Search Results (343)

Background/Objectives: Reliable detection of residual root canal filling material after retreatment is essential for comparing retreatment protocols. However, available methods quantify different clinical–physical dimensions and may not yield comparable estimates. This in vitro study compared cone-beam computed tomography (CBCT) and digital microscopy (DGM) for detecting residual obturation material after retreatment, using microcomputed tomography (micro-CT) as the reference standard. Methods: Fifteen extracted human mandibular premolars with single, straight canals were instrumented, obturated with gutta-percha and a calcium silicate-based sealer (AH Plus Bioceramic), and retreated with ProTaper Universal Retreatment files. Residual material was assessed in the coronal, middle, and apical thirds using CBCT (voxel size 0.10 mm), micro-CT (voxel size 60 µm), and DGM after longitudinal root splitting. Surface-based (DGM) and volumetric (CBCT and micro-CT) outcomes were analyzed separately using Wilcoxon signed-rank tests, diagnostic accuracy metrics (sensitivity, specificity, predictive values), and Cohen’s kappa for agreement. Results: DGM showed low median residual surface percentages across thirds (0.34–1.52%), whereas CBCT yielded higher median residual volume percentages (10.20–14.20%) than micro-CT (3.27–5.04%). The difference in the middle third between CBCT and micro-CT remained significant after Bonferroni correction (p = 0.002). For binary detection, CBCT showed higher sensitivity but lower specificity (overclassification of positive thirds), whereas DGM showed high specificity but limited sensitivity in the coronal and middle thirds. Conclusions: Within the limitations of this laboratory study, micro-CT was the most reliable reference method. CBCT tended to overestimate residual material, suggesting that clinical decisions based solely on CBCT may lead to unnecessary retreatment. DGM underestimated remnants because it assesses only the exposed split surface. These method-specific limitations should guide both clinical interpretation and future research design. Full article

Background/Objectives: This study aimed to evaluate the effect of intracanal cryotherapy on postoperative pain across obturation materials with different chemical compositions and physical properties in single-visit root canal treatment. Methods: Patients diagnosed with irreversible pulpitis (n = 73), treated in a single visit by the same operator, were categorized based on the obturation material used (AH Plus, TotalFill BC Sealer, and TotalFill BC RRM) and whether intracanal cryotherapy (20 mL of sterile saline at 4 °C for 5 min) was applied. Visual Analog Scale (VAS) scores obtained from patient follow-up forms at 24, 48, and 72 h were evaluated. Results: Cryotherapy (+) groups showed consistently lower pain scores at all time points compared with cryotherapy (−) groups (p < 0.001). Within the cryotherapy (+) groups, both TotalFill BC Sealer and TotalFill BC RRM exhibited significantly lower pain scores than AH Plus at 48 h (p < 0.05). In the cryotherapy (−) groups, TotalFill BC Sealer showed significantly lower pain scores on the third postoperative day (p < 0.05). Conclusions: Intracanal cryotherapy may serve as an effective adjunctive technique associated with lower early postoperative pain scores. Material-related differences became evident at 48 and 72 h, suggesting that obturation material selection may influence postoperative pain patterns and patient comfort during the later postoperative period. Full article

Background/Objectives: Midurethral sling (MUS) surgery is a standard treatment for stress urinary incontinence in women. Obturator-route MUS procedures reduce retropubic morbidity, but rare concealed hemorrhagic complications can be severe and rapidly progressive. This report describes a complex case of life-threatening hemorrhage, upper urinary tract extravasation, and delayed infection involving a persistent pelvic collection after obturator-route MUS. Methods: We reviewed the clinical course, imaging findings, interventions, and follow-up of a 77-year-old woman who developed severe complications after outpatient obturator-route MUS. A descriptive narrative summary of published hemorrhagic complications after TOT or TVT-O procedures was also performed. Result: On postoperative day 1, the patient presented with left lower abdominal pain, dizziness, vomiting, tachycardia, and severe anemia. Contrast-enhanced computed tomography showed active bleeding from the left obturator artery, an 11.5 cm pelvic hematoma with bladder displacement, and upper urinary tract contrast extravasation at the left renal pelvis and ureteropelvic junction. Emergency transcatheter arterial embolization and left percutaneous nephrostomy were performed, followed by delayed antegrade double-J ureteral stenting. Four months later, she developed E. coli urosepsis with a persistent 7.9 cm paravesical collection. Persistent symptoms despite initial antibiotic therapy required broad-spectrum antibiotics and percutaneous catheter drainage. The drainage fluid was serous, and S. hominis isolated from the drainage culture was interpreted as a contaminant; therefore, the collection was managed as a clinically suspected infection involving a persistent pelvic collection rather than as a microbiologically confirmed infected hematoma. Conclusions: After obturator-route MUS, severe abdominal or pelvic pain, dizziness, tachycardia, hypotension, or abrupt hemoglobin decline should prompt contrast-enhanced CT to evaluate for concealed pelvic arterial bleeding and associated urinary tract extravasation. Early multidisciplinary coordination and follow-up of persistent pelvic collections may be important in complex cases. Full article

Background: Full pulpotomy has gained increasing attention as a conservative treatment option for managing complicated crown fractures and pulp exposures in mature permanent teeth. However, little is known about how undergraduate dental students perceive this treatment approach and which factors influence their willingness to adopt it in clinical practice. Objective: This study aimed to evaluate undergraduate dental students’ knowledge, attitudes, and preferences regarding full pulpotomy and to identify factors associated with willingness to use full pulpotomy as a definitive treatment option. Materials and Methods: A cross-sectional questionnaire-based study was conducted among fourth- and fifth-year dental students. The questionnaire evaluated participants’ treatment preferences, perceived procedural difficulties, preferred pulp capping materials, attitudes toward rubber dam use, perceived barriers to full pulpotomy adoption, and willingness to use full pulpotomy as a definitive treatment. Associations between variables were assessed using chi-square tests and multivariable binary logistic regression analysis. Results: In total, 255 undergraduate dental students participated in the study. Spontaneous pain (69.4%), prolonged pain to heat (50.6%), percussion sensitivity (46.7%), and radiographic findings (43.9%) were the most frequently reported diagnostic criteria for symptomatic irreversible pulpitis. In the standardized clinical scenario, a pulpotomy-based approach was the most preferred treatment strategy (45.1%), followed by single-visit pulpectomy with obturation (28.6%) and pulpectomy with calcium hydroxide dressing (24.7%). MTA was the most preferred pulp capping material (57.3%), followed by Biodentin (12.9%) and calcium hydroxide (8.2%). Overall, 55.7% of participants reported willingness to use full pulpotomy as a definitive treatment option. Clinical year, previous exposure to pulpotomy cases, and confidence in bleeding control were independently associated with willingness to use full pulpotomy. Previous performance of pulpotomy procedures and attitude toward mandatory rubber dam use were independently associated with greater willingness to use full pulpotomy, whereas perceived barriers and uncertainty regarding implementation were negatively associated. Conclusions: In this single-center, questionnaire-based study, undergraduate dental students generally showed a positive attitude toward full pulpotomy; however, acceptance was strongly influenced by practical experience, confidence in procedural protocols, and perceived implementation barriers. These findings may help inform future educational strategies aimed at improving confidence and supporting evidence-based adoption of conservative pulp-preserving approaches. Full article

Root canal disinfection remains challenging due to anatomical complexity and the limitations of mechanical instrumentation. Evidence on irrigation is often fragmented and focused on isolated outcomes, limiting clinically integrated protocols. This narrative review provides a clinically oriented interpretation of contemporary irrigation and activation strategies, introducing a substrate-centered perspective emphasizing dentin modification and material interaction. A structured narrative search was conducted in PubMed, Scopus, and Web of Science up to February 2026 using keywords related to irrigants, irrigation protocols, activation techniques, and dentin–material interactions. Studies were selected based on clinical relevance, including complex anatomy, mature biofilms, and realistic irrigation sequences. Irrigation effectiveness is determined by the interplay between irrigant chemistry, fluid dynamics, and activation-mediated distribution within the root canal system, as well as by irrigation-induced dentin modifications influencing the dentin–material interface. Sodium hypochlorite and chelating agents remain central, although their performance depends on delivery and activation. Activation enhances irrigant exchange, biofilm disruption, and penetration into complex regions. Irrigation also induces physicochemical changes in dentin, affecting sealer penetration and interfacial stability. It should not only be considered a disinfection step but also a substrate-conditioning phase linking cleaning to obturation, with implications for treatment predictability and long-term outcomes. Full article

Background: COVID-19 is primarily a respiratory disease, but increasing evidence suggests possible oral and maxillofacial complications. This study presents a case series of post-COVID maxillary osteonecrosis (PC-RONJ) cases from western Romania and explores the possible association between SARS-CoV-2 infection, its treatment, and this complication. Methods: We conducted a multicenter retrospective case series of two patients with recent PCR-confirmed SARS-CoV-2 infection who subsequently developed maxillary osteonecrosis (ONC) between 2021 and 2023. Clinical examination, CT imaging (including 3D reconstructions), and ENT assessment were used to assess the severity of the disease. All medical records were reviewed to identify comorbidities, details of COVID-19 treatment, and the appearance of maxillofacial symptoms. Results: Both patients had been hospitalized for severe COVID-19 and treated according to the national protocol with systemic corticosteroids, oxygen therapy, anticoagulation, and antivirals. CT scans revealed marked osteolytic destruction of the maxilla and maxillary sinus walls, with extension toward adjacent facial bones. Microbiological analysis revealed a complex polymicrobial profile, including Gram-positive and Gram-negative bacteria as well as opportunistic fungal species, consistent with a chronic biofilm-associated infectious process. Patients received surgical treatment, followed by local care and, in both cases, prosthetic rehabilitation with maxillary obturators, which improved speech, chewing, and oral function. Conclusions: This case series suggests a possible association between severe COVID-19, its treatment, and subsequent maxillary osteonecrosis in susceptible patients; however, the small number of cases precludes causal inference. To our knowledge, this is the first Romanian report describing such cases in patients without prior antiresorptive therapy. These findings highlight the need for careful use of systemic corticosteroids and vigilant post-recovery monitoring of maxillofacial complications. Further studies are required to clarify the underlying mechanisms and risk factors. Full article

Objective: To report a rare case of pulp space tissue growth in a mature mandibular molar with severe endo-periodontal involvement after conservative endodontic treatment and to discuss the possible biological explanations, including regeneration and granulation tissue healing. Severe endo-periodontal lesions are challenging, particularly as endodontic regeneration is usually observed in immature teeth, while revascularization in mature teeth, especially in cases of advanced periodontal disease, is rare, as demonstrated in this case. Methods: This study reports a rare case of tissue regeneration versus granulation tissue healing in the pulp space, occurring alongside periodontal healing, in a mature mandibular molar with necrotic pulp and severe periodontal involvement. A 52-year-old patient presented with a mature mandibular molar (tooth #19) exhibiting necrotic pulp with severe endo-periodontal involvement, including grade-3 mobility, tenderness to percussion, a 12 mm probing depth, and extensive periradicular radiolucency. The tooth was diagnosed with necrotic pulp and symptomatic apical periodontitis and was deemed hopeless, with extraction planned. Results: Following patient refusal, endodontic treatment was initiated, including cleaning, shaping, and placement of the intracanal medicament, Ledermix. The patient canceled the extraction due to symptom resolution and disappeared for 12 months. On return, the patient presented with spontaneous pain exacerbated by thermal stimuli, consistent with symptoms of irreversible pulpitis. Clinical examination revealed significant clinical and radiographic improvements, including reduced probing depth (3 mm), no mobility, resolution of apical translucency, radiographic findings suggestive of canal narrowing, and a positive pulp sensibility response. Re-entry elicited profuse bleeding with newly formed vital tissue beneath the medicament. Sodium hypochlorite irrigation failed to achieve hemostasis; inflamed tissue was removed; root canals were cleaned, shaped and obturated; and treatment was completed with placement of a permanent coronal resin composite restoration. A forty-month follow-up showed an asymptomatic tooth with clinical and radiographic healing. Conclusions: This case demonstrates that conservative endodontic management may result in favorable clinical and radiographic outcomes in mature teeth with severe endo-peroidontal involvement, influencing extraction decisions. It provides clinical evidence suggestive of tissue regeneration and periodontal healing in a mature tooth with necrotic pulp and severe periodontal compromise, challenging conventional prognosis. The observed pulp space tissue growth may be suggestive of regeneration; however, alternative explanations, including granulation tissue healing or repair processes, cannot be excluded. Healing by granulation tissue in the pulp space remains possible. Root canal treatment in advanced endo-perio lesions can yield favorable outcomes and may influence extraction decisions. Further clinical and histological studies are needed to clarify underlying mechanisms and optimize treatment strategies. Full article

Background and Objectives: Premature loss of primary teeth can disrupt occlusal development and oral function. Although iodoform-based materials such as Vitapex^® are widely used, concerns remain regarding their cytotoxicity and potential to accelerate root resorption. Sodium iodide (NaI) has emerged as a biocompatible, antibacterial alternative. This study evaluated the feasibility of a NaI-based root canal filling material in a canine model of Enterococcus faecalis-induced periapical inflammation. Methods: Periapical lesions were induced in a healthy male mongrel dog using E. faecalis (10⁶ CFU/mL). After six weeks, the root canals were obturated with NaI paste, Vitapex^®, or Calcipex. Untreated teeth and an E. faecalis-only group served as controls. Radiographic lesion sizes were monitored at 4, 8, 12, and 16 weeks post-obturation. Histological analysis at 16 weeks assessed inflammatory area and perimeter, stromal fibrosis, inflammatory cell infiltration, and myeloperoxidase (MPO) expression. Results: Radiographically, all treatment groups showed reduced lesion size relative to the positive control. No significant differences were observed among the NaI, Vitapex^®, and Calcipex groups at 4 and 8 weeks; however, significant differences emerged at 12 and 16 weeks (p < 0.05). The NaI group showed lesion reduction until week 8, followed by subsequent expansion thereafter, whereas the Vitapex^® and Calcipex groups showed continuous lesion reduction over time. Histologically, the periapical inflammatory area increased in the order of Vitapex^® < Calcipex < NaI < positive control (p < 0.05). MPO staining identified neutrophils as the primary inflammatory cells. Conclusions: NaI paste showed favorable early radiographic healing but limited long-term stability compared with conventional materials. With further optimization, it may have potential as an alternative root canal filling material. However, given the single-animal exploratory design, these findings should be interpreted as preliminary rather than definitive evidence. Full article

Type 2 endoleaks (EL2s) are potentially life-threatening complications, defined as persistent arterial perfusion of the excluded aneurysmal sac after endovascular aneurysm repair (EVAR). Most EL2s are managed endovascularly, through embolization of the aneurysmal sac and its arterial feeders. During embolization, attention should be given to anatomical variants such as “corona mortis”, an arterial anastomosis connecting external iliac (via inferior epigastric) and internal iliac (via obturator) arteries. We present the case of an 88-year-old male previously treated with EVAR for a left common iliac artery aneurysm (CIAA), complicated by EL2 originating from the ipsilateral ilio-lumbar branch of the internal iliac artery. Successful embolization of the endoleak was achieved through catheterization of the inferior epigastric artery, taking advantage of the “corona mortis” variant. This route allowed access to the sac and embolization with ethylene-vinyl-alcohol-copolymer. This approach represents a safe alternative to direct sac puncture or superior gluteal artery access in patients exhibiting this anatomical variant. Full article

Background and Objectives: Fragmented anatomical, imaging, and surgical accounts of the gracilis muscle hinder reproducible reporting and operative planning. We aimed to integrate prior systems into an Integrated Gracilis Framework (IGF)—an integrative synthesis, not a new classification—that harmonizes terminology, defines imaging correlates/pitfalls, and links morphology to surgical decisions. Methods: Integrative narrative review (January 1900–October 2025) of PubMed/MEDLINE, Scopus, and Web of Science covering vascularization (pedicles, perforators), innervation (motor points/segments), imaging (ultrasound, MRI, MR neurography, CTA/MRA), and clinical applications (facial reanimation, elbow flexion, perineal and breast reconstruction). Two reviewers screened/extracted with consensus adjudication. Searches were restricted to English or records with reliable English-language summaries. Results: IGF consolidates morphological variants, motor-point/segmental innervation, and pedicle/perforator patterns with imaging correlates and common pitfalls. It provides a crosswalk mapping historical systems to IGF and a proposed preoperative workflow (anatomy → imaging → harvest → neurotization) for structured planning and reporting (proposed framework; not prospectively validated). We summarize considerations for free/functional gracilis in facial reanimation and elbow-flexion, and for pedicled/free myocutaneous or perforator flaps in perineal and breast reconstruction. Conclusions: IGF offers a standardized language and decision scaffold to improve study comparability and transparency in operative reporting; as a nonvalidated synthesis, it requires systematic validation through cadaver–imaging correlation and prospective surgical cohorts. Full article

Calcium silicate-based sealers are widely used in contemporary endodontics, but their strong interaction with dentinal substrates may complicate their removal during nonsurgical retreatment and potentially hinder canal disinfection. This ex vivo study evaluated the effectiveness of different irrigation activation techniques in removing a calcium silicate-based sealer from oval-shaped root canals. Sixty extracted single-rooted teeth were instrumented and obturated using the single-cone technique with NeoSealer Flo, followed by retreatment using a reciprocating system. Specimens were randomly assigned to four final irrigation protocols: conventional needle irrigation (CNI) with NaOCl/EDTA, ultrasonic activation (US), diode laser activation (LI), and Er:YAG laser activation using the SWEEPS mode (SW) (n = 15). Residual filling material was quantified before and after final irrigation using stereomicroscopic imaging and ImageJ (version 1.54) analysis. Dentinal surface morphology and residual sealer were further evaluated using SEM–EDS. Statistical analysis included one-way ANOVA and chi-square tests (p < 0.05). All protocols significantly reduced residual filling material compared with mechanical retreatment alone (US 15.08%, CNI 7.89%, LI 8.01%, SW 7.20%) (p < 0.01). US resulted in significantly greater sealer removal compared with CNI, LI, and SW, with mean differences ranging from 7.08% to 7.88% (p < 0.05). These findings indicate that irrigation activation enhances the removal of NeoSealer Flo calcium silicate-based sealer, with ultrasonic activation demonstrating greater effectiveness among the evaluated techniques, under the conditions of this experimental setup. Full article

Objectives: To evaluate the physicochemical properties of a novel strontium silicate-based root canal sealer (C-Root SP) in comparison with a calcium silicate-based sealer (TotalFill BC) and an epoxy resin-based sealer (AH Plus). Methods: Setting time, net mass change (apparent solubility behavior), pH changes, and surface characteristics were assessed based on ISO 6876 and ANSI/ADA Specification No. 57, with minor methodological modifications. Net mass change and pH were evaluated over 28 days. Surface morphology and elemental composition were analyzed after dry and aqueous aging in deionized water using scanning electron microscopy coupled with energy-dispersive X-ray spectroscopy. Data were analyzed using one-way and repeated-measures ANOVA with Tukey’s post hoc test (α = 0.05). Results: AH Plus exhibited the longest initial and final setting times (10.93 ± 0.65 h and 37.33 ± 0.13 h), whereas TotalFill BC showed the shortest (7.98 ± 0.32 h and 30.18 ± 0.20 h); C-Root SP demonstrated intermediate values (9.35 ± 0.38 h and 32.75 ± 0.57 h) (p < 0.001). C-Root SP exhibited positive net mass change values (indicative of net mass loss), ranging from 5.32 ± 4.72% at 24 h to 6.83 ± 5.55% at 28 days, significantly higher than AH Plus and TotalFill BC (p < 0.001), which showed negative values indicative of apparent mass gain. All sealers demonstrated alkaline conditions, with C-Root SP maintaining the highest apparent pH values throughout the evaluation period (p < 0.001). Surface and compositional changes were observed in the bioceramic sealers following aqueous aging, with increased detectable strontium content in C-Root SP. Conclusions: C-Root SP exhibited physicochemical behavior consistent with a strontium-modified calcium silicate-based sealer, characterized by hydration-driven hydroxyl ion release resulting in apparent alkalinity and ion exchange-associated behavior, and dynamic surface changes consistent with those reported for bioceramic materials. Clinical Significance: Strontium incorporation may influence hydration-mediated physicochemical behavior; however, further in vitro and in vivo studies are required to determine its clinical relevance. Full article

Taraxacum kok-saghyz (TK), the rubber dandelion, is an emerging crop offering potential for sustainable natural rubber production independent of tropical climates. Successful domestication of TK requires a mechanistic understanding of its reproductive biology, yet floral anatomy, sporogenesis, and gametogenesis remain poorly characterized. We hypothesized that TK’s reproductive development follows the general patterns of sexually reproducing diploid Taraxacum species and other Asteraceae, distinguishable from the irregular meiosis reported in apomictic taxa. Here, using light and scanning electron microscopy across multiple developmental stages, we describe the floral and inflorescence anatomy, as well as sporogenesis and gametogenesis in TK. Anther development in TK predominantly follows the simultaneous microsporogenesis pattern, typical of eudicots, producing regular tetrahedral tetrads. Notably, we also observed occasional successive-type events resulting in dyads and tetragonal tetrads, indicating a previously unreported developmental variation within the species, culminating in mature tricellular pollen. We detail key reproductive structures, including anther wall layers, ovary mesophyll differentiation, and the presence of a micropylar obturator. The meiotic behavior and gametophyte development observed in TK are consistent with those of diploid, sexually reproducing Taraxacum species and other members of the Asteraceae, in contrast to the irregular meiosis reported in Taraxacum apomictic taxa. These newly described morphoanatomical details on reproductive aspects will inform breeding strategies and advance our understanding of pollination, fertilization, and seed development in TK. Full article

Background: Successful healing of chronic apical periodontitis after endodontic treatment requires a reduction in the size of the radiolucent area and the healing of the bone. This study aimed to compare the effects of different irrigation activation techniques on healing in single-rooted mandibular premolar teeth with periapical lesions of endodontic origin. Methods: A total of 132 systemically healthy patients with mandibular single-rooted premolar teeth and a periapical index (PAI) score ≥ 3 were assigned to five experimental groups (Sonic activation, Passive ultrasonic irrigation, Photon-Induced Photoacoustic Streaming, Shock Wave Enhanced Emission Photoacoustic Streaming and Manual dynamic activation) and a control group (Conventional Syringe Irrigation). After access cavity preparation, the canals were prepared up to three sizes larger than the initial apical diameter with 5 mL of 2.5% NaOCl used between each file. Final irrigation was performed via the assigned activation system. The root canals were obturated with gutta-percha in a single visit. The effects of the activation systems on healing were compared at 1-year follow-up. The primary outcome measure was the change in lesion diameter. PAI score and fractal dimension (FD) were evaluated as secondary outcomes. Results: At the 1-year follow-up, FD values significantly increased, PAI scores and lesion size decreased in all groups compared with baseline (p < 0.001). However, the increase in FD was comparable among the irrigation groups (p > 0.05). In contrast, lesion size reduction and PAI-based healing rates favored the laser-activated groups. The PAI scores and lesion size in the control group were significantly greater than that in the laser groups (p < 0.05). Conclusions: At the 1-year follow-up, all the groups presented similar FD increases, while the laser irrigation groups presented significantly greater reductions in lesion size than did the control group. Full article

Background: Persistent endodontic infections involving Enterococcus faecalis and Candida albicans are a major cause of root canal treatment failure. Although conventional irrigants, such as sodium hypochlorite and chlorhexidine (CHX), exhibit strong immediate antimicrobial activity, microbes may survive and recover from the initial antimicrobial effect, hence limiting their effectiveness, especially in complex root canal anatomies and in the apical terminus of the tooth. Antibacterial dressing techniques were not proven satisfactory due to depletion of the antibacterial component or difficulty in spreading it evenly along the entire root canal. This study aimed to develop and evaluate the antimicrobial efficacy and release characteristics of a novel sustained-release device (SRD), delivering CHX via gutta-percha points coated with a sustained-release formulation used as a temporary intracanal medicament. Methods: Gutta-percha points were coated with two sustained-release CHX varnishes (CHX1 and CHX2) or a placebo and assessed in vitro. Antimicrobial activity against E. faecalis and C. albicans was evaluated using agar diffusion assays over time. Release kinetics were analyzed using Rhodamine-labeled SRD in a 3D-printed acrylic molar tooth model via fluorescence microscopy. Additionally, biofilm-infected acrylic molar teeth were treated with a placebo, a single 2% CHX irrigation, or SRD-coated gutta-percha points placed as an intracanal dressing prior to obturation. Microbial viability was quantified by colony-forming unit (CFU/mL) analysis from root canals and gutta-percha points. Statistical analysis was performed using one-way ANOVA followed by Tukey’s post hoc multiple comparison test (p < 0.05). Results: SRD-coated gutta-percha points demonstrated sustained antimicrobial activity for up to 21 days against E. faecalis and 19 days against C. albicans. Fluorescence analysis, in an acrylic tooth model, confirmed continuous release for up to 15 days, with pronounced diffusion in the isthmus and palatal canals. In biofilm-infected acrylic teeth models, SRD treatment resulted in a significant reduction of 2–3 log₁₀ CFU/mL compared to placebo groups (p < 0.001) and prevented microbial rebound over the 14-day observation period. In contrast, a single application of 2% CHX solution showed only transient reduction followed by regrowth. Conclusions: Sustained-release CHX delivery via polymer-coated gutta-percha points provided prolonged antimicrobial activity against bacterial and fungal biofilms compared to conventional single-dose CHX application in this in vitro model. These findings support the potential use of coated gutta-percha points as a removable intracanal drug delivery platform prior to final obturation, although further studies incorporating direct-release quantification and in vivo validation are required before clinical translation. Full article