Pub Date : 2024-10-01DOI: 10.1016/j.joen.2024.07.008
Yeon-Jee Yoo DDS, MS, PhD , Jae-Hoon Kim DDS, MS, PhD , Jae-Joon Hwang DDS, MS, PhD , Asgeir Sigurdsson DDS, MS , Hyeon-Cheol Kim DDS, MS, PhD
Introduction
The aim of this study was to evaluate the efficacy of different irrigation needles and passive ultrasonic activation in removing Ca(OH)2 from an endodontic model that duplicated a root canal configuration of a human natural tooth.
Methods
An extracted human maxillary premolar was subjected to root canal preparation and scanned with microcomputed tomography. A 3-dimensional reconstruction model of the natural tooth was printed to endodontic models using a polyjet printer. The root canals of the models were filled with Ca(OH)2 paste and divided into 2 groups based on the irrigation protocol: conventional syringe-needle irrigation (conventional group) and passive ultrasonic irrigation (PUI) group. Each group was subdivided into 3 groups (n = 10) according to the type of needle: half-cut, side-vented, and TruNatomy irrigation needle. Microcomputed tomographyimaging was used to assess the percentage of reduction of Ca(OH)2. Data were analyzed using two-way analysis of variance test (α = .05).
Results
The side-vented and TruNatomy irrigation needles showed significantly higher percentage reductions than the half-cut needle (P < .05) in the conventional irrigation group. The PUI group showed significantly higher percentage reductions of Ca(OH)2 than the conventional group regardless of the type of needle (P < .05). However, no significant difference was found among the needles in the PUI group.
Conclusions
The type of irrigation needle and the use of PUI influenced the removal efficacy of Ca(OH)2. PUI enhanced the removal of Ca(OH)2 regardless of the type of irrigation needle.
{"title":"Efficacy of Different Irrigation Needles and Ultrasonic Activation on Calcium Hydroxide Removal: A Micro-CT Study Using 3D-Printed Endodontic Models","authors":"Yeon-Jee Yoo DDS, MS, PhD , Jae-Hoon Kim DDS, MS, PhD , Jae-Joon Hwang DDS, MS, PhD , Asgeir Sigurdsson DDS, MS , Hyeon-Cheol Kim DDS, MS, PhD","doi":"10.1016/j.joen.2024.07.008","DOIUrl":"10.1016/j.joen.2024.07.008","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of this study was to evaluate the efficacy of different irrigation needles and passive ultrasonic activation in removing Ca(OH)<sub>2</sub> from an endodontic model that duplicated a root canal configuration of a human natural tooth.</div></div><div><h3>Methods</h3><div>An extracted human maxillary premolar was subjected to root canal preparation and scanned with microcomputed tomography. A 3-dimensional reconstruction model of the natural tooth was printed to endodontic models using a polyjet printer. The root canals of the models were filled with Ca(OH)<sub>2</sub> paste and divided into 2 groups based on the irrigation protocol: conventional syringe-needle irrigation (conventional group) and passive ultrasonic irrigation (PUI) group. Each group was subdivided into 3 groups (<em>n</em> = 10) according to the type of needle: half-cut, side-vented, and TruNatomy irrigation needle. Microcomputed tomographyimaging was used to assess the percentage of reduction of Ca(OH)<sub>2</sub>. Data were analyzed using two-way analysis of variance test (α = .05).</div></div><div><h3>Results</h3><div>The side-vented and TruNatomy irrigation needles showed significantly higher percentage reductions than the half-cut needle (<em>P</em> < .05) in the conventional irrigation group. The PUI group showed significantly higher percentage reductions of Ca(OH)<sub>2</sub> than the conventional group regardless of the type of needle (<em>P</em> < .05). However, no significant difference was found among the needles in the PUI group.</div></div><div><h3>Conclusions</h3><div>The type of irrigation needle and the use of PUI influenced the removal efficacy of Ca(OH)<sub>2</sub>. PUI enhanced the removal of Ca(OH)<sub>2</sub> regardless of the type of irrigation needle.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 10","pages":"Pages 1478-1483"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141734310","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}
Pub Date : 2024-10-01DOI: 10.1016/j.joen.2024.07.010
Gabriela Gavilán Hadid DDS, MS , Miguel Angel Ventura DDS, MS , Iago Ramirez MS , Helena Cristina de Assis DDS, MS , Rafael Verardino de Camargo DDS, MS , Manoel Damião de Sousa-Neto DDS, MS, PhD , Jardel Francisco Mazzi-Chaves DDS, MS, PhD , Fabiane Carneiro Lopes-Olhê DDS, MS, PhD
Introduction
To assess the effect of combinations of two different endodontic sealers used in initial and endodontic retreatment on the bond strength of the secondary obturation and the penetrability of the sealers.
Methods
Forty-eight mandibular premolars were used, receiving standardized endodontic access and biomechanical preparation. Twenty-four teeth received AH Plus sealer (AHP) in primary obturation and the others received Bio-C Sealer (BCS). Retreatment protocol was performed with an R50 instrument. The samples were further subdivided into four groups (n = 12) based on the combination of primary/secondary obturation sealers: AHP/AHP; AHP/BCS; BCS/AHP; and BCS/BCS. Four samples from each subgroup received the addition of fluorophores to the sealer for penetrability analysis using laser scanning confocal fluorescence microscopy. The root portion on the 8 push-out samples was sectioned into 6 slices of 1.0 mm. Bond strength (BS) was assessed using a universal testing machine until displacement of the filling mass. Failure pattern was evaluated under a stereomicroscope (20× magnification). BS data were analyzed using two-way analysis of variance followed by Tukey's test (P < .05), and the association between the failure pattern and BS value was assessed using the chi-square test (P < .05). Penetrability was qualitatively evaluated.
Results
The highest BS values were observed in the AHP/AHP (4.54 ± 1.5 MPa) and BCS/AHP (5.00 ± 1.0 MPa) groups (P < .05), with a higher percentage of adhesive failures to the filling material for all groups. Laser scanning confocal fluorescence microscopy images indicated greater penetrability of AHP compared to BCS, both in initial treatment and retreatment.
Conclusion
AHP sealer exhibited higher BS and greater penetrability compared to BCS sealer.
{"title":"Influence of Initial Root Canal Treatment on Intratubular Penetrability and Bond Strength of Nonsurgical Retreatment: An In Vitro Study","authors":"Gabriela Gavilán Hadid DDS, MS , Miguel Angel Ventura DDS, MS , Iago Ramirez MS , Helena Cristina de Assis DDS, MS , Rafael Verardino de Camargo DDS, MS , Manoel Damião de Sousa-Neto DDS, MS, PhD , Jardel Francisco Mazzi-Chaves DDS, MS, PhD , Fabiane Carneiro Lopes-Olhê DDS, MS, PhD","doi":"10.1016/j.joen.2024.07.010","DOIUrl":"10.1016/j.joen.2024.07.010","url":null,"abstract":"<div><h3>Introduction</h3><div>To assess the effect of combinations of two different endodontic sealers used in initial and endodontic retreatment on the bond strength of the secondary obturation and the penetrability of the sealers.</div></div><div><h3>Methods</h3><div>Forty-eight mandibular premolars were used, receiving standardized endodontic access and biomechanical preparation. Twenty-four teeth received AH Plus sealer (AHP) in primary obturation and the others received Bio-C Sealer (BCS). Retreatment protocol was performed with an R50 instrument. The samples were further subdivided into four groups (<em>n</em> = 12) based on the combination of primary/secondary obturation sealers: AHP/AHP; AHP/BCS; BCS/AHP; and BCS/BCS. Four samples from each subgroup received the addition of fluorophores to the sealer for penetrability analysis using laser scanning confocal fluorescence microscopy. The root portion on the 8 push-out samples was sectioned into 6 slices of 1.0 mm. Bond strength (BS) was assessed using a universal testing machine until displacement of the filling mass. Failure pattern was evaluated under a stereomicroscope (20× magnification). BS data were analyzed using two-way analysis of variance followed by Tukey's test (<em>P</em> < .05), and the association between the failure pattern and BS value was assessed using the chi-square test (<em>P</em> < .05). Penetrability was qualitatively evaluated.</div></div><div><h3>Results</h3><div>The highest BS values were observed in the AHP/AHP (4.54 ± 1.5 MPa) and BCS/AHP (5.00 ± 1.0 MPa) groups (<em>P</em> < .05), with a higher percentage of adhesive failures to the filling material for all groups. Laser scanning confocal fluorescence microscopy images indicated greater penetrability of AHP compared to BCS, both in initial treatment and retreatment.</div></div><div><h3>Conclusion</h3><div>AHP sealer exhibited higher BS and greater penetrability compared to BCS sealer.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 10","pages":"Pages 1495-1504"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878832","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}
Pub Date : 2024-10-01DOI: 10.1016/j.joen.2024.07.016
Theeb A. Alquria BDS, FRCD, PhD candidate , Aneesha Acharya BDS, MDS, PhD , Binait Kabir DDS, MS , Ina L. Griffin DMD , Patricia A. Tordik DMD, FICD , Frederico C. Martinho DDS, MS, PhD
Introduction
This study characterized the bacteriome in primary endodontic infection (PEI) with apical periodontitis (AP), identified core and rare bacteriome species and community diversity metrics, and analyzed the relationship between the bacteriome composition, diversity and features, and patient variables.
Methods
Twenty-seven patients with PEI and AP were sampled. The DNA was extracted and quantified using quantitative polymerase chain reaction. Raw V3-V4 amplicon sequencing data were processed with the DADA2 pipeline to generate amplicon sequence variants, and taxonomic assignment of the amplicon sequence variants up to the species level was done against the Human Oral Microbiome Database. Core bacteriome and differential abundance analyses were performed using ANCOM. Alpha diversity was determined using Chao1, Shannon, and Simpson indexes. LeFse analysis was used to identify abundant taxa. Sparse Estimation of Correlations among Microbiomes analysis estimated linear and nonlinear relationships among bacteria.
Results
Of 27, 24 root canal samples were analyzed, and 3 root canal sampling were filtered out with a low read count. The bacterial phyla with top mean relative abundance were Bacteroidetes, Firmicutes, Synergistetes, Fusobacteria, and Actinobacteria. A total of 113 genera and 215 species were identified. The samples were gathered into 3 clusters. LefSe analysis identified differences in abundant taxa between distinct age, gender, symptomatology, and lesion size groups. Sparse Estimation of Correlations among Microbiomes distance analysis indicated Slackia exigua as the node with the highest degree.
Conclusions
The bacteriome in PEI with AP among the patients in this study was complex and displayed high microbial heterogeneity. Moreover, age, gender, symptomatology, and lesion size were associated with differences in bacteriome features in PEI with AP.
导言：本研究描述了原发性牙髓炎（PEI）合并根尖周炎（AP）患者细菌组的特征，确定了细菌组的核心和稀有物种以及群落多样性指标，并分析了细菌组的组成、多样性和特征与患者变量之间的关系：方法：对 27 名 PEI 和 AP 患者进行了采样。方法：对 27 名 PEI 和 AP 患者进行采样，提取 DNA 并使用 qPCR 进行定量。使用 DADA2 管道处理原始 V3-V4 扩增子测序数据，生成扩增子序列变异（ASV），并根据 HOMD 对 ASV 进行分类，直至物种水平。使用 ANCOM 进行了核心细菌组和差异丰度分析。使用 Chao1、Shannon 和 Simpson 指数确定阿尔法多样性。LeFse 分析用于确定丰富的类群。SECOM 分析估计了细菌之间的线性和非线性关系。平均相对丰度最高的细菌门为类杆菌属、固形菌属、协同菌属、镰刀菌属和放线菌属。共鉴定出 113 个属和 215 个种。样本被分为三个群组。LeFse 分析确定了不同年龄组、性别组、症状组和病变大小组之间丰富类群的差异。SECOM 距离分析表明，Slackia exigua 是程度最高的节点：结论：本研究中，伴有 AP 的 PEI 患者的细菌组十分复杂，显示出高度的微生物异质性。此外，年龄、性别、症状和病变大小与伴有 AP 的 PEI 细菌组特征的差异有关。
{"title":"Clinical Investigation of Bacteriome in Primary Endodontic Infections With Apical Periodontitis Using High-Throughput Sequencing Analysis","authors":"Theeb A. Alquria BDS, FRCD, PhD candidate , Aneesha Acharya BDS, MDS, PhD , Binait Kabir DDS, MS , Ina L. Griffin DMD , Patricia A. Tordik DMD, FICD , Frederico C. Martinho DDS, MS, PhD","doi":"10.1016/j.joen.2024.07.016","DOIUrl":"10.1016/j.joen.2024.07.016","url":null,"abstract":"<div><h3>Introduction</h3><div>This study characterized the bacteriome in primary endodontic infection (PEI) with apical periodontitis (AP), identified core and rare bacteriome species and community diversity metrics, and analyzed the relationship between the bacteriome composition, diversity and features, and patient variables.</div></div><div><h3>Methods</h3><div>Twenty-seven patients with PEI and AP were sampled. The DNA was extracted and quantified using quantitative polymerase chain reaction. Raw V3-V4 amplicon sequencing data were processed with the DADA2 pipeline to generate amplicon sequence variants, and taxonomic assignment of the amplicon sequence variants up to the species level was done against the Human Oral Microbiome Database. Core bacteriome and differential abundance analyses were performed using ANCOM. Alpha diversity was determined using Chao1, Shannon, and Simpson indexes. LeFse analysis was used to identify abundant taxa. Sparse Estimation of Correlations among Microbiomes analysis estimated linear and nonlinear relationships among bacteria.</div></div><div><h3>Results</h3><div>Of 27, 24 root canal samples were analyzed, and 3 root canal sampling were filtered out with a low read count. The bacterial phyla with top mean relative abundance were Bacteroidetes, Firmicutes, Synergistetes, Fusobacteria, and Actinobacteria. A total of 113 genera and 215 species were identified. The samples were gathered into 3 clusters. LefSe analysis identified differences in abundant taxa between distinct age, gender, symptomatology, and lesion size groups. Sparse Estimation of Correlations among Microbiomes distance analysis indicated <em>Slackia exigua</em> as the node with the highest degree.</div></div><div><h3>Conclusions</h3><div>The bacteriome in PEI with AP among the patients in this study was complex and displayed high microbial heterogeneity. Moreover, age, gender, symptomatology, and lesion size were associated with differences in bacteriome features in PEI with AP.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 10","pages":"Pages 1393-1402"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141988046","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}
Pub Date : 2024-10-01DOI: 10.1016/j.joen.2024.08.003
Liliana Artaza PhD , Andrea F. Campello PhD , Giuliana Soimu MS , Flávio R.F. Alves PhD , Isabela N. Rôças PhD , José F. Siqueira Jr. PhD
Introduction
This study reported on the outcome of the nonsurgical root canal treatment/retreatment of teeth with large apical periodontitis lesions. The influence of some variables on the prognosis was also evaluated.
Methods
The study included 199 teeth with large apical periodontitis lesions from 184 patients, treated/retreated by a single operator. Most teeth were managed in a single visit using NaOCl irrigation. Cases were followed up periodically from >1 to 8 years. Treatment/retreatment outcome was evaluated by clinical and radiographic/tomographic criteria and categorized as healed, healing, or diseased. For statistical analysis, data were dichotomized in such a way that healing cases were considered as success in a loose criterion or failure in a rigid one.
Results
Clinical/radiographic analyses revealed that 67% of the initial treatment cases were classified as healed, 22.5% as healing, and 11% as diseased. Treatment success rates were 89% (loose) and 67% (rigid). Variables that influenced the treatment outcome included previous abscess and antibiotic use, very large lesions (≥10 mm), and a sinus tract. The median follow-up time for treatment was 31.5 months. As for retreatment cases, 47% were healed, 32% were healing, and 21% were diseased. Retreatment success rates were 79% (loose) and 47% (rigid), in a median follow-up of 32 months. Cases evaluated by cone-beam computed tomography had lower healed rates.
Conclusions
Findings demonstrate that high favorable outcome rates can be achieved by nonsurgical root canal treatment or retreatment of teeth with large apical periodontitis lesions.
{"title":"Outcome of Nonsurgical Root Canal Treatment of Teeth With Large Apical Periodontitis Lesions: A Retrospective Study","authors":"Liliana Artaza PhD , Andrea F. Campello PhD , Giuliana Soimu MS , Flávio R.F. Alves PhD , Isabela N. Rôças PhD , José F. Siqueira Jr. PhD","doi":"10.1016/j.joen.2024.08.003","DOIUrl":"10.1016/j.joen.2024.08.003","url":null,"abstract":"<div><h3>Introduction</h3><div>This study reported on the outcome of the nonsurgical root canal treatment/retreatment of teeth with large apical periodontitis lesions. The influence of some variables on the prognosis was also evaluated.</div></div><div><h3>Methods</h3><div>The study included 199 teeth with large apical periodontitis lesions from 184 patients, treated/retreated by a single operator. Most teeth were managed in a single visit using NaOCl irrigation. Cases were followed up periodically from >1 to 8 years. Treatment/retreatment outcome was evaluated by clinical and radiographic/tomographic criteria and categorized as healed, healing, or diseased. For statistical analysis, data were dichotomized in such a way that healing cases were considered as success in a loose criterion or failure in a rigid one.</div></div><div><h3>Results</h3><div>Clinical/radiographic analyses revealed that 67% of the initial treatment cases were classified as healed, 22.5% as healing, and 11% as diseased. Treatment success rates were 89% (loose) and 67% (rigid). Variables that influenced the treatment outcome included previous abscess and antibiotic use, very large lesions (≥10 mm), and a sinus tract. The median follow-up time for treatment was 31.5 months. As for retreatment cases, 47% were healed, 32% were healing, and 21% were diseased. Retreatment success rates were 79% (loose) and 47% (rigid), in a median follow-up of 32 months. Cases evaluated by cone-beam computed tomography had lower healed rates.</div></div><div><h3>Conclusions</h3><div>Findings demonstrate that high favorable outcome rates can be achieved by nonsurgical root canal treatment or retreatment of teeth with large apical periodontitis lesions.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 10","pages":"Pages 1403-1411"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995800","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}
Pub Date : 2024-10-01DOI: 10.1016/j.joen.2024.09.003
Anita Aminoshariae DDS, MS, Amir Azarpazhooh DDS, MSc, PhD, FRCD(C), Ashraf F. Fouad DDS, MS, Gerald N. Glickman DDS, MS, MBA, JD, Jianing He DMD, PhD, Sahng G. Kim DDS, MS, Anil Kishen BDS, MDS, PhD, Ariadne M. Letra DDS, MS, PhD, Linda Levin DDS, PhD, Frank C. Setzer DMD, PhD, MS, Franklin R. Tay BDSc(Hons), PhD, Kenneth M. Hargreaves DDS, PhD
{"title":"Insights Into the Oct 2024 Issue of the Journal of Endodontics","authors":"Anita Aminoshariae DDS, MS, Amir Azarpazhooh DDS, MSc, PhD, FRCD(C), Ashraf F. Fouad DDS, MS, Gerald N. Glickman DDS, MS, MBA, JD, Jianing He DMD, PhD, Sahng G. Kim DDS, MS, Anil Kishen BDS, MDS, PhD, Ariadne M. Letra DDS, MS, PhD, Linda Levin DDS, PhD, Frank C. Setzer DMD, PhD, MS, Franklin R. Tay BDSc(Hons), PhD, Kenneth M. Hargreaves DDS, PhD","doi":"10.1016/j.joen.2024.09.003","DOIUrl":"10.1016/j.joen.2024.09.003","url":null,"abstract":"","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 10","pages":"Pages 1367-1369"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142288959","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}
Pub Date : 2024-10-01DOI: 10.1016/S0099-2399(24)00501-6
{"title":"Guidelines for Authors","authors":"","doi":"10.1016/S0099-2399(24)00501-6","DOIUrl":"10.1016/S0099-2399(24)00501-6","url":null,"abstract":"","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 10","pages":"Pages A5-A10"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142417423","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}
Pub Date : 2024-10-01DOI: 10.1016/j.joen.2024.07.006
Alessandra Baasch MSc , Andrea F. Campello PhD , Renata C.V. Rodrigues PhD , Flávio R.F. Alves PhD , Danielle D. Voigt PhD , Ibrahimu Mdala PhD , Renata Perez PhD , Sabrina C. Brasil PhD , Isabela N. Rôças PhD , José F. Siqueira Jr PhD
Introduction
This ex vivo study evaluated the disinfecting and cleaning effects of root canal preparation using sodium hypochlorite irrigation with 3 different needle designs.
Methods
Mesial roots from extracted mandibular molars with Vertucci class II configuration were anatomically matched based on micro-computed tomography (micro-CT) analyses and distributed into 3 groups (n = 18/group). The canals were contaminated with a mixed bacterial culture for 30 days and then subjected to preparation using 2.5% sodium hypochlorite irrigation with open-ended flat needle (3 mm short of the working length - WL), closed-ended side-vented irrigation needle (1 mm short of the WL), or a closed-ended plastic needle with 2 lateral outlets (TruNatomy) (1 mm short of the WL). Bacteriological samples were taken from the canals before (S1) and after preparation (S2). After another micro-CT scan, the roots were sectioned and samples were also taken from the apical canal segment (S3). Bacterial reduction was assessed by quantitative real-time polymerase chain reaction. The amount of accumulated hard tissue debris was evaluated by micro-CT.
Results
A substantial reduction in bacterial counts was observed in all 3 groups when comparing S1 with S2 (99.95%, 98.93%, and 98.90% in the open-ended, closed-ended, and TruNatomy needle groups, respectively) (P < .01). No significant differences were observed between groups for bacterial reduction in the full and apical canal (P > .05). There were no intergroup differences in the amount of accumulated hard tissue debris either (P > .05). The open-ended needle group showed significantly more specimens with quantitative real-time polymerase chain reaction negative results for bacteria in S3 than TruNatomy (P < .05).
Conclusion
When used up to an appropriate insertion depth, the 3 needle types result in similar antibacterial and cleaning performance, provided variables such as needle size and irrigant type, volume and flow rate are controlled. Exclusive analysis of the apical segment, including the isthmus, revealed that the open-ended needle yielded more cases negative for bacteria.
{"title":"Effects of the Irrigation Needle Design on Root Canal Disinfection and Cleaning","authors":"Alessandra Baasch MSc , Andrea F. Campello PhD , Renata C.V. Rodrigues PhD , Flávio R.F. Alves PhD , Danielle D. Voigt PhD , Ibrahimu Mdala PhD , Renata Perez PhD , Sabrina C. Brasil PhD , Isabela N. Rôças PhD , José F. Siqueira Jr PhD","doi":"10.1016/j.joen.2024.07.006","DOIUrl":"10.1016/j.joen.2024.07.006","url":null,"abstract":"<div><h3>Introduction</h3><div>This <em>ex vivo</em> study evaluated the disinfecting and cleaning effects of root canal preparation using sodium hypochlorite irrigation with 3 different needle designs.</div></div><div><h3>Methods</h3><div>Mesial roots from extracted mandibular molars with Vertucci class II configuration were anatomically matched based on micro-computed tomography (micro-CT) analyses and distributed into 3 groups (<em>n</em> = 18/group). The canals were contaminated with a mixed bacterial culture for 30 days and then subjected to preparation using 2.5% sodium hypochlorite irrigation with open-ended flat needle (3 mm short of the working length - WL), closed-ended side-vented irrigation needle (1 mm short of the WL), or a closed-ended plastic needle with 2 lateral outlets (TruNatomy) (1 mm short of the WL). Bacteriological samples were taken from the canals before (S1) and after preparation (S2). After another micro-CT scan, the roots were sectioned and samples were also taken from the apical canal segment (S3). Bacterial reduction was assessed by quantitative real-time polymerase chain reaction. The amount of accumulated hard tissue debris was evaluated by micro-CT.</div></div><div><h3>Results</h3><div>A substantial reduction in bacterial counts was observed in all 3 groups when comparing S1 with S2 (99.95%, 98.93%, and 98.90% in the open-ended, closed-ended, and TruNatomy needle groups, respectively) (<em>P</em> < .01). No significant differences were observed between groups for bacterial reduction in the full and apical canal (<em>P</em> > .05). There were no intergroup differences in the amount of accumulated hard tissue debris either (<em>P</em> > .05). The open-ended needle group showed significantly more specimens with quantitative real-time polymerase chain reaction negative results for bacteria in S3 than TruNatomy (<em>P</em> < .05).</div></div><div><h3>Conclusion</h3><div>When used up to an appropriate insertion depth, the 3 needle types result in similar antibacterial and cleaning performance, provided variables such as needle size and irrigant type, volume and flow rate are controlled. Exclusive analysis of the apical segment, including the isthmus, revealed that the open-ended needle yielded more cases negative for bacteria.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 10","pages":"Pages 1463-1471"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141727259","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}
Pub Date : 2024-10-01DOI: 10.1016/j.joen.2024.06.012
Introduction
The current evidence linking tooth loss and cardiovascular disease mortality is inconclusive. Thus, the aim of this systematic review was to explore the association between tooth loss and cardiovascular disease (CVD) mortality.
Methods
A comprehensive literature search of databases and gray literature included: Web of Science, Scopus, PubMed, Cochrane Central Register of Controlled Trials, Google Scholar, various digital repositories. The included studies reported on CVD mortality and tooth loss. The Newcastle-Ottawa scale was used to assess the quality of included studies. Random-effects meta-analysis method, sub-group analysis (based on the tooth loss categories (edentulous and fewer than 10 teeth present), meta-regression (based on the number. of confounders), publication bias, and sensitivity analysis were performed.
Results
Twelve articles met the eligibility criteria with an overall “Good” quality. A significant association between tooth loss (edentulous or less than 10 teeth present) and CVD mortality was found in the primary meta-analysis, which compiled data from 12 studies. The estimated hazard ratio was 1.66 (95% CI: 1.32–2.09), and there was high heterogeneity (I2 = 82.42). Subgroup analysis revealed that the edentulous subgroup showed a higher risk with no significant heterogeneity, while the subgroup with fewer than 10 teeth showed a higher risk with substantial heterogeneity. Meta-regression analysis did not reveal any significant impact (P = .626) on whether variations in the number of confounders across studies would substantially affect the overall findings. No publication bias was detected and the sensitivity analysis based on the critical confounders also confirmed that tooth loss as a risk factor for CVD mortality (hazard ratio = 1.52, 95% CI: 1.28–1.80), (I2 51.82%).
Conclusion
The present systematic review reported that being edentulous or having lesser than 10 teeth is a predictive indicator of CVD mortality.
{"title":"Tooth Loss is a Risk Factor for Cardiovascular Disease Mortality: A Systematic Review with Meta-analyses","authors":"","doi":"10.1016/j.joen.2024.06.012","DOIUrl":"10.1016/j.joen.2024.06.012","url":null,"abstract":"<div><h3>Introduction</h3><div>The current evidence linking tooth loss and cardiovascular disease mortality is inconclusive. Thus, the aim of this systematic review was to explore the association between tooth loss and cardiovascular disease (CVD) mortality.</div></div><div><h3>Methods</h3><div>A comprehensive literature search of databases and gray literature included: Web of Science, Scopus, PubMed, Cochrane Central Register of Controlled Trials, Google Scholar, various digital repositories. The included studies reported on CVD mortality and tooth loss. The Newcastle-Ottawa scale was used to assess the quality of included studies. Random-effects meta-analysis method, sub-group analysis (based on the tooth loss categories (edentulous and fewer than 10 teeth present), meta-regression (based on the number. of confounders), publication bias, and sensitivity analysis were performed.</div></div><div><h3>Results</h3><div>Twelve articles met the eligibility criteria with an overall “Good” quality. A significant association between tooth loss (edentulous or less than 10 teeth present) and CVD mortality was found in the primary meta-analysis, which compiled data from 12 studies. The estimated hazard ratio was 1.66 (95% CI: 1.32–2.09), and there was high heterogeneity (I<sup>2</sup> = 82.42). Subgroup analysis revealed that the edentulous subgroup showed a higher risk with no significant heterogeneity, while the subgroup with fewer than 10 teeth showed a higher risk with substantial heterogeneity. Meta-regression analysis did not reveal any significant impact (<em>P</em> = .626) on whether variations in the number of confounders across studies would substantially affect the overall findings. No publication bias was detected and the sensitivity analysis based on the critical confounders also confirmed that tooth loss as a risk factor for CVD mortality (hazard ratio = 1.52, 95% CI: 1.28–1.80), (I<sup>2</sup> 51.82%).</div></div><div><h3>Conclusion</h3><div>The present systematic review reported that being edentulous or having lesser than 10 teeth is a predictive indicator of CVD mortality.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 10","pages":"Pages 1370-1380"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468416","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}
Pub Date : 2024-10-01DOI: 10.1016/j.joen.2024.07.012
Rui Qi Chen PhD , Yeonju Lee PhD , Hao Yan MS, PhD , Muralidhar Mupparapu DMD, MDS, DipABOMR , Fleming Lure PhD , Jing Li PhD , Frank C. Setzer DMD, PhD, MS
Introduction
Cone-beam computed tomography (CBCT) is widely used to detect jaw lesions, although CBCT interpretation is time-consuming and challenging. Artificial intelligence for CBCT segmentation may improve lesion detection accuracy. However, consistent automated lesion detection remains difficult, especially with limited training data. This study aimed to assess the applicability of pretrained transformer-based architectures for semantic segmentation of CBCT volumes when applied to periapical lesion detection.
Methods
CBCT volumes (n = 138) were collected and annotated by expert clinicians using 5 labels – "lesion," "restorative material," "bone," "tooth structure," and "background." U-Net (convolutional neural network-based) and Swin-UNETR (transformer-based) models, pretrained (Swin-UNETR-PRETRAIN), and from scratch (Swin-UNETR-SCRATCH), were trained with subsets of the annotated CBCTs. These models were then evaluated for semantic segmentation performance using the Sørensen–Dice coefficient (DICE), lesion detection performance using sensitivity and specificity, and training sample size requirements by comparing models trained with 20, 40, 60, or 103 samples.
Results
Trained with 103 samples, Swin-UNETR-PRETRAIN achieved a DICE of 0.8512 for "lesion," 0.8282 for "restorative materials," 0.9178 for "bone," 0.9029 for "tooth structure," and 0.9901 for "background." “Lesion” DICE was statistically similar between Swin-UNETR-PRETRAIN trained with 103 and 60 images (P > .05), with the latter achieving 1.00 sensitivity and 0.94 specificity in lesion detection. With small training sets, Swin-UNETR-PRETRAIN outperformed Swin-UNETR-SCRATCH in DICE over all labels (P < .001 [n = 20], P < .001 [n = 40]), and U-Net in lesion detection specificity (P = .006 [n = 20], P = .031 [n = 40]).
Conclusions
Transformer-based Swin-UNETR architectures allowed for excellent semantic segmentation and periapical lesion detection. Pretrained, it may provide an alternative with smaller training datasets compared to classic U-Net architectures.
{"title":"Leveraging Pretrained Transformers for Efficient Segmentation and Lesion Detection in Cone-Beam Computed Tomography Scans","authors":"Rui Qi Chen PhD , Yeonju Lee PhD , Hao Yan MS, PhD , Muralidhar Mupparapu DMD, MDS, DipABOMR , Fleming Lure PhD , Jing Li PhD , Frank C. Setzer DMD, PhD, MS","doi":"10.1016/j.joen.2024.07.012","DOIUrl":"10.1016/j.joen.2024.07.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Cone-beam computed tomography (CBCT) is widely used to detect jaw lesions, although CBCT interpretation is time-consuming and challenging. Artificial intelligence for CBCT segmentation may improve lesion detection accuracy. However, consistent automated lesion detection remains difficult, especially with limited training data. This study aimed to assess the applicability of pretrained transformer-based architectures for semantic segmentation of CBCT volumes when applied to periapical lesion detection.</div></div><div><h3>Methods</h3><div>CBCT volumes (<em>n</em> = 138) were collected and annotated by expert clinicians using 5 labels – \"lesion,\" \"restorative material,\" \"bone,\" \"tooth structure,\" and \"background.\" U-Net (convolutional neural network-based) and Swin-UNETR (transformer-based) models, pretrained (Swin-UNETR-PRETRAIN), and from scratch (Swin-UNETR-SCRATCH), were trained with subsets of the annotated CBCTs. These models were then evaluated for semantic segmentation performance using the Sørensen–Dice coefficient (DICE), lesion detection performance using sensitivity and specificity, and training sample size requirements by comparing models trained with 20, 40, 60, or 103 samples.</div></div><div><h3>Results</h3><div>Trained with 103 samples, Swin-UNETR-PRETRAIN achieved a DICE of 0.8512 for \"lesion,\" 0.8282 for \"restorative materials,\" 0.9178 for \"bone,\" 0.9029 for \"tooth structure,\" and 0.9901 for \"background.\" “Lesion” DICE was statistically similar between Swin-UNETR-PRETRAIN trained with 103 and 60 images (<em>P</em> > .05), with the latter achieving 1.00 sensitivity and 0.94 specificity in lesion detection. With small training sets, Swin-UNETR-PRETRAIN outperformed Swin-UNETR-SCRATCH in DICE over all labels (<em>P</em> < .001 [<em>n</em> = 20], <em>P</em> < .001 [<em>n</em> = 40]), and U-Net in lesion detection specificity (<em>P</em> = .006 [<em>n</em> = 20], <em>P</em> = .031 [<em>n</em> = 40]).</div></div><div><h3>Conclusions</h3><div>Transformer-based Swin-UNETR architectures allowed for excellent semantic segmentation and periapical lesion detection. Pretrained, it may provide an alternative with smaller training datasets compared to classic U-Net architectures.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 10","pages":"Pages 1505-1514.e1"},"PeriodicalIF":3.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889429","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}
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