Enterococcus faecalis plays the key role in endodontic infections and is responsible for the formation of biofilm on dentin, which causes a resistance against periradicular lesions treatment, consequently the aim of this study is to use nanoparticles entrapping anibacterial agents coated with chitosan that in authors previous study showed a successful in vitro biofilm inhibition, additionally incorporated in thermoresponsive gel.to benefit nanoparticles` small size, and the positive charge of their surfaces that binds with the negatively charged surface of bacterial cell causing its destruction, in addition to the sustained release pattern of the drug based nanoparticles in gel. Therefore, Ciprofloxacin hydrochloride (CIP) encapsulated in PLGA nanoparticles coated with chitosan (CIP-CS-PLGA-NPs), in addition to free CIP, were incorporated in Pluronic® 407/188 to form thermosensitive gels (F1) and (F2), respectively. The thermosensitive gels were tested with regards to rheology, gelling temperature and the release pattern of the drug. A clinical study of the efficacy of F1 and F2 as antibacterial treatments was conducted on patients followed by a comparative studies against CIP and Ca(OH)₂ pastes in terms of biofilm inhibition assay and total bacterial reduction count and percent.The results revealed that F1 and F2 exhibited gelation temperature of 36.9 ± 0.3 °C and 36.0 ± 0.4 °C, viscosity was 15,000 ± 360.6 and 7023.3 ± 296.8 cP respectively. The cumulative release of F1 and F2 after 72 h was 50.03% ± 0.7345 and 77.98% ± 3.122 respectively. F1 was the most efficient treatment against recurrent E.faecalis infection in endodontics that was evident by the highest total bacterial reduction count and percent and biofilm inhibition percent that were recorded in the group treated with F1followed by the group treated with F2. Nanocarriers succeeded in carrying the drug deeply in the root canal and sustaining its effect to abolish the obstinate E. faecalis recurrent infection and its biofilm formation.

Background: This is a triple-blinded, prospective split-mouth clinical trial. It is important to shed light on the effect of different apical preparation sizes regarding postoperative pain within the same patient with the same pulpal histological status. The aim is to compare and evaluate the severity of postoperative pain following apical enlargement with two different sizes after the IBF using the visual analogue scale. Methods: Fifty “teeth” in 25 patients were assigned into two equal groups (25 per group) using E3 Azure rotary files; Group A was prepared two sizes greater than the Initial binding file (IBF) (the largest K file to bind at the actual working length) mesial canals, which were enlarged to 35#/0.04 and 40#/0.04 for the distal canals. Group B was prepared in three sizes larger than the IBF: 40#/0.04 for mesial canals and 45#/0.04 for the distal canals. On a modified VAS form, patients were questioned to indicate the degree of their pain and assisted in narrating their pain intensity during the following periods: 12, 24, and 72 h, and after a week. VAS data were non-parametric and analyzed using the signed-rank test for intergroup comparisons, Freidman’s test, and the Nemenyi post hoc test for intragroup comparisons. The significance level was set at p < 0.05. Results: showed that regardless of measurement time, enlargement of apical preparation was significantly associated with higher pain scores (p < 0.001). Within both groups, there was a significant reduction of measured pain score with time, with values measured after 12 and 24 h being significantly higher than values measured at other intervals (p < 0.001) and with values measured after three days being significantly higher than 1-week value (p < 0.001). Conclusion: The size of apical preparation had a significant effect on postoperative pain. Trial registration number & date: NCT05847738, 08/05/2023.

Root canal therapy remains a cornerstone in dentistry for the prevention and management of pulpal and periapical infections. Despite its widespread use, the treatment continues to face challenges due to the complex root canal anatomy, including curvatures, isthmuses, and accessory canals that often harbor resistant microorganisms. The persistence of these microorganisms frequently leads to incomplete disinfection, reinfection, and treatment failure. This review aims to analyze recent progress in root canal therapy and evaluate the role of emerging technologies in overcoming these limitations. A comprehensive literature search was performed using Web of Science, Scopus, PubMed, Springer, and published scientific texts. Conventional root canal therapy involves canal shaping, cleaning, and obturation, but these methods are frequently limited by their inability to fully eliminate biofilms and residual infected tissue. Over the past decade, novel approaches have been developed to address these shortcomings. Cone‐beam computed tomography (CBCT) has enhanced three‐dimensional visualization of the canal system, allowing for more accurate diagnosis and treatment planning. Robotics‐assisted systems offer improved precision and reproducibility in endodontic procedures. Furthermore, nanotechnology has introduced innovative antimicrobial strategies, as nanoparticles (NPs) demonstrate unique properties such as high surface reactivity and the ability to penetrate dentinal tubules, thereby improving disinfection efficacy. This review highlights that, although conventional approaches remain the foundation of root canal therapy, integration with advanced technologies has the potential to significantly improve clinical outcomes. NPs, CBCT, and robotics collectively show promise in enhancing canal disinfection, treatment accuracy, and long‐term success rates. However, current evidence is still largely experimental or limited to early clinical studies. To conclude, the incorporation of nanotechnology, advanced imaging, and robotic systems into endodontic practice represents a major step forward in addressing the persistent challenges of root canal therapy. Although these innovations hold significant potential, further large‐scale clinical trials and long‐term studies are necessary to validate their safety, cost‐effectiveness, and clinical applicability. Ultimately, combining conventional expertise with emerging technologies may redefine the future standard of care in endodontics.

Aim: This study compared the efficacy of gutta percha and sealer removal during retreatment using Protaper universal retreatment rotary files, D-Race rotary files and hand files with Gates Glidden. Methods: Thirty six extracted single rooted teeth were selected for the current study. The canals were prepared using a modified crown-down technique then filled using the lateral compaction technique. Specimens were randomly divided into 3 equal groups each consisted of twelve specimens. Group one used manual files, group 2 used D-Race system while group 3 used Protaper retreatment system. Samples were split longitudinally and examined under the stereomicroscope. Results: No significant differences among the Protaper and the D-RaCe groups in the mean values of root canal filling remnants, whereas the hand files and Gates Glidden group differed significantly. Conclusion: D-Race and Protaper retreatment files removed gutta percha and sealer more efficiently than hand files and Gates Glidden.

The success and failure after treatment of necrotic primary molars causes a hassle to clinicians. This study aims to study the difference between clinical success and radiographic success after treatment using Lesion Sterilization and Tissue Repair technique. The study was conducted on 41 subjects in each group, all subjects were treated by LSTR technique. At the end of the study despite of radiographic failure in 21%from group A & 4% from group B. Molars were clinically successful with absence of pain, swelling, mobility, fistula formation, and were maintained functioning till the end of the study.