الفهرس 
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Abstract
Nowadays, there is an increasing demand by most of the people to retain their teeth whatever their state.
Post treatment endodontic disease is commonly faced by clinicians where they have to clearly understand its causes and how to correctly manage. Failed root canal treatment is mainly due to microbes whether they are persistent or reintroduced ones
Understanding the virulence factors of microbes is very important to be able to counteract these factors and increase our clinical success rate. Microbial biofilm is one of the most effective virulence factors produced by different types of microbes and proved to be one of the most common causes of microbial resistance toward different disinfecting agents used during endodontic treatment.
Enterococcus faecalis species is one of the most biofilm forming bacteria.
Introduction of nanotechnology into different fields of medicine with its well-known antibacterial effect encouraged us to try it in our field of endodontics.
This study was done to evaluate the effect of some intracanal medicaments in their nanoform on the bacterial count and their ability to produce biofilm in comparison with others in the regular form.
Patients (n=39) with failed single root canal treated teeth participated in this study and were divided randomly into 3 group; 2 study groups and one positive control group according to the medicament used.
In the first visit, teeth were isolated, old filling was removed and samples representing the original state was obtained, then complete cleaning and shaping was done and another sample was obtained representing the microbial state after cleaning and shaping and before medicament application, then one of the medicaments according to the randomization table was applied for one week. Patients were instructed to rate their post-operative pain on specific intervals after the first visit.
In the second visit, teeth were isolated, medicament was removed and the last sample was obtained.
These samples were used to obtain total bacterial count, E. faecalis count and the ability of the microbes to form a biofilm.
Results revealed that all first samples contained different bacterial species. Cleaning and shaping procedures results in great reduction in bacterial count and biofilm forming ability as well. Different used medicaments were able to decrease both the count and the biofilm forming ability of the microbial community, but with no difference among different groups. Also post-operative pain degree was found to be of statistically insignificant difference between different groups.
Conclusions
Within the limitation of this study, the following conclusions can be withdrawn:
• Irrigation with sodium hypochlorite remains an integral step in root canal retreatment for its antibacterial and antibiofilm effects.
• Antibacterial and antibiofilm effects of nanobased calcium hydroxide and nano silver were comparable to that of conventional calcium hydroxide intracanal medication.
• Nanobased Intracanal medication used in this study contributed to better control of clinical pain by the end of the observation period.