Advancements in Root Canal Therapy: Translational Innovations and the Role of Nanoparticles in Endodontic Treatment

Document Type

Article

Publication Date

Winter 12-8-2025

Abstract

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.

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