Mechanisms of resistance to silver nanoparticles in endodontic bacteria: A literature review

Abstract

In recent years, the use and research in nanomaterials have increased considerably. In dentistry, nanomaterials have been investigated in all their specialties like dental prosthesis, implantology, dental operative, periodontics, and endodontics. The nanomaterials are investigated in the areas of dentistry due to their application in the improvement of the physical and chemical properties of conventional materials, as well as the use of the antimicrobial activity of nanomaterials such as silver nanoparticles. Recently, silver nanoparticles (AgNPs) have been studied for their use as an endodontic irrigator due to their high antimicrobial activity. But little is known about the possible mechanisms of the adaptation to AgNPs by endodontic bacteria. These mechanisms may be intrinsic (such as efflux pumps, downregulation of porins, and chromosomal resistance genes) or extrinsic (such as point and adaptive mutations and plasmids with resistance genes) adaptation systems. In addition to this, it has been reported that coselection or coregulation of metal resistance mechanisms, as in the case of nanoparticles, is accompanied by increased resistance to various antibiotics. For these reasons, the objective of this article is to do a review of the literature on the possible mechanisms used by endodontic bacteria to generate resistance to silver nanoparticles and the possible side effects of these mechanisms.