Investigating the effect of mouthwash containing chitosan / magnesium oxide / silver nanocomposite on Helicobacter pylori

Investigating the effect of mouthwash containing chitosan / magnesium oxide / silver nanocomposite on Helicobacter pylori | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Investigating the effect of mouthwash containing chitosan / magnesium oxide / silver nanocomposite on Helicobacter pylori Neda Omidpanah, Mohsen Safaei, Solmaz Maleki Dizaj, Ali Salimian This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4411058/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: Helicobacter pylori is known to be the main cause of stomach cancer and may be transmitted through the mouth or feces. Therefore, this study was conducted with the aim of preparing a mouthwash consisting of chitosan / magnesium oxide, and silver nanocomposite against Helicobacter. Methods: The new nanocomposite group was used as a test group, and five conventional antibiotic groups were used to compare the antimicrobial effects of the new material as a positive control and distilled water as a negative control. The two-way ANOVA test was used, and the data was analyzed by SPSS software version 24. Results: The results showed that chitosan, magnesium oxide, and silver nanocomposite mouthwash in concentrations of 50, 25, 12.5, and 6.25 micrograms/ml have antibacterial effects against Helicobacter pylori. The two-way ANOVA analysis test showed that among all the substances tested, metronidazole had the largest lack of growth halo, so that this lack of growth halo had a significant difference compared to the rest of the groups (P<0.0001). Also, the lowest number of non-growth auras was related to the tested nanocomposite sample, which was statistically significantly different from all groups except gentamicin and amikacin (P<0.0001). Conclusions: The results of the present study showed that the composition prepared in this study has significant effects in reducing Helicobacter pylori. Helicobacter pylori nanocomposite chitosan magnesium oxide silver Figures Figure 1 Figure 2 Figure 3 Introduction Helicobacter pylori is a gram-negative microaerophile that usually infects humans and is the main cause of gastrointestinal-duodenal diseases, including chronic gastritis, gastric ulcer, gastric adenocarcinoma, and MALT lymphoma [ 1 , 2 ]. Helicobacter pylori infection is estimated to affect approximately 50% of the world's population [ 3 ].This infection usually occurs in childhood and remains lifelong in the absence of appropriate antibiotic treatment [ 4 ]. Today, antibiotic resistance in Helicobacter pylori is a global threat to human health [ 5 ]. Helicobacter pylori may be transmitted through the mouth or feces; Therefore, the oral cavity may act as its possible reservoir. On the other hand, dental plaque can keep and transmit this bacteria. Therefore, by paying attention to oral hygiene, the occurrence and spread of this infection can be prevented [ 6 ]. Among all adjuvants, chlorhexidine, a broad-spectrum bacteriostatic and bactericidal agent, has been commonly used since the 1950s, and its use has been proven to control dental plaque and prevent bacterial biofilm [ 7 ]. But due to the disadvantages of chlorhexidine mouthwash (unpleasant taste, bad color of the mouth and teeth, and its side effects as a chemical), there is a need to provide new mouthwashes [ 8 ]. In recent years, the search for natural compounds that affect biological mechanisms has increased [ 9 ]. Treatment based on natural substances can be a natural, effective and compatible choice against treatment using antibiotics, with the risk of developing drug-resistant bacteria, for the prevention of oral diseases [ 10 ]. Nanotechnology as a developing scientific field using drug delivery systems as a biological carrier is considered to be a desirable method in the treatment and control of oral and dental diseases [ 11 ]. Compounds containing nanoparticles can inhibit bacteria without causing drug resistance [ 12 ]. Metal nanoparticles with unique properties seem to be suitable as a new generation of antimicrobial materials for medical applications [ 13 ]. It has been proven that nanoparticles have better penetration ability, antimicrobial activity and economic cost than other anti-biofilm materials [ 14 , 15 ]. Meanwhile, chitosan, a natural polymer containing carbon and nitrogen, consisting of glucosamine units, is one of the derivatives of chitin, which is also produced by some fungal species. This compound has unique biological properties such as anti-oxidation, anti-allergy, anti-bacterial and anti-virus [ 16 ]. This compound has been noticed due to its significant biological properties and effectiveness against microorganisms, including biodegradability, biological compatibility, and non-toxicity, and its effect on microorganisms that cause oral diseases such as dental caries. Also, this polysaccharide shows stronger antibacterial activity in acidic conditions [ 17 , 18 ]. On the other hand, magnesium oxide nanoparticles are odorless and non-toxic white powder with high melting point and high hardness. These nanoparticles are widely used in industries due to their biocompatibility, biodegradability and relatively low cost. It has many applications in medicine and is also used as an antimicrobial and antitumor agent [ 19 ]. Magnesium oxide nanoparticles can be used as effective antimicrobial alone or in combination with other antimicrobial agents [ 20 ]. Also, silver nanoparticles have become important in the fields of medicine, biology, physics and chemistry due to their antimicrobial effects against bacteria, fungi and viruses and anti-inflammatory properties. Silver nanoparticles have shown excellent antibacterial activity against some species [ 21 ]. Therefore, considering the importance of preventing the spread of Helicobacter pylori and its consequences, as well as finding suitable antibacterial substances. The present study aimed to investigate the effect of mouthwash containing chitosan / magnesium oxide / silver nanocomposite on Helicobacter pylori. Materials and Methods In this laboratory study, chitosan polymer and magnesium and silver oxide nanoparticles were commercially prepared. In order to prepare the desired nanocomposite, 2 mg / ml of chitosan solution, 6 mg / ml of magnesium oxide nanoparticles and 2 mg / ml of silver nanoparticles with a concentration of 2000 ppm were prepared separately with distilled water solvent. Each solution was stirred separately by a magnetic stirrer for 60 minutes. Then these three solutions were dispersed for 20 minutes at a temperature of 30 degrees Celsius by an ultrasonic homogenizer. In the next step, solutions of magnesium oxide nanoparticles and silver nanoparticles were added drop by drop to chitosan biopolymer solution simultaneously and the final solution was continuously stirred for one hour. After this period, the solution was dispersed for 20 minutes at 30°C. The structural properties and characteristics of the synthesized nanomaterials were investigated using different analyses. For this purpose, Transmission electron microscopy was used to determine the approximate size and morphology, X-ray diffraction was used to identify the nature of the material and crystallinity, and dynamic light scattering was used to determine the average particle size. Transmission electron microscope a microtome device was used for thin and accurate cutting of the samples and a thin plate of pre-prepared nanomaterials was cut. The target plate was placed under an Olympus electron microscope made in Japan and examined. X-ray diffraction In order to determine the size, identify the phase and evaluate the formed crystal structure, the X-ray diffraction test was performed by a German Siemens D5000 machine. For this purpose, X-rays with a wavelength of 1.5405 Å, a voltage of 40 kV and a current of 30 mA were irradiated to the sample. By measuring the amount of diffraction of the reflected rays, the curve of scattering intensity was drawn in terms of the angle θ 2, at certain angles, peaks corresponding to the distances between the crystal plates were observed in the curve, and thus the crystal structure of the samples was determined. Then the size of the crystallites was measured using Scherer's relation. Dynamic light scattering method for this purpose, a qualitative suspension of nano material was prepared in distilled water and poured into a special tube of Tesken-USA device. The device reported the particle size chart along with the average particle size. Disc diffusion method was used to determine the sensitivity of bacteria to mouthwash. In this way, first McFarland's Neem solution was prepared from the bacterial strain, and then, using a sterile cotton swab, some of the suspension was spread and a uniform grass culture was made on the surface of Mueller Hinton Agar medium. Then 100 microliters of Mueller Hinton broth culture medium (105 x 5 CFU / ml) was poured into the houses of the 96-well plate and 100 microliters of mouthwash was added to the first well of each row and dilution was done in the next houses. In this way, each well had half the concentration of the previous well. In other rows, amoxicillin, metronidazole, ciprofloxacin, amikacin and gentamicin antibiotics were used as control (positive control) and water solvent was used as (negative control). The wells were placed in a 35°C incubator for 24 hours and then checked for turbidity caused by the growth of microorganisms, and after that, the halos of non-growth around the discs containing nanoparticles were measured from the back of the plate using a millimeter ruler. and the results of antibiotics were compared with the standard table. In all stages, the work was performed in a sterile manner, and in case of suspicion of non-sterilization of the materials, they were excluded from the study. Finally, the collected data were analyzed with descriptive statistics and inferential statistics. Data analysis was done by two-way analysis. Then using SPSS Version 18.0 software (Inc., Chicago, IL, USA) and R Version 3.2.2 software with dunn.test package, data analysis was done. The significance level in this study was considered 0.05. Results Table 1 demonstrates the results of non-growth halo for 4 concentration groups nanocomposite (50, 25, 12.5 and 6.25 µg / ml). Minimum Growth Inhibitory Concentration (MIC) and Growth Inhibitory Concentration (MBC) results are shown in Table 2 , 3 . Table 1 The results of non-growth halo for 4 concentration groups (50, 25, 12.5 and 6.25 µg / ml) Type of Material Average of lack of growth halo (mm) Metronidazole 16 ± 2.1 Ciprofloxacin 13 ± 1.8 Amoxicillin 14 ± 2.3 Amikacin 12 ± 1.7 Gentamicin 11 ± 1.5 The tested nanocomposite sample (50 µg/ml) 12 ± 2.2 Blank disk soaked in distilled water without substance 0 Metronidazole 17 ± 2.3 Ciprofloxacin 13 ± 1.5 Amoxicillin 13 ± 2.2 Amikacin 12 ± 2.1 Gentamicin 12 ± 1.9 The tested nanocomposite sample (25 µg/ml) 11 ± 1.5 Blank disk soaked in distilled water without substance 0 Metronidazole 16 ± 1.7 Ciprofloxacin 13 ± 2.3 Amoxicillin 14 ± 1.5 amikacin 11 ± 2.2 Gentamicin 12 ± 1.4 The tested nanocomposite sample (12.5 µg/ml) 10 ± 2.2 Blank disk soaked in distilled water without substance 0 Metronidazole 16 ± 2.2 Ciprofloxacin 13 ± 2.3 Amoxicillin 13 ± 2.4 Amikacin 12 ± 2.1 Gentamicin 11 ± 2.5 The tested nanocomposite sample (6.25 µg/ml) 9 ± 1.6 Blank disk soaked in distilled water without substance 0 Table 2 the results related to the lowest growth inhibitory concentration Type of Material Minimum Inhibitory Concentration µg/ml)) Metronidazole 1.56 Ciprofloxacin 3.12 Amoxicillin 3.12 Amikacin 3.12 Gentamicin 6.25 The tested nanocomposite sample 6.25 Distilled water without substance 0 Table 3 the results related to the lowest growth bactericidal concentration Type of Material Minimum bactericidal Concentration (µg/ml) Metronidazole 3.12 Ciprofloxacin 6.25 Amoxicillin 6.25 Amikacin 6.25 Gentamicin 12.5 The tested nanocomposite sample 12.5 Distilled water without substance 0 Figure 1 shows the electron microscope image for the prepared nanocomposite. As it is clear from the results, all the components of the prepared nanocomposite are in nanometer dimensions and their morphology is semi-spherical mixed with rods. The X-ray diffraction results are shown in Fig. 2 . According to these results, both the raw materials including silver nanoparticles, magnesium oxide nanoparticles and chitosan and the prepared nanocomposite showed all the peaks related to the nature of these materials well in the X-ray peaks. Figure 3 shows the results of the average particle size of the prepared nanocomposite. The results of this evaluation showed that the average particle size of nanocomposite is 135 nm. Also, the polydispersity index (pdi) for this material is 0.51, which indicates the uniformity of the particle size in this composite. The two-way ANOVA analysis test showed that among all the substances tested, metronidazole had the highest growth halo, which had a significant difference compared to the rest of the groups (P value = 0.0001). Also, the lowest number of non-growth aura was related to the tested nanocomposite sample, which was statistically significantly different from all groups except gentamicin and amikacin (P value = 0.0001). But there was no significant difference with these two antibiotics. That is, it was able to overcome Helicobacter pylori as much as these two antibiotics (for gentamicin P value = 0.02 and for amikacin P value = 0.02). Also, according to the statistical results, with the decrease in the concentration of the nanocomposite under investigation, the diameter of the growth halo decreased, which was not statistically significant (P = 0.95). This means that this nanocomposite has been effective even in the lowest concentration investigated in this research. Discussion Stomach cancer is the fifth most common cancer and the third most common cause of cancer death in the world. Helicobacter pylori is the most common infectious agent of stomach diseases all over the world, and it is believed that it has accompanied humans in the course of evolution and has changed and evolved along with them [ 22 ]. Since the identification of bacteria, researchers have always been looking for effective substances against them. Over the years, bacteria have achieved an effective mechanism to deal with antibiotics through chromosomal and gene mutations. Antibiotic-resistant bacteria increase the risk of infectious diseases that threaten human life [ 23 ]. The results of the present study showed that there was a statistically significant difference among the antibiotics used, and among them, metronidazole showed the greatest aura of lack of growth. Also, the lowest non-growth aura was related to the tested nanocomposite sample, which was statistically significantly different from all groups except gentamicin and amikacin. But there was no significant difference with these two antibiotics. That is, it was able to overcome Helicobacter pylori as much as these two antibiotics. In their study, Souza et al. (2018) investigated the antimicrobial and antibiofilm activities of new nanocomposites containing silver nanoparticles linked or not linked with beta-calcium glycerophosphate on oral microorganisms. These nanocomposites were produced using extracts of different parts of pomegranate. They found in this study that all the extracts used in the production of silver nanoparticles were successful. The composites made with skin extract showed the highest antimicrobial and antibiofilm activity against both tested microorganisms and had similar or even better performance than chlorhexidine [ 24 ]. Kaishen et al. (2008) in their study treated the disinfection of the root canal using chitosan nanoparticles and the results showed that chitosan can penetrate into the bends of the root canal and the dentin tubes, therefore, it kills microorganisms based on its concentration and time-dependent characteristics, Remove even after 3 months [ 25 ]. Irish et al. (2023) conducted a review study with the aim of investigating the antimicrobial effects of silver nanoparticles and its application in dentistry, and the results showed that the mechanism of action of silver nanoparticles in killing bacteria is still unknown. But these components can play an acceptable role in cleaning bacteria in dentistry [ 26 ]. In their study, Naguib et al. (2021) investigated the antimicrobial effect of magnesium oxide nanoparticles on a sample of oral microorganisms and the results indicated that these nanoparticles have an acceptable antimicrobial activity on Staphylococcus mutans, Staphylococcus aureus, E. faecalis and C. albicans in the disc diffusion test [ 27 ]. Rodríguez et al also conducted a study in 2022 with the aim of evaluating the antibacterial properties of magnesium oxide nanoparticles in laboratory conditions for dental applications. The results of this study also confirmed the results of the present study and showed that the investigated nanoparticles have a significant effect in reducing different strains of bacteria [ 28 ]. The results of the mentioned studies and some other studies [ 29 , 30 , 31 , 32 ], Although they have investigated the effects of particles in this studies separately, they are consistent with the results of the present study and are in the same direction and confirm the effects of the particles used on bacteria. While some studies indicate that these nanoparticles are ineffective or show weak effects against bacteria [ 33 , 34 ]. Perhaps the reason for the results obtained from the mentioned studies is due to the difference in the bacteria species studied. On the other hand, the mentioned studies only used a part of the particles of this study and did not examine all three particles together, which could be the reason for the difference in the results. Conclusions But in general, the results of the present study show that the compound prepared in this study can have significant effects in reducing Helicobacter pylori, and perhaps these materials can be used to eliminate other bacteria by using the optimal formulation of these materials. Every study faces some limitations, and this study is not an exception to this rule, and it was faced with issues such as the lack of facilities and appropriate laboratory equipment, especially the electron microscope to observe the particles. Therefore, it is suggested; In future studies, the results of the experiments should be examined with more detailed facilities, and these materials should be examined on different strains so that the results have a high generalization power. 'Declarations': Declarations Ethics approval and consent to participate: The study method wasapproved by the Ethics Committee of Kermanshah University of Medical Sciences with the registry ID of IR.KUMS.REC.1402.242 Availability of data and materials: The data will be available upon the request. Competing interests: The authors declare that they have no competing interests. Funding: Not funding Authors' contributions: N Omidpanah contributed to the supervision, Methodology, Software and data interpretation and writing the original draft and review the manuscript. M Safaeic ontributed to supervision, and review the manuscript; S- Maleki Dizaj contributed data collection and analysis; A Salimian contributed to the data collection References Ren S, Cai P, Liu Y, Wang T, Zhang Y, Li Q, et al. Prevalence of Helicobacter pylori infection in China: A systematic review and meta-analysis. J Gastroenterol Hepatol. 2022;37(3):464–70. 10.1111/jgh.15751 . Feldman M, Friedman LS, Brandt LJ. Sleisenger and Fordtran's gastrointestinal and liver disease E-book: pathophysiology, diagnosis, management. Elsevier health sciences; 2015. Hooi JKY, Lai WY, Ng WK, Suen MMY, Underwood FE, Tanyingoh D, et al. Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis. Gastroenterology. 2017;153(2):420–9. 10.1053/j.gastro.2017.04.022 . Šterbenc A, Jarc E, Poljak M, Homan M. Helicobacter pylori virulence genes. World J Gastroenterol. 2019;25(33):4870–84. 10.3748/wjg.v25.i33.4870 . Tshibangu-Kabamba E, Yamaoka Y. Helicobacter pylori infection and antibiotic resistance — from biology to clinical implications. Nat Reviews Gastroenterol Hepatol. 2021;18(9):613–29. 10.1038/s41575-021-00449-x . Megraud F. Transmission of Helicobacter pylori: faecal-oral versus oral-oral route. Aliment Pharmacol Ther. 1995;9(Suppl 2):85–91. Zhao R, Liu S, Liu Y, Cui S. Adjunctive Use of Active Compounds such as Chlorhexidine in the Nonsurgical Treatment of Peri-Implant Mucositis for Oral Health: A Systematic Review and Meta-Analysis. Oxidative Med Cell Longev. 2022;2022:2312784. 10.1155/2022/2312784 . Kashyap D, Baral B, Verma TP, Sonkar C, Chatterji D, Jain AK, et al. Oral rinses in growth inhibition and treatment of Helicobacter pylori infection. BMC Microbiol. 2020;20(1):1–18. https://doi.org/10.1186/s12866-020-01728-4 . Casarin M, Pazinatto J, Oliveira LM, MEd SOUZA, Santos RCV, Zanatta FB. Anti-biofilm and anti-inflammatory effect of a herbal nanoparticle mouthwash: a randomized crossover trial. Brazilian oral Res. 2019;33:e062. 10.1590/1807-3107bor-2019.vol33.0062 . Krausz AE, Adler BL, Cabral V, Navati M, Doerner J, Charafeddine RA, et al. Curcumin-encapsulated nanoparticles as innovative antimicrobial and wound healing agent. Nanomed Nanotechnol Biol Med. 2015;11(1):195–206. 10.1016/j.nano.2014.09.004 . Ficai D, Sandulescu M, Ficai A, Andronescu E, Yetmez M, Agrali B. Drug delivery systems for dental applications. Curr Org Chem. 2017;21(1):64–73. https://dx.doi.org/10.2174/1385272820666160511104145 . Zhang N, Yu X, Hu J. Synthesis of copper nanoparticle-coated poly (styrene-co-sulfonic acid) hybrid materials and its antibacterial properties. Mater Lett. 2014;125:120–3. 10.1016/j.matlet.2014.03.161 . Beyth N, Houri-Haddad Y, Domb A, Khan W, Hazan R. Alternative antimicrobial approach: nano-antimicrobial materials. Evidence-based Complement Altern Med. 2015;2015. 10.1155/2015/246012 . Pelgrift RY, Friedman AJ. Nanotechnology as a therapeutic tool to combat microbial resistance. Adv Drug Deliv Rev. 2013;65(13–14):1803–15. 10.1016/j.addr.2013.07.011 . Ramasamy M, Lee J. Recent nanotechnology approaches for prevention and treatment of biofilm-associated infections on medical devices. BioMed Research International. 2016;2016. Tripathi N, Choppala G, Singh RS. Evaluation of modified chitosan for remediation of zinc contaminated soils. J Geochem Explor. 2017;182:180–4. Tabari M, Alaghemand H, Rabiee M, Khefri S, Ahadi MS, Nikpour M-R. The Effect of Silicone Oil and Nano-hydroxyapatite/Chitosan Powder on Microhardness and Surface Structure of Primary Teeth Enamel After Iron Drop Consumption. J Dent School Shahid Beheshti Univ Med Sci. 2013;31(2). https://journals.sbmu.ac.ir/dentistry/article/view/29106 . Sahariah P, Másson M. Antimicrobial chitosan and chitosan derivatives: A review of the structure–activity relationship. Biomacromolecules. 2017;18(11):3846–68. Imani MM, Safaei M. Optimized synthesis of magnesium oxide nanoparticles as bactericidal agents. Journal of Nanotechnology. 2019;2019. Dizaj SM, Lotfipour F, Barzegar-Jalali M, Zarrintan MH, Adibkia K. Antimicrobial activity of the metals and metal oxide nanoparticles. Mater Sci Engineering: C. 2014;44:278–84. 10.1016/j.msec.2014.08.031 . Kim JS, Kuk E, Yu KN, Kim J-H, Park SJ, Lee HJ, et al. Antimicrobial effects of silver nanoparticles. Nanomed Nanotechnol Biol Med. 2007;3(1):95–101. 10.1016/j.nano.2006.12.001 . Smyth EC, Nilsson M, Grabsch HI, van Grieken NC, Lordick F. Gastric cancer. Lancet. 2020;396(10251):635–48. 10.1016/S0140-6736(20)31288-5 . Thamphiwatana S, Gao W, Obonyo M, Zhang L. In vivo treatment of Helicobacter pylori infection with liposomal linolenic acid reduces colonization and ameliorates inflammation. Proceedings of the National Academy of Sciences. 2014;111(49):17600-5. 10.1073/pnas.1418230111 . Souza JA, Barbosa DB, Berretta AA, Do Amaral JG, Gorup LF, de Souza Neto FN, et al. Green synthesis of silver nanoparticles combined to calcium glycerophosphate: antimicrobial and antibiofilm activities. Future Microbiol. 2018;13(3):345–57. 10.2217/fmb-2017-0173 . Kishen A, Shi Z, Shrestha A, Neoh KG. An investigation on the antibacterial and antibiofilm efficacy of cationic nanoparticulates for root canal disinfection. J Endod. 2008;34(12):1515–20. 10.1016/j.joen.2008.08.035 . Yin IX, Zhang J, Zhao IS, Mei ML, Li Q, Chu CH. The antibacterial mechanism of silver nanoparticles and its application in dentistry. Int J Nanomed. 2020;2555–62. https://doi.org/10.2147/IJN.S246764 . Naguib GH, Abd El-Aziz GS, Mously HA, Alhazmi WA, Alnowaiser AM, Hassan AH et al. In vitro investigation of the antimicrobial activity of mouth washes incorporating zein-coated magnesium oxide nanoparticles. Clin Cosmet Invest Dentistry. 2021:395–403. doi: 10.2147/CCIDE.S327912. PMID: 34588818; PMCID: PMC8473931. Rodríguez-Hernández A-P, Vega-Jiménez AL, Vázquez-Olmos AR, Ortega-Maldonado M, Ximenez-Fyvie L-A. Antibacterial Properties In Vitro of Magnesium Oxide Nanoparticles for Dental Applications. Nanomaterials. 2023;13(3):502. 10.3390/nano13030502 . Naguib GH, Nassar HM, Hamed MT. Antimicrobial properties of dental cements modified with zein-coated magnesium oxide nanoparticles. Bioactive Mater. 2022;8:49–56. 10.1016/j.bioactmat.2021.06.011 . Behera K, Nasim I, Rajesh Kumar S. Antioxidant & anti inflammatory activity of magnesium oxide nanoparticles-an in vitro study. Int J Dent Oral Sci. 2021;8(5):2913–7. Talapko J, Matijević T, Juzbašić M, Antolović-Požgain A, Škrlec I. Antibacterial activity of silver and its application in dentistry, cardiology and dermatology. Microorganisms. 2020;8(9):1400. 10.3390/microorganisms8091400 . Arif W, Rana NF, Saleem I, Tanweer T, Khan MJ, Alshareef SA, et al. Antibacterial activity of dental composite with ciprofloxacin loaded silver nanoparticles. Molecules. 2022;27(21):7182. https://doi.org/10.3390/molecules27217182 . Noori AJ, Kareem FA. The effect of magnesium oxide nanoparticles on the antibacterial and antibiofilm properties of glass-ionomer cement. Heliyon. 2019;5(10). 10.1016/j.heliyon.2019.e02568 . Naguib GH, Hosny KM, Hassan AH, et al. Zein based magnesium oxide nanoparticles: Assessment of antimicrobial activity for dental implications. Pak J Pharm Sci. 2018;31(1Suppl):245–50. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4411058","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":316609784,"identity":"cb3dc47d-6f38-45e0-b51b-ab2a5e1293bd","order_by":0,"name":"Neda Omidpanah","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABBklEQVRIiWNgGAWjYLCCBDYQycP4IMFAgocfLFJAnBZmgw8VNnKSDSARA0LWQLSwSc44k2ZscADEwaPFnIH56IYHZXfkzdnPHpDmbTucuPn86sQPDwwY5PnFDmDVYtnAlnYj4dwzw509eQnGIC3bbrzdLAF0mOHM2QlYtRgc4DG7kdh2mHHDgRyDZIiWsxtAWhIMbuPXYr/h/BuDw2CHzTi7+QcxWhI33MgxbAR7n793G35bDkP8krzhxhtjBlAgS9zg3WYBjCDcfjnefOzmj7I7thvO55j/AEdl/9nNN39U2MjzS2PXwsAMJg8giUiAVUpgV44AyFr4D+BQNApGwSgYBSMVAAAMHG0F088F1wAAAABJRU5ErkJggg==","orcid":"","institution":"Kermanshah University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"Neda","middleName":"","lastName":"Omidpanah","suffix":""},{"id":316609785,"identity":"f001ae49-acc0-4277-84c3-14a7082d1388","order_by":1,"name":"Mohsen Safaei","email":"","orcid":"","institution":"Kermanshah University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Mohsen","middleName":"","lastName":"Safaei","suffix":""},{"id":316609786,"identity":"4fc59722-696b-4167-90f0-23711f93fd55","order_by":2,"name":"Solmaz Maleki Dizaj","email":"","orcid":"","institution":"Tabriz University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Solmaz","middleName":"Maleki","lastName":"Dizaj","suffix":""},{"id":316609787,"identity":"dddc4564-ea55-41d0-b72b-4f9fae7a7b55","order_by":3,"name":"Ali Salimian","email":"","orcid":"","institution":"Kermanshah University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Ali","middleName":"","lastName":"Salimian","suffix":""}],"badges":[],"createdAt":"2024-05-13 06:26:28","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4411058/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4411058/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":58791434,"identity":"84a34534-8eb2-4df8-be15-5e8a929549de","added_by":"auto","created_at":"2024-06-21 07:20:03","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":146828,"visible":true,"origin":"","legend":"\u003cp\u003eElectron microscope image for prepared nanocomposite\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-4411058/v1/3d7c187fc0297179f907708f.png"},{"id":58792036,"identity":"88c16728-ecf2-49a9-b544-d43b5089a32d","added_by":"auto","created_at":"2024-06-21 07:28:03","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":476106,"visible":true,"origin":"","legend":"\u003cp\u003eX-ray diffraction results of raw materials and prepared nanocomposite\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-4411058/v1/c1c3eabad5df0e3ec1267adc.png"},{"id":58791433,"identity":"ee7364db-28d2-4af7-aef0-9dac969e9bb1","added_by":"auto","created_at":"2024-06-21 07:20:03","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":124572,"visible":true,"origin":"","legend":"\u003cp\u003eResults related to the average particle size of prepared nanocomposite\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-4411058/v1/4765a7d63d1e875371e5b179.png"},{"id":59701506,"identity":"19a6abe3-13eb-428b-aeaa-78238a6b93b7","added_by":"auto","created_at":"2024-07-05 04:53:48","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1146052,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4411058/v1/664237dd-b347-4721-8a1c-27db71a62feb.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Investigating the effect of mouthwash containing chitosan / magnesium oxide / silver nanocomposite on Helicobacter pylori","fulltext":[{"header":"Introduction","content":"\u003cp\u003eHelicobacter pylori is a gram-negative microaerophile that usually infects humans and is the main cause of gastrointestinal-duodenal diseases, including chronic gastritis, gastric ulcer, gastric adenocarcinoma, and MALT lymphoma [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Helicobacter pylori infection is estimated to affect approximately 50% of the world's population [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].This infection usually occurs in childhood and remains lifelong in the absence of appropriate antibiotic treatment [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Today, antibiotic resistance in Helicobacter pylori is a global threat to human health [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. Helicobacter pylori may be transmitted through the mouth or feces; Therefore, the oral cavity may act as its possible reservoir. On the other hand, dental plaque can keep and transmit this bacteria. Therefore, by paying attention to oral hygiene, the occurrence and spread of this infection can be prevented [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. Among all adjuvants, chlorhexidine, a broad-spectrum bacteriostatic and bactericidal agent, has been commonly used since the 1950s, and its use has been proven to control dental plaque and prevent bacterial biofilm [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. But due to the disadvantages of chlorhexidine mouthwash (unpleasant taste, bad color of the mouth and teeth, and its side effects as a chemical), there is a need to provide new mouthwashes [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn recent years, the search for natural compounds that affect biological mechanisms has increased [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. Treatment based on natural substances can be a natural, effective and compatible choice against treatment using antibiotics, with the risk of developing drug-resistant bacteria, for the prevention of oral diseases [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. Nanotechnology as a developing scientific field using drug delivery systems as a biological carrier is considered to be a desirable method in the treatment and control of oral and dental diseases [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Compounds containing nanoparticles can inhibit bacteria without causing drug resistance [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Metal nanoparticles with unique properties seem to be suitable as a new generation of antimicrobial materials for medical applications [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e]. It has been proven that nanoparticles have better penetration ability, antimicrobial activity and economic cost than other anti-biofilm materials [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eMeanwhile, chitosan, a natural polymer containing carbon and nitrogen, consisting of glucosamine units, is one of the derivatives of chitin, which is also produced by some fungal species. This compound has unique biological properties such as anti-oxidation, anti-allergy, anti-bacterial and anti-virus [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. This compound has been noticed due to its significant biological properties and effectiveness against microorganisms, including biodegradability, biological compatibility, and non-toxicity, and its effect on microorganisms that cause oral diseases such as dental caries. Also, this polysaccharide shows stronger antibacterial activity in acidic conditions [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. On the other hand, magnesium oxide nanoparticles are odorless and non-toxic white powder with high melting point and high hardness. These nanoparticles are widely used in industries due to their biocompatibility, biodegradability and relatively low cost. It has many applications in medicine and is also used as an antimicrobial and antitumor agent [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Magnesium oxide nanoparticles can be used as effective antimicrobial alone or in combination with other antimicrobial agents [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Also, silver nanoparticles have become important in the fields of medicine, biology, physics and chemistry due to their antimicrobial effects against bacteria, fungi and viruses and anti-inflammatory properties. Silver nanoparticles have shown excellent antibacterial activity against some species [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]. Therefore, considering the importance of preventing the spread of Helicobacter pylori and its consequences, as well as finding suitable antibacterial substances. The present study aimed to investigate the effect of mouthwash containing chitosan / magnesium oxide / silver nanocomposite on Helicobacter pylori.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003eIn this laboratory study, chitosan polymer and magnesium and silver oxide nanoparticles were commercially prepared. In order to prepare the desired nanocomposite, 2 mg / ml of chitosan solution, 6 mg / ml of magnesium oxide nanoparticles and 2 mg / ml of silver nanoparticles with a concentration of 2000 ppm were prepared separately with distilled water solvent. Each solution was stirred separately by a magnetic stirrer for 60 minutes. Then these three solutions were dispersed for 20 minutes at a temperature of 30 degrees Celsius by an ultrasonic homogenizer. In the next step, solutions of magnesium oxide nanoparticles and silver nanoparticles were added drop by drop to chitosan biopolymer solution simultaneously and the final solution was continuously stirred for one hour. After this period, the solution was dispersed for 20 minutes at 30\u0026deg;C. The structural properties and characteristics of the synthesized nanomaterials were investigated using different analyses. For this purpose, Transmission electron microscopy was used to determine the approximate size and morphology, X-ray diffraction was used to identify the nature of the material and crystallinity, and dynamic light scattering was used to determine the average particle size.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eTransmission electron microscope\u003c/strong\u003e \u003cp\u003ea microtome device was used for thin and accurate cutting of the samples and a thin plate of pre-prepared nanomaterials was cut. The target plate was placed under an Olympus electron microscope made in Japan and examined.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eX-ray diffraction\u003c/strong\u003e \u003cp\u003eIn order to determine the size, identify the phase and evaluate the formed crystal structure, the X-ray diffraction test was performed by a German Siemens D5000 machine. For this purpose, X-rays with a wavelength of 1.5405 \u0026Aring;, a voltage of 40 kV and a current of 30 mA were irradiated to the sample. By measuring the amount of diffraction of the reflected rays, the curve of scattering intensity was drawn in terms of the angle θ 2, at certain angles, peaks corresponding to the distances between the crystal plates were observed in the curve, and thus the crystal structure of the samples was determined. Then the size of the crystallites was measured using Scherer's relation.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eDynamic light scattering method\u003c/strong\u003e \u003cp\u003efor this purpose, a qualitative suspension of nano material was prepared in distilled water and poured into a special tube of Tesken-USA device. The device reported the particle size chart along with the average particle size.\u003c/p\u003e \u003c/p\u003e \u003cp\u003eDisc diffusion method was used to determine the sensitivity of bacteria to mouthwash. In this way, first McFarland's Neem solution was prepared from the bacterial strain, and then, using a sterile cotton swab, some of the suspension was spread and a uniform grass culture was made on the surface of Mueller Hinton Agar medium. Then 100 microliters of Mueller Hinton broth culture medium (105 x 5 CFU / ml) was poured into the houses of the 96-well plate and 100 microliters of mouthwash was added to the first well of each row and dilution was done in the next houses. In this way, each well had half the concentration of the previous well. In other rows, amoxicillin, metronidazole, ciprofloxacin, amikacin and gentamicin antibiotics were used as control (positive control) and water solvent was used as (negative control). The wells were placed in a 35\u0026deg;C incubator for 24 hours and then checked for turbidity caused by the growth of microorganisms, and after that, the halos of non-growth around the discs containing nanoparticles were measured from the back of the plate using a millimeter ruler. and the results of antibiotics were compared with the standard table. In all stages, the work was performed in a sterile manner, and in case of suspicion of non-sterilization of the materials, they were excluded from the study. Finally, the collected data were analyzed with descriptive statistics and inferential statistics. Data analysis was done by two-way analysis. Then using SPSS Version 18.0 software (Inc., Chicago, IL, USA) and R Version 3.2.2 software with dunn.test package, data analysis was done. The significance level in this study was considered 0.05.\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e demonstrates the results of non-growth halo for 4 concentration groups nanocomposite (50, 25, 12.5 and 6.25 \u0026micro;g / ml). Minimum Growth Inhibitory Concentration (MIC) and Growth Inhibitory Concentration (MBC) results are shown in Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e, \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eThe results of non-growth halo for 4 concentration groups (50, 25, 12.5 and 6.25 \u0026micro;g / ml)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eType of Material\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eAverage of lack of growth halo (mm)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMetronidazole\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e16\u0026thinsp;\u0026plusmn;\u0026thinsp;2.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eCiprofloxacin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e13\u0026thinsp;\u0026plusmn;\u0026thinsp;1.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAmoxicillin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e14\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAmikacin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e12\u0026thinsp;\u0026plusmn;\u0026thinsp;1.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eGentamicin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e11\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eThe tested nanocomposite sample (50 \u0026micro;g/ml)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e12\u0026thinsp;\u0026plusmn;\u0026thinsp;2.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eBlank disk soaked in distilled water without substance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMetronidazole\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e17\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eCiprofloxacin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e13\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAmoxicillin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e13\u0026thinsp;\u0026plusmn;\u0026thinsp;2.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAmikacin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e12\u0026thinsp;\u0026plusmn;\u0026thinsp;2.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eGentamicin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e12\u0026thinsp;\u0026plusmn;\u0026thinsp;1.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eThe tested nanocomposite sample (25 \u0026micro;g/ml)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e11\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eBlank disk soaked in distilled water without substance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMetronidazole\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e16\u0026thinsp;\u0026plusmn;\u0026thinsp;1.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eCiprofloxacin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e13\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAmoxicillin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e14\u0026thinsp;\u0026plusmn;\u0026thinsp;1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eamikacin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e11\u0026thinsp;\u0026plusmn;\u0026thinsp;2.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eGentamicin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e12\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eThe tested nanocomposite sample (12.5 \u0026micro;g/ml)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e10\u0026thinsp;\u0026plusmn;\u0026thinsp;2.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eBlank disk soaked in distilled water without substance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eMetronidazole\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e16\u0026thinsp;\u0026plusmn;\u0026thinsp;2.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eCiprofloxacin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e13\u0026thinsp;\u0026plusmn;\u0026thinsp;2.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAmoxicillin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e13\u0026thinsp;\u0026plusmn;\u0026thinsp;2.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eAmikacin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e12\u0026thinsp;\u0026plusmn;\u0026thinsp;2.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eGentamicin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e11\u0026thinsp;\u0026plusmn;\u0026thinsp;2.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eThe tested nanocomposite sample (6.25 \u0026micro;g/ml)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e9\u0026thinsp;\u0026plusmn;\u0026thinsp;1.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e \u003cp\u003eBlank disk soaked in distilled water without substance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"1\" nameend=\"c5\" namest=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ethe results related to the lowest growth inhibitory concentration\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType of Material\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMinimum Inhibitory Concentration\u003c/p\u003e \u003cp\u003e\u0026micro;g/ml))\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMetronidazole\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1.56\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCiprofloxacin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAmoxicillin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAmikacin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGentamicin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe tested nanocomposite sample\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDistilled water without substance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ethe results related to the lowest growth bactericidal concentration\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eType of Material\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMinimum bactericidal Concentration\u003c/p\u003e \u003cp\u003e(\u0026micro;g/ml)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMetronidazole\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3.12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCiprofloxacin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAmoxicillin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAmikacin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e6.25\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGentamicin\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eThe tested nanocomposite sample\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDistilled water without substance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e shows the electron microscope image for the prepared nanocomposite. As it is clear from the results, all the components of the prepared nanocomposite are in nanometer dimensions and their morphology is semi-spherical mixed with rods.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe X-ray diffraction results are shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. According to these results, both the raw materials including silver nanoparticles, magnesium oxide nanoparticles and chitosan and the prepared nanocomposite showed all the peaks related to the nature of these materials well in the X-ray peaks.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e shows the results of the average particle size of the prepared nanocomposite. The results of this evaluation showed that the average particle size of nanocomposite is 135 nm. Also, the polydispersity index (pdi) for this material is 0.51, which indicates the uniformity of the particle size in this composite.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe two-way ANOVA analysis test showed that among all the substances tested, metronidazole had the highest growth halo, which had a significant difference compared to the rest of the groups (P value\u0026thinsp;=\u0026thinsp;0.0001). Also, the lowest number of non-growth aura was related to the tested nanocomposite sample, which was statistically significantly different from all groups except gentamicin and amikacin (P value\u0026thinsp;=\u0026thinsp;0.0001). But there was no significant difference with these two antibiotics. That is, it was able to overcome Helicobacter pylori as much as these two antibiotics (for gentamicin P value\u0026thinsp;=\u0026thinsp;0.02 and for amikacin P value\u0026thinsp;=\u0026thinsp;0.02). Also, according to the statistical results, with the decrease in the concentration of the nanocomposite under investigation, the diameter of the growth halo decreased, which was not statistically significant (P\u0026thinsp;=\u0026thinsp;0.95). This means that this nanocomposite has been effective even in the lowest concentration investigated in this research.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eStomach cancer is the fifth most common cancer and the third most common cause of cancer death in the world. Helicobacter pylori is the most common infectious agent of stomach diseases all over the world, and it is believed that it has accompanied humans in the course of evolution and has changed and evolved along with them [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Since the identification of bacteria, researchers have always been looking for effective substances against them. Over the years, bacteria have achieved an effective mechanism to deal with antibiotics through chromosomal and gene mutations. Antibiotic-resistant bacteria increase the risk of infectious diseases that threaten human life [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The results of the present study showed that there was a statistically significant difference among the antibiotics used, and among them, metronidazole showed the greatest aura of lack of growth. Also, the lowest non-growth aura was related to the tested nanocomposite sample, which was statistically significantly different from all groups except gentamicin and amikacin. But there was no significant difference with these two antibiotics. That is, it was able to overcome Helicobacter pylori as much as these two antibiotics. In their study, Souza et al. (2018) investigated the antimicrobial and antibiofilm activities of new nanocomposites containing silver nanoparticles linked or not linked with beta-calcium glycerophosphate on oral microorganisms. These nanocomposites were produced using extracts of different parts of pomegranate. They found in this study that all the extracts used in the production of silver nanoparticles were successful. The composites made with skin extract showed the highest antimicrobial and antibiofilm activity against both tested microorganisms and had similar or even better performance than chlorhexidine [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Kaishen et al. (2008) in their study treated the disinfection of the root canal using chitosan nanoparticles and the results showed that chitosan can penetrate into the bends of the root canal and the dentin tubes, therefore, it kills microorganisms based on its concentration and time-dependent characteristics, Remove even after 3 months [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. Irish et al. (2023) conducted a review study with the aim of investigating the antimicrobial effects of silver nanoparticles and its application in dentistry, and the results showed that the mechanism of action of silver nanoparticles in killing bacteria is still unknown. But these components can play an acceptable role in cleaning bacteria in dentistry [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. In their study, Naguib et al. (2021) investigated the antimicrobial effect of magnesium oxide nanoparticles on a sample of oral microorganisms and the results indicated that these nanoparticles have an acceptable antimicrobial activity on Staphylococcus mutans, Staphylococcus aureus, E. faecalis and C. albicans in the disc diffusion test [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Rodr\u0026iacute;guez et al also conducted a study in 2022 with the aim of evaluating the antibacterial properties of magnesium oxide nanoparticles in laboratory conditions for dental applications. The results of this study also confirmed the results of the present study and showed that the investigated nanoparticles have a significant effect in reducing different strains of bacteria [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. The results of the mentioned studies and some other studies [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e, \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e], Although they have investigated the effects of particles in this studies separately, they are consistent with the results of the present study and are in the same direction and confirm the effects of the particles used on bacteria. While some studies indicate that these nanoparticles are ineffective or show weak effects against bacteria [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e, \u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e]. Perhaps the reason for the results obtained from the mentioned studies is due to the difference in the bacteria species studied. On the other hand, the mentioned studies only used a part of the particles of this study and did not examine all three particles together, which could be the reason for the difference in the results.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eBut in general, the results of the present study show that the compound prepared in this study can have significant effects in reducing Helicobacter pylori, and perhaps these materials can be used to eliminate other bacteria by using the optimal formulation of these materials. Every study faces some limitations, and this study is not an exception to this rule, and it was faced with issues such as the lack of facilities and appropriate laboratory equipment, especially the electron microscope to observe the particles. Therefore, it is suggested; In future studies, the results of the experiments should be examined with more detailed facilities, and these materials should be examined on different strains so that the results have a high generalization power.\u003c/p\u003e \u003cp\u003e'Declarations':\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003eEthics approval and consent to participate:\u003c/p\u003e\n\u003cp\u003eThe study method wasapproved by the Ethics Committee of Kermanshah University of Medical Sciences with the registry ID of\u0026nbsp;IR.KUMS.REC.1402.242\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eAvailability of data and materials:\u0026nbsp;The data will be available upon the request.\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eCompeting interests: The authors declare that they have no competing interests.\u003c/p\u003e\n\u003cul\u003e\n \u003cli\u003eFunding: Not funding\u003c/li\u003e\n\u003c/ul\u003e\n\u003cp\u003eAuthors\u0026apos; contributions: N Omidpanah contributed to the supervision, Methodology, Software and data interpretation and writing the original draft and review the manuscript. M \u0026nbsp; Safaeic ontributed to supervision, and review the manuscript; S- Maleki Dizaj contributed data collection and analysis; A Salimian contributed to the data collection\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eRen S, Cai P, Liu Y, Wang T, Zhang Y, Li Q, et al. Prevalence of Helicobacter pylori infection in China: A systematic review and meta-analysis. J Gastroenterol Hepatol. 2022;37(3):464\u0026ndash;70. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/jgh.15751\u003c/span\u003e\u003cspan address=\"10.1111/jgh.15751\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFeldman M, Friedman LS, Brandt LJ. Sleisenger and Fordtran's gastrointestinal and liver disease E-book: pathophysiology, diagnosis, management. Elsevier health sciences; 2015.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHooi JKY, Lai WY, Ng WK, Suen MMY, Underwood FE, Tanyingoh D, et al. Global Prevalence of Helicobacter pylori Infection: Systematic Review and Meta-Analysis. Gastroenterology. 2017;153(2):420\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1053/j.gastro.2017.04.022\u003c/span\u003e\u003cspan address=\"10.1053/j.gastro.2017.04.022\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eŠterbenc A, Jarc E, Poljak M, Homan M. Helicobacter pylori virulence genes. World J Gastroenterol. 2019;25(33):4870\u0026ndash;84. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3748/wjg.v25.i33.4870\u003c/span\u003e\u003cspan address=\"10.3748/wjg.v25.i33.4870\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTshibangu-Kabamba E, Yamaoka Y. Helicobacter pylori infection and antibiotic resistance \u0026mdash; from biology to clinical implications. Nat Reviews Gastroenterol Hepatol. 2021;18(9):613\u0026ndash;29. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1038/s41575-021-00449-x\u003c/span\u003e\u003cspan address=\"10.1038/s41575-021-00449-x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMegraud F. Transmission of Helicobacter pylori: faecal-oral versus oral-oral route. Aliment Pharmacol Ther. 1995;9(Suppl 2):85\u0026ndash;91.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhao R, Liu S, Liu Y, Cui S. Adjunctive Use of Active Compounds such as Chlorhexidine in the Nonsurgical Treatment of Peri-Implant Mucositis for Oral Health: A Systematic Review and Meta-Analysis. Oxidative Med Cell Longev. 2022;2022:2312784. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1155/2022/2312784\u003c/span\u003e\u003cspan address=\"10.1155/2022/2312784\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKashyap D, Baral B, Verma TP, Sonkar C, Chatterji D, Jain AK, et al. Oral rinses in growth inhibition and treatment of Helicobacter pylori infection. BMC Microbiol. 2020;20(1):1\u0026ndash;18. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s12866-020-01728-4\u003c/span\u003e\u003cspan address=\"10.1186/s12866-020-01728-4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCasarin M, Pazinatto J, Oliveira LM, MEd SOUZA, Santos RCV, Zanatta FB. Anti-biofilm and anti-inflammatory effect of a herbal nanoparticle mouthwash: a randomized crossover trial. Brazilian oral Res. 2019;33:e062. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1590/1807-3107bor-2019.vol33.0062\u003c/span\u003e\u003cspan address=\"10.1590/1807-3107bor-2019.vol33.0062\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKrausz AE, Adler BL, Cabral V, Navati M, Doerner J, Charafeddine RA, et al. Curcumin-encapsulated nanoparticles as innovative antimicrobial and wound healing agent. Nanomed Nanotechnol Biol Med. 2015;11(1):195\u0026ndash;206. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.nano.2014.09.004\u003c/span\u003e\u003cspan address=\"10.1016/j.nano.2014.09.004\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFicai D, Sandulescu M, Ficai A, Andronescu E, Yetmez M, Agrali B. Drug delivery systems for dental applications. Curr Org Chem. 2017;21(1):64\u0026ndash;73. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://dx.doi.org/10.2174/1385272820666160511104145\u003c/span\u003e\u003cspan address=\"10.2174/1385272820666160511104145\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eZhang N, Yu X, Hu J. Synthesis of copper nanoparticle-coated poly (styrene-co-sulfonic acid) hybrid materials and its antibacterial properties. Mater Lett. 2014;125:120\u0026ndash;3. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.matlet.2014.03.161\u003c/span\u003e\u003cspan address=\"10.1016/j.matlet.2014.03.161\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBeyth N, Houri-Haddad Y, Domb A, Khan W, Hazan R. Alternative antimicrobial approach: nano-antimicrobial materials. Evidence-based Complement Altern Med. 2015;2015. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1155/2015/246012\u003c/span\u003e\u003cspan address=\"10.1155/2015/246012\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePelgrift RY, Friedman AJ. Nanotechnology as a therapeutic tool to combat microbial resistance. Adv Drug Deliv Rev. 2013;65(13\u0026ndash;14):1803\u0026ndash;15. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.addr.2013.07.011\u003c/span\u003e\u003cspan address=\"10.1016/j.addr.2013.07.011\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRamasamy M, Lee J. Recent nanotechnology approaches for prevention and treatment of biofilm-associated infections on medical devices. BioMed Research International. 2016;2016.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTripathi N, Choppala G, Singh RS. Evaluation of modified chitosan for remediation of zinc contaminated soils. J Geochem Explor. 2017;182:180\u0026ndash;4.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTabari M, Alaghemand H, Rabiee M, Khefri S, Ahadi MS, Nikpour M-R. The Effect of Silicone Oil and Nano-hydroxyapatite/Chitosan Powder on Microhardness and Surface Structure of Primary Teeth Enamel After Iron Drop Consumption. J Dent School Shahid Beheshti Univ Med Sci. 2013;31(2). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://journals.sbmu.ac.ir/dentistry/article/view/29106\u003c/span\u003e\u003cspan address=\"https://journals.sbmu.ac.ir/dentistry/article/view/29106\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSahariah P, M\u0026aacute;sson M. Antimicrobial chitosan and chitosan derivatives: A review of the structure\u0026ndash;activity relationship. Biomacromolecules. 2017;18(11):3846\u0026ndash;68.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eImani MM, Safaei M. Optimized synthesis of magnesium oxide nanoparticles as bactericidal agents. Journal of Nanotechnology. 2019;2019.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDizaj SM, Lotfipour F, Barzegar-Jalali M, Zarrintan MH, Adibkia K. Antimicrobial activity of the metals and metal oxide nanoparticles. Mater Sci Engineering: C. 2014;44:278\u0026ndash;84. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.msec.2014.08.031\u003c/span\u003e\u003cspan address=\"10.1016/j.msec.2014.08.031\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKim JS, Kuk E, Yu KN, Kim J-H, Park SJ, Lee HJ, et al. Antimicrobial effects of silver nanoparticles. Nanomed Nanotechnol Biol Med. 2007;3(1):95\u0026ndash;101. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.nano.2006.12.001\u003c/span\u003e\u003cspan address=\"10.1016/j.nano.2006.12.001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSmyth EC, Nilsson M, Grabsch HI, van Grieken NC, Lordick F. Gastric cancer. Lancet. 2020;396(10251):635\u0026ndash;48. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/S0140-6736(20)31288-5\u003c/span\u003e\u003cspan address=\"10.1016/S0140-6736(20)31288-5\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eThamphiwatana S, Gao W, Obonyo M, Zhang L. In vivo treatment of Helicobacter pylori infection with liposomal linolenic acid reduces colonization and ameliorates inflammation. Proceedings of the National Academy of Sciences. 2014;111(49):17600-5. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1073/pnas.1418230111\u003c/span\u003e\u003cspan address=\"10.1073/pnas.1418230111\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSouza JA, Barbosa DB, Berretta AA, Do Amaral JG, Gorup LF, de Souza Neto FN, et al. Green synthesis of silver nanoparticles combined to calcium glycerophosphate: antimicrobial and antibiofilm activities. Future Microbiol. 2018;13(3):345\u0026ndash;57. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2217/fmb-2017-0173\u003c/span\u003e\u003cspan address=\"10.2217/fmb-2017-0173\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKishen A, Shi Z, Shrestha A, Neoh KG. An investigation on the antibacterial and antibiofilm efficacy of cationic nanoparticulates for root canal disinfection. J Endod. 2008;34(12):1515\u0026ndash;20. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.joen.2008.08.035\u003c/span\u003e\u003cspan address=\"10.1016/j.joen.2008.08.035\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eYin IX, Zhang J, Zhao IS, Mei ML, Li Q, Chu CH. The antibacterial mechanism of silver nanoparticles and its application in dentistry. Int J Nanomed. 2020;2555\u0026ndash;62. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.2147/IJN.S246764\u003c/span\u003e\u003cspan address=\"10.2147/IJN.S246764\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNaguib GH, Abd El-Aziz GS, Mously HA, Alhazmi WA, Alnowaiser AM, Hassan AH et al. In vitro investigation of the antimicrobial activity of mouth washes incorporating zein-coated magnesium oxide nanoparticles. Clin Cosmet Invest Dentistry. 2021:395\u0026ndash;403. doi: 10.2147/CCIDE.S327912. PMID: 34588818; PMCID: PMC8473931.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRodr\u0026iacute;guez-Hern\u0026aacute;ndez A-P, Vega-Jim\u0026eacute;nez AL, V\u0026aacute;zquez-Olmos AR, Ortega-Maldonado M, Ximenez-Fyvie L-A. Antibacterial Properties In Vitro of Magnesium Oxide Nanoparticles for Dental Applications. Nanomaterials. 2023;13(3):502. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/nano13030502\u003c/span\u003e\u003cspan address=\"10.3390/nano13030502\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNaguib GH, Nassar HM, Hamed MT. Antimicrobial properties of dental cements modified with zein-coated magnesium oxide nanoparticles. Bioactive Mater. 2022;8:49\u0026ndash;56. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.bioactmat.2021.06.011\u003c/span\u003e\u003cspan address=\"10.1016/j.bioactmat.2021.06.011\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBehera K, Nasim I, Rajesh Kumar S. Antioxidant \u0026amp; anti inflammatory activity of magnesium oxide nanoparticles-an in vitro study. Int J Dent Oral Sci. 2021;8(5):2913\u0026ndash;7.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTalapko J, Matijević T, Juzbašić M, Antolović-Požgain A, Škrlec I. Antibacterial activity of silver and its application in dentistry, cardiology and dermatology. Microorganisms. 2020;8(9):1400. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/microorganisms8091400\u003c/span\u003e\u003cspan address=\"10.3390/microorganisms8091400\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArif W, Rana NF, Saleem I, Tanweer T, Khan MJ, Alshareef SA, et al. Antibacterial activity of dental composite with ciprofloxacin loaded silver nanoparticles. Molecules. 2022;27(21):7182. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/molecules27217182\u003c/span\u003e\u003cspan address=\"10.3390/molecules27217182\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNoori AJ, Kareem FA. The effect of magnesium oxide nanoparticles on the antibacterial and antibiofilm properties of glass-ionomer cement. Heliyon. 2019;5(10). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.heliyon.2019.e02568\u003c/span\u003e\u003cspan address=\"10.1016/j.heliyon.2019.e02568\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNaguib GH, Hosny KM, Hassan AH, et al. Zein based magnesium oxide nanoparticles: Assessment of antimicrobial activity for dental implications. Pak J Pharm Sci. 2018;31(1Suppl):245\u0026ndash;50.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Helicobacter pylori, nanocomposite, chitosan, magnesium oxide, silver","lastPublishedDoi":"10.21203/rs.3.rs-4411058/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4411058/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground:\u003c/strong\u003e Helicobacter pylori is known to be the main cause of stomach cancer and may be transmitted through the mouth or feces. Therefore, this study was conducted with the aim of preparing a mouthwash consisting of chitosan / magnesium oxide, and silver nanocomposite against Helicobacter.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e The new nanocomposite group was used as a test group, and five conventional antibiotic groups were used to compare the antimicrobial effects of the new material as a positive control and distilled water as a negative control. The two-way ANOVA test was used, and the data was analyzed by SPSS software version 24.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The results showed that chitosan, magnesium oxide, and silver nanocomposite mouthwash in concentrations of 50, 25, 12.5, and 6.25 micrograms/ml have antibacterial effects against Helicobacter pylori. The two-way ANOVA analysis test showed that among all the substances tested, metronidazole had the largest lack of growth halo, so that this lack of growth halo had a significant difference compared to the rest of the groups (P\u0026lt;0.0001). Also, the lowest number of non-growth auras was related to the tested nanocomposite sample, which was statistically significantly different from all groups except gentamicin and amikacin (P\u0026lt;0.0001).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e The results of the present study showed that the composition prepared in this study has significant effects in reducing Helicobacter pylori.\u003c/p\u003e","manuscriptTitle":"Investigating the effect of mouthwash containing chitosan / magnesium oxide / silver nanocomposite on Helicobacter pylori","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-21 07:19:58","doi":"10.21203/rs.3.rs-4411058/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"4705b427-913c-4a4e-8fcb-94d249810501","owner":[],"postedDate":"June 21st, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2024-07-05T04:53:33+00:00","versionOfRecord":[],"versionCreatedAt":"2024-06-21 07:19:58","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4411058","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4411058","identity":"rs-4411058","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}