Nanozymes as antimicrobial agents in endodontics

Abstract

Objectives

Traditional root canal disinfectants face significant limitations in eradicating biofilm-associated infections, including the inability to effectively disrupt extracellular polymeric substance and potential detrimental effects on dentin structure. Nanozymes, nanomaterials with intrinsic enzyme-mimicking properties, represent a promising alternative approach to eradicate pathogens and tackling biofilm-associated infections. This narrative review aims to provide a comprehensive overview of metal and metal oxide nanozymes, their classification, and antimicrobial mechanism of action as well as to evaluate the evidence for their application in endodontic therapy.

Search Strategy

Studies focusing on the antimicrobial effects of metal-based nanozyme systems in the context of root canal disinfection and periapical healing were included.

Citation Sources

Three databases (PubMed, Google Scholar, Scopus) were searched for peer-reviewed articles, including laboratory studies, clinical investigations, and reviews published from January 1, 2004, through November 30, 2025.

Study Selection Criteria

Research investigating metal-based nanozymes showing antimicrobial or antibiofilm activity in endodontics, from in vitro to clinical studies, was included.

Data Elements Included

Studies were analyzed for nanozyme characteristics, experimental outcome (antibacterial and antibiofilm effects), mechanisms of nanozymes, and clinical applicability.

Overall Conclusions

Metal and metal oxide-based nanozymes have multifaceted antimicrobial mechanisms, including nanozyme-catalyzed activity (reactive oxygen species generation) as well as direct interaction of the nanoparticles with the microbes (disruption of bacterial membrane, interference with metabolic processes). Despite their promising antimicrobial and antibiofilm potential, to our knowledge, researchers in only 9 studies have investigated metal-based nanozymes specifically in endodontic applications to date, highlighting an emerging field of research with considerable potential for future development.