Highly flexible antibiotic implants for root canal treatment.

In endodontic procedures, the elimination of bacteria from the complex root canal system is crucial for ensuring the overall success of treatment. Given that commonly employed irrigation solutions lack sustained antimicrobial activity and that intracanal medicaments are difficult to remove and may adversely affect the dentinal microstructure, a highly flexible antimicrobial poly(ethylene-co-vinyl acetate) (PEVA) implant was developed as an alternative strategy for eradication. On the basis of a screening of various PEVAs for optimal properties, implants were prepared via ram extrusion with fine-tuning of their diameters (0.3-1.5 mm) to satisfy application demands. Along with a comprehensive assessment of physicochemical properties, a demonstration of the controlled release of gentamicin from implants of various diameters, and ex vivo implantation experiments, an in vivo study of a Galleria mellonella larvae model demonstrated the effectiveness of antimicrobial implants against Enterococcus faecalis based on survival data. Overall, the here reported dental implants can be considered for future temporary infills and should next be evaluated under multispecies biofilm conditions.