Using nanodiamonds to fortify a material used in a root canal treatment may prevent tooth loss and combat infection, according to researchers from the University of California, Los Angeles (UCLA) School of Dentistry.

Nanodiamonds refer to the tiny particles formed as byproducts of diamond refining and mining. With their size significantly smaller than human hair, nanodiamonds have been widely used in various applications such as in dentistry, cancer therapy, imaging and regenerative medicine.

In every root canal procedure, dentists seek to save their patients’ teeth from infected dental “pulp,” which is the part of a tooth that includes blood vessels and nerve tissue. Dentists remove the inflamed dental pulp and fill in the empty space with a polymer called gutta percha, which is used in part because it does not react within the body. However, some root canals do not entirely remove the infection which may lead to tooth loss. Using traditional gutta percha also result in limited capacity to ward off infection and less-than-optimal rigidity, among other disadvantages.

The new study, which appeared in the journal ACS Nano, the UCLA team addresses these issues by developing and testing two types of reinforced gutta percha. They strengthened one type with nanodiamonds and fortified another with nanodiamonds that had been pre-loaded with antibiotics.

To analyse the effectivity of the first type, the researchers filled actual teeth from human patients using conventional radiography and micro-computed tomography, or micro-CT. While they found that the nanodiamond-enhanced compound filled the space just as effectively as traditional gutta percha, the team also observed that the enhanced material also left small gaps in the canal where harmful bacteria could grow.

In the second phase of the research, the team tested nanodiamonds that had been loaded with amoxicillin, a broad-spectrum antibiotic used to combat infection. They found that combining the drug-reinforced nanodiamonds with the gutta percha effectively prevented bacteria growth following a root canal.

“Validating this novel material in teeth extracted from patients serves as a strong foundation for the potential translation of nanodiamond-reinforced gutta percha toward clinical testing,” said Dean Ho, a senior author of the study and a professor of oral biology and medicine.

For the next steps, the team plan to optimise the formulation of the nanodiamond-reinforced gutta percha and begin clinical trials at UCLA in the next two years.

In 1910, root canal treatments were disclosed to lead to cancer and other diseases, according to Mayo’s Clinic and US dentist Dr Weston Price. In his textbook on root canals, published in 1922, Price concluded that even after the dentist hollows out the tooth and fills it with a substance, the maze of tiny tubes remains and becomes the perfect hideout for bacteria. The Weston Price Foundation, established based on his research, showed in their records that of 5,000 surgical cavitation cleanings, just two were found healed.

While the American Dental Association rejects the evidence brought by Price, it acknowledges the fact that oral bacteria can be transported from mouth to heart and cause life-threatening infections.

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