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

Abstract

Complexities in obturation and difficulties in disinfection are the major problems that make endodontic treatment very time-consuming. A new perspective is needed to reduce the working time as well as to answer these two problems. Until now, none of the established obturation techniques for root canal filling can guarantee a perfect seal. Solid substances cannot be manipulated easily to fill the tiny branches of the root canal system hermetically. At the same time, anaerobes and facultative anaerobes, especially Enterococcus faecalis, are very dominant in endodontic infections discussion. As shown in many studies, it is extremely difficult to perfectly disinfect Enterococcus faecalis even by using some irrigating solutions with strong antibacterial properties. Under anaerobic conditions, the invasion efficiency of facultative anaerobes is increased. In case irrigation and disinfection cannot totally eliminate anaerobes and facultative anaerobes, a new strategy is also needed to deal with the bacteria that still survive in the root canal. Oxygen can fill the root canal system with ease, eliminate anaerobes, and prevent facultative anaerobes from being pathogenic. Therefore, using oxygen as obturation biomaterial after proper cleaning and shaping procedures is expected to solve the two major endodontic problems. The aim of this article was to discuss a new possible concept of dental restoration system that uses an oxygen-permeable membrane to decrease the time required in endodontic treatment. The membrane is placed at the orifice of a duct created to connect the entire root canal system with free air outside the restoration. The function of the membrane is more or less similar to the mask used during the COVID-19 pandemic, as it enables the oxygen to circulate while preventing any fluid, debris, and microorganisms from passing. We hypothesize that the oxygen circulating in the root canal system will also act as an antimicrobial agent that is constantly renewed.