Tooth infections that keep coming back are a nightmare for dentists. These stubborn cases often involve a specific germ called E. faecalis that hides deep inside the tooth structure. A new review looked at how different medicines placed inside the tooth canal fight this germ. Twelve studies provided the data for this analysis. The goal was to find which treatment works best to clear these infections.
Triple antibiotic paste generally performed better than calcium hydroxide. This common material showed variable and often lower effectiveness, especially in the deepest parts of the tooth. Combining different treatments also improved performance. However, new agents like nanoparticle-based systems showed promising but inconsistent results.
The evidence is not perfect. The studies varied greatly in how they were done, making it hard to draw a single clear conclusion. Only two studies allowed for direct numerical comparison. Overall certainty of the evidence ranged from low to moderate. We must wait for more standardized research before changing standard practice.