It is tackling antimicrobial resistance in endodontics, specifically comparing different intracanal medications used in root canal treatment. Given the growing concern over resistant bacterial strains, our study aims to evaluate the effectiveness of various medicaments in eliminating endodontic pathogens while minimising the risk of resistance development. By integrating microbiological analysis and clinical relevance, our research seeks to provide evidence-based recommendations for optimising intracanal disinfection protocols and improving treatment outcomes in endodontic infections.

Inclusion Criteria

• Patients presenting with a single rooted mandibular premolar tooth with a closed apex and a single patent canal type I in Vertucci's classification (Vertucci et al., 1974).
• Having a necrotic pulp.
• A pocket depth measurement of < 3 mm.
• Teeth with no previous history of endodontic treatment.
• Teeth with periapical lesions of endodontic origin having a periapical index score of 4 or 5 (Orstavik et al., 1986)
• Patients who took antibiotics within the period of three months before the study.
• Non-restorable teeth.
• Teeth with periodontal pockets deeper than 4mm, with or without concomitant or combined endo-perio communication
• Multirooted teeth.
• Previously initiated or treated teeth.
• Teeth with root canal calcifications or resorption.
• Teeth with internal/external root resorption or root fracture.
• Immune-compromised patients or patients with systemic diseases i.e. (diabetes mellitus, human immunodeficiency virus, leukemia, neutropenia, undergoing chemo- or systemic corticosteroid therapy)
• Teeth with root curvature of more than 15 degrees.
• Pregnant women
• Patients with known sensitivity to the medicaments used in this study.