Journal of endodontics最新文献

{"title":"Comparison of the Accuracy and Efficiency of Two Dynamic Navigation System Workflow for Fiber-post Removal: Small versus Large Field-of-view Registration Workflows","authors":"","doi":"10.1016/j.joen.2024.06.011","DOIUrl":"10.1016/j.joen.2024.06.011","url":null,"abstract":"<div><h3>Introduction</h3><div>This study investigates the feasibility of a dynamic navigation system (DNS) small field of view workflow (DNS-SFOVw) for fiber-post removal and compares its accuracy and efficiency to the conventional large field of view workflow (DNS-LFOVw).</div></div><div><h3>Methods</h3><div>Fifty-six extracted human maxillary molars were divided into DNS-SFOVw (<em>n</em> = 28) and DNS-LFOVw (<em>n</em> = 28). The palatal canal was restored with an intraradicular RelyX fiber post and luted with RelyX Unicem; a core buildup was used. Teeth were mounted in a 3D-printed surgical jaw. A preoperative cone-beam computed tomography (CBCT) scan was taken with a 40 × 40 mm FOV for the DNS-SFOVw and a single arch CBCT scan for the DNS-LFOVw. The drilling entry point, trajectory, angle, and depth were planned in the X-guide software. The DNS registration method for the DNS-SFOVw was virtual-based registration on teeth, and the marker point-based method was used for the DNS-LFOVw. The fiber posts were drilled out under DNS guidance. A postoperative CBCT scan was taken. Three-dimensional deviations, angular deflection, number of mishaps, registration, and total operation time were calculated.</div></div><div><h3>Results</h3><div>The DNS-SFOVw was as accurate as DNS-LFOVw (<em>P</em> &gt; .05). The DNS-LFOVw registration time was less than DNS-SFOVw (<em>P</em> &lt; .05). There was no difference in the number of mishaps (<em>P</em> &gt; .05). Both DNS-SFOVw and DNS-LFOVw were time-efficient, with DNS-LFOVw taking less total operational time (<em>P</em> &lt; .05).</div></div><div><h3>Conclusion</h3><div>Within the limitations of this <em>in-vitro</em> study, the DNS-SFOVw was as accurate as the DNS-LFOVw for fiberpost removal. Both DNS-LFOVw and DNS-SFOVw were time-efficient in removing fiber-posts.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 10","pages":"Pages 1455-1462"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of a Penrose Drain for Decompression of a Large Periapical Lesion: A Case Report With 4.5-Year Follow-up","authors":"Feng-Ming Wang DDS, PhD ,&nbsp;Hui Liang BDS, MS, PhD ,&nbsp;Gerald N. Glickman DDS, MS, MBA, JD ,&nbsp;James L. Gutmann DDS, PhD, FACD, FICD, FADI, FAHD, IBE, FDSRCSEd","doi":"10.1016/j.joen.2024.07.005","DOIUrl":"10.1016/j.joen.2024.07.005","url":null,"abstract":"<div><div>Managing large cyst-like periapical lesions poses significant challenges, especially when nonsurgical treatment or retreatment options are ineffective. Despite its efficacy, decompression remains an underutilized minimally invasive alternative in modern dentistry. This case report describes the use of a Penrose drain for decompression following aspiration and irrigation to manage a large periapical lesion associated with a 56-year-old man's maxillary lateral incisor. The lesion had caused thinning and perforation of the facial and palatal cortical plates, as well as the inferior border of the nasal fossa. Cone-beam computed tomography was used to evaluate the lesion preoperatively and to assess the healing progress postoperatively. Complete 3-dimensional healing was observed after a subsequent root-end surgery performed 3.5 years post-decompression. This report suggests that decompression using a Penrose drain in combination with aspiration and irrigation could be a simple but effective modality for managing large cyst-like periapical lesions when nonsurgical endodontics are attempted and deemed ineffective.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 10","pages":"Pages 1521-1526"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141723726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of the Time Interval of Functional Loading on the Periapical Healing of Endodontically Treated Mandibular Molar Teeth with Pulp Necrosis and Asymptomatic Apical Periodontitis: A Split-mouth Randomized Clinical Study","authors":"Gunadhar Singh Kangjam MDS ,&nbsp;Ajay Logani MDS ,&nbsp;Veena Jain MDS ,&nbsp;Vijay Kumar MDS ,&nbsp;Amrita Chawla MDS ,&nbsp;Babina Chirom MDS","doi":"10.1016/j.joen.2024.07.013","DOIUrl":"10.1016/j.joen.2024.07.013","url":null,"abstract":"<div><h3>Introduction</h3><div>This prospective study evaluated the effect of immediate functional loading (IFL) of a full-coverage prosthesis on the clinical and radiographic outcome of nonsurgical endodontic therapy (NSET) performed on mandibular molar teeth with pulp necrosis and asymptomatic apical periodontitis.</div></div><div><h3>Methods</h3><div>In 20 subjects, standardized 2-visit NSET was performed in bilateral mandibular first molar teeth (split-mouth model) with a diagnosis of pulp necrosis and asymptomatic apical periodontitis exhibiting a radiographic periapical index (PAI) score ≥3. In each subject, the nonvital bilateral mandibular first molar teeth were randomized to 1 of 2 groups: the IFL group or the functional loading after a time interval of 6 months group. Provisional full-coverage prostheses were provided within 7 days after the completion of endodontic therapy. The cases were followed up clinically and radiographically at 6 and 12 months. Radiographs were assessed for periapical healing based on PAI scores, which were dichotomized as healed (PAI score ≤2) or nonhealed (PAI score ≥3). The data were compared using chi-square and Fisher exact tests.</div></div><div><h3>Results</h3><div>A recall rate of 100% was achieved at the end of 12 months. All teeth in the IFL group and the functional loading after a time interval of 6 months group were clinically asymptomatic. According to an intergroup comparison between the proportion of teeth healed and nonhealed (radiographic), there was a significant difference (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>IFL of a full-coverage prosthesis in endodontically treated mandibular molar teeth with pulp necrosis and asymptomatic apical periodontitis delayed periapical healing.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 10","pages":"Pages 1381-1392"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Accuracy and Operation Time in Robotic, Dynamic, and Static-Assisted Endodontic Microsurgery: An In Vitro Study","authors":"","doi":"10.1016/j.joen.2024.05.018","DOIUrl":"10.1016/j.joen.2024.05.018","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to compare the accuracy and operation time (OT) of robotic-assisted endodontic<span> microsurgery (RA-EMS), dynamic navigation-guided (DN-guided) EMS, and static navigation-guided (SN-guided) EMS.</span></div></div><div><h3>Methods</h3><div><span>Seventy-two teeth from three sets of standardized jaw models (TrueTooth, DELendo, Santa Barbara, CA) randomly assigned into 3 groups underwent osteotomy<span> and root-end resection. Preoperative plans and postoperative cone-beam computed tomography images were imported into an accuracy analysis system and aligned based on the anatomical structures to assess accuracy. The OT was recorded from the moment the foot pedal was pressed down until the bur reached the target depth. Statistical analyses were conducted using Kruskal–Wallis and Scheirer–Ray–Hare tests, with significance set at </span></span><em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>RA-EMS exhibited significantly higher accuracy than DN- and SN-guided EMS in terms of platform, angular, and resection angular deviations (<em>P</em> &lt; .05). Additionally, RA-EMS exhibited significantly higher accuracy than DN-guided EMS in resection length deviation (<em>P</em> &lt; .05). Significant differences were also observed in OTs between the 3 approaches, with SN-guided EMS showing the shortest OT, followed by RA-EMS and DN-guided EMS. Differences in jaw types within the DN-guided EMS group were observed in terms of angular deviation (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>All 3 treatment approaches demonstrated acceptable clinical accuracy and OT. RA-EMS exhibited superior accuracy, suggesting its potential application prospects in endodontics. Further high-quality clinical studies are warranted.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 10","pages":"Pages 1448-1454"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Novel and Traditional Intracanal Medicaments on Biofilm Viability and Composition","authors":"Shuk Yi Siu BDS ,&nbsp;Akhila Pudipeddi BSc, MSc ,&nbsp;Vijetha Vishwanath MDS ,&nbsp;Angeline Hui Cheng Lee MDS ,&nbsp;Amelia Wan Tin Cheung MDS ,&nbsp;Gary Shun Pan Cheung MDS, PhD ,&nbsp;Prasanna Neelakantan MDS, PhD","doi":"10.1016/j.joen.2024.07.003","DOIUrl":"10.1016/j.joen.2024.07.003","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of this study was to test the hypothesis that a combination of D-amino acids (DAAs) and <em>trans</em>-cinnamaldehyde (TC) demonstrates superior antibiofilm activity to calcium hydroxide (CH) and untreated controls.</div></div><div><h3>Methods</h3><div>In this 3-part <em>in vitro</em> study, the concentration of DAAs (D-methionine, D-leucine, D-tyrosine, and D-tryptophan) that would significantly decrease <em>Enterococcus faecalis</em> and <em>Actinomyces naeslundii</em> biofilm biomass was first determined. Then, the effect of TC + selected DAAs on polymicrobial biofilms was characterized by quantifying the biomass and biofilm viability. Finally, the antibiofilm effects of TC + DAA was compared with CH and untreated controls by (i) determining bacterial viability and (ii) quantifying biofilm matrix composition using selective fluorescence-binding analysis. Statistical analysis was performed using one-way ANOVA and appropriate multiple comparisons test, with <em>P</em> &lt; .05 considered as statistically significant.</div></div><div><h3>Results</h3><div>TC (0.06%) + D-tyrosine (1 mM) + D-tryptophan (25 mM) significantly reduced the biomass and biofilm viability compared to the control (<em>P</em> &lt; .05). While no significant difference was observed between TC + DAA and CH in the cultivable bacterial counts (<em>P</em> &gt; .05), confocal microscopy demonstrated a significantly greater percentage of dead bacteria in TC + DAA-treated biofilms compared to CH and the control (<em>P</em> &lt; .05). TC + DAA significantly decreased the biovolume and all the examined components of the biofilm matrix quantity compared to the control, while CH significantly reduced only the exopolysaccharide quantity (<em>P</em> &lt; .05).</div></div><div><h3>Conclusion</h3><div>The combination of TC + D-tyrosine + D-tryptophan demonstrated superior antibiofilm activity (biofilm bacterial killing and reduction of matrix quantity) to CH and has potential to be developed as an intracanal medicament.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 10","pages":"Pages 1412-1419"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141633618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Compatibility of Dual Rinse 1-Hydroxyethane-1,1-Diphosphonic Acid with Sodium Hypochlorite Solutions Containing Proprietary Additives","authors":"Honey Kottathil MDent ,&nbsp;Matthias Zehnder PhD ,&nbsp;Andrea Gubler ,&nbsp;Thomas Attin PhD ,&nbsp;Rajkumar Narkedamalli MDS ,&nbsp;Nidambur Vasudev Ballal MDS, PhD","doi":"10.1016/j.joen.2024.07.007","DOIUrl":"10.1016/j.joen.2024.07.007","url":null,"abstract":"<div><h3>Introduction</h3><div>A salt of 1-hydroxyethylidene-1,1-diphosphonic acid (HEDP) was commercialized some years ago. This so-called Dual Rinse (DR) HEDP has been tested for its combined actions and interactions with pure sodium hypochlorite (NaOCl) solutions. The aim of this study was to assess DR interactions with NaOCl solutions containing proprietary additives.</div></div><div><h3>Methods</h3><div>Designated endodontic NaOCl solutions that come at 2 different strengths (2% and 5.25%), and without or with additives (Chloraxid and Chloraxid Extra, respectively) were tested. Some of their key chemical and physical properties were determined in the presence or absence of HEDP (9%) in the solution. In addition, soft tissue dissolution efficacy of test and control solutions was assessed in extracted teeth (<em>n</em> = 10 per group, 90 teeth in total).</div></div><div><h3>Results</h3><div>The NaOCl content in the 2% Chloraxid solutions was slightly above, that in the 5.25% solutions below the labeled concentration. The additives in the Chloraxid Extra solutions neither altered their surface tension nor their viscosity. The addition of HEDP to any of the tested NaOCl solutions reduced their pH, and increased their surface tension and viscosity. HEDP-induced available chlorine loss over the first hour was similar between all NaOCl solutions. Soft tissue dissolution in the root canals was affected by NaOCl concentration, but neither by any proprietary NaOCl additive in the Chloraxid solutions, nor the addition of DR HEDP.</div></div><div><h3>Conclusions</h3><div>Proprietary additives had no influence on any of the tested parameters, including surface tension of the \"Extra\" solutions. The increased viscosity of combined NaOCl/HEDP solutions deserves further attention.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 10","pages":"Pages 1472-1477"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surface Modification of Dentin Powder With Alginate and Evaluation of Its Effects on the Viability and Proliferation of Dental Pulp Stem Cells (In Vitro), Its Biocompatibility (In Vivo)","authors":"Melika Manzarpour DDS ,&nbsp;Mohammad Reza Mousavi DDS ,&nbsp;Yas Mahdavinaderi DDS ,&nbsp;Mohammadali Najimi DDS ,&nbsp;Amin Ghalambor DDS ,&nbsp;Sadegh Hasannia PhD ,&nbsp;Sarah Rajabi PhD ,&nbsp;Mohamad Pezeshki-Modaress PhD ,&nbsp;Amir Kamali PhD ,&nbsp;Hengameh Bakhtiar DDS, MSc, FRCD","doi":"10.1016/j.joen.2024.07.015","DOIUrl":"10.1016/j.joen.2024.07.015","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to synthesize dentin powder surface modified with alginate, a potential substance for dental pulp regeneration, and evaluate its effects on the viability and proliferation of human dental pulp stem cells <em>in vitro</em> and its biocompatibility <em>in vivo</em>.</div></div><div><h3>Methods</h3><div>In the <em>in vitro</em> phase, dentin powder was synthesized in 3 size groups (150–250 μm, 250–500 μm, and 500–1000 μm) after demineralization and atelopeptidization which is used to remove dentin collagen telopeptides and eliminate host immune response. Surface modification with alginate was performed and followed by field-emission scanning electron microscopy, energy dispersive X-ray spectroscopy, and cell viability and proliferation testing for 14 days with human dental pulp stem cells studied. In the <em>in vivo</em> phase, dentin powders were implanted in rat calvarial defects for 8 weeks, and histologic analysis was conducted. All nonparametric data were analyzed with the Kruskal–Wallis test, and all the quantitative data were analyzed by 1-way analysis of variance using SPSS, and <em>P</em> &lt; .05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Demineralization and atelopeptidization were successful in all groups. Cell viability was optimal and equal (<em>P</em> &gt; .05) in all groups. The 500- to 1000-μm group exhibited significantly higher cell proliferation (<em>P</em> &lt; .05). Histologic assessment shows acceptable biocompatibility in all groups; the angiogenesis score was significantly greater in both 250–500 and 500–1000, and minimal inflammatory response was noted in the 500- to 1000-μm group, and the amount of newly formed bone in this group was higher than other groups.</div></div><div><h3>Conclusions</h3><div>Surface modification of demineralized and atelopeptidized dentin powder with alginate enhanced surface physical properties and cell proliferation while showing great biocompatibility within tissue and reducing the host immune response. These findings hold promise for dentin-pulp complex regeneration.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 10","pages":"Pages 1429-1439"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Radiographic Evaluation of Regenerative Endodontic Procedures and Apexification Treatments with the Assessment of External Root Resorption","authors":"","doi":"10.1016/j.joen.2024.06.003","DOIUrl":"10.1016/j.joen.2024.06.003","url":null,"abstract":"<div><h3>Introduction</h3><div>This multicentered cohort study evaluated the radiographic outcomes of regenerative endodontic procedures (REPs) and apexification treatments (APEX) of immature teeth with endodontic disease.</div></div><div><h3>Materials and Methods</h3><div>This cohort study included a retrospective record review and prospective data collection of pediatric patients with teeth treated with REPs or APEX between 2005 and 2014. Data including the presence of a periapical lesion, external root resorption, obliteration, apical hard tissue, apical closure, intracanal calcifications, and radiographic root area (RRA) change based on measurements were collected/measured from radiographic images. Univariate and multivariate analyses were conducted.</div></div><div><h3>Results</h3><div>The cohort included 190 subjects (204 teeth (92 REPs; 112 APEX)). The frequency of pretreatment periapical pathology was similar between cases in which the clinical treatment failed versus successful treatment cases. However, the frequency of pretreatment external root resorption was higher in failed cases than in successful cases (<em>P</em> = .007). The mean RRA change was greater than twenty percent in 21% of the REPs cases. In traumatized teeth, REPs resulted in less hard tissue formation than other endodontic disease etiologies measured by RRA (<em>P</em> = .001). Fifty-three percent of cases with ERR (16/30) showed signs of healing/arrest and were mostly treated with REPs (11/16).</div></div><div><h3>Conclusions</h3><div>The presence of ERR negatively affected the treatment outcome. There was significant variability in RRA change in REPs. Signs of healing/arrest of the resorptive lesion were radiographically visible in many cases treated with REPs.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 10","pages":"Pages 1420-1428.e1"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141327551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dens invaginatus Type II in an Immature Lateral Incisor With Apical Periodontitis Treated With Regenerative and Strategic Antimicrobial Procedures: A Case Report","authors":"Gabriela Martin DDS, MSc, PhD ,&nbsp;Florencia Cires DDS ,&nbsp;Jorge Alberdi DDS, PhD ,&nbsp;Cecilia I. Rourera DDS ,&nbsp;Claudia Bonnin DDS, PhD ,&nbsp;Isabela N. Rôças DDS, MSc, PhD ,&nbsp;José F. Siqueira Jr DDS, MSc, PhD","doi":"10.1016/j.joen.2024.07.004","DOIUrl":"10.1016/j.joen.2024.07.004","url":null,"abstract":"<div><div><em>Dens invaginatus</em> is a developmental dental anomaly that can predispose the tooth to pulp and periradicular disease. Management of this condition can be challenging because of anatomic and microbiologic issues. This case report describes the regenerative endodontic treatment using a strategic antimicrobial protocol for management of an immature maxillary lateral incisor with type-II <em>dens invaginatus</em> associated with apical periodontitis in a 13-year-old patient. The tooth presented with a complex anatomy and was associated with an active sinus tract. Because the true root canal was not negotiable in its coronal part due to the presence of the <em>dens invaginatus,</em> the closed end of the invagination (pseudocanal) was perforated to permit access to the apical segment of the true root canal for cleaning and disinfection. Both the invagination and the true canal were treated using an antimicrobial regimen based on chemomechanical preparation with sodium hypochlorite irrigation, supplementary disinfection with passive ultrasonic irrigation and interappointment calcium hydroxide medication. After 2 exchanges of calcium hydroxide medication, the sinus tract did not disappear, then the antimicrobial protocol was changed to include an antibiotic solution for irrigation and antibiotic paste for intracanal medication. After signs and symptoms disappeared, regenerative endodontic treatment was performed by inducing blood clot formation within the root canal. The coronal canal segment including the invagination was filled with Biodentine. Follow-up including cone-beam computed tomography examination showed complete healing of the apical periodontitis lesion and mineralized tissue formation at the apical portion of the true root canal.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 10","pages":"Pages 1515-1520"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141693718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Fluorescence-based Method to Reaccess Root Canals in Endodontically Treated Teeth: A Micro–Computed Tomography Tridimensional Assessment","authors":"Iago Ramirez DDS, MSc ,&nbsp;Lautaro Gallardo Altube DDS, MSc ,&nbsp;Rafael Verardino Camargo DDS, MSc ,&nbsp;Alice Corrêa Silva-Sousa DDS, MSc, PhD ,&nbsp;Aline Evangelista Souza-Gabriel DDS, MSc, PhD ,&nbsp;Liviu Steier DDS, MSc, PhD ,&nbsp;Fabiane Carneiro Lopes-Olhê DDS, MSc, PhD ,&nbsp;Manoel Damião Sousa-Neto DDS, MSc, PhD ,&nbsp;Jardel Francisco Mazzi-Chaves DDS, MSc, PhD","doi":"10.1016/j.joen.2024.07.009","DOIUrl":"10.1016/j.joen.2024.07.009","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of this study was to evaluate the volume of dentin removal and the volume of remnants of restorative material after the removal of an esthetic restorative coronal set and cervical barrier in endodontically treated mandibular molars with the aid of different magnification methods using 3-dimensional (3D) micro–computed tomographic (micro-CT) morphometric analysis.</div></div><div><h3>Methods</h3><div>A sample of 30 mandibular first molars (<em>N</em> = 30) was used. All teeth were endodontically treated, and the specimens were initially scanned using micro-CT imaging and reconstructed. The molars were filled by a single-cone technique, and immediately the material at the initial 2-mm cervical level was removed. Cervical barriers were confected using ionomer glass cement with fluorescein 0.1%, filling the 2 mm at the cervical level of the canals and an additional 2 mm as the base. The coronal restoration set was performed using esthetic resin composites. A simulated tooth aging process was performed with 20,000 thermocycling cycles. The sample was distributed into the following 3 groups (<em>n</em> = 10) for the removal of the restoration set and cervical barrier with diamond burs based on the magnification aid: no magnification aid (naked eye), operative microscope aid, and REVEAL device (Design for Vision Inc, Bohemia, NY) aid. After removal, the final 3D micro-CT scanning and reconstruction were conducted with the same parameters as the initial scanning, and superposition of the final and initial scanning was performed. Morphometric analysis was conducted using CTAn software (Bruker microCT, Kontich, Belgium) to assess the volume of remnant restorative material (mm³), the volume of dentin removal (mm³), and the direction and site of dentin removal. Data were analyzed using 1-Way analysis of variance (<em>P</em> &lt; .05).</div></div><div><h3>Results</h3><div>The REVEAL group showed better results regarding the volume of remnant material (3.17 ± 1.65) and the percentage of dentin removal (2.56 ± 1.34). The microscope group showed no statistical difference compared with the REVEAL group regarding dentin removal (3.30 ± 1.48) and was statistically similar to the naked eye group in the volume of remnant material (9.63 ± 4.33). The naked eye group showed the worst results for the volume of remnant material (7.60 ± 2.68) and the percentage of dentin removal (6.60 ± 3.70).</div></div><div><h3>Conclusions</h3><div>The use of fluorescence associated with magnification was the method that presented the best results, with lower percentages of dentin removal and smaller volumes of remaining restorative material. This is an innovative technology in endodontics that shows potential to overcome the challenge of reaccessing root canals in the context of endodontic retreatment.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 10","pages":"Pages 1484-1494"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141748318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}