Liposomal formulation increases local antiseptic delivery in calcium hydroxide-based root canal sealer and improves antibacterial properties against E. faecalis in an in vitro model

<h2>Abstract</h2><h3>Aim</h3> To evaluate the drug release capacity and the antibacterial properties of incorporating chlorhexidine digluconate (CHX) liposomal formulation in a calcium hydroxide-based root canal sealer. <h3>Methods</h3> The sealers tested were SEALAPEX and APEXIT, containing 1 % of the different liposomal formulations. The drug release capacity was assessed by Rhodamine B detection and CHX detection by spectrophotometer, and the antibacterial properties by agar diffusion test (ADT), direct contact test (DCT), and modified direct contact test (MDCT). <h3>Results</h3> The best release profile was found for the SEALAPEX with the liposomal formulation using the 1,2-dioleoyl-sn-glycero-3-phosphoethanolamine (DOPE)/L-α-phosphatidylcholine hydrogenated (HSPC). This liposomal formulation containing 4 % CHX improved the antibacterial properties of SEALAPEX compared to non-encapsulated CHX and control. <h3>Conclusion</h3> The liposomal formulation increased the release of CHX, improving the antibacterial effect of the SEALAPEX, representing a promising strategy for local anti-biofilm therapy in the endodontic field.