European Endodontic Journal最新文献

Root canal calcification poses a substantial challenge in endodontic practice and may lead to treatment failure. The difficulty lies in accessing, penetrating, and negotiating these canals. This article reports on a series of calcified root canals successfully treated using static-guided endodontics. Eleven cases of calcified root canals were treated by the same endodontist using static-guided endodontics. The sample encompassed four tooth types including a premolar with two canals, effectively managed using two templates (drill guides). Guided endodontic treatment was based on evidence of calcified root canals diagnosed with clinical, radiographic, and cone beam computed tomography (CBCT) findings. A high-resolution CBCT and an intraoral scan were used for virtual cavity planning. The CBCT and intraoral scan were superimposed, and virtual sleeves were accurately placed to avoid drilling deviation. Templates were fabricated and fitted, and guided access was conducted with low-speed drilling, monitored with intraoperative radiographs. Canals were negotiated with K-files, and prepared with Wave One Gold system, using 2.5% NaOCl as irrigant. In all cases, virtually planned guided coronal and root canal access allied to the 3D printed templates allowed canal location through obliterated pulp spaces with a conservative access approach and without accidents. The cases demonstrated that static-guided endodontics is a safe accurate treatment approach to access calcified canals, reducing working time, minimizing removal of tooth structure, and decreasing the risk of iatrogenic damage. (EEJ-2024-07-106).

Objective: Patients requiring endodontic treatment often experience high levels of anxiety. The aim of this research is to investigate the effect of oral administration of lavender on the anxiety score of these patients.

Methods: In this double-blinded randomized clinical trial conducted in 2021, 64 patients with symptomatic irreversible pulpitis were recruited using a simple random sampling technique. Blinding was achieved for both the patients and the evaluators. The samples were split into intervention and control groups using a table of random integers to randomize them. An hour before the commencement of the procedure, the patients filled out the dental anxiety questionnaire. Twenty drops of water in 250 ml of water were given to the control group, whereas 20 drops of lavender extract added to 250 ml of water were given to the intervention group. Two groups completed the anxiety questionnaire 60 minutes after ingesting the remedies. To analyse the data, paired and independent t-tests, and multiple regression analysis were used.

Results: 64 patients were randomized and analyzed. Thirty-two of them who were in the control group experienced a substantially smaller decrease in their dental anxiety score compared to those 32 patients who were in the control group (p=0.001). This difference persisted even after grouping individuals by age, sex, and weight.

Conclusion: The administration of oral lavender extract drops to individuals requiring endodontic treatment appeared to significantly reduce their dental anxiety scores. The research registration number in the Iranian Registry of Clinical Trials is IRCT20120908010773N2, which is available at https: //irct.behdasht.gov.ir/. (EEJ-2024-03-50).

Objective: To investigate the effect of increasing the apical size of roots enlarged for root canal obturation on the outcome of non-surgical endodontic treatment for teeth with apical periodontitis.

Methods: In this retrospective study, we included 210 cases of single-rooted canals treated at our dental units between October 2009 and January 2022. The clinical outcomes of teeth with enlarged root apical size from the International Organization for Standardization standard numbers 25 to 100 were investigated.

Results: The number of teeth with a root apical size of ≤50 and ≥ 55 were 158 and 52, respectively. In the former case, 144 (68.6%) teeth had good prognoses and 14 (6.7%) had poor prognoses. In the latter case, 28 (13.3%) teeth had good prognoses and 24 (11.4%) had poor prognoses.

Conclusion: Unfavourable clinical outcomes were observed in root canal-filled teeth with an enlarged apical root size of ≥ 55. Thus, these sizes potentially indicate poor outcomes of nonsurgical endodontic treatments.

Discipline-specific terminology is a central element of the vocabulary used by dentists and scientists in the context of their professional activities and plays a critical role in the understanding of dentistry. A number of controversial terms and non-standardized definitions exist in the field of endodontology. For example, in root and canal anatomy, variations exist in the definitions of root morphology (including apical bifurcation, fusion and dilaceration), pulp chamber anatomy (including the outline of the floor, pulp horns and location of the root canal orifice), apical root canal bifurcations, canal isthmuses, accessory canals and apical foramen. This narrative review provides a critical analysis of a range of controversial terms currently used to describe root and canal anatomy. It also addresses the consequences of using such controversial terms on the accuracy and reliability of research findings and clinical practice.

Objective: The purpose of this randomized, controlled study was to evaluate the effectiveness of Biodentine compared with MTA used as a pulp space barrier in healing periapical lesions and regaining pulp sensitivity after regenerative treatment in mature single-canal permanent teeth with pulp necrosis and apical periodontitis.

Methods: The study involved 36 patients with mature teeth with necrotic pulp and apical periodontitis. The patient underwent a regenerative treatment that utilized the blood clot technique. Teeth were randomly allocated to either the intervention, Biodentine, group (n=18) or the control, MTA, group (n=18). The healing of periapical lesions and tooth sensibility were evaluated throughout follow-up visits for up to 18 months.

Results: The study analyzed 31 patients; two patients within the biodentine group and three in the MTA group were lost to follow-up. After 18 months, both groups showed effective healing of periradicular lesions; 21 out of 31 patients (67.7%) were healed, ten patients (32.3%) were healing, and no failure cases occurred. There were no significant differences between the groups (p=1.00). More than 70% (22 out of 31 patients) regained their sensibility in their teeth, and the groups had no statistically significant difference (p=0.703).

Conclusion: Regenerative treatment using blood clots with either MTA or Biodentine effectively resolved periapical lesions and regained the sensibility of mature teeth.

Objective: The objectives of this study were (i) to assess the overall treatment outcomes of direct pulp capping in permanent teeth and (ii) to investigate and identify the prognostic factors.

Methods: For the selection of included studies, MEDLINE via Ovid, EMBASE, PubMed, Cochrane Library, and manual search methods were used. After thorough screening, the quality assessment and data extraction criteria were established.

Results: This systematic review is comprised of 33 studies, including 11 prospective cohort studies, 9 retrospective cohort studies, and 13 randomized clinical trials. After applying the quality assessment criteria, 26 articles were included in the meta-analysis. The weighted pooled success rate was 83% with a 95% confidence interval between 79-87%. Meta-regression analysis indicated that rubber dam isolation in all treatment steps was significantly more effective than other techniques (risk ratio=1.44; 95% confidence interval 1.06-2.16, p<0.05).

Conclusion: This study provides evidence of successful treatment outcomes using direct pulp capping in permanent teeth, with 'adequate tooth isolation" identified as a significant prognostic factor.

Objective: Endoplasmic reticulum (ER) stress plays important roles not only in stress avoidance, but also in cell differentiation and maturation, cell proliferation, and promotion of bone formation. This study aimed to investigate the involvement of ER stress in the onset of pulpitis.

Methods: Immunohistochemical analysis was conducted on human teeth extracted for orthodontic reasons. The effects of tunicamycin (TM), an inducer of ER stress, lipopolysaccharide (LPS), and 4μ8c, an inhibitor of inositol-requiring enzyme 1 (IRE1) on cultured human dental pulp cells (hDPCs) were also examined.

Results: The expressions of two ER stress markers, X-box binding protein (XBP)-1 and binding immunoglobulin protein (BiP)/78 kDa glucose-regulated protein (GRP78), were found in the human pulp tissues of a decayed tooth that had not developed irreversible acute pulpitis, but not in an impacted tooth without inflammation in pulp tissue. Both TM and LPS increased the mRNA levels of XBP-1, interleukin (IL)-6, and IL-8, whereas TM, but not LPS, enhanced the mRNA expression of BiP/GRP78 in hDPCs. 4μ8c significantly suppressed the increased level of XBP-1 by LPS.

Conclusion: This study is the first to demonstrate that XBP-1, in addition to inflammatory cytokines, may participate in the onset of pulpitis through IRE1. These findings provide a more comprehensive understanding of pulpitis pathogenesis through the cooperation of ER stress and inflammatory cytokines.

Objective: Our purpose was to investigate the physicochemical properties of Bio-C Temp, a bioceramic intracanal medication, and whether its residues remain adhered to the dentine walls after conventional manual irrigation (CMI) or passive ultrasonic irrigation (PUI) in comparison to Calen.

Methods: The pH after 12 hours, 1 day, 3 days, 7 days, 14 days, 21 days and 28 days, and the flow, radiopacity, and the solubility of the medications after immersion for 7 and 30 days in distilled water (dH2O) or phosphate-buffered saline (PBS) solution were evaluated. Filling capacity, and volumetric changes after 14 days were assessed by micro-computed tomography (micro-CT). The residues of medications after CMI or PUI were analysed with scanning electron microscopy. Statistical analysis was performed using ANOVA and Tukey's post-hoc test, Student's t test or the Kruskal-Wallis and Dunn post-hoc test (α = 0.05).

Results: Bio-C Temp presented a lower pH, flow, volumetric change, and weight loss after immersion in PBS on the 7th and 14th days (p < 0.05) and greater radiopacity and filling capacity (p < 0.05) than Calen. Both medications showed lower solubility in PBS than in dH2O (p < 0.05). There was no difference in the residue content of the two medications between two irrigation methods in three-thirds of the roots (p > 0.05).

Conclusion: Although Bio-C Temp had less volumetric loss and satisfactory filling capacity, this medication provided lower alkalinity than did Calen. Furthermore, neither CMI nor PUI completely removed the medicament residues within the human root canal.

Objectives: The final irrigation solution should have the capability of a chelation agent to remove the smear layer. The purpose of this study was to determine the effect of EDTA, novel silver citrate, and chitosan nanoparticles as a final irrigation solution on the mechanical properties of root canal dentine, namely the flexural strength and elastic modulus.

Methods: Thirty-two intact, single, and straight roots, with no caries, no cracks, and no restoration of premolars, were assigned into four groups of 8 teeth each. Group 1: irrigated with EDTA; Group 2: irrigated with novel silver citrate; Group 3: irrigated with chitosan nanoparticles; Group 4: irrigated with saline as control. Using a Universal Testing Machine, each sample was tested for flexural strength and elastic modulus with a three-point bend test. The data were analysed using one-way ANOVA and followed by the Tukey's test with a significance level of 95%.

Results: Chitosan nanoparticles generated the highest flexural strength and elastic modulus of root canal dentine (212.03 +- 1.64 and 16.40 +- 1.05, respectively) than EDTA (127.10 +- 0.90 and 7.37 +- 0.94) and novel silver citrate (177.87 +- 2.03, and 12.27 +- 1.01) (p<0.05). However, chitosan nanoparticles have similar flexural strength and elastic modulus of root canal dentine when compared to saline (213.76 +- 1.48, 17.02 +- 1.14, respectively) (p>0.05).

Conclusion: Among final irrigations used, chitosan nanoparticles produced the highest flexural strength and elastic modulus of root canal dentine compared to EDTA and novel silver citrate.

Objective: To evaluate the effect of a newly developed MTA-based material and two antibacterial-enhanced MTAs as pulp capping materials in immature permanent dental elements underwent full pulpotomy.

Methods: The present animal study included 20 Wistar albino rats that, after full pulpotomy, were randomly divided into 4 groups receiving different MTA formulations as pulp capping materials: conventional MTA, Tricalcium aluminate (TCA)- free MTA, and MTA enhanced with metronidazole or doxycycline. Histopathological assessments were carried out at 7- and 28-days post-treatment to evaluate dentinal bridge formation, inflammatory reactions, pulp tissue necrosis and internal resorption.

Results: Seven days post-treatment, all groups exhibited inflammation and pulp necrosis, that were minimal in Groups III and IV than Group I. Group II showed a statistically significant difference only in terms of pulp necrosis (p<0.001). At 28-days all Groups showed slight inflammation and pulp necrosis, mainly in Groups I. Dentinal bridge formation was appreciated in all samples belonging to Groups II, III and IV and in 7/10 specimens of Group I, resulting in a statistically significant difference (p≤0.001).

Conclusion: TCA-free MTA and antibiotic-enhanced MTAs showed superior performances in dentinal bridge formation and exhibited minimal pulpal necrosis than conventional MTA. The inclusion of antibiotics might contribute to create a more sterile environment that would improve the outcomes, favoring deposition of a mineralized matrix. However, further studies are needed to support these preliminary results. (EEJ-2024-10-157).