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The Impact of Training Dental Students to Use an Artificial Intelligence-Based Platform for Pulp Exposure Prediction Prior to Deep Caries Excavation: A Proof-of-Concept Randomised Controlled Trial. 训练牙科学生在深龋挖掘前使用基于人工智能的牙髓暴露预测平台的影响:一项概念验证随机对照试验。
IF 7.1 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-10-10 DOI: 10.1111/iej.70046
Shaqayeq Ramezanzade, Tudor Laurentiu Dascalu, Azam Bakhshandeh, Sergio E Uribe, Bulat Ibragimov, Lars Bjørndal

Aim: This study evaluated the effect of a short, personalised training session on student performance in using an artificial intelligence (AI)-based platform for pulp exposure prediction before caries excavation and determined the required sample size for a further randomised controlled trial (RCT).

Methodology: Undergraduate dental students were randomly assigned to the experimental (training) group and the control (no training) group. The training group received a 1-h training session before undertaking the experiment, focusing on the uses, applications, and drawbacks of AI and carious lesion penetration depth. The theoretical presentation was followed by practical exercises and a quiz to check learning progress. Later, participants in both groups completed an experimental task involving 292 cases. They were asked to predict pulp exposure using an AI-based website. Sample size calculations determined the required sample size, with 80% power and an alpha of 5%.

Results: 18 participants were enrolled (9 in each group). The agreement between participants' decisions and AI predictions regarding the presence or absence of pulp exposure (agreeableness with AI) was higher in the training group compared to the control group (0.83 vs. 0.76). The training group had a slightly higher mean F1-score (0.63 vs. 0.62), accuracy (0.69 vs. 0.68), and sensitivity (0.63 vs. 0.59) than the control group. Based on the sample size calculation, at least 31 participants per group are needed for the future RCT.

Conclusions: The results support further investigation of customised training sessions prior to using an AI-based platform to assess their impact on dental students' agreement with AI predictions.

Trial registration: ClinicalTrial.gov identifier: NCT05912361.

目的:本研究评估了短期个性化培训课程对学生在龋挖掘前使用基于人工智能(AI)的牙髓暴露预测平台表现的影响,并确定了进一步随机对照试验(RCT)所需的样本量。方法:将牙科本科学生随机分为实验组(训练组)和对照组(未训练组)。实验组在实验前进行1小时的培训,重点了解人工智能和龋齿穿透深度的用途、应用和不足。理论陈述之后是实践练习和测试,以检查学习进度。随后,两组参与者都完成了一项涉及292个案例的实验任务。他们被要求使用一个基于人工智能的网站来预测牙髓暴露。样本量计算确定所需的样本量,功率为80%,alpha为5%。结果:共入组18例(每组9例)。与对照组相比,训练组参与者的决定与人工智能预测之间关于是否存在牙髓暴露(与人工智能的亲和性)的一致性更高(0.83对0.76)。训练组的平均f1得分(0.63 vs. 0.62)、准确率(0.69 vs. 0.68)和灵敏度(0.63 vs. 0.59)略高于对照组。根据样本量计算,未来的RCT每组至少需要31名参与者。结论:结果支持在使用基于人工智能的平台之前进一步调查定制培训课程,以评估其对牙科学生同意人工智能预测的影响。试验注册:ClinicalTrial.gov标识符:NCT05912361。
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引用次数: 0
Accuracy of Robot-Guided Access Cavity Preparation in Managing Calcified Canals: An In Vitro Study 机器人引导的通道腔制备在钙化管管理中的准确性:一项体外研究。
IF 7.1 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-10-10 DOI: 10.1111/iej.70049
Yuchen Liu, Chen Liu, Shizhu Bai, Yimin Zhao

Aim

To evaluate the accuracy of guided access cavity preparation in calcified canals using a robotic system, compared to static and dynamic guided methods.

Methodology

Three 3D-printed mandibular models presenting with pulp canal obliteration were allocated into three groups for robot, static and dynamic-guided access cavity preparations. The primary outcomes measured were the coronal deviation, apical deviation and angular deviation between the planned and actual paths of access cavity preparation. Additionally, all access cavities were confirmed to determine whether the canal was located. The data were analysed using the one-way analysis of variance (ANOVA), Tukey's post hoc test and multilevel linear regression models. The significance level was set at 0.05.

Results

All canals (n = 12) in the robot-guided and static-guided groups were located. In the dynamic guided group, a total of 10 out of 12 canals were found, with 2 resulting in root perforations. The accuracy of access cavity preparation using a robotic system showed no significant difference compared to the static-guided group (p > 0.05). However, the apical and angular deviation results were significantly lower in the robot-guided group than the dynamic-guided group (p < 0.05).

Conclusions

The robotic system exhibited comparable accuracy to the static guide, whereas it significantly outperformed dynamic navigation in terms of guided access cavity preparation for calcified root canals. However, further clinical studies are needed to confirm these preliminary findings.

目的:比较静态和动态引导方法在钙化根管中引导通道预备的准确性。方法:将3个牙髓管闭塞的3d打印下颌模型分为三组,分别用于机器人、静态和动态引导下的通道腔制备。测量的主要结果是冠状面偏差、根尖偏差和计划通道与实际通道的角度偏差。此外,所有的通道腔都被确认,以确定是否找到了根管。采用单因素方差分析(ANOVA)、Tukey事后检验和多水平线性回归模型对数据进行分析。显著性水平设为0.05。结果:机器人引导组和静态引导组12个根管均被定位。动态引导组12个根管中发现10个根管,2个根管发生根穿孔。与静态引导组相比,机器人系统预备通道腔的准确性无显著差异(p < 0.05)。然而,机器人引导组的根尖和角度偏差结果明显低于动态引导组(p结论:机器人系统具有与静态引导相当的准确性,而在钙化根管的引导通道预备方面,机器人系统明显优于动态导航。然而,需要进一步的临床研究来证实这些初步发现。
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引用次数: 0
A Thermosensitive Gel Containing Biodegradable Nanoparticles Carrying Calcium Hydroxide as Antibacterial Intracanal Therapy 含有可生物降解纳米颗粒的热敏凝胶携带氢氧化钙作为抗菌肛管治疗。
IF 7.1 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-10-07 DOI: 10.1111/iej.70032
Xavier Roig-Soriano, Luis María Delgado, Firas Elmsmari, Fernando Duran-Sindreu, Miriam Teulé, Marta Espina, Gerard Esteruelas, Maria Luisa García, José Antonio González Sánchez, Elena Sánchez-López

Aim

To characterise and evaluate mucoadhesive strength and antibacterial properties of a nanotechnological formulation for endodontic disinfection based on biodegradable nanoparticles dispersed in a thermosensitive gel containing calcium hydroxide (Ca(OH)2-NPs-gel).

Methodology

Morphology of Ca(OH)2-NPs-gel was studied using transmission electron microscopy. Moreover, Ca(OH)2-NPs-gel was sterilised using gamma irradiation (25 kGy), and the stability after the sterilisation process was studied by measuring Ca(OH)2-NPs-gel average size, polydispersity index, zeta potential and encapsulation efficiency. To assess the ex vivo mucoadhesive strength, extracted single-rooted human teeth were used to measure the force necessary to separate the formulation from the teeth. In addition, the short-time stability of Ca(OH)2-NPs-gel was evaluated monthly, analysing entrapment efficacy, backscattering and transmittance of Ca(OH)2-NPs-gel stored at different temperatures (4°C, 25°C and 37°C). Furthermore, the antibacterial analysis of Ca(OH)2-NPs-gel was performed against Enterococcus faecalis inoculated in extracted human single-root teeth and evaluated by confocal and scanning electron microscopy. Finally, the metabolic activity of bacteria was studied through a resazurin assay to evaluate bacterial survival after treatment.

Results

Ca(OH)2-NPs-gel owned a round shape and a smooth surface without particle aggregation. Sterilisation did not induce an alteration in Ca(OH)2-NPs-gel physicochemical properties and Ca(OH)2-NPs-gel presented a high adhesion strength. In addition, 4°C was the best temperature to store Ca(OH)2-NPs-gel. Regarding the antibacterial therapeutic efficacy, Ca(OH)2-NPs-gel possesses suitable antibacterial properties, indicating that it efficiently reduces bacterial biofilms.

Conclusion

Calcium hydroxide-loaded PLGA nanoparticles dispersed in a thermosensitive gel have been developed, optimised and characterised, obtaining excellent antibacterial properties and achieving bacterial disinfection levels similar to those of commercial formulations.

目的:表征和评价一种基于分散在含氢氧化钙的热敏凝胶(Ca(OH)2- nps凝胶)中的可生物降解纳米颗粒的根管消毒纳米配方的粘着强度和抗菌性能。方法:用透射电镜研究了Ca(OH)2- nps凝胶的形貌。采用γ辐照(25 kGy)对Ca(OH)2- nps -凝胶进行灭菌,通过测定Ca(OH)2- nps -凝胶的平均粒径、多分散性指数、zeta电位和包封效率,研究灭菌后的稳定性。为了评估离体黏附强度,使用拔出的单根人牙来测量将配方与牙齿分离所需的力。此外,每月评估Ca(OH)2- nps -凝胶的短期稳定性,分析Ca(OH)2- nps -凝胶在不同温度(4°C、25°C和37°C)下的捕获效率、后向散射和透射率。此外,还对Ca(OH)2- nps -凝胶对提取的人单根牙接种的粪肠球菌进行了抗菌分析,并通过共聚焦和扫描电镜进行了评价。最后,通过reazurin试验研究细菌的代谢活性,以评估治疗后细菌的存活率。结果:Ca(OH)2- nps -凝胶呈圆形,表面光滑,无颗粒聚集。灭菌未引起Ca(OH)2- nps -凝胶理化性质的改变,Ca(OH)2- nps -凝胶具有较高的粘附强度。4℃是Ca(OH)2- nps凝胶的最佳保存温度。在抗菌治疗效果方面,Ca(OH)2- nps -凝胶具有合适的抗菌性能,表明其有效地减少了细菌生物膜。结论:开发、优化和表征了分散在热敏凝胶中的氢氧化钙负载PLGA纳米颗粒,获得了优异的抗菌性能,达到了与商业配方相似的细菌消毒水平。
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引用次数: 0
Assessment of Case Complexity of Root Canal Treatments Using Contemporary Complexity Grading Systems: A Clinical Service Evaluation 应用现代复杂性分级系统评价根管治疗的病例复杂性:一项临床服务评价。
IF 7.1 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-10-06 DOI: 10.1111/iej.70039
Nour Ghazi, Har-amrit Singh, Edward Longbottom, Jeremy Hayes, Damian Farnell, Arindam Dutta
<div> <section> <h3> Aim</h3> <p>To assess the complexity of root canal treatments allocated to Postgraduate Endodontology trainees at Cardiff University Dental Hospital (CUDH) using the English Clinical Standards for Restorative Dentistry (ECS) in comparison with the Dental Practicality Index (DPI), the EndoApp (EA), and the Endodontic Complexity Assessment Tool (E-CAT).</p> </section> <section> <h3> Material and Methods</h3> <p>Two-hundred-and-one case records were evaluated by two calibrated examiners using each complexity assessment system. Inter-examiner and intra-examiner variability was calculated using Cohen's kappa coefficient. Statistical analyses compared the scores obtained for the same case using the different systems.</p> </section> <section> <h3> Results</h3> <p>Most cases were assigned level 3 complexity using ECS, EA and E-CAT (82%, 92% and 74.1%, respectively), and scores of 3–5 (78.6%) using DPI. EA consistently assigned higher complexity scores compared with ECS and E-CAT. E-CAT assigned lower complexity scores compared with ECS. A statistically significant moderate–substantial level of agreement was demonstrated between E-CAT and ECS (weighted kappa = 0.647 [95% CI: 0.517 to 0.776], <i>p</i> < 0.001). A statistically significant fair level of agreement was demonstrated between EA and ECS (weighted kappa = 0.290 [95% CI: 0.113 to 0.466], <i>p</i> < 0.001) and EA and E-CAT (weighted kappa: 0.385 [95% CI: 0.226 to 0.544], <i>p</i> < 0.001). A statistically significant weak positive correlation was found between DPI and ECS [Spearman's correlation coefficient (<i>r</i><sub>s</sub>) = 0.202, <i>p</i> = 0.004], DPI and EA (<i>r</i><sub>s</sub> = 0.344, <i>p</i> < 0.001), and DPI and E-CAT (<i>r</i><sub>s</sub> = 0.364, <i>p</i> < 0.001). The most common cause of increase in complexity scores was ‘canal negotiability’ for ECS (47%) and the ‘endodontic treatment need’ for DPI (84.1%). The unknown algorithm used by EA and E-CAT prevented the identification of specific factors that contributed to the endodontic treatment complexity.</p> </section> <section> <h3> Conclusion</h3> <p>The majority of cases treated at CUDH were of high complexity. E-CAT assigned slightly lower complexity scores compared with ECS and EA, potentially due to its detailed assessment of factors. A weak positive correlation was found between the complexity grading systems. DPI's broader assessment justifies a cut-off score of 3 for specialist referral due to the increased agreement with ECS, E-CAT and EA at this threshold.</p> </sectio
目的:通过与牙科实用性指数(DPI)、牙髓应用程序(EA)和牙髓复杂性评估工具(E-CAT)比较,评估卡迪夫大学牙科医院(CUDH)牙髓学研究生使用英国临床标准(ECS)进行根管治疗的复杂性。材料和方法:由两名经过校准的审查员使用每种复杂性评估系统对221份病例记录进行评估。使用Cohen's kappa系数计算考官之间和考官内部的变异性。统计分析比较了使用不同系统对同一病例获得的分数。结果:大多数病例的ECS、EA和E-CAT评分为3级(分别为82%、92%和74.1%),DPI评分为3-5级(78.6%)。与ECS和E-CAT相比,EA始终分配更高的复杂性分数。与ECS相比,E-CAT的复杂性评分较低。E-CAT与ECS(加权kappa = 0.647 [95% CI: 0.517 ~ 0.776], p s) = 0.202, p = 0.004)、DPI与EA (rs = 0.344, p s = 0.364, p)的一致性具有统计学意义。与ECS和EA相比,E-CAT的复杂性评分略低,这可能是由于其对因素的详细评估。复杂度分级系统之间存在弱正相关关系。由于与ECS, E-CAT和EA在这一阈值上的一致性增加,DPI更广泛的评估证明了专家转诊的截止分数为3分。
{"title":"Assessment of Case Complexity of Root Canal Treatments Using Contemporary Complexity Grading Systems: A Clinical Service Evaluation","authors":"Nour Ghazi,&nbsp;Har-amrit Singh,&nbsp;Edward Longbottom,&nbsp;Jeremy Hayes,&nbsp;Damian Farnell,&nbsp;Arindam Dutta","doi":"10.1111/iej.70039","DOIUrl":"10.1111/iej.70039","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aim&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To assess the complexity of root canal treatments allocated to Postgraduate Endodontology trainees at Cardiff University Dental Hospital (CUDH) using the English Clinical Standards for Restorative Dentistry (ECS) in comparison with the Dental Practicality Index (DPI), the EndoApp (EA), and the Endodontic Complexity Assessment Tool (E-CAT).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Material and Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Two-hundred-and-one case records were evaluated by two calibrated examiners using each complexity assessment system. Inter-examiner and intra-examiner variability was calculated using Cohen's kappa coefficient. Statistical analyses compared the scores obtained for the same case using the different systems.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Most cases were assigned level 3 complexity using ECS, EA and E-CAT (82%, 92% and 74.1%, respectively), and scores of 3–5 (78.6%) using DPI. EA consistently assigned higher complexity scores compared with ECS and E-CAT. E-CAT assigned lower complexity scores compared with ECS. A statistically significant moderate–substantial level of agreement was demonstrated between E-CAT and ECS (weighted kappa = 0.647 [95% CI: 0.517 to 0.776], &lt;i&gt;p&lt;/i&gt; &lt; 0.001). A statistically significant fair level of agreement was demonstrated between EA and ECS (weighted kappa = 0.290 [95% CI: 0.113 to 0.466], &lt;i&gt;p&lt;/i&gt; &lt; 0.001) and EA and E-CAT (weighted kappa: 0.385 [95% CI: 0.226 to 0.544], &lt;i&gt;p&lt;/i&gt; &lt; 0.001). A statistically significant weak positive correlation was found between DPI and ECS [Spearman's correlation coefficient (&lt;i&gt;r&lt;/i&gt;&lt;sub&gt;s&lt;/sub&gt;) = 0.202, &lt;i&gt;p&lt;/i&gt; = 0.004], DPI and EA (&lt;i&gt;r&lt;/i&gt;&lt;sub&gt;s&lt;/sub&gt; = 0.344, &lt;i&gt;p&lt;/i&gt; &lt; 0.001), and DPI and E-CAT (&lt;i&gt;r&lt;/i&gt;&lt;sub&gt;s&lt;/sub&gt; = 0.364, &lt;i&gt;p&lt;/i&gt; &lt; 0.001). The most common cause of increase in complexity scores was ‘canal negotiability’ for ECS (47%) and the ‘endodontic treatment need’ for DPI (84.1%). The unknown algorithm used by EA and E-CAT prevented the identification of specific factors that contributed to the endodontic treatment complexity.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The majority of cases treated at CUDH were of high complexity. E-CAT assigned slightly lower complexity scores compared with ECS and EA, potentially due to its detailed assessment of factors. A weak positive correlation was found between the complexity grading systems. DPI's broader assessment justifies a cut-off score of 3 for specialist referral due to the increased agreement with ECS, E-CAT and EA at this threshold.&lt;/p&gt;\u0000 &lt;/sectio","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"59 1","pages":"47-56"},"PeriodicalIF":7.1,"publicationDate":"2025-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iej.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145232436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
From Cells to Animals: Connexin43 Suppression Enhances Autophagic Flux to Restore Odontogenesis in Inflamed Dental Pulp 从细胞到动物:抑制Connexin43增强自噬通量以恢复发炎牙髓的牙生成。
IF 7.1 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-10-05 DOI: 10.1111/iej.70044
Peiling Hu, Yingqing Chen, Ping Long, Anni Zhang, Xiaorong Lan, Yuanpei He, Guangwen Li, Shiting Li
<div> <section> <h3> Aim</h3> <p>Under certain conditions, infection-induced inflammation may activate reparative processes to form a hard tissue barrier against microbial invasion. Autophagy participates in odontogenic differentiation during inflammation in vitro, but its role in pulp repair remains unclear. This study investigated how autophagy regulated odontogenic differentiation within the inflammatory microenvironment, emphasising the regulatory role of connexin43 (Cx43) on autophagy.</p> </section> <section> <h3> Methodology</h3> <p>Autophagy activation was detected in inflamed pulpal tissues using immunofluorescence (IF). Human dental pulp cells (hDPCs) were stimulated with 0.1/5 μg/mL lipopolysaccharide (LPS). Autophagy dynamics, including autophagic flux, were analysed through western blotting (WB), transmission electron microscopy (TEM), and mRFP-GFP-LC3 plasmid transfection. Odontogenic differentiation and mineralisation were assessed using molecular assays and Alizarin Red staining. Pharmacological inhibitors or activators were applied to determine autophagy's role. Cx43 knockdown in hDPCs and a dentine injury model in Cx43 cKO mice were used to validate their effects on autophagy. Results were analysed by two-way ANOVA.</p> </section> <section> <h3> Results</h3> <p>Autophagy-related proteins were predominantly localised in the odontoblast layer. As dental pulp infection advanced, concurrent upregulation of LC3 and p62 levels was observed, indicating that autophagy activation occurs in the pulp alongside potential impairment of autophagic flux. 0.1 μg/mL LPS promoted autophagic flux, thereby facilitating odontogenic differentiation and mineralisation, whereas autophagy inhibition attenuated these effects. Conversely, 5 μg/mL LPS induced autophagosome accumulation but blocked autophagic flux, suppressing odontogenic differentiation and mineralisation; however, restoring autophagic flux reversed this inhibition. These data suggested that maintenance of autophagic flux integrity is essential for sustaining odontogenic differentiation capacity under inflammatory stress. Cx43 knockdown under high-inflammatory conditions rescued autophagic flux and improved differentiation. Similarly, in the dentine injury model of cKO mice, Cx43 deletion attenuated p62 expression while upregulating DSPP expression, accompanied by enhanced tertiary dentine formation beneath the injury site, indicating that blockade of Cx43 promotes autophagic flux to improve pulp repair.</p> </section> <section> <h3> Conclusion</h3> <p>Autophagy regulates both inflammatory r
目的:在一定条件下,感染引起的炎症可激活修复过程,形成坚硬的组织屏障,以抵御微生物的入侵。体外炎症过程中自噬参与牙源性分化,但其在牙髓修复中的作用尚不清楚。本研究探讨了自噬如何在炎症微环境中调节牙源性分化,强调了connexin43 (Cx43)对自噬的调节作用。方法:采用免疫荧光法(IF)检测炎症牙髓组织的自噬激活。0.1/5 μg/mL脂多糖刺激人牙髓细胞(hDPCs)。通过western blotting (WB)、透射电镜(TEM)和mRFP-GFP-LC3质粒转染分析自噬动力学,包括自噬通量。用分子分析和茜素红染色评估牙源性分化和矿化。应用药物抑制剂或激活剂来确定自噬的作用。通过hDPCs中Cx43的敲除和Cx43 cKO小鼠的牙本质损伤模型来验证其对自噬的影响。结果采用双因素方差分析。结果:自噬相关蛋白主要分布于成牙层。随着牙髓感染的进展,观察到LC3和p62水平同时上调,表明自噬激活在牙髓中发生,同时自噬通量可能受损。0.1 μg/mL LPS促进自噬通量,从而促进牙源性分化和矿化,而自噬抑制则减弱这些作用。相反,5 μg/mL LPS诱导自噬体积累,但阻断自噬通量,抑制牙源性分化和矿化;然而,恢复自噬通量逆转了这种抑制作用。这些数据表明,维持自噬通量的完整性对于在炎症应激下维持牙源性分化能力至关重要。在高炎症条件下,Cx43的下调挽救了自噬通量并改善了分化。同样,在cKO小鼠的牙本质损伤模型中,Cx43缺失降低了p62的表达,同时上调了DSPP的表达,并伴有损伤部位下三级牙本质的形成增强,表明Cx43的阻断促进了自噬通量,从而改善了牙髓修复。结论:自噬调节牙髓的炎症反应和修复过程。具体而言,维持功能性自噬通量可确保细胞适应病理性应激,同时保持其形成矿化组织的能力。抑制Cx43通过恢复炎症条件下的自噬通量来促进牙髓修复,突出了其作为深部龋的治疗靶点的潜力,通过协同调节炎症和促进再生。
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引用次数: 0
Unveiling the Vital Role of Dental Nerves in Dental Pulp Immune Defence and Repair 揭示牙神经在牙髓免疫防御和修复中的重要作用。
IF 7.1 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-10-04 DOI: 10.1111/iej.70040
Wenji Luo, Mingmei Yang, Chi Zhan, Zongshan Shen, Zhi Song, Zhengmei Lin, Lingling Chen
<div> <section> <h3> Background</h3> <p>Dental pulp sustains oral health through dentine formation, sensation, nutrition and defence. Beyond these classical roles, pulpal nerves have emerged as key coordinators of immune responses and tissue repair. While traditionally viewed as limited to sensory and vascular regulation, recent advances reveal that the nervous system interacts with immune mechanisms to manage inflammation and facilitate regeneration following injury or infection.</p> </section> <section> <h3> Objectives</h3> <p>To synthesise evidence on the anatomy, distribution and functional diversity of dental pulp innervation, emphasising how nerves regulate innate/adaptive immunity and orchestrate pulp tissue repair and regeneration.</p> </section> <section> <h3> Method</h3> <p>The review included studies up to the search period, utilising PubMed and Google Scholar. Search terms covered nervous-system concepts (“nerves”, “neuropeptides”, “nervefibres”, “Schwann cells”) and immune/repair concepts (“immune response”, “inflammation”, “immune cells”, “fibroblasts”, “odontoblasts”, “dental pulpstem cells”, “dentine regeneration”, “odontogenic differentiation”). Key termswere combined with Boolean operators: [nervous-system terms] AND [immune/repairterms] AND [dental], to capture studies on the role of dental nerves in pulpimmune defence and repair.</p> </section> <section> <h3> Results</h3> <p>In innate immunity, dental nerves recognise pathogens, undergo sprouting in inflamed pulp, mediate neurogenic inflammation and engage in dynamic crosstalk with immune cells. In adaptive immunity, they influence antigen presentation and regulate T-cell activation through neuropeptides, highlighting their central role in immune modulation. Furthermore, dental nerves are indispensable for tissue repair, facilitating key processes such as progenitor cell recruitment, proliferation, differentiation and reparative dentine formation. Schwann cells and sensory and sympathetic innervation play distinct yet interconnected roles throughout these stages.</p> </section> <section> <h3> Conclusion</h3> <p>The neuro-immune-endodontic axis is central to the pulp's ability to defend and repair itself, offering insights into innovative therapeutic strategies for managing dental pulp diseases. By integrating neural regulation into endodontic therapies, we can develop more effective treatments that leverage the complex interplay between the nervous and immune systems, enhancing
背景:牙髓通过牙本质的形成、感觉、营养和防御来维持口腔健康。除了这些经典的角色,牙髓神经已经成为免疫反应和组织修复的关键协调者。虽然传统上被认为仅限于感觉和血管调节,但最近的进展表明,神经系统与免疫机制相互作用,以控制炎症并促进损伤或感染后的再生。目的:综合牙髓神经支配的解剖、分布和功能多样性的证据,强调神经如何调节先天/适应性免疫和协调牙髓组织修复和再生。方法:本综述纳入了PubMed和谷歌Scholar检索期的研究。搜索词包括神经系统概念(“神经”、“神经肽”、“神经纤维”、“雪旺细胞”)和免疫/修复概念(“免疫反应”、“炎症”、“免疫细胞”、“成纤维细胞”、“成牙细胞”、“牙髓细胞”、“牙本质再生”、“成牙分化”)。关键术语与布尔运算符组合:[神经系统术语]和[免疫/修复术语]和[牙科],以捕捉牙神经在牙髓免疫防御和修复中的作用的研究。结果:在先天免疫中,牙神经识别病原体,在炎症牙髓中萌芽,介导神经源性炎症,并与免疫细胞进行动态串话。在适应性免疫中,它们通过神经肽影响抗原递呈和调节t细胞活化,突出了它们在免疫调节中的核心作用。此外,牙神经在组织修复中不可或缺,促进了祖细胞募集、增殖、分化和修复性牙本质形成等关键过程。雪旺细胞和感觉和交感神经支配在这些阶段起着不同但相互关联的作用。结论:神经-免疫-根管轴是牙髓防御和自我修复能力的核心,为管理牙髓疾病的创新治疗策略提供了见解。通过将神经调节整合到牙髓治疗中,我们可以开发出更有效的治疗方法,利用神经系统和免疫系统之间复杂的相互作用,提高牙齿健康和再生的效果。
{"title":"Unveiling the Vital Role of Dental Nerves in Dental Pulp Immune Defence and Repair","authors":"Wenji Luo,&nbsp;Mingmei Yang,&nbsp;Chi Zhan,&nbsp;Zongshan Shen,&nbsp;Zhi Song,&nbsp;Zhengmei Lin,&nbsp;Lingling Chen","doi":"10.1111/iej.70040","DOIUrl":"10.1111/iej.70040","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Dental pulp sustains oral health through dentine formation, sensation, nutrition and defence. Beyond these classical roles, pulpal nerves have emerged as key coordinators of immune responses and tissue repair. While traditionally viewed as limited to sensory and vascular regulation, recent advances reveal that the nervous system interacts with immune mechanisms to manage inflammation and facilitate regeneration following injury or infection.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To synthesise evidence on the anatomy, distribution and functional diversity of dental pulp innervation, emphasising how nerves regulate innate/adaptive immunity and orchestrate pulp tissue repair and regeneration.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Method&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The review included studies up to the search period, utilising PubMed and Google Scholar. Search terms covered nervous-system concepts (“nerves”, “neuropeptides”, “nervefibres”, “Schwann cells”) and immune/repair concepts (“immune response”, “inflammation”, “immune cells”, “fibroblasts”, “odontoblasts”, “dental pulpstem cells”, “dentine regeneration”, “odontogenic differentiation”). Key termswere combined with Boolean operators: [nervous-system terms] AND [immune/repairterms] AND [dental], to capture studies on the role of dental nerves in pulpimmune defence and repair.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;In innate immunity, dental nerves recognise pathogens, undergo sprouting in inflamed pulp, mediate neurogenic inflammation and engage in dynamic crosstalk with immune cells. In adaptive immunity, they influence antigen presentation and regulate T-cell activation through neuropeptides, highlighting their central role in immune modulation. Furthermore, dental nerves are indispensable for tissue repair, facilitating key processes such as progenitor cell recruitment, proliferation, differentiation and reparative dentine formation. Schwann cells and sensory and sympathetic innervation play distinct yet interconnected roles throughout these stages.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The neuro-immune-endodontic axis is central to the pulp's ability to defend and repair itself, offering insights into innovative therapeutic strategies for managing dental pulp diseases. By integrating neural regulation into endodontic therapies, we can develop more effective treatments that leverage the complex interplay between the nervous and immune systems, enhancing ","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"59 1","pages":"2-18"},"PeriodicalIF":7.1,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iej.70040","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Uncertainty in Relation to Clinical Experience-A Qualitative Study on Dental Students' Reflections on Risk Assessment of Root Filled Teeth. 不确定性与临床经验的关系——对牙科学生对根补牙风险评估反思的定性研究。
IF 7.1 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-10-02 DOI: 10.1111/iej.70047
Joséphine Brodén, Maria Pigg, Niklas Vareman, Helena Fransson

Aim: In uncertain clinical situations, such as assessing the risk of exacerbation of apical periodontitis in root-filled teeth, undergraduate students can benefit from being trained to reflect. This study aimed to explore how students specifically reflected on clinical experiences in relation to uncertainty when assessing a case involving a root-filled tooth with apical periodontitis.

Methodology: Short reflections were written by 52 dental students at Malmö University in 2021. All students were asked to reflect on the risk for exacerbation of apical periodontitis in a case with a root-filled tooth with a diffuse widening of the periodontal ligament space. The reflections were written according to prompts developed to stimulate reflection. For each student, the reflections were analysed by a qualitative method, Systematic Text Condensation (STC).

Results: The analysis of the qualitative data resulted in the formulation of two themes about experience and lack of experience: Theme 1 'The meaning of clinical experience' and Theme 2 'Differences and similarities'. The themes were subdivided into nine subgroups and described the relationship between experience and certainty.

Conclusions: The students believed that certainty comes with experience even when there is a lack of scientific evidence.

目的:在不确定的临床情况下,如评估根填充牙齿的根尖牙周炎恶化的风险,大学生可以从训练中获益。本研究旨在探讨学生如何具体反映临床经验的不确定性,当评估一个病例涉及根填充牙与根尖牙周炎。方法:由Malmö大学52名牙科学生于2021年撰写的简短反思。所有的学生被要求反映的风险加剧根尖牙周炎的情况下,牙根充盈的牙齿,弥漫性牙周韧带间隙扩大。这些反思是根据刺激反思的提示写的。对每个学生的反思,通过定性方法进行分析,系统文本浓缩(STC)。结果:通过对定性数据的分析,形成了两个关于经验与缺乏的主题:主题1“临床经验的意义”和主题2“差异与相似”。这些主题被细分为九个小组,描述了经验和确定性之间的关系。结论:学生们相信,即使在缺乏科学证据的情况下,确定性也来自经验。
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引用次数: 0
Comparative Analysis of AI-Generated and Manually Designed Approaches in Accuracy and Design Time for Surgical Path Planning of Dynamic Navigation-Aided Endodontic Microsurgery: A Retrospective Study 人工智能生成和人工设计方法在动态导航辅助牙髓显微外科手术路径规划的准确性和设计时间上的对比分析:一项回顾性研究。
IF 7.1 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-10-01 DOI: 10.1111/iej.70045
Chen Chen, Xining Zhang, Li Qin, Liuyan Meng

Aim

To compare the accuracy and design time of artificial intelligence (AI)-generated and manually designed (MD) surgical pathways for osteotomies and root-end resections in dynamic navigation (DN)-aided endodontic microsurgery (EMS).

Methodology

Fifty-one surgical pathways were analysed, each planned using both AI and MD methodologies. Accuracy was assessed using the DCARE Navigation System (v3.2, MedNav Ltd) and AutoCAD (2023, Autodesk Inc.), evaluating five parameters: start deviation, end deviation, angular deviation, root-end resection length deviation, and root-end resection angulation deviation. Design time was measured from the point of CBCT dataset import to the finalisation of the surgical pathway design. Mann–Whitney U test was used to compare the accuracy and design time of the AI and MD groups, whereas the rank-based ANCOVA was used to assess deviations according to tooth type, jaw type, and root number. Statistical significance was set at p < 0.05.

Results

Compared with the MD group, the AI group exhibited significantly smaller root-end resection length deviations (AI: 0.01 [0.01, 0.02] mm; MD: 0.02 [0.01, 0.03] mm; p = 0.029) but significantly larger root-end resection angulation deviations (AI: 3.48 [1.01, 7.48]; MD: 0.35 [0.16, 0.73]; p < 0.001). There were no significant differences in the start deviation, end deviation, angular deviation, root-end resection length deviation, or root-end resection angulation deviation across tooth type, jaw type, or root number. The design time was significantly shorter in the AI group than in the MD group (55 [21, 74] s vs. 379 [215, 553] s; p < 0.001).

Conclusions

A clinically operational AI-based surgical path design approach is capable of minimising manual interventions and delivering time-efficient, accurate results for clinical use. The integration of AI with DN-aided EMS may contribute to the development of increasingly autonomous surgical procedures.

目的:比较动态导航(DN)辅助牙髓显微外科(EMS)中人工智能(AI)生成和人工设计(MD)手术路径的截骨和根端切除的准确性和设计时间。方法:分析了51条手术路径,每条路径均采用人工智能和MD方法进行规划。使用DCARE导航系统(v3.2, MedNav Ltd)和AutoCAD (2023, Autodesk Inc.)评估精度,评估五个参数:开始偏差、结束偏差、角度偏差、根端切除长度偏差和根端切除角度偏差。从CBCT数据集导入到手术路径设计的最终完成,测量设计时间。使用Mann-Whitney U检验比较AI组和MD组的准确性和设计时间,而使用基于秩的ANCOVA评估根据牙型、颌型和根数的偏差。结果:与MD组相比,AI组根尖切除长度偏差明显小于MD组(AI: 0.01 [0.01, 0.02] mm; MD: 0.02 [0.01, 0.03] mm; p = 0.029),但根尖切除角度偏差明显大于MD组(AI: 3.48 [1.01, 7.48]; MD: 0.35 [0.16, 0.73];结论:临床可操作的基于人工智能的手术路径设计方法能够最大限度地减少人工干预,并为临床使用提供高效、准确的结果。人工智能与dn辅助EMS的整合可能有助于日益自主的外科手术的发展。
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引用次数: 0
Prevalence, Classification and Factors Associated With Cemental Tears—A Retrospective Observational Cross-Sectional Study in a Postgraduate Endodontic Clinic 骨水泥撕裂的患病率、分类及相关因素——一项牙髓临床研究生的回顾性观察性横断面研究。
IF 7.1 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-09-30 DOI: 10.1111/iej.70042
A. H. C. Lee, A. W. K. Yeung, A. Sigurdsson, M. C. M. Wong, C. F. Zhang
<div> <section> <h3> Introduction</h3> <p>There is a lack of epidemiology studies on cemental tears. This study aimed to (i) investigate the prevalence of cemental tears among the patients referred to a Postgraduate Endodontic Clinic, (ii) classify the cases diagnosed with cemental tears, and (iii) assess factors associated with cemental tears.</p> </section> <section> <h3> Materials and Methods</h3> <p>This retrospective, cross-sectional study included 445 cases/teeth recruited between 1 September 2019 and 31 March 2024 at a University Postgraduate Endodontic Clinic. Information was collated from the clinical records of case history, clinical findings and radiographic interpretations from periapical radiograph (PR) and cone beam computed tomography (CBCT) images. For each case/tooth, cemental tear/s were categorised as either absent or present, and those with cemental tear/s were further classified. Thirty potential factors were studied, including patient-, jaw-, tooth-, previous endodontic treatment and periodontal-related factors. Factors were individually tested using univariate analysis with Pearson chi-squared (exact) tests. Any significant factors identified were further subjected to multiple logistic regression analyses based on a forward stepwise regression model (<i>p</i> < 0.05).</p> </section> <section> <h3> Results</h3> <p>Cemental tear/s were found in 25 out of 445 cases/teeth, with a prevalence of 5.6%. Sensitivity and specificity of PR in detecting cemental tears were 0.6 and 1.0, respectively. Most cases/teeth detected were classified as Class 2 and 4 (<i>n</i> = 19, 76%) or Stage C and D (<i>n</i> = 19, 76%). Mean age of the subjects with cemental tears was 58.7 years, with comparable prevalence between males and females. Most cases (72%) with cemental tear/s had root canal treatment initiated or completed. Incisors, increased tooth mobility, severe crestal bone loss and adequate root filling quality were significantly associated with the higher prevalence of cemental tears (<i>p</i> < 0.05).</p> </section> <section> <h3> Conclusion</h3> <p>Cemental tears should always be considered as a differential diagnosis in endodontic practice. Clinicians should be particularly vigilant for increased risks of cemental tears in incisors, mobile teeth, teeth exhibiting increased crestal bone loss and those with adequately filled root canals, as they may be misdiagnosed as periodontal-endodontic lesions. The use of CBCT is crucial for accurate diagnosis, guiding effective treatment planning and improving clinical outcomes in endodontic ma
前言:目前缺乏关于骨水泥撕裂的流行病学研究。本研究旨在(1)调查在牙髓学研究生诊所就诊的患者中牙髓撕裂的患病率,(2)对诊断为牙髓撕裂的病例进行分类,(3)评估与牙髓撕裂相关的因素。材料和方法:这项回顾性、横断面研究包括2019年9月1日至2024年3月31日在大学研究生牙髓诊所招募的445例病例/牙齿。从临床记录、临床表现和根尖周x线片(PR)和锥形束计算机断层扫描(CBCT)图像的放射学解释中整理信息。对于每个病例/牙齿,骨水泥撕裂分为无骨水泥撕裂和有骨水泥撕裂两种,有骨水泥撕裂的患者进一步分类。研究了30个潜在因素,包括患者、颌骨、牙齿、以前的牙髓治疗和牙周相关因素。各因素分别采用单因素分析和皮尔逊卡方(精确)检验进行检验。结果:445例患者/牙齿中有25例出现骨水泥撕裂/s,患病率为5.6%。PR检测骨水泥撕裂的敏感性为0.6,特异性为1.0。多数病例/检出的牙齿属于2、4期(19.76%)或C、D期(19.76%)。骨水泥撕裂患者的平均年龄为58.7岁,男女患病率相当。大多数(72%)骨水泥撕裂患者已经开始或完成了根管治疗。门牙、增加的牙齿活动度、严重的牙冠骨丢失和足够的牙根填充质量与较高的牙髓撕裂发生率显著相关(p结论:牙髓撕裂应始终被视为牙髓治疗实践中的鉴别诊断。临床医生应特别警惕门牙、活动牙、牙冠骨质流失增加的牙齿和根管填充充分的牙齿的牙髓撕裂风险增加,因为它们可能被误诊为牙周-根管病变。在根管治疗中,CBCT的使用对于准确诊断、指导有效的治疗计划和改善临床结果至关重要。
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引用次数: 0
Outcome of Partial Pulpotomy in Mature Permanent Molars After Lavage With Chlorhexidine or Sodium Hypochlorite: A Randomised Clinical Trial 一项随机临床试验:氯己定或次氯酸钠洗胃后部分切髓治疗成熟恒磨牙的疗效。
IF 7.1 1区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-09-30 DOI: 10.1111/iej.70043
Soumyashree Mishra, Pankaj Sangwan, Jigyasa Duhan, Mayank Arora, Shweta Mittal, Vinay Kumar, Ankita Ramani

Aim

This randomised clinical trial compared the effect of wound lavage using chlorhexidine (CHX) versus sodium hypochlorite (NaOCl) on the outcome of partial pulpotomy (PP) in mature permanent molars with carious pulpal exposure and symptomatic irreversible pulpitis (SIP).

Methodology

In this double-arm parallel-group randomised clinical trial, 104 mandibular molars undergoing PP were randomised equally to either NaOCl lavage group (NL) (n = 52) or CHX lavage group (CL) (n = 52). The pulpal wound after pulp amputation during PP was irrigated with 3% NaOCl in the NL and 2% CHX in the CL group. After haemostasis, ProRoot Mineral Trioxide Aggregate (ProRoot MTA) was used as a pulpotomy agent. Patients were evaluated for pain experience at every 24 h for 7 days, clinical success at 3, 6 and 12 months, and radiographic success at 6 and 12 months. Data were analysed using Mann–Whitney U test to compare age, duration of haemostasis, pain score and analgesic consumption between groups and Chi-square test/Fisher's exact test to compare gender, the number of tooth surfaces involved by caries, hard tissue barrier, clinical and radiographic success, pain incidence and pulp sensibility responses.

Results

Ninety-nine patients were assessed for clinical and radiographic success at 12 months follow-up. The NL group showed a higher success (91.8%) than the CL group (84%), albeit with no significant difference (p > 0.05). No significant difference was observed between the groups in postoperative pain experience (p > 0.05). Significantly less time was required to achieve haemostasis in NL (p < 0.001), and evidence of hard tissue barrier formation was significantly higher in the CL group (p = 0.024).

Conclusion

Comparable success was observed following the use of the two lavage agents during PP in managing cariously exposed adult teeth with SIP. CHX can serve as a suitable alternative to NaOCl as a pulpal wound lavage agent.

Trial Registration

clinicaltrials.gov identifier: NCT06240130

目的:本随机临床试验比较氯己定(CHX)与次氯酸钠(NaOCl)伤口灌洗对成熟恒磨牙牙髓部分切开术(PP)结果的影响,这些恒磨牙牙髓暴露为龋齿,症状性不可逆牙髓炎(SIP)。方法:在这项双臂平行组随机临床试验中,104颗接受PP治疗的下颌磨牙平均随机分为NaOCl灌洗组(n = 52)和CHX灌洗组(n = 52)。残髓切除后的牙髓创面,NL组用3% NaOCl冲洗,CL组用2% CHX冲洗。止血后,使用prooroot Mineral Trioxide Aggregate (prooroot MTA)作为切髓剂。在7天内每24小时评估一次患者的疼痛体验,在3个月、6个月和12个月时评估一次临床成功,在6个月和12个月时评估一次影像学成功。数据分析采用Mann-Whitney U检验比较两组患者的年龄、止血时间、疼痛评分和止痛药用量;采用卡方检验/Fisher精确检验比较两组患者的性别、蛀牙面数量、硬组织屏障、临床和影像学成功程度、疼痛发生率和牙髓敏感性反应。结果:在12个月的随访中,对99例患者的临床和影像学成功进行了评估。NL组的成功率(91.8%)高于CL组(84%),但差异无统计学意义(p < 0.05)。两组术后疼痛体验差异无统计学意义(p < 0.05)。结论:PP期间使用两种灌洗剂治疗严重外露的成牙,在SIP治疗中取得了相当的成功。CHX可作为NaOCl的合适替代品作为牙髓创面灌洗剂。试验注册:clinicaltrials.gov标识符:NCT06240130。
{"title":"Outcome of Partial Pulpotomy in Mature Permanent Molars After Lavage With Chlorhexidine or Sodium Hypochlorite: A Randomised Clinical Trial","authors":"Soumyashree Mishra,&nbsp;Pankaj Sangwan,&nbsp;Jigyasa Duhan,&nbsp;Mayank Arora,&nbsp;Shweta Mittal,&nbsp;Vinay Kumar,&nbsp;Ankita Ramani","doi":"10.1111/iej.70043","DOIUrl":"10.1111/iej.70043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This randomised clinical trial compared the effect of wound lavage using chlorhexidine (CHX) versus sodium hypochlorite (NaOCl) on the outcome of partial pulpotomy (PP) in mature permanent molars with carious pulpal exposure and symptomatic irreversible pulpitis (SIP).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>In this double-arm parallel-group randomised clinical trial, 104 mandibular molars undergoing PP were randomised equally to either NaOCl lavage group (NL) (<i>n</i> = 52) or CHX lavage group (CL) (<i>n</i> = 52). The pulpal wound after pulp amputation during PP was irrigated with 3% NaOCl in the NL and 2% CHX in the CL group. After haemostasis, ProRoot Mineral Trioxide Aggregate (ProRoot MTA) was used as a pulpotomy agent. Patients were evaluated for pain experience at every 24 h for 7 days, clinical success at 3, 6 and 12 months, and radiographic success at 6 and 12 months. Data were analysed using Mann–Whitney <i>U</i> test to compare age, duration of haemostasis, pain score and analgesic consumption between groups and Chi-square test/Fisher's exact test to compare gender, the number of tooth surfaces involved by caries, hard tissue barrier, clinical and radiographic success, pain incidence and pulp sensibility responses.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Ninety-nine patients were assessed for clinical and radiographic success at 12 months follow-up. The NL group showed a higher success (91.8%) than the CL group (84%), albeit with no significant difference (<i>p</i> &gt; 0.05). No significant difference was observed between the groups in postoperative pain experience (<i>p</i> &gt; 0.05). Significantly less time was required to achieve haemostasis in NL (<i>p</i> &lt; 0.001), and evidence of hard tissue barrier formation was significantly higher in the CL group (<i>p</i> = 0.024).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Comparable success was observed following the use of the two lavage agents during PP in managing cariously exposed adult teeth with SIP. CHX can serve as a suitable alternative to NaOCl as a pulpal wound lavage agent.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>clinicaltrials.gov identifier: NCT06240130</p>\u0000 </section>\u0000 </div>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"59 1","pages":"80-90"},"PeriodicalIF":7.1,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
International endodontic journal
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