Formulation and Characterization of a Novel Palm-Oil-Based Α-Mangostin Nano-Emulsion (PO-AMNE) As an Antimicrobial Endodontic Irrigant: an in Vitro Study

Aim: To formulate and characterize a palm-oil-in-water-based α-Mangostin nano-emulsion (PO-AMNE) endodontic irrigant, in order to evaluate its antibacterial efficacy against Enterococcus faecalis, Staphylococcus epidermidis, and Candida albicans biofilms, as well as its capacity to remove smear layer. Methods: The solubility of α-Mangostin in various oils was determined and selected, surfactants and co-surfactants were used for the nano-emulsion trial. PO-AMNE was prepared and optimized. The MIC was performed, and the antimicrobial efficacy was estimated against biofilms. The optimized 0.2% PO-AMNE irrigant antimicrobial efficacy in a tooth model was done using colony-forming units. The treated teeth were processed by scanning electron microscopic examination for debris and smear layer removal. An Alamar Blue assay was used to evaluate cell viability. The optimization of the PO-AMNE irrigant was performed using Box–Behnken statistical design. Results: The optimized 0.2% PO-AMNE irrigant was found to have a particle size of 340.9 nm with 0.246 PDI of the dispersed droplets, and a zeta potential (mV) of −27.2 ± 0.7 mV. The MIC values showed that 0.2% PO-AMNE (1.22 ± 0.02) were comparable to 2% CHX (1.33 ± 0.01), and 3.25% NaOCl (2.2 ± 0.09) had the least inhibition for E. faecalis. NaOCl (3.25%) showed the maximum inhibition of S. epidermidis (0.26 ± 0.05), whereas 0.2% PO-AMNE (1.25 ± 0.0) was comparable to 2% CHX (1.86 ± 0.07). For C. albicans, 2% CHX (8.12 ± 0.12) showed the least inhibition as compared to 0.2% PO-AMNE (1.23 ± 0.02) and 3.25% NaOCl (0.59 ± 0.02). The 0.2% PO-AMNE irrigant was then evaluated for its antimicrobial efficacy against the three biofilms, using colony-forming units. The 0.2% PO-AMNE was comparable to both 3.25% NaOCl and 2% CHX in inhibiting the growth of biofilms. The 0.2% PO-AMNE and 17% EDTA eliminated the smear layer with the lowest mean scores (p < 0.001). Finally, 0.2% PO-AMNE was shown to be biocompatible when compared to 17% EDTA, 3.25% NaOCl, and 2% CHX in immortalized oral keratinocyte cells. Conclusion: Overall, the formulated 0.2% PO-AMNE irrigant was an effective antimicrobial and biocompatible which could combat endodontic-infection-related polymicrobial biofilms.