Effect of Chlorhexidine, Silver Nanoparticles, and Their Combination on the Fracture Resistance of Teeth: An In Vitro Comparative Study

Abstract

Introduction: Silver nanoparticles (AgNPs) have demonstrated promising antimicrobial efficacy as intracanal medicaments; however, concerns remain regarding their interaction with radicular dentin and the potential compromise of mechanical integrity. The effect of combining AgNPs with chlorhexidine (CHX), a collagen-preserving agent, on fracture resistance has not been adequately explored.

Objectives: To comparatively evaluate the effect of Chlorhexidine, Silver nanoparticles and their combination as intracanal medicaments on fracture resistance of teeth.

Methods: Sixty extracted human single rooted mandibular premolars were decoronated and prepared using standard rotary instrumentation and randomly grouped as (n=20) Group 1 – 2% chlorhexidine gel, Group 2 –silver nanoparticles, and Group 3 –chlorhexidine-loaded-silver nanoparticles gel. After applying the intracanal medicaments and incubating for 7 days, the medicaments were removed, and universal testing machine was employed to measure the fracture resistance, and using one-way ANOVA the resulting data were subjected to statistical analysis followed by Tukey’s post hoc test applied at a significance level of p≤0.05.

Results: Group 3 demonstrated the highest average fracture resistance, followed by Group 1 and Group 2 in decreasing order. Significant difference was observed between Group 2 and both Group 1 and Group 3 (p ≤ 0.05), whereas no statistically significant differences were identified between Group 2 and Group 3.

Conclusions: The combination enhanced fracture resistance compared to silver nanoparticles alone and was comparable to that of chlorhexidine. These findings suggest that chlorhexidine mitigates the adverse effects of silver nanoparticles on dentin, making the combination a promising intracanal medicament with minimal compromise in mechanical integrity.