# Antibacterialativity of Endodontic Gutta-Percha--A Systematic Review
## 4 Discussion  
In contemporary dentistry, a rapidly advancing scientific field, efforts are directed toward enhancing the quality of dental materials and devices to optimize treatment outcomes [31; 32; 33; 34; 35]. A multitude of research focuses on dental materials, encompassing those used in endodontics, with the objective of improving their properties. This study aimed to identify potential approaches for increasing the antibacterial activity of gutta-percha by introducing additional substances into its composition. The results obtained indicated that there is no singular ideal component capable of significantly enhancing the antimicrobial and antifungal properties of gutta-percha. None of the materials added to gutta-percha demonstrated a comprehensive improvement in its antimicrobial efficacy, including activity against _Enterococcus faecalis_. However, the addition of certain studied substances may indeed enhance the antimicrobial potency of gutta-percha. According to the studies incorporated in the present review, the most notable quantitative outcomes are observed with the addition of chlorhexidine. Chlorhexidine, a synthetic antiseptic agent, effectively aids in reducing bacterial and fungal counts within the canal system, even against highly resistant strains such as _E. faecalis_. The antimicrobial properties of chlorhexidine are also applicable in a single-substance temporary root canal filling [29]. Based on the analyzed studies, iodoform may be an underappreciated yet promising material to incorporate into gutta-percha. Iodoform exhibits antimicrobial activity through the release of iodine [36], and its addition to gutta-percha resulted in a 100% enhancement of the material's properties in all cases. Unfortunately, only three papers included in this review provided studies on MGP gutta-percha. The addition of calcium hydroxide to gutta-percha has been shown to enhance antibacterial properties. Calcium hydroxide, considered one of the oldest biomaterials used in endodontics, was introduced by [PERSON] in 1920 in Germany [37]. The fundamental action of calcium hydroxide involves ionic dissociation into hydroxyl ions and calcium ions, exerting a positive effect on microorganisms and tissue healing processes [38]. Hydroxyl ions of calcium hydroxide act on enzymes in the cell membrane, contributing to its wide-ranging antimicrobial activities, effective against various microorganisms, irrespective of their metabolic capabilities [38]. However, the combination of gutta-percha and calcium hydroxide does not seem to exhibit antimicrobial activity against _E. faecalis_, highlighting a limitation in the material. Further research is warranted on silver [2], cetylpyridinium chloride-CPC [4], and nanocurcinin [20] incorporated into gutta-percha. Taking all aspects into consideration, the authors demonstrated that gutta-percha alone may exhibit antibacterial activity, including activity against _E. faecalis_. These findings align with [PERSON] et al. [39], who assert that zinc oxide, the primary component of gutta-percha cones, contributes to these antibacterial properties. Indeed, additional zinc oxide supplementation enhances the antimicrobial action of the cones [7; 10; 23]. The most significant antimicrobial effects are achieved when using gutta-percha with chlorhexidine, indicating the greatest reduction in bacterial cultures after contact with this substance. Study results