Oxygen as obturation biomaterial in endodontic treatment: development of novel membranous dental restoration system

Complexities in obturation and difficulties in disinfection represent significant issues that render endodontic treatment notably time-consuming. A new perspective is essential to reduce both working time and address these two challenges. To date, none of the established techniques for root canal obturation can assure a perfect seal. Solid materials are not easily manipulated to hermetically fill the intricate branches of the root canal system. Concurrently, anaerobic and facultative anaerobic bacteria, particularly Enterococcus faecalis, are predominant in discussions surrounding endodontic infections. Numerous studies have demonstrated that achieving complete disinfection of Enterococcus faecalis is exceedingly difficult, even with the use of irrigating solutions that possess strong antibacterial properties. Under anaerobic conditions, the invasion efficiency of facultative anaerobes is heightened. If irrigation and disinfection fail to entirely eliminate anaerobes and facultative anaerobes, a novel strategy is required to address the bacteria that persist within the root canal. Oxygen can easily permeate the root canal system, eradicate anaerobes, and inhibit facultative anaerobes from becoming pathogenic. Therefore, employing oxygen as a biomaterial for obturation following appropriate cleaning and shaping procedures is anticipated to address the two primary endodontic issues. This article aims to explore a new potential concept for a dental restoration system that utilizes an oxygen-permeable membrane to reduce the time required for endodontic treatment. The membrane is positioned at the orifice of a duct designed to connect the entire root canal system with ambient air outside the restoration. The function of the membrane is somewhat analogous to the masks used during the COVID-19 pandemic, as it allows for the circulation of oxygen while preventing the passage of fluids, debris, and microorganisms. We hypothesize that the oxygen circulating within the root canal system will also function as a continuously renewing antimicrobial agent.