Pectin as a Biomaterial in Regenerative Endodontics—Assessing Biocompatibility and Antibacterial Efficacy against Common Endodontic Pathogens: An In Vitro Study

Abstract

Regenerative endodontics (REP) is a new clinical modality aiming to regenerate damaged soft and hard dental tissues, allowing for root completion in young adults' teeth. Effective disinfection is crucial for REP success, but commonly used antimicrobials often harm the niche dental pulp stem cells (DPSCs). To our knowledge, this is the first study to explore the biocompatibility and antimicrobial potential of pectin as a potential natural intracanal medicament for REPs. Low methoxyl commercial citrus pectin (LM) (pectin CU701, Herbstreith&Fox.de) was used in all experiments. The pectin's antibacterial activity against single species biofilms (<i>E. faecalis</i> and <i>F. nucleatum)</i> was assessed using growth curves. The pectin's antimicrobial effect against mature dual-species biofilm was also evaluated using confocal laser scanning microscopy (CLSM) after 30 min and 7 days of treatment. The DPSC biocompatibility with 2% and 4% <i>w</i>/<i>v</i> of the pectin coatings was evaluated using live/dead staining, LDH, and WST-1 assays. Pectin showed a concentration-dependent inhibitory effect against single-species biofilms (<i>E. faecalis</i> and <i>F. nucleatum)</i> but failed to disrupt dual-species biofilm. Pectin at 2% <i>w</i>/<i>v</i> concentration proved to be biocompatible with the HDPSCs. However, 4% <i>w</i>/<i>v</i> pectin reduced both the viability and proliferation of the DPSCs. Low concentration (2% <i>w</i>/<i>v</i>) pectin was biocompatible with the DPSCs and showed an antimicrobial effect against single-species biofilms. This suggests the potential for using pectin as an injectable hydrogel for clinical applications in regenerative endodontics.