results have been\npositive enough to open the door for more clinical studies that will confirm\nthe usefulness of nanotechnology-based materials for therapeutic purposes. Thus,\nby promoting better oral health and lowering healthcare costs, the use of metal\noxide nanoparticles in dentistry can ultimately benefit both individual\npatients and society at large. It can also increase the antibacterial efficacy,\nlengthen the duration of dental treatments and significantly reduce the\nincidence of dental diseases.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Acknowledgement<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The authors appreciate and thank Sree Balaji Dental College, Bharath Institute of Higher Education and Research for supporting this research publication.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Conflict of Interest<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The author(s) declares no conflict of interest.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Funding Source<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">The author(s) received no financial support for the research, authorship, and\/or publication of this article.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Data Availability Statement<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This statement does not apply to this article.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Ethics Statement<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">This research did not involve human participants, animal subjects, or any material that requires ethical approval.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>References<\/strong><\/p>\n\n\n\n<ol class=\"wp-block-list\"><li>Belibasakis GN. Microbiological changes of the\nageing oral cavity. Arch Oral Biol., 2018;96:230-232.<\/li><li>Yamashita Y, Takeshita T. The oral microbiome and\nhuman health. J Oral Sci., 2017;59(2):201-206.<\/li><li>Wade WG. The oral microbiome in health and disease.\nPharmacol Res., 2013;69(1):137-143.<\/li><li>Patil S, Rao RS, Sanketh DS, Amrutha N. Microbial\nflora in oral diseases. J Contemp Dent Pract., 2013;14(6):1202-1208.<\/li><li>Allahverdiyev AM, Abamor ES, Bagirova M,\nRafailovich M. Antimicrobial effects of TiO2 and Ag2O nanoparticles against\ndrug-resistant bacteria and leishmania parasites. Future Microbiol.,\n2011;6(8):933-940.<\/li><li>Ni\u00f1o-Mart\u00ednez N, Salas Orozco MF, Mart\u00ednez-Casta\u00f1\u00f3n\nGA, Torres M\u00e9ndez F, Ruiz F. Molecular mechanisms of bacterial resistance to\nmetal and metal oxide nanoparticles. Int J Mol Sci., 2019;20(11):2808.<\/li><li>Yao C, Storey D, Webster TJ. Nanostructured metal\ncoatings on polymers increase osteoblast attachment. Int J Nanomedicine.,\n2007;2(3):487-492.<\/li><li>Padovani GC, Feitosa VP, Sauro S, et al. Advances\nin dental materials through nanotechnology: facts, perspectives and\ntoxicological aspects. Trends Biotechnol., 2015;33(11):621-636.<\/li><li>Hamouda IM. Current perspectives of nanoparticles\nin medical and dental biomaterials. J Biomed Res., 2012;26(3):143-151.<\/li><li>Winkler KC, Van Amerongen J. Bacteriologic results\nfrom 4,000 root canal cultures. Oral Surg Oral Med Oral Pathol.,\n1959;12(7):857-875.<\/li><li>Antunes HS, R\u00f4\u00e7as IN, Alves FRF, Siqueira JF. Total\nand specific bacterial levels in the apical root canal system of teeth with\npost-treatment apical periodontitis. J Endod., 2015;41(7):1037-1042.<\/li><li>Bystr\u00f6m A, Sundqvist G. Bacteriologic evaluation of\nthe efficacy of mechanical root canal instrumentation in endodontic therapy.\nScand J Dent Res., 1981;89(4):321-328.<\/li><li>Sundqvist GK, Eckerbom MI, Larsson AP, Sj\u00f6gren UT.\nCapacity of anaerobic bacteria from necrotic dental pulps to induce purulent\ninfections. Infect Immun., 1979;25(2):685-693.<\/li><li>Provenzano JC, Siqueira JF, R\u00f4\u00e7as IN, et al.\nMetaproteome analysis of endodontic infections in association with different\nclinical conditions. PLoS One., 2013;8(10).<\/li><li>Haapasalo M, Udn\u00e6s T, Endal U. Persistent,\nrecurrent, and acquired infection of the root canal system post-treatment.\nEndod Topics., 2003;6(1):29-56.<\/li><li>R\u00f4\u00e7as IN, Siqueira JF. Identification of bacteria\nenduring endodontic treatment procedures by a combined reverse\ntranscriptase-polymerase chain reaction and reverse-capture checkerboard\napproach. J Endod., 2010;36(1):45-52.<\/li><li>Alves FRF, Andrade-Junior CV, Marceliano-Alves MF,\net al. Adjunctive steps for disinfection of the mandibular molar root canal\nsystem: a correlative bacteriologic, micro-computed tomography, and\ncryopulverization approach. J Endod., 2016;42(11):1667-1672.<\/li><li>Anderson AC, Hellwig E, Vespermann R, et al.\nComprehensive analysis of secondary dental root canal infections: a combination\nof culture and culture-independent approaches reveals new insights. PLoS One.,\n2012;7(11):e49576.<\/li><li>Lins RX, de Oliveira Andrade A, Hirata Junior R, et\nal. Antimicrobial resistance and virulence traits of Enterococcus faecalis from\nprimary endodontic infections. J Dent., 2013;41(9):779-786.<\/li><li>Ran S, He Z, Liang J. Survival of Enterococcus faecalis\nduring alkaline stress: changes in morphology, ultrastructure, physiochemical\nproperties of the cell wall and specific gene transcripts. Arch Oral Biol.,\n2013;58(11):1667-1676.<\/li><li>Love RM. Enterococcus faecalis\u2014a mechanism for its\nrole in endodontic failure. Int Endod J., 2001;34(5):399-405.<\/li><li>Wang J, Jiang Y, Chen W, Zhu C, Liang J. Bacterial\nflora and extraradicular biofilm associated with the apical segment of teeth\nwith post-treatment apical periodontitis. J Endod., 2012;38(7):954-959.<\/li><li>Kim YH, Lee DK, Cha HG, et al. Preparation and\ncharacterization of the antibacterial Cu nanoparticle formed on the surface of\nSiO<sub>2<\/sub> nanoparticles. J Phys Chem., 2006;110(49):24923-24928.<\/li><li>Wang D, Lin Z, Wang T, et al. Where does the\ntoxicity of metal oxide nanoparticles come from: the nanoparticles, the ions,\nor a combination of both? J Hazard Mater., 2016;308:328-334.<\/li><li>Nel A, Xia T, M\u00e4dler L, Li N. Toxic potential of\nmaterials at the nanolevel. Science., 2006;311(5761):622-627.<\/li><li>Lynch I, Salvati A, Dawson KA. Protein-nanoparticle\ninteractions: what does the cell see? Nat Nanotechnol., 2009;4(9):546-547.<\/li><li>Aggarwal P, Hall JB, McLeland CB, Dobrovolskaia MA,\nMcNeil SE. Nanoparticle interaction with plasma proteins as it relates to\nparticle biodistribution, biocompatibility and therapeutic efficacy. Adv Drug\nDeliv Rev., 2009;61(6):428-437.<\/li><li>Giannousi K, Lafazanis K, Arvanitidis J, Pantazaki\nA, Dendrinou-Samara C. Hydrothermal synthesis of copper-based nanoparticles:\nantimicrobial screening and interaction with DNA. J Inorg Biochem.,\n2014;133:24-32.<\/li><li>Arakha M, Pal S, Samantarrai D, et al.\nAntimicrobial activity of iron oxide nanoparticle upon modulation of\nnanoparticle-bacteria interface. Sci Rep., 2015;5:14813.<\/li><li>Kirstein J, Turgay K. A new tyrosine\nphosphorylation mechanism involved in signal transduction in Bacillus subtilis.\nJ Mol Microbiol Biotechnol., 2005;9(3-4):182-188.<\/li><li>Lemire JA, Harrison JJ, Turner RJ. Antimicrobial\nactivity of metals: mechanisms, molecular targets and applications. Nat Rev\nMicrobiol., 2013;11(6):371-384.<\/li><li>Pearson RG. Hard and soft acids and bases. J Am\nChem Soc., 1963;85(22):3533-3539.<\/li><li>Mili\u010devi\u0107 A, Branica G, Raos N. Irving-Williams\norder in the framework of connectivity index 3\u03c7v enables simultaneous\nprediction of stability constants of bivalent transition metal complexes.\nMolecules., 2011;16(2):1103-1112.<\/li><li>Nair S, Sasidharan A, Divya Rani VV, Menon\nD, Nair S, Manzoor K, Raina S. Role of size scale of ZnO nanoparticles and\nmicroparticles on toxicity toward bacteria and osteoblast cancer cells. J Mater\nSci Mater Med., 2009;20:235-41.<\/li><li>Raghupathi KR, Koodali RT, Manna AC. Size-dependent\nbacterial growth inhibition and mechanism of antibacterial activity of zinc\noxide nanoparticles. Langmuir., 2011;27(7):4020-4028.<\/li><li>Jones N, Ray B, Ranjit KT, Manna AC. Antibacterial\nactivity of ZnO nanoparticle suspensions on a broad spectrum of microorganisms.\nFEMS Microbiol Lett., 2008;279(1):71-76.<\/li><li>Pandiyarajan T, Udayabhaskar R, Vignesh S, James\nRA, Karthikeyan B. Synthesis and concentration dependent antibacterial activities\nof CuO nanoflakes. Mater Sci Eng C Mater Biol Appl., 2013;33(4):2020-2024.<\/li><li>Dimapilis EA, Hsu CS, Mendoza RM, Lu MC. Zinc oxide\nnanoparticles for water disinfection. Sustain Environ Res., 2018;28(2):47-56.<\/li><li>Andrews JM. Determination of minimum inhibitory\nconcentrations. J Antimicrob Chemother., 2001;48 Suppl 1:5-16.<\/li><li>Cha SH, Hong J, McGuffie M, Yeom B, VanEpps JS,\nKotov NA. Shape-dependent biomimetic inhibition of enzyme by nanoparticles and\ntheir antibacterial activity. ACS Nano., 2015;9(9):9097-9105.<\/li><li>Bukhari S, Kim D, Liu Y, Karabucak B, Koo H. Novel\nendodontic disinfection approach using catalytic nanoparticles. J Endod.,\n2018;44(5):806.<\/li><li>Bystr\u00f6m A, Sundqvist G. The antibacterial action of\nsodium hypochlorite and EDTA in 60 cases of endodontic therapy. Int Endod J.,\n1985;18(1):35-40.<\/li><li>Lopes MB, Sinhoreti MA, Gonini J\u00fanior A, Consani S,\nMcCabe JF. Comparative study of tubular diameter and quantity for human and\nbovine dentin at different depths. Braz Dent J., 2009;20(4):279-283.<\/li><li>Heling I, Chandler NP. Antimicrobial effect of\nirrigant combinations within dentinal tubules. Int Endod J., 1998;31(1):8-14.<\/li><li>Gao L, Liu Y, Kim D, et al. Nanocatalysts promote\nStreptococcus mutans biofilm matrix degradation and enhance bacterial killing\nto suppress dental caries in vivo. Biomaterials., 2016;101:272-284.<\/li><li>R\u00fccker VB, Balbinot GS, Collares FM, de Ara\u00fajo Neto\nVG, Giannini M, Leitune VCB. Synthesis of silver core-shell nanoparticles and\ntheir influence on an experimental resin endodontic sealer: an in vitro\nanalysis. Int Endod J., 2023;56(2):289-303.<\/li><li>Moghadas L, Shahmoradi M, Narimani T. Antimicrobial\nactivity of a new nanobased endodontic irrigation solution: in vitro study.\nDent Hypotheses., 2012;3:142.<\/li><li>Wu D, Fan W, Kishen A, Gutmann JL, Fan B.\nEvaluation of the antibacterial efficacy of silver nanoparticles against\nEnterococcus faecalis biofilm. J Endod., 2014;40(2):285-290.<\/li><li>Xu VW, Nizami MZI, Yin IX, et al. Application of\ncopper nanoparticles in dentistry. Nanomaterials (Basel)., 2022;12(5):805.<\/li><li>Chandraleka S, Ramya K, Chandramohan G, et al.\nAntimicrobial mechanism of copper (II) 1,10-phenanthroline and 2,2\u2032-bipyridyl\ncomplex on bacterial and fungal pathogens. J Saudi Chem Soc.,\n2014;18(6):953-962.<\/li><li>Maleki Dizaj S, Barzegar-Jalali M, Zarrintan MH,\nAdibkia K, Lotfipour F. Calcium carbonate nanoparticles as cancer drug delivery\nsystem. Expert Opin Drug Deliv., 2015;12(10):1649-1660.<\/li><li>Soltani Nezhad S, Rabbani Khorasgani M, Emtiazi G,\nYaghoobi MM, Shakeri S. Isolation of copper oxide (CuO) nanoparticles resistant\nPseudomonas strains from soil and investigation on possible mechanism for\nresistance. World J Microbiol Biotechnol., 2014;30(3):809-817.<\/li><li>Chang YN, Zhang M, Xia L, Zhang J, Xing G. The\ntoxic effects and mechanisms of CuO and ZnO nanoparticles. Materials (Basel).,\n2012;5(12):2850-2871.<\/li><li>Chatterjee AK, Sarkar RK, Chattopadhyay AP, et al.\nA simple robust method for synthesis of metallic copper nanoparticles of high\nantibacterial potency against E. coli. Nanotechnology., 2012;23(8):085103.<\/li><li>Essa AM, Khallaf MK. Antimicrobial potential of\nconsolidation polymers loaded with biological copper nanoparticles. BMC\nMicrobiol., 2016;16(1):144.<\/li><li>Zakharova OV, Godymchuk AY, Gusev AA, et al.\nConsiderable variation of antibacterial activity of Cu nanoparticles\nsuspensions depending on the storage time, dispersive medium, and particle\nsizes. Biomed Res Int., 2015;2015.<\/li><li>Ahamed\nM, Alhadlaq HA, Khan MAM, Karuppiah P, Al-Dhabi NA. Synthesis,\nCharacterization, and Antimicrobial Activity of Copper Oxide Nanoparticles. J\nNanomater., 2014;2014.<\/li><li>Thneibat\nA, Fontana M, Cochran MA, Gonzalez-Cabezas C, Moore BK, Matis BA, et al.\nAnticariogenic and antibacterial properties of a copper varnish using an in\nvitro microbial caries model. Oper Dent., 2008;33(2):142\u20138.<\/li><li>Toodehzaeim\nMH, Zandi H, Meshkani H, Hosseinzadeh Firouzabadi A. The Effect of CuO\nNanoparticles on Antimicrobial Effects and Shear Bond Strength of Orthodontic\nAdhesives. J Dent (Shiraz)., 2018;19(1):1\u20135.<\/li><li>Guti\u00e9rrez\nMF, Malaquias P, Matos TP, Szesz A, Souza S, Bermudez J, et al. Mechanical and\nmicrobiological properties and drug release modeling of an etch-and-rinse\nadhesive containing copper nanoparticles. Dent Mater., 2017;33(3):309\u201320.<\/li><li>Ansarifard\nE, Zareshahrabadi Z, Sarafraz N, Zomorodian K. Evaluation of Antimicrobial and\nAntibiofilm Activities of Copper Oxide Nanoparticles within Soft Denture Liners\nagainst Oral Pathogens. Bioinorg Chem Appl., 2021;2021:9939275.<\/li><li>Lughi\nV, Sergo V. Low temperature degradation -aging- of zirconia: A critical review\nof the relevant aspects in dentistry. Dent Mater., 2010;26(8):807\u201320.<\/li><li>Bona\nAD, Pecho OE, Alessandretti R. Zirconia as a Dental Biomaterial. Materials\n(Basel)., 2015;8(8):4978-4991.<\/li><li>Guerreiro-Tanomaru\nJM, Trindade-Junior A, Cesar Costa B, da Silva GF, Drullis Cifali L, Basso\nBernardi MI, et al. Effect of Zirconium Oxide and Zinc Oxide Nanoparticles on\nPhysicochemical Properties and Antibiofilm Activity of a Calcium Silicate-Based\nMaterial. ScientificWorldJournal. 2014;2014:975213.<\/li><li>Niazi\nFH, Luddin N, Alghawazi AM, Al Sebai L, Alqerban A, Alqahtani YM, Barakat A,\nSamran A, Noushad M. Aluminum zirconate nanoparticles in etch and rinse\nadhesive to caries affected dentine: An in-vitro scanning electron microscopy,\nelemental distribution, antibacterial, degree of conversion and micro-tensile\nbond strength assessment. Microsc Res Tech., 2024;87(8):1955-1964.<\/li><li>Mohammadi\nS, Mohammadi P, Hosseinkhani S, Shipour R. Antifungal Activity of TiO2\nnanoparticles and EDTA on Candida albicans Biofilms. Infect Epidemiol Med.,\n2013;1:33\u20138.<\/li><li>Ahmed\nFY, Farghaly Aly U, Abd El-Baky RM, Waly NGFM. Comparative Study of\nAntibacterial Effects of Titanium Dioxide Nanoparticles Alone and in\nCombination with Antibiotics on MDR Pseudomonas aeruginosa Strains. Int J\nNanomedicine., 2020;15:3393\u2013404.<\/li><li>Zhang\nJF, Wu R, Fan Y, Liao S, Wang Y, Wen ZT, et al. Antibacterial dental composites\nwith chlorhexidine and mesoporous silica. J Dent Res., 2014;93(12):1283\u20139.<\/li><li>Xue\nJ, Wang J, Feng D, Huang H, Wang M. Application of Antimicrobial Polymers in\nthe Development of Dental Resin Composite. Molecules., 2020;25(20):4738.<\/li><li>Sun\nY, Zhou Z, Jiang H, Duan Y, Li J, Liu X, et al. Preparation and evaluation of\nnovel bio-based Bis-GMA-free dental composites with low estrogenic activity.\nDent Mater., 2022;38(2):281\u201393.<\/li><li>Askar\nH, Krois J, G\u00f6stemeyer G, Schwendicke F. Secondary caries risk of different\nadhesive strategies and restorative materials in permanent teeth: Systematic\nreview and network meta-analysis. J Dent., 2021;104:103541.<\/li><li>Beck\nF, Lettner S, Graf A, Bitriol B, Dumitrescu N, Bauer P, et al. Survival of\ndirect resin restorations in posterior teeth within a 19-year period\n(1996-2015): A meta-analysis of prospective studies. Dent Mater.,\n2015;31(8):958\u201385.<\/li><li>Montoya\nC, Jain A, Londo\u00f1o JJ, Correa S, Lelkes PI, Melo MA, et al. Multifunctional\nDental Composite with Piezoelectric Nanofillers for Combined Antibacterial and\nMineralization Effects. ACS Appl Mater Interfaces., 2021;13(37):43868\u201379.<\/li><li>Moezzi\nA, McDonagh AM, Cortie MB. Zinc oxide particles: Synthesis, properties and\napplications. Chem Eng J., 2012;185\u2013186:1\u201322.<\/li><li>Wang\nY, Hua H, Li W, Wang R, Jiang X, Zhu M. Strong antibacterial dental resin\ncomposites containing cellulose nanocrystal\/zinc oxide nanohybrids. J Dent.,\n2019;80:23\u20139.<\/li><li>Vanajassun\nPP, Nivedhitha MS, Nishad NT, Soman D. Effects of Zinc Oxide Nanoparticles in\nCombination with Conventional Glass Ionomer Cement: In vitro Study. Adv Hum\nBiol., 2014;4(3):31.<\/li><li>Saffarpour\nM, Rahmani M, Tahriri M, Peymani A. Antimicrobial and bond strength properties\nof a dental adhesive containing zinc oxide nanoparticles. Braz J Oral Sci.,\n2016;15(1):66\u20139.<\/li><li>Jowkar\nZ, Farpour N, Koohpeima F, Mokhtari MJ, Shafiei F. Effect of Silver\nNanoparticles, Zinc Oxide Nanoparticles and Titanium Dioxide Nanoparticles on\nMicroshear Bond Strength to Enamel and Dentin. J Contemp Dent Pract.,\n2018;19(11):1404\u201311.<\/li><li>Guti\u00e9rrez\nMF, Alegr\u00eda-Acevedo LF, M\u00e9ndez-Bauer L, Bermudez J, D\u00e1vila-S\u00e1nchez A, Buvinic\nS, et al. Biological, mechanical and adhesive properties of universal adhesives\ncontaining zinc and copper nanoparticles. J Dent., 2019;82:45\u201355.<\/li><li>Roig-Soriano\nX, Souto EB, Elmsmari F, Garcia ML, Espina M, Duran-Sindreu F, S\u00e1nchez-L\u00f3pez E,\nGonz\u00e1lez S\u00e1nchez JA. Nanoparticles in Endodontics Disinfection: State of the\nArt. Pharmaceutics., 2022;14(7):1519.<\/li><li>Mutoh\nN, Tani-Ishii N. A biocompatible model for evaluation of the responses of rat\nperiapical tissue to a new zinc oxide-eugenol sealer. Dent Mater J.,\n2011;30(2):176\u201382.<\/li><li>Poggio\nC, Lombardini M, Colombo M, Dagna A, Saino E, Arciola CR, et al. Antibacterial\neffects of six endodontic sealers. Int J Artif Organs., 2011;34(9):908\u201313.<\/li><li>Kozuszko\nSN, Sanchez MA, de Ferro MI, Sfer AM, Madrid AP, Takabatake K, Nakano K,\nNagatsuka H, Rodriguez AP. Antibacterial activity and biocompatibility of zinc\noxide and graphite particles as endodontic materials. J Hard Tissue Biol.,\n2017;26(4):311-8.<\/li><li>Nicolai\nP, Mensi M, Marsili F, Piccioni M, Salgarello S, Gilberti E, et al. Maxillary\nfungus ball: zinc-oxide endodontic materials as a risk factor. Acta\nOtorhinolaryngol Ital., 2015;35(2):93\u20136.<\/li><li>Rahman\nEF, Christiono S. Effectivity antibacterial zinc oxide eugenol with zinc oxide\npropolis for endodontic treatment in primary teeth. Odonto: Dental Journal.,\n2019;6(2):113-7.<\/li><li>Shayani\nRad M, Kompany A, Khorsand Zak A, Javidi M, Mortazavi SM. Microleakage and\nantibacterial properties of ZnO and ZnO: Ag nanopowders prepared via a sol\u2013gel\nmethod for endodontic sealer application. J Nanopart Res., 2013;15:1-8.<\/li><li>Aguiar\nAS, Guerreiro-Tanomaru JM, Faria G, Leonardo RT, Tanomaru-Filho M.\nAntimicrobial Activity and pH of Calcium Hydroxide and Zinc Oxide Nanoparticles\nIntracanal Medication and Association with Chlorhexidine. J Contemp Dent Pract.,\n2015;16(8):624\u20139.<\/li><li>Alves MJ, Grenho L, Lopes C, Borges J, Vaz F, Vaz\nIP, et al. Antibacterial effect and biocompatibility of a novel nanostructured\nZnO-coated gutta-percha cone for improved endodontic treatment. Mater Sci Eng C\nMater Biol Appl., 2018;92:840\u20138.<\/li><li>Ryu JH, Mangal U, Yoo J, Youm JH, Kim JY, Seo JY,\nKim D, Kwon JS, Choi SH. Low concentration zinc oxide nanoparticles enrichment\nenhances bacterial and pro-inflammatory resistance of calcium silicate-based\ncements. J Mech Behav Biomed Mater., 2024;151:106399.<\/li><li>Turssi CP, Vianna LMFF, Hara AT, do Amaral FLB,\nFran\u00e7a FMG, Basting RT. Counteractive effect of antacid suspensions on\nintrinsic dental erosion. Eur J Oral Sci., 2012;120(4):349\u201352.<\/li><li>Featherstone JDB. The caries balance: the basis for\ncaries management by risk assessment. Oral Health Prev Dent., 2004;2 Suppl\n1:259\u201364.<\/li><li>Robinson C. Fluoride and the caries lesion:\ninteractions and mechanism of action. Eur Arch Paediatr Dent.,\n2009;10(3):136\u201340.<\/li><li>Staiger MP, Pietak AM, Huadmai J, Dias G. Magnesium\nand its alloys as orthopedic biomaterials: a review. Biomaterials.,\n2006;27(9):1728\u201334.<\/li><li>Jawed M, Alabdulmonem W, Alkhamiss A, Alghsham R,\nAlsaeed T, Alhumaydhi F, Hershan A, Shahid S. Role of serum magnesium in dental\ncaries. Bahrain Med Bull., 2021;43:327-30.<\/li><li>Noori AJ, Kareem FA. The effect of magnesium oxide\nnanoparticles on the antibacterial and antibiofilm properties of glass-ionomer\ncement. Heliyon., 2019;5(10):e02568. <\/li><li>96.&nbsp;&nbsp;&nbsp;\nMacKeown JM, Cleaton\u2010Jones PE, Fatti P. Caries and\nmicronutrient intake among urban South African children: a cohort study.\nCommunity Dent Oral Epidemiol., 2003;31(3):213\u201320.<\/li><li>Jawed\nM, Shahid SM, Qader SA, Azhar A. Dental caries in diabetes mellitus: role of\nsalivary flow rate and minerals. J Diabetes Complications., 2011;25(3):183\u20136.<\/li><li>Cheng\nL, Weir MD, Xu HH, Kraigsley AM, Lin NJ, Lin-Gibson S, Zhou X. Antibacterial\nand physical properties of calcium-phosphate and calcium-fluoride nanocomposites\nwith chlorhexidine. Dent Mater., 2012;28(5):573\u201383.<\/li><li>Salman\nSA, Usami T, Kuroda K, Okido M. Synthesis and characterization of cobalt\nnanoparticles using hydrazine and citric acid. J Nanotechnol., 2014;2014:1\u20137.<\/li><li>Alkheraif\nAA, AlMufareh NA, AlQhtani FA, Asiri W, Abuhadi RI, Hamoud M, et al.\nMinocycline incorporated cobalt oxide nanoparticles in dental sealants: an in\nvitro study. Microsc Res Tech., 2022;85(7):2558\u201366.<\/li><\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Introduction Human body biology is associated with a variety of  [&#8230;]<\/p>\n","protected":false},"author":15,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[117],"tags":[],"class_list":["post-61203","post","type-post","status-publish","format-standard","hentry","category-vol17no3"],"_links":{"self":[{"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/posts\/61203","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/users\/15"}],"replies":[{"embeddable":true,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/comments?post=61203"}],"version-history":[{"count":5,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/posts\/61203\/revisions"}],"predecessor-version":[{"id":61698,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/posts\/61203\/revisions\/61698"}],"wp:attachment":[{"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/media?parent=61203"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/categories?post=61203"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/biomedpharmajournal.org\/staging\/wp-json\/wp\/v2\/tags?post=61203"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}