Nanoparticle-based Irrigants: Future of Endodontic Disinfection?

Abstract Effective disinfection of the root canal system is critical for endodontic success; however, conventional irrigants such as sodium hypochlorite and chlorhexidine are limited by cytotoxicity, restricted penetration into dentinal tubules, and incomplete biofilm elimination. Advances in nanotechnology have introduced nanoparticle-based antimicrobial systems that offer enhanced surface reactivity, improved penetration, and targeted antimicrobial action. This narrative review synthesizes current evidence on the application of nanoparticle-based irrigants in endodontics, emphasizing their mechanisms of action, types, formulations, advantages, limitations, and translational potential. A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science to identify peer-reviewed in vitro, ex vivo, animal, and review studies evaluating nanoparticles for root canal disinfection. Findings indicate that silver, chitosan, zinc oxide, titanium dioxide, and nano-calcium hydroxide nanoparticles exhibit significant antimicrobial and antibiofilm efficacy, superior dentinal tubule penetration, and potential synergistic effects when combined with conventional irrigants or light-activated systems. These effects are attributed to mechanisms such as microbial membrane disruption, reactive oxygen species generation, ion release, and interference with biofilm architecture. Despite these promising outcomes, challenges including nanoparticle aggregation, uncertainties regarding long-term biocompatibility, lack of standardized formulations, and limited in vivo and clinical evidence remain. Nanoparticle-based irrigants appear to be promising adjuncts or potential future alternatives to conventional endodontic irrigants; however, well-designed in vivo and clinical studies are necessary to confirm their safety, optimize formulations, and facilitate clinical translation.