الفهرس 
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Abstract
Irrigation is essential during the chemo-mechanical approach for pathogen removal and root canal cleansing.
Enterococcus faecalis and Candida albicans are two common resistant bacteria seen in endodontic infections. It is very adaptable, can grow in harsh settings, and is resistant to many intracanal medications. Candida albicans is the most often identified fungus species in the root canal, and it is typically seen in necrotic teeth with persistent endodontic infections.
The goal of this study was to emphasise the importance of researching root canal irrigant microorganisms in biofilm form, since bacteria in biofilms are more resistant to antibacterial treatments than bacteria in planktonic form. Sodium hypochlorite is considered the gold standard irrigant because to its antimicrobial and tissue-dissolving properties. However, it has drawbacks such as caustic and toxic effects on vital tissues, as well as collagen denaturation. Chitosan, a non-toxic cationic biopolymer derived from chitin, and silver nanoparticles are being explored as potential alternatives. Chitosan is antimicrobial and enhances dentin degradation resistance. Silver nanoparticles demonstrate antibacterial and smear layer removal efficacy by releasing silver ions.
1. Based on the irrigating solution to be used, 40 samples were randomly allocated to five equal experimental groups of eight samples each (n=8). The first three groups received silver nanoparticles, chitosan nanoparticles, NaOCl, and EDTA as final irrigation procedures, in that sequence. The last two groups (positive and negative control groups) received live microbe injections (n=8).
2.A total sample size of 78 patients divided into three groups of 26 each according to the assigned irrigating solution to evaluate antimicrobial activity and post operative pain.
The results of the study were:
I. Primary Outcome:
1. Antibacterial Activity:
Regarding the in-vitro study:
• All three irrigating treatments significantly decreased the microbial count.
• The NaOCl and EDTA groups had the highest mean value of non-viable bacteria, while the Silver NPs group had the lowest.
Regarding the in-vivo study:
• The bacterial count varied statistically significantly between the S1, S2, and S3 groups.
• Significant differences were found between the Silver NPs, Chitosan NPs, NaOCl, and EDTA groups.
• There was no statistically significant difference between the groups of Silver NPs and Chitosan NPs.
• The NaOCl and EDTA groups decreased the greatest germs, whereas the Silver NPs groups reduced the least bacteria.
II. Secondary Outcome (Postoperative Pain):
Furthermore, results showed.
• There was a statistically significant difference between the groups after 6 hours, with the NaOCl and EDTA group experiencing the least discomfort.
• There were statistically significant differences between the groups after 12, 24, and 48 hours, with the Chitosan NPs group having the least discomfort.
Overall, the research discovered that when compared to the control groups, the experimental groups (Silver NPs, Chitosan NPs.) had significant antibacterial activity and bacterial count decreases. Furthermore, the NaOCl plus EDTA group outperformed the others in terms of antibacterial activity. In terms of postoperative pain, the NaOCl group had the least amount of discomfort at different time intervals, especially during the first 6 hours.