Pub Date : 2025-01-09DOI: 10.1016/j.joen.2024.12.019
Mohammad Sabeti, Julian Gabbay, David Lotfi
Introduction: This systematic review and meta-analysis assess the impact of the XP-endo Shaper (XPS) on postoperative pain following root canal treatment and compare its efficacy with other endodontic systems.
Methods: A comprehensive literature search was conducted in MEDLINE, Web of Science, Embase, and the Cochrane Library from January 2000-August 2024. Randomized controlled trials using XPS and reporting postoperative pain were included. Pain levels were measured using the Visual Analog Scale at multiple postoperative time points. Data were pooled and analyzed using a random effects model, revealing significant heterogeneity.
Results: Six randomized controlled trials involving 731 patients met the inclusion criteria. The pooled analysis revealed that XPS significantly reduced pain scores at the 6, 12, and 24-hour time points (standardized mean difference [SMD] -1.30, 95% confidence interval [CI] [-2.36, -0.24], P = .016; SMD -3.00, 95% CI [-3.54, -2.46], P < .001; SMD -0.91, 95% CI [-1.53, -0.28], P = .005, respectively) compared to other systems, including WaveOne Gold and HyFlex EDM. Pain scores beyond 48 hours were comparable between XPS and other file systems.
Conclusions: XPS shows substantial short-term efficacy in reducing postoperative pain following root canal treatments, likely due to its flexible design and reduced debris extrusion. The findings suggest that XPS can potentially improve patient comfort, though long-term pain outcomes remain similar to other systems.
本系统综述和荟萃分析评估了XP-endo Shaper （XPS）对根管治疗（rct）术后疼痛的影响，并将其与其他根管系统的疗效进行了比较。方法：检索2000年1月~ 2024年8月MEDLINE、Web of Science、Embase、Cochrane Library等数据库的文献。纳入使用XPS和报告术后疼痛的随机对照试验。采用视觉模拟评分法（VAS）在术后多个时间点测量疼痛水平。使用随机效应模型对数据进行汇总和分析，显示出显著的异质性。结果：6项随机对照试验731例患者符合纳入标准。合并分析显示，XPS显著降低了6、12和24小时时间点的疼痛评分(SMD -1.30, 95% CI [-2.36, -0.24], p = 0.016；SMD -3.00, 95% CI [-3.54, -2.46], p < 0.001；SMD -0.91, 95% CI [-1.53, -0.28], p = 0.005)，与其他系统相比，包括WaveOne Gold （WOG）和HyFlex EDM （HEDM）。超过48小时的疼痛评分在XPS和其他文件系统之间具有可比性。结论：在随机对照试验中，XPS在减轻术后疼痛方面显示出显著的短期疗效，这可能是由于其灵活的设计和减少碎片挤压。研究结果表明，尽管长期疼痛结果与其他系统相似，但XPS可能会改善患者的舒适度。
{"title":"The XP-endo Shaper and Its Impact on Posttreatment Discomfort: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Mohammad Sabeti, Julian Gabbay, David Lotfi","doi":"10.1016/j.joen.2024.12.019","DOIUrl":"10.1016/j.joen.2024.12.019","url":null,"abstract":"<p><strong>Introduction: </strong>This systematic review and meta-analysis assess the impact of the XP-endo Shaper (XPS) on postoperative pain following root canal treatment and compare its efficacy with other endodontic systems.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in MEDLINE, Web of Science, Embase, and the Cochrane Library from January 2000-August 2024. Randomized controlled trials using XPS and reporting postoperative pain were included. Pain levels were measured using the Visual Analog Scale at multiple postoperative time points. Data were pooled and analyzed using a random effects model, revealing significant heterogeneity.</p><p><strong>Results: </strong>Six randomized controlled trials involving 731 patients met the inclusion criteria. The pooled analysis revealed that XPS significantly reduced pain scores at the 6, 12, and 24-hour time points (standardized mean difference [SMD] -1.30, 95% confidence interval [CI] [-2.36, -0.24], P = .016; SMD -3.00, 95% CI [-3.54, -2.46], P < .001; SMD -0.91, 95% CI [-1.53, -0.28], P = .005, respectively) compared to other systems, including WaveOne Gold and HyFlex EDM. Pain scores beyond 48 hours were comparable between XPS and other file systems.</p><p><strong>Conclusions: </strong>XPS shows substantial short-term efficacy in reducing postoperative pain following root canal treatments, likely due to its flexible design and reduced debris extrusion. The findings suggest that XPS can potentially improve patient comfort, though long-term pain outcomes remain similar to other systems.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965296","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}
Fear of dentistry, often due to past painful experiences, is a significant barrier preventing patients from visiting dentists. Achieving effective pain control, especially during root canal treatments, is crucial. However, inferior alveolar nerve blocks (IANBs) have a low success rate, influenced by factors such as anxiety, anatomical variations, and technique limitations, leading to anesthesia failure. Although numerous studies have examined the cold test and electric pulp test (EPT) in assessing the success of local anesthesia, no standardized method has been established. This study evaluated the effectiveness of EPT and cold tests in assessing the depth of anesthesia in patients with symptomatic irreversible pulpitis in the mandibular first molar teeth.
Methods
A cross-sectional study was conducted on 50 patients with symptomatic irreversible pulpitis who met the inclusion criteria and exhibited lip numbness. Following the administration of the IANBs and confirmation of lip numbness, cold tests and EPT were performed on all patients. Subsequently, the preparation of the access cavity (gold standard test) was initiated, and patients' responses during cavity preparation were recorded as either “presence of pain or discomfort” or “absence of pain or discomfort,” indicating IANB failure and success, respectively. Sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), positive and negative likelihood ratios, and accuracy (AC) with 95% confidence intervals were calculated for each test separately as well as for sequential testing.
Results
IANB failure was determined in 56% of the patients. A comparative analysis of diagnostic tests (cold test and EPT) showed no significant difference in SN, NPV, and AC; however, the cold test had higher SP, PPV, and positive likelihood ratio. Combining cold test and EPT evaluations improved SN, NPV, PPV, and negative likelihood ratio, but SP and AC were similar to EPT alone. No correlation was found between IANB success and patient age, sex, or initial pain.
Conclusions
Despite evidence of lip numbness, a significant number of IANBs failed in cases of painful pulpitis. A positive result from the cold test strongly indicated anesthesia failure. The findings of the current study suggested that when the cold test yielded a negative result, further evaluation with EPT was necessary to confirm anesthetic success and ensure complete pain control.
{"title":"Evaluation of Cold and Electric Pulp Tests for Assessing the Success of Inferior Alveolar Nerve Block for Mandibular First Molars Diagnosed with Symptomatic Irreversible Pulpitis","authors":"Farzaneh Afkhami DDS, MSc , Sholeh Ghabraei DDS, MSc , Nasim Hashemi DDS, MSc , Ove A. Peters DMD, MS, PhD","doi":"10.1016/j.joen.2024.10.013","DOIUrl":"10.1016/j.joen.2024.10.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Fear of dentistry, often due to past painful experiences, is a significant barrier preventing patients from visiting dentists. Achieving effective pain control, especially during root canal treatments, is crucial. However, inferior alveolar nerve blocks (IANBs) have a low success rate, influenced by factors such as anxiety, anatomical variations, and technique limitations, leading to anesthesia failure. Although numerous studies have examined the cold test and electric pulp test (EPT) in assessing the success of local anesthesia, no standardized method has been established. This study evaluated the effectiveness of EPT and cold tests in assessing the depth of anesthesia in patients with symptomatic irreversible pulpitis in the mandibular first molar teeth.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted on 50 patients with symptomatic irreversible pulpitis who met the inclusion criteria and exhibited lip numbness. Following the administration of the IANBs and confirmation of lip numbness, cold tests and EPT were performed on all patients. Subsequently, the preparation of the access cavity (gold standard test) was initiated, and patients' responses during cavity preparation were recorded as either “presence of pain or discomfort” or “absence of pain or discomfort,” indicating IANB failure and success, respectively. Sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), positive and negative likelihood ratios, and accuracy (AC) with 95% confidence intervals were calculated for each test separately as well as for sequential testing.</div></div><div><h3>Results</h3><div>IANB failure was determined in 56% of the patients. A comparative analysis of diagnostic tests (cold test and EPT) showed no significant difference in SN, NPV, and AC; however, the cold test had higher SP, PPV, and positive likelihood ratio. Combining cold test and EPT evaluations improved SN, NPV, PPV, and negative likelihood ratio, but SP and AC were similar to EPT alone. No correlation was found between IANB success and patient age, sex, or initial pain.</div></div><div><h3>Conclusions</h3><div>Despite evidence of lip numbness, a significant number of IANBs failed in cases of painful pulpitis. A positive result from the cold test strongly indicated anesthesia failure. The findings of the current study suggested that when the cold test yielded a negative result, further evaluation with EPT was necessary to confirm anesthetic success and ensure complete pain control.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 1","pages":"Pages 28-34"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621748","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 : 2025-01-01DOI: 10.1016/j.joen.2024.10.005
Ganesh R. Jadhav MDS , Priya Mittal MDS
Introduction
This study aimed to determine the correlation between proximal caries and the extent and site of pulp canal obliteration (PCO) in cone-beam computed tomographic (CBCT) scans of mandibular molar teeth.
Methods
A total of 1491 CBCT scans of patients 18–49 years of age were selected from the database (2002–2022). From them, 328 teeth with proximal caries and satisfying inclusion criteria were evaluated by 2 calibrated evaluators. PCO was observed in the sagittal and coronal planes. PCO and proximal caries were compared concerning different age groups, sexes, and sites using an independent sample t test.
Results
The prevalence of PCO among patients with proximal caries is 47%. In mesial proximal caries, the extent of PCO is significantly greater in the distal root canal (73.4%), whereas in distal proximal caries, PCO is more often found in the mesial canal (77.3%). The mean extent of intraradicular calcification was higher in the distal canal (P < .001). Moreover, mesial proximal caries showed a greater extent of intraradicular obliteration (P < .001). The probability of developing PCO was significantly higher in females (P = .003).
Conclusions
Within the limitations of this study, it can be concluded that the extent of calcification is more common on the opposite side of the location of the proximal caries. Moreover, such intraradicular calcification is greater in a distal canal compared to a mesial canal. Sex plays a significant role in the calcification process, showing higher predilection in females compared to males.
研究目的本研究旨在确定下颌磨牙 CBCT 扫描中近端龋（PC）与牙髓管阻塞（PCO）的程度和部位之间的相关性：从数据库（2002 年至 2022 年）中选取了 1491 例 18-49 岁患者的 CBCT 扫描结果。两名经过校准的评估员对其中 328 颗符合纳入标准的 PC 牙进行了评估。在矢状面和冠状面上观察 PCO。采用独立样本 t 检验比较了不同年龄组、性别和部位的 PCO 和 PC：结果：PC 患者的 PCO 患病率为 47%。在中线型 PC 中，远端根管的 PCO 程度明显更高（73.4%）；而在远端型 PC 中，中线根管的 PCO 程度更高（77.3%）。根管内钙化的平均程度在远端根管较高（p结论：在本研究的局限性范围内，可以得出结论：PC位置相反一侧的钙化程度更常见。此外，与中轴管相比，远端管内的钙化程度更高。性别在钙化过程中起着重要作用，女性比男性更容易发生钙化：临床相关性：了解 PC 与 PCO 之间的相关性有助于减少牙髓治疗过程中的错误，从而改善患者的治疗效果。
{"title":"Cone-Beam Computed Tomographic Scan–based Assessment of the Correlation between the Location of Caries and Pulp Canal Obliteration: An Aid to Treatment Planning","authors":"Ganesh R. Jadhav MDS , Priya Mittal MDS","doi":"10.1016/j.joen.2024.10.005","DOIUrl":"10.1016/j.joen.2024.10.005","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to determine the correlation between proximal caries and the extent and site of pulp canal obliteration (PCO) in cone-beam computed tomographic (CBCT) scans of mandibular molar teeth.</div></div><div><h3>Methods</h3><div>A total of 1491 CBCT scans of patients 18–49 years of age were selected from the database (2002–2022). From them, 328 teeth with proximal caries and satisfying inclusion criteria were evaluated by 2 calibrated evaluators. PCO was observed in the sagittal and coronal planes. PCO and proximal caries were compared concerning different age groups, sexes, and sites using an independent sample <em>t</em> test.</div></div><div><h3>Results</h3><div>The prevalence of PCO among patients with proximal caries is 47%. In mesial proximal caries, the extent of PCO is significantly greater in the distal root canal (73.4%), whereas in distal proximal caries, PCO is more often found in the mesial canal (77.3%). The mean extent of intraradicular calcification was higher in the distal canal (<em>P</em> < .001). Moreover, mesial proximal caries showed a greater extent of intraradicular obliteration (<em>P</em> < .001). The probability of developing PCO was significantly higher in females (<em>P</em> = .003).</div></div><div><h3>Conclusions</h3><div>Within the limitations of this study, it can be concluded that the extent of calcification is more common on the opposite side of the location of the proximal caries. Moreover, such intraradicular calcification is greater in a distal canal compared to a mesial canal. Sex plays a significant role in the calcification process, showing higher predilection in females compared to males.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 1","pages":"Pages 15-20"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467136","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}
The aim of this study was to examine the temperature changes on root canal and root surface in immature teeth with thin dentinal walls when irrigation solutions are preheated or intracanal heated, as well as the additional effects of passive ultrasonic irrigation (PUI) on these temperature changes.
Methods
Sixteen maxillary canine teeth were trimmed to a length of 20 mm and prepared to mimic immature teeth with an apical width of 1.3 mm by enlarging those using Gates Glidden burs. To measure temperatures inside the canal and on the root surface, one thermocouple was placed from the apex into the root canal, while the other thermocouple was positioned outside the root. Irrigation was performed by heating the irrigation solution with different methods (room temperature, preheated to 60°C, 5 sec intracanal heated, 20 sec intracanal heated), and PUI was applied after each method. Temperature changes occurring inside the root canal and on the root surface were recorded and subjected to statistical analysis.
Results
Using the irrigation solution preheated and intracanal heated resulted in a significant increase in both intracanal and root surface temperatures compared to using at room temperature (P < .05). The application of PUI significantly increased the temperature of the irrigation solution only at room temperature group (P < .05). None of the applications caused an increase in temperature on the root surface exceeding 10°C.
Conclusions
Applying PUI to heated solutions does not significantly increase the temperature in heating methods, but it does prolong heat retention in the canal by slowing down the cooling process. Although using preheated solution for 20 seconds results in higher intracanal temperatures, it should be noted that the solution cools rapidly within the canal. Short-term heating applications, such as 5 seconds, repeated frequently, can help maintain the high temperature during activation.
{"title":"Comparative Analysis of Temperature Changes with Preheated and Intracanal Heated Solutions and Ultrasonic Activation in Immature Teeth","authors":"Öznur Sariyilmaz DDS, MSc , Evren Sariyilmaz DDS, PhD , Cangül Keskin DDS, PhD","doi":"10.1016/j.joen.2024.10.009","DOIUrl":"10.1016/j.joen.2024.10.009","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of this study was to examine the temperature changes on root canal and root surface in immature teeth with thin dentinal walls when irrigation solutions are preheated or intracanal heated, as well as the additional effects of passive ultrasonic irrigation (PUI) on these temperature changes.</div></div><div><h3>Methods</h3><div>Sixteen maxillary canine teeth were trimmed to a length of 20 mm and prepared to mimic immature teeth with an apical width of 1.3 mm by enlarging those using Gates Glidden burs. To measure temperatures inside the canal and on the root surface, one thermocouple was placed from the apex into the root canal, while the other thermocouple was positioned outside the root. Irrigation was performed by heating the irrigation solution with different methods (room temperature, preheated to 60°C, 5 sec intracanal heated, 20 sec intracanal heated), and PUI was applied after each method. Temperature changes occurring inside the root canal and on the root surface were recorded and subjected to statistical analysis.</div></div><div><h3>Results</h3><div>Using the irrigation solution preheated and intracanal heated resulted in a significant increase in both intracanal and root surface temperatures compared to using at room temperature (<em>P</em> < .05). The application of PUI significantly increased the temperature of the irrigation solution only at room temperature group (<em>P</em> < .05). None of the applications caused an increase in temperature on the root surface exceeding 10°C.</div></div><div><h3>Conclusions</h3><div>Applying PUI to heated solutions does not significantly increase the temperature in heating methods, but it does prolong heat retention in the canal by slowing down the cooling process. Although using preheated solution for 20 seconds results in higher intracanal temperatures, it should be noted that the solution cools rapidly within the canal. Short-term heating applications, such as 5 seconds, repeated frequently, can help maintain the high temperature during activation.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 1","pages":"Pages 71-77"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545810","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 : 2025-01-01DOI: 10.1016/j.joen.2024.10.014
Maria Emília Mota DDS , José F. Siqueira Jr DDS, MSc, PhD , Isabela N. Rôças DDS, MSc, PhD , Fábio Abreu Alves DDS, MSc, PhD , Graziella Chagas Jaguar DDS, PhD , Juliana Bertoldi Franco DDS, PhD , Jayr Schmidt Filho MD , Maria Stella Moreira DDS, MSc, PhD
Introduction
This study investigated the implications of root canal treatment (RCT) of infected teeth with apical periodontitis (AP) in patients undergoing hematopoietic stem cell transplantation (HSCT).
Methods
One hundred patients were selected. Clinical data, oncologic and endodontic diagnosis and treatment, and type of HSCT were recorded. Data on the exacerbation of AP were investigated. Leukocyte/neutrophil and C-reactive protein levels were evaluated before and after RCT.
Results
One hundred patients underwent HSCT (55% autologous). The need for RCT was identified in 41% of the participants. AP was diagnosed in 75.6% of these patients and large lesions (≥5 mm) occurred in 45.2%. A higher prevalence of AP was observed in males (P = .012). RCT was performed in 54.8% of the individuals and no AP exacerbation, pain, swelling, bacteremia, and need for additional medications was observed. Blood cultures were negative for bacteria and fungi. C-reactive protein levels were ≥1 mg/dL in 54.9% of the individuals 1 month before RCT and <1 mg/dL in 64.6% 6 months after treatment (P > .05).
Conclusions
RCT was effective in controlling infection with no complications in patients undergoing HSCT. Given the potential for exacerbation of endodontic infections, RCT and patient monitoring are essential and highly recommended.
{"title":"Endodontic Treatment in Patients Undergoing Hematopoietic Stem Cell Transplantation: A Retrospective Cohort Study","authors":"Maria Emília Mota DDS , José F. Siqueira Jr DDS, MSc, PhD , Isabela N. Rôças DDS, MSc, PhD , Fábio Abreu Alves DDS, MSc, PhD , Graziella Chagas Jaguar DDS, PhD , Juliana Bertoldi Franco DDS, PhD , Jayr Schmidt Filho MD , Maria Stella Moreira DDS, MSc, PhD","doi":"10.1016/j.joen.2024.10.014","DOIUrl":"10.1016/j.joen.2024.10.014","url":null,"abstract":"<div><h3>Introduction</h3><div>This study investigated the implications of root canal treatment (RCT) of infected teeth with apical periodontitis (AP) in patients undergoing hematopoietic stem cell transplantation (HSCT).</div></div><div><h3>Methods</h3><div>One hundred patients were selected. Clinical data, oncologic and endodontic diagnosis and treatment, and type of HSCT were recorded. Data on the exacerbation of AP were investigated. Leukocyte/neutrophil and C-reactive protein levels were evaluated before and after RCT.</div></div><div><h3>Results</h3><div>One hundred patients underwent HSCT (55% autologous). The need for RCT was identified in 41% of the participants. AP was diagnosed in 75.6% of these patients and large lesions (≥5 mm) occurred in 45.2%. A higher prevalence of AP was observed in males (<em>P</em> = .012). RCT was performed in 54.8% of the individuals and no AP exacerbation, pain, swelling, bacteremia, and need for additional medications was observed. Blood cultures were negative for bacteria and fungi. C-reactive protein levels were ≥1 mg/dL in 54.9% of the individuals 1 month before RCT and <1 mg/dL in 64.6% 6 months after treatment (<em>P</em> > .05).</div></div><div><h3>Conclusions</h3><div>RCT was effective in controlling infection with no complications in patients undergoing HSCT. Given the potential for exacerbation of endodontic infections, RCT and patient monitoring are essential and highly recommended.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 1","pages":"Pages 35-42"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621747","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 : 2025-01-01DOI: 10.1016/S0099-2399(24)00653-8
{"title":"Guidelines for Authors","authors":"","doi":"10.1016/S0099-2399(24)00653-8","DOIUrl":"10.1016/S0099-2399(24)00653-8","url":null,"abstract":"","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 1","pages":"Pages A8-A13"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143353820","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 : 2025-01-01DOI: 10.1016/j.joen.2024.11.003
Noriaki Yoshihashi DDS
Autogenous tooth transplantation (ATT) offers advantages; however, success rates depend on factors like socket formation, donor tooth manipulation, and endodontic treatment. Root canal treatment in a mature post-ATT tooth remains challenging. Cell-based regenerative endodontic therapy (RET) shows promise for regenerating the pulp-dentin complex in mature teeth. However, its application in a post-ATT tooth is unexplored. This case report demonstrates the feasibility and outcomes of cell-based RET in a post-ATT tooth. A 37-year-old male underwent ATT for a missing maxillary left first molar. The maxillary right third molar served as the donor tooth and transplanted with surgical guides. Root canal treatment began two weeks after ATT, confirming no detectable residual bacteria and fungi after 11 weeks. Dental pulp stem cells isolated from the maxillary left third molar were transplanted into the root canal 17 weeks after ATT. The ATT tooth responded positively to the electric pulp test after 1 week. Most of the periodontal ligament of the donor tooth was absent, and the ATT tooth initially showed ankylosis-like signs but regained normal mobility after 28 weeks after RET. Cone-beam computed tomography imaging showed successful outcomes with the presence of the periodontal ligament space and lamina dura, and without root resorption and ankylosis after 52 weeks. Magnetic resonance imaging revealed signal intensity of the regenerated tissue comparable to normal pulp after 60 weeks. This case report suggests the effectiveness of dental pulp stem cells in regenerating dental pulp and periodontal ligament, potentially preventing root resorption and ankylosis in the post-ATT tooth.
自体牙移植（ATT）具有很多优点，但成功率取决于牙槽窝的形成、供体牙的操作和牙髓治疗等因素。ATT后成熟牙齿的根管治疗仍然具有挑战性。基于细胞的再生根管疗法（RET）有望再生成熟牙齿的牙髓-牙本质复合体。然而，该疗法在 ATT 后牙齿中的应用尚未得到探索。本病例报告展示了以细胞为基础的 RET 在一颗 ATT 后牙齿中的可行性和结果。一名 37 岁的男性因上颌左侧第一磨牙缺失接受了 ATT 治疗。上颌右侧第三磨牙作为供体牙，用手术导板移植。ATT 两周后开始进行根管治疗，11 周后确认未检测到残留细菌和真菌。ATT 17 周后，从上颌左侧第三磨牙中分离出的牙髓干细胞（DPSCs）被移植到根管中。ATT 牙齿在 1 周后对电髓测试做出了积极反应。供体牙齿的大部分牙周韧带缺失，ATT牙齿最初表现出类似强直的症状，但在RET 28周后恢复了正常的活动度。锥形束计算机断层扫描（CBCT）成像结果显示，52 周后牙周韧带间隙和硬膜存在，牙根没有吸收和强直。磁共振成像（MRI）显示，60 周后再生组织的信号强度与正常牙髓相当。本病例报告表明，DPSCs 能有效再生牙髓和牙周韧带，从而有可能防止 ATT 后牙齿的牙根吸收和强直。
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Pub Date : 2025-01-01DOI: 10.1016/j.joen.2024.10.004
Ukseong Kim DDS , Sunil Kim DDS, MSD, PhD , Stephanie Myeong Choi DDS, MSD , Mo K. Kang DDS, MSD, PhD , Insoon Chang DDS, MSD, PhD , Euiseong Kim DDS, MSD, PhD
Introduction
Regenerative endodontic procedures (REPs) using cell-based approaches have emerged as novel treatment modalities. This clinical study aimed to present the outcomes and explore factors influencing REPs with minced pulp tissue (MP) grafts in a mature tooth.
Methods
Healthy patients requiring non-surgical root canal treatment were enrolled. MP obtained from the third molar was grafted into the instrumented, disinfected, and blood-filled root canal. After treatment, patients were evaluated clinically and radiographically.
Results
Follow-ups for 6 cases (male patients aged 20–27) ranged from 19 to 42 months. Radiographically, all the teeth showed favorable outcomes. Among the 6 teeth, 2 showed neither intracanal calcification nor recovery in sensibility tests, and one had no intracanal calcification with an inapplicable sensibility test evaluation. In 2 teeth, intracanal calcification was observed in the apical third; however, there was no recovery in the sensibility tests. One tooth exhibited intracanal calcification in the apical third and showed recovery in the sensibility tests. Considering these outcomes and clinical variables, the size of the apical foramen and the composition of the transplanted pulp tissue were identified as tentative influencing factors.
Conclusions
This exploratory clinical study on simplified cell-based REPs using autologous MP grafts for pulp/dentin regeneration in adult teeth not only enhances our understanding of REPs but also suggests its potential as an alternative treatment option to conventional endodontic treatment.
{"title":"Regenerative Endodontic Procedures With Minced Pulp Tissue Graft in Mature Permanent Teeth: A Clinical Study","authors":"Ukseong Kim DDS , Sunil Kim DDS, MSD, PhD , Stephanie Myeong Choi DDS, MSD , Mo K. Kang DDS, MSD, PhD , Insoon Chang DDS, MSD, PhD , Euiseong Kim DDS, MSD, PhD","doi":"10.1016/j.joen.2024.10.004","DOIUrl":"10.1016/j.joen.2024.10.004","url":null,"abstract":"<div><h3>Introduction</h3><div>Regenerative endodontic procedures (REPs) using cell-based approaches have emerged as novel treatment modalities. This clinical study aimed to present the outcomes and explore factors influencing REPs with minced pulp tissue (MP) grafts in a mature tooth.</div></div><div><h3>Methods</h3><div>Healthy patients requiring non-surgical root canal treatment were enrolled. MP obtained from the third molar was grafted into the instrumented, disinfected, and blood-filled root canal. After treatment, patients were evaluated clinically and radiographically.</div></div><div><h3>Results</h3><div>Follow-ups for 6 cases (male patients aged 20–27) ranged from 19 to 42 months. Radiographically, all the teeth showed favorable outcomes. Among the 6 teeth, 2 showed neither intracanal calcification nor recovery in sensibility tests, and one had no intracanal calcification with an inapplicable sensibility test evaluation. In 2 teeth, intracanal calcification was observed in the apical third; however, there was no recovery in the sensibility tests. One tooth exhibited intracanal calcification in the apical third and showed recovery in the sensibility tests. Considering these outcomes and clinical variables, the size of the apical foramen and the composition of the transplanted pulp tissue were identified as tentative influencing factors.</div></div><div><h3>Conclusions</h3><div>This exploratory clinical study on simplified cell-based REPs using autologous MP grafts for pulp/dentin regeneration in adult teeth not only enhances our understanding of REPs but also suggests its potential as an alternative treatment option to conventional endodontic treatment.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 1","pages":"Pages 43-53.e2"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467137","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}
This study evaluated the effects of retrieval strategies of separated nickel-titanium files on the biomechanical behavior of endodontically treated teeth by finite element analysis.
Methods
Six FE models were created: intact tooth; simulated a scenario where the apical 3 mm of a nickel-titanium file is separated and retained; TD, simulated application of a trephine drill to expose 1 mm of the separated file; simulated troughing of 180° at the inner wall of root canal for an extra 1 mm of the separated file beyond the staging platform; simulated circumferential ultrasonic troughing done for an extra 1 mm after the TD; and PM, simulated iatrogenic perforation sealed using mineral trioxide aggregate. Occlusal loading followed the occlusal fingerprint of the tooth before maximum von Mises stresses, maximum principal stresses, safety factor, and number of cycles till failure were determined. The cervical region of the teeth and mid-root sections including the separated file was chosen as the areas of interest for further analysis.
Results
Intact tooth recorded the highest number of cycles till failure and safety factor. Other models showed a narrow range of variation in all aspects with the PM recording the lowest number of cycles till failure. The highest von Mises stress was recorded at the mesiobuccal line angle of the PM near its cervical margin, while the lowest was found at the intact tooth.
Conclusion
Under the limitation of this study, various file retrieval strategies removing the surrounding root dentin within the amounts of general guidelines do not affect the biomechanical behavior of the tooth.
{"title":"The Effect of Different Separated File Retrieval Strategies on the Biomechanical Behavior of a Mandibular Molar: A Finite Element Analysis Study","authors":"Anas Sira BDS , Nawar Naguib Nawar BDS, MSc, PhD , Shehabeldin Mohamed Saber BDS, MSc, PhD , Hyeon-Cheol Kim DDS, MS, PhD","doi":"10.1016/j.joen.2024.10.008","DOIUrl":"10.1016/j.joen.2024.10.008","url":null,"abstract":"<div><h3>Introduction</h3><div>This study evaluated the effects of retrieval strategies of separated nickel-titanium files on the biomechanical behavior of endodontically treated teeth by finite element analysis.</div></div><div><h3>Methods</h3><div>Six FE models were created: intact tooth; simulated a scenario where the apical 3 mm of a nickel-titanium file is separated and retained; TD, simulated application of a trephine drill to expose 1 mm of the separated file; simulated troughing of 180° at the inner wall of root canal for an extra 1 mm of the separated file beyond the staging platform; simulated circumferential ultrasonic troughing done for an extra 1 mm after the TD; and PM, simulated iatrogenic perforation sealed using mineral trioxide aggregate. Occlusal loading followed the occlusal fingerprint of the tooth before maximum von Mises stresses, maximum principal stresses, safety factor, and number of cycles till failure were determined. The cervical region of the teeth and mid-root sections including the separated file was chosen as the areas of interest for further analysis.</div></div><div><h3>Results</h3><div>Intact tooth recorded the highest number of cycles till failure and safety factor. Other models showed a narrow range of variation in all aspects with the PM recording the lowest number of cycles till failure. The highest von Mises stress was recorded at the mesiobuccal line angle of the PM near its cervical margin, while the lowest was found at the intact tooth.</div></div><div><h3>Conclusion</h3><div>Under the limitation of this study, various file retrieval strategies removing the surrounding root dentin within the amounts of general guidelines do not affect the biomechanical behavior of the tooth.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 1","pages":"Pages 64-70"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142558018","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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