Endodontic Intracanal Medicaments and Agents: The Old and the New, What Is the Evidence?

Successful endodontic treatment primarily depends on effective disinfection of the root canal system through the integrated use of irrigants, intracanal medicaments, and sealers. While traditional agents such as sodium hypochlorite, ethylenediaminetetraacetic acid, calcium hydroxide, and zinc oxide eugenol have long been used, limitations in antimicrobial efficacy and biocompatibility have led the development of newer intracanal agents. Recent advancements, including nanoparticle-based, herbal, and bioceramic agents, offer superior biocompatibility, antimicrobial activity, and biofilm disruption. This review highlights the evolution, clinical relevance, and comparative properties of older and newer intracanal agents, emphasizing their roles in enhancing treatment outcomes through evidence-based approaches.