Abstract
Introduction: Persistent microbial biofilms and complex root canal anatomy continue to challenge effective endodontic disinfection. This systematic review aimed to evaluate the antimicrobial, antibiofilm, anti-inflammatory, and regenerative effects of propolis nanoparticles (PNPs) in endodontic applications.
Methods: A comprehensive search of Web of Science, PubMed, Scopus, EMBASE, and the Cochrane Library was conducted from database inception to April 2026 according to PRISMA guidelines. In vitro, animal, and clinical studies evaluating PNP-based delivery systems in endodontics were included. Risk of bias and methodological quality were assessed using Quality Assessment Tool for In Vitro Studies (QUIN), SYRCLE, and RoB 2 tools.
Results: Fifteen studies met the inclusion criteria, most of which were in vitro investigations. PNP-based systems demonstrated antimicrobial and antibiofilm activity, particularly against Enterococcus faecalis. Several studies also reported reduced inflammation, improved dentinal tubule penetration, sustained bioactive release, and favorable biocompatibility compared with conventional materials and pure propolis formulations.
Conclusion: PNPs show promising potential as adjunctive endodontic therapeutic agents due to their antimicrobial and biocompatible properties. However, current evidence is limited by the predominance of heterogeneous preclinical studies; well-designed clinical studies are required to confirm their efficacy and safety.