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Injectable thermosensitive antibiotic-laden chitosan hydrogel for regenerative endodontics.

Alexandre Henrique Dos Reis-Prado1,2, Maedeh Rahimnejad1, Renan Dal-Fabbro1

  • 1Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, MI, USA.

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Injectable chitosan hydrogels loaded with azithromycin (AZI) effectively treat periapical disease in regenerative endodontics. The 3% AZI hydrogel promotes tissue repair and root formation while eliminating infection.

Keywords:
AntibioticsAzithromycinChitosanHydrogelsInjectableRegenerative endodontics

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Area of Science:

  • Biomaterials Science
  • Dental Regenerative Medicine
  • Pharmacology

Background:

  • Injectable thermosensitive chitosan (CH) hydrogels offer minimally invasive delivery for dental therapeutics.
  • Regenerative endodontic procedures (REPs) require effective intracanal medications for infection control and tissue regeneration.

Purpose of the Study:

  • To develop and evaluate azithromycin (AZI)-loaded thermosensitive CH hydrogels for use as intracanal medication in REPs.
  • To assess the physicochemical properties, cytocompatibility, antibacterial efficacy, and in vivo performance of AZI-CH hydrogels.

Main Methods:

  • Characterization of hydrogels using SEM, EDS, and FTIR.
  • Evaluation of thermosensitivity, gelation kinetics, mechanical strength, and cytocompatibility.
  • In vitro antibacterial assays against endodontic bacteria and in vivo studies in a rat periapical disease model.

Main Results:

  • AZI was successfully incorporated into porous CH hydrogels without compromising thermosensitivity, mechanical strength, or injectability.
  • 3% and 5% AZI concentrations showed enhanced antibacterial efficacy against E. faecalis biofilms with minimal cytotoxicity.
  • In vivo, 3% AZI-CH hydrogel promoted mineralized tissue formation and vascularization, effectively ablating infection.

Conclusions:

  • Thermosensitive CH hydrogels loaded with 3% AZI are a promising injectable intracanal medication for regenerative endodontics.
  • This formulation effectively eradicates infection and supports neotissue formation in a clinically relevant model.
  • AZI-CH hydrogels represent a significant advancement for minimally invasive dental regenerative therapies.