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Relationship between Craniofacial Skeletal Patterns and the Prevalence of Tooth Fractures 颅面骨骼形态与牙齿骨折发生率的关系。
IF 3.6 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-01 DOI: 10.1016/j.joen.2025.08.013
Julia Jeong DMD , Lucy Kim DMD , Soriul Kim PhD, MPH , Hyeran Helen Jeon DMD, MSD, DScD , Frank C. Setzer DMD, PhD, MS

Introduction

Tooth fractures are associated with various etiological factors, including occlusal stress. While science has shown associations between maximum bite force and craniofacial skeletal patterns, a direct link between skeletal morphology and the prevalence of tooth fractures has not been established. This study aimed to investigate whether sagittal and vertical skeletal patterns, as determined by cephalometric analysis, are associated with the prevalence of tooth fractures in an adult orthodontic population.

Methods

A retrospective review was conducted of 1001 adult orthodontic patients with complete records, including lateral cephalometric radiographs and demographic data. Patients were classified into vertical (high, neutral, low mandibular angle) and sagittal (Angle Class I, II, III) skeletal patterns using population-specific cephalometric norms. Tooth fractures were identified through clinical records and Current Dental Terminology codes, including whether fractured teeth were extracted or retained, and whether endodontic treatment was involved. Statistical analysis included analysis of covariance, chi-square, and Fisher exact tests.

Results

No significant differences were observed in the prevalence of tooth fractures, either extracted or retained, across vertical or sagittal skeletal classes for the overall population. Within the Caucasian subpopulation, a significantly higher prevalence of tooth fractures was noted in ANGLE-I compared to ANGLE-II (P = .02). Similarly, previously endodontically treated teeth were more frequently extracted due to fracture in ANGLE-I and ANGLE-III compared to ANGLE-II (P = .02). No significant associations were found in the African-American, Asian, or Hispanic subpopulations.

Conclusions

Craniofacial skeletal patterns may not aid in predicting tooth fracture risk in the general population. While limited associations were noted within the Caucasian subgroup, further prospective studies incorporating direct bite force measurements are warranted to clarify biomechanical contributions to tooth fractures.
牙齿骨折与多种病因有关,包括牙合应力。虽然科学已经表明最大咬合力与颅面骨骼形态之间存在关联,但骨骼形态与牙齿骨折患病率之间的直接联系尚未建立。本研究旨在调查矢状和垂直骨骼模式是否与成人正畸人群中牙齿骨折的患病率有关。材料和方法:回顾性分析1001例成人正畸患者的完整记录,包括侧位头颅x线片和人口统计资料。根据人群特异性头颅测量标准,将患者分为垂直(高、中、低下颌角)和矢状(角度I、II、III类)骨骼模式。通过临床记录和CDT (Current Dental Terminology)代码识别牙齿骨折,包括骨折的牙齿是否被拔出或保留,以及是否涉及牙髓治疗。统计分析包括ANCOVA、卡方检验和Fisher’s Exact检验。结果:在整个人群中,在垂直或矢状骨类别中,没有观察到牙齿骨折的发生率有显著差异,无论是拔出的还是保留的。在高加索人亚群中,与ANGLE-II相比,ANGLE-I的牙齿骨折发生率明显更高(p = 0.02)。同样,与ANGLE-II相比,先前进行过根管治疗的牙齿因ANGLE-I和ANGLE-III骨折而拔出的频率更高(p = 0.02)。在非裔美国人、亚洲人或西班牙裔亚人群中未发现显著关联。结论:颅面骨骼模式可能不能帮助预测一般人群的牙齿骨折风险。虽然在高加索亚组中注意到有限的关联,但进一步的前瞻性研究包括直接咬合力测量,以澄清生物力学对牙齿骨折的影响。
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引用次数: 0
Biocompatibility of a Novel Light-Curable Hydrogel-Based Root Canal Obturation Material: In Vivo and In Vitro Analyses 一种新型光固化水凝胶根管封闭材料的生物相容性:体内和体外分析。
IF 3.6 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-01 DOI: 10.1016/j.joen.2025.08.017
Moe Sandar Kyaw PhD, MDSc , Yoshio Yahata DDS, PhD , Masato Nakano DDS, PhD , Fusami Toyama DDS , Chen Ke DDS , Wang Shuai DDS, MDSc , Yuya Kamano DDS, PhD , Futaba Harada DDS, PhD , Tomose Noguchi DDS , Masahiro Saito DDS, PhD

Introduction

This study aims to evaluate the biocompatibility of a new light-curable hydrogel-based root canal obturation material, OdneFill, through in vivo and in vitro analyses.

Methods

Intentional overinstrumentation and overobturation were performed on the mandibular first molars of 10-week-old male rats, divided into 4 groups: group 1 (instrumentation only), group 2 (OdneFill), group 3 (gutta-percha + AH Plus), and group 4 (sound teeth). Mandibles were dissected after 3, 28, and 90 days for micro–computed tomography, histological analysis, and immunohistochemical staining and analyzed by two-way analysis of variance and post hoc Tukey test. Cytotoxicity and proinflammatory cytokine expression were assessed using RAW 264.7 cells and analyzed by 1-way analysis of variance and Tukey test (α = 0.05).

Results

Micro–computed tomographic analysis showed no significant difference in bone resorption (P > .05). However, AH Plus exhibited a higher inflammatory score (score: 1%–90%, score: 2%–10%) with increased neutrophil and macrophage infiltration in immunostaining (P < .05) compared to the instrumentation only group at day 90. In contrast, Odnefill showed comparable results (score: 0%–50%, score: 1%–30%, score: 2%–20%) to the instrumentation-only group (P > .05). Moreover, Odnefill did not affect the viability of RAW 264.7 cells, whereas the AH Plus extract decreased cell viability and upregulated inflammatory cytokines such as interleukin-1 beta and interleukin-6.

Conclusions

OdneFill demonstrated superior biocompatibility, and a minimal inflammatory response compared to AH Plus.
本研究旨在通过体内和体外分析来评估一种新型光固化水凝胶基根管封闭材料OdneFill(瑞士Odne)的生物相容性。方法:对10周龄雄性大鼠下颌第一磨牙进行故意过内固定和过封闭,分为4组:1组(仅内固定)、2组(OdneFill)、3组(古塔百尔沙+ AH Plus)和4组(健全牙)。分别于第3、28和90天解剖下颌骨,进行显微计算机断层扫描、组织学分析和免疫组织染色(IHC),并通过双向方差分析和事后Tukey检验进行分析。采用RAW 264.7细胞评价细胞毒性和促炎细胞因子的表达,采用单因素方差分析和Tukey检验(α = 0.05)。结果:微计算机层析分析显示骨吸收差异无统计学意义(P < 0.05)。然而,与仅使用器械组相比,AH Plus在第90天表现出更高的炎症评分(评分:1-90%,2-10%),免疫组化染色中中性粒细胞和巨噬细胞浸润增加(P < 0.05)。相比之下,Odnefill显示了与仅使用器械组相当的结果(评分:0-50%,1-30%,2-20%)(P < 0.05)。此外,Odnefill不影响RAW 264.7细胞的活力,而AH Plus提取物降低细胞活力并上调炎症细胞因子如IL-1β和IL-6。结论:与AH Plus相比,OdneFill表现出优越的生物相容性和最小的炎症反应。
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引用次数: 0
Investigation of Endodontic Disinfection by Combination of Laser and Nanobubble Technology 激光与纳米气泡联合消毒牙髓的研究。
IF 3.6 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-01 DOI: 10.1016/j.joen.2025.08.016
Haosu Ci DDS , Bingchang Xin DDS , Andrew W. Hubbard DMD, MDS , Evan Hamilton DDS, MDS , Chaz Ainsworth DDS, MS , Brett M. Dagen DDS , Enrique R. Bursian DMD , Yuting Zhang DDS , Yanhui H. Zhang PhD , Brian R. Morrow MS , Misako Nakashima DDS, PhD , George J.-T. Huang DDS, MSD, DSc

Introduction

To investigate the combined use of laser, nanobubble water (NB-H2O), and calcium hydroxide (Ca(OH)2) for endodontic disinfection, particularly in regenerative endodontic cases where maximum effectiveness is needed.

Methods

The canal of human teeth were prepared, sterilized, and inoculated with Enterococcus faecalis (E. faecalis). Teeth were assigned to 4 groups for 2 rounds of disinfection with Er,Cr: YSGG laser (Biolase). Group I - control, no disinfection, Group II - 6.25% NaOCl, Group III - 1.25% NaOCl, and Group IV - 1.25% NaOCl/NB-H2O. Ca(OH)2 was placed in the canal for ∼10 days between the 2 disinfection rounds. Teeth were evaluated by scanning electron microscopy for biofilm removal and confocal laser scanning microscopy to detect live/dead bacteria in the dentinal tubules.

Results

Scanning electron microscopy analysis of the canal disinfection indicated that the NB-H2O group (1.25% NaOCl/NB-H2O) appeared to enhance the removal of biofilm/smear layer. However, it was not consistently more effective than other groups in killing the bacteria in the dentinal tubules. The combined use of low-concentration NaOCl, laser, NB-H2O and Ca(OH)2 largely reduced E. faecalis but did not achieve complete eradication from the canal or in the dentinal tubules.

Conclusions

Our comprehensive disinfection protocol reduced the bacteria in the dentinal tubules to a level potentially suited for regenerative endodontic therapy.
简介:研究激光、纳米泡水(NB-H2O)和氢氧化钙(Ca(OH)2)联合用于根管消毒,特别是在需要最大效果的再生根管病例中。方法:制备人牙管,消毒后接种粪肠球菌(E. faecalis)。采用Er、Cr: YSGG激光(Biolase)对牙齿进行2轮消毒。第一组为对照组,未消毒,第二组为6.25% NaOCl,第三组为1.25% NaOCl,第四组为1.25% NaOCl/NB-H2O。Ca(OH)2在两轮消毒之间放置在管中~ 10天。采用扫描电镜(SEM)检查生物膜的去除情况,用共聚焦激光扫描显微镜(CLSM)检查牙本质小管内的活/死细菌。结果:管道消毒后的扫描电镜分析表明,NB-H2O组(1.25% NaOCl/NB-H2O)对生物膜/涂抹层的去除有促进作用。然而,在杀死牙本质小管中的细菌方面,它并不总是比其他组更有效。低浓度NaOCl、激光、NB-H2O和Ca(OH)2联合使用可显著减少粪肠球菌,但不能完全根除根管或牙本质小管内的粪肠球菌。结论:我们的综合消毒方案将牙本质小管中的细菌减少到可能适合再生根管治疗的水平。
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引用次数: 0
A Novel Robot-Assisted Access in Endodontic Microsurgery Combined with Sinus Floor Elevation for Maxillary First Molar. 上颌第一磨牙牙髓显微手术联合窦底提升的新型机器人辅助通道。
IF 3.6 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-01 DOI: 10.1016/j.joen.2025.11.022
Weiwei Qiao, Li Qin, Chen Chen, Yeyu Lin, Xining Zhang, Yi Zhou, Liuyan Meng

Endodontic microsurgery (EMS) is an important treatment option for endodontic disease when the nonsurgical endodontic treatment fails. However, EMS for maxillary molars often presents a clinical challenge due to the root apex close to the maxillary sinus floor, which may increase the risk of sinus membrane perforation. Furthermore, the depth between the apex of the palatal root and the buccal cortical plate significantly impacts EMS precision for restricting visualization and instrument access. This case report is the first to use an autonomous robotic system for minimally invasive EMS on a maxillary first molar, combined with precise lateral wall sinus fenestration. A 55-year-old male patient presented with symptomatic apical periodontitis associated with previously treated left maxillary first molar. Cone-beam computed tomography revealed low-density areas surrounding the mesiobuccal and palatal (P) roots, and maxillary sinus floor descended between the palatal and buccal roots. Integrating cone-beam computed tomography and intraoral scan data, the autonomous robotic system performed guided sinus fenestration localization, autonomous osteotomy, and a 15-mm root-end resection from buccal to palatal root, with real-time monitoring of depth, angulation, and force. The clinician employed endoscopic assistance to verify the integrity of the sinus membrane and ensure the removal of debris from the surgical site. Root-end preparation and filling were carried out under a microscope. Follow-ups at 1 week, 1 month, 3 months, and 6 months indicated an absence of clinical symptoms. This approach offers a precise and minimally invasive treatment option for molars with a descended maxillary sinus floor located between the buccal and palatal root.

当非手术治疗牙髓疾病失败时,显微手术是治疗牙髓疾病的重要选择。然而,由于上颌磨牙的根尖靠近上颌窦底,可能增加窦膜穿孔的风险,EMS治疗上颌磨牙往往面临临床挑战。此外,腭根顶端与颊皮质板之间的深度显著影响EMS的精度,限制了可视化和器械的使用。本病例报告是首次使用自主机器人(ATR)系统对上颌第一磨牙进行微创EMS,并结合精确的侧壁窦开窗。一个55岁的男性病人提出了症状根尖牙周炎与先前治疗的左上颌第一磨牙。锥形束计算机断层扫描(CBCT)显示中颊根(MB)和腭根(P)周围低密度区,上颌窦底在腭根和颊根之间下降。结合CBCT和口内扫描数据,ATR系统进行了引导窦开窗定位、自主截骨和从颊根到腭根的15mm根端切除,并实时监测深度、角度和力。临床医生使用内窥镜辅助来验证窦膜的完整性,并确保手术部位的碎片被清除。在显微镜下进行根端准备和充填。随访1周、1个月、3个月和6个月均无临床症状。该入路为颊根和腭根之间上颌窦底下降的磨牙提供了一种精确和微创的治疗选择。
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引用次数: 0
Corrigendum to ‘The XP-endo Shaper and Its Impact on Posttreatment Discomfort: A Systematic Review and Meta-Analysis of Randomized Controlled Trials [Journal of Endodontics, Volume 51, Issue 4, April (2025), 481-490] XP-endo塑形器及其对治疗后不适的影响的更正:随机对照试验的系统回顾和荟萃分析[Journal of Endodontics, vol . 51, Issue 4, April (2025), 481-490]
IF 3.6 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-01 DOI: 10.1016/j.joen.2025.08.010
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引用次数: 0
Diabetes Increases Residual Stress and Microcrack Length in Dentin: An XRD–SEM Study with AI-assisted Quantification 糖尿病增加牙本质的残余应力和微裂纹长度:人工智能辅助定量的x射线扫描电镜研究。
IF 3.6 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-01 DOI: 10.1016/j.joen.2025.09.002
Mohammad Ali Saghiri BS, MS, DEng, PhD , Kasra Momeni DEng, PhD , Chao-Ho Chien DDS, DScD , Michael Conte DDS , Praneetha Pinnaka MPH , Steven M. Morgano DMD

Introduction

This study evaluated the association between residual stress and microcracks length in root dentin using an AI-assisted quantification workflow run in parallel with Fiji/ImageJ.

Methods

Twenty mandibular premolars were collected, including ten (n = 10) from diabetic patients and ten (n = 10) from healthy controls. Following standardized rotary instrumentation and irrigation protocols, the roots were longitudinally sectioned. Residual stress was assessed using the sin2ψ X-ray diffraction method. Microcracks were visualized under scanning electron microscopy and quantitatively analyzed using a Fiji-based workflow with an AI-assisted comparator. Statistical analyses included independent t tests, Pearson correlation, and linear regression, using two-sided tests with α = 0.05.

Results

Significant differences were observed between diabetic and nondiabetic dentin in terms of residual stress (1.40 ± 0.47 MPa vs −1.10 ± 0.44 MPa, P < .001). Microcracks length was greater in diabetic dentin (54.6 ± 9.4 μm) than in nondiabetic controls (20.0 ± 4.6 μm, P < .001), indicating that higher stress levels were associated with longer microcracks.

Conclusion

This study found that residual stress contributes to increased microcracks length in instrumented roots, with diabetic dentin showing longer cracks. These findings may explain the higher failure risk in diabetic patients.
本研究使用ai辅助的量化工作流程,与Fiji/ImageJ并行运行,评估了牙根内残余应力与微裂纹长度之间的关系。方法:采集20颗下颌前磨牙,其中糖尿病患者10颗(n = 10),健康对照10颗(n = 10)。按照标准化的旋转仪器和灌溉方案,根被纵向切片。残余应力用sin2ψ x射线衍射法测定。在扫描电子显微镜(SEM)下观察微裂缝,并使用基于斐济的工作流和人工智能辅助比较器进行定量分析。统计分析采用独立t检验、Pearson相关检验和线性回归,采用双侧检验,α = 0.05。结果:糖尿病患者与非糖尿病患者牙本质残余应力差异有统计学意义(1.40±0.47 MPa vs -1.10±0.44 MPa, p < 0.001)。糖尿病患者牙本质的微裂纹长度(54.6±9.4 μm)大于非糖尿病对照组(20.0±4.6 μm, p < 0.001),表明应力水平越高,微裂纹越长。结论:本研究发现,残余应力导致器械根的微裂纹长度增加,糖尿病患者牙本质的裂纹更长。这些发现可能解释了糖尿病患者较高的衰竭风险。
{"title":"Diabetes Increases Residual Stress and Microcrack Length in Dentin: An XRD–SEM Study with AI-assisted Quantification","authors":"Mohammad Ali Saghiri BS, MS, DEng, PhD ,&nbsp;Kasra Momeni DEng, PhD ,&nbsp;Chao-Ho Chien DDS, DScD ,&nbsp;Michael Conte DDS ,&nbsp;Praneetha Pinnaka MPH ,&nbsp;Steven M. Morgano DMD","doi":"10.1016/j.joen.2025.09.002","DOIUrl":"10.1016/j.joen.2025.09.002","url":null,"abstract":"<div><h3>Introduction</h3><div>This study evaluated the association between residual stress and microcracks length in root dentin using an AI-assisted quantification workflow run in parallel with Fiji/ImageJ.</div></div><div><h3>Methods</h3><div>Twenty mandibular premolars were collected, including ten (<em>n</em> = 10) from diabetic patients and ten (<em>n</em> = 10) from healthy controls. Following standardized rotary instrumentation and irrigation protocols, the roots were longitudinally sectioned. Residual stress was assessed using the sin<sup>2</sup>ψ X-ray diffraction method. Microcracks were visualized under scanning electron microscopy and quantitatively analyzed using a Fiji-based workflow with an AI-assisted comparator. Statistical analyses included independent t tests, Pearson correlation, and linear regression, using two-sided tests with α = 0.05.</div></div><div><h3>Results</h3><div>Significant differences were observed between diabetic and nondiabetic dentin in terms of residual stress (1.40 ± 0.47 MPa vs −1.10 ± 0.44 MPa, <em>P</em> &lt; .001). Microcracks length was greater in diabetic dentin (54.6 ± 9.4 μm) than in nondiabetic controls (20.0 ± 4.6 μm, <em>P</em> &lt; .001), indicating that higher stress levels were associated with longer microcracks.</div></div><div><h3>Conclusion</h3><div>This study found that residual stress contributes to increased microcracks length in instrumented roots, with diabetic dentin showing longer cracks. These findings may explain the higher failure risk in diabetic patients.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 12","pages":"Pages 1823-1829"},"PeriodicalIF":3.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040242","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}
引用次数: 0
Clinical Validation of Smartphone-Enabled Pulse Oximetry for Objective Pulp Vitality Assessment: A Diagnostic Accuracy Study 智能手机脉搏血氧仪用于客观牙髓活力评估的临床验证:一项诊断准确性研究。
IF 3.6 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-01 DOI: 10.1016/j.joen.2025.09.003
Celso Luiz Caldeira DDS, MSc, PhD , Stephanie Isabel Diaz Zamalloa DDS, MSc, PhD , Claudia Regina Guimaro Sakitani DDS , Fernando Branco Barletta DDS, MSc, PhD , Marinella Holzhausen DDS, MSc, PhD

Introduction

Pulse oximetry exhibits great potential for use in endodontic diagnosis as an effective method to assess pulp vitality. Cell phone-integrated oximeters represent an emerging alternative that may offer greater accessibility. This study aimed to investigate the relation between pulp oxygenation rates (%SpO2) and clinical diagnosis of healthy pulp (HP), reversible pulpitis (RP), symptomatic irreversible pulpitis (IP), or pulp necrosis (PN), comparing 2 pulse oximeters (conventional [PO1] and mobile-connected).

Methods

Thirty affected premolars were grouped according to the clinical diagnosis of RP, IP, or PN and compared to vitality diagnosis by %SpO2 obtained by both pulse oximeters: PO1 and by smartphone-based (PO2). For each affected tooth, 2 additional teeth (adjacent and contralateral) with HP were tested. Statistical analysis was performed using one-way ANOVA with Tukey's post-hoc test.

Results

The mean %SpO2 values measured by PO1 were 87.7% for RP, 80.5% for IP, 73.2% for PN, and 91.89% for HP. Corresponding values obtained with PO2 were 85.6% (RP), 79.3% (IP), 72.1% (PN), and 90.1% (HP). Significant differences in %SpO2 were observed among RP, IP, and PN groups (P < .05), but not between healthy control subgroups (adjacent and contralateral). PO1 consistently recorded higher oxygen saturation than PO2 across all clinical conditions (P < .05), demonstrating superior discriminatory capability.

Conclusions

Both pulse oximeters demonstrated significant clinical value for pulp vitality assessment and differentiation of pulpal inflammation stages and necrosis. The smartphone-adapted oximeter has proven to be comparable to PO1 in diagnostic performance, while offering data collection efficiency and clinical workflow integration.
简介:脉搏血氧仪作为评估牙髓活力的有效方法,在牙髓诊断中显示出巨大的潜力。手机集成血氧仪代表了一种新兴的替代方案,可能提供更大的可及性。本研究旨在探讨牙髓氧合率(%SpO2)与健康牙髓(HP)、可逆性牙髓炎(RP)、症状性不可逆性牙髓炎(IP)或牙髓坏死(PN)临床诊断的关系,并比较两种脉搏血氧仪(常规和移动连接)。方法:将30例患前磨牙根据RP、IP或PN的临床诊断进行分组,并与常规脉搏血氧仪(PO1)和智能手机脉搏血氧仪(PO2)测得的%SpO2对活力的诊断进行比较。对于每一个受影响的牙齿,另外两个牙齿(相邻(A)和对侧(C))进行HP检测。统计学分析采用单因素方差分析和Tukey事后检验。结果:PO1测定的平均%SpO2值RP为87.7%,IP为80.5%,PN为73.2%,HP为91.89%。PO2分别为85.6% (RP)、79.3% (IP)、72.1% (PN)和90.1% (HP)。结论:两种脉搏血氧仪对牙髓活力评估和牙髓炎症分期及坏死的鉴别具有重要的临床价值。这款适用于智能手机的血氧仪已被证明在诊断性能上与传统血氧仪相当,同时提供数据收集效率和临床工作流程集成。
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引用次数: 0
Biomechanical Behavior of Maxillary Premolars with Non-carious Cervical Lesions: Influence of Minimally Invasive Endodontic Access and Restoration Protocols 非龋齿颈椎病变上颌前磨牙的生物力学行为:微创根管接入和修复方案的影响。
IF 3.6 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-01 DOI: 10.1016/j.joen.2025.07.019
Fabiane Carneiro Lopes-Olhê DDS, MS, PhD , Helena Cristina de Assis DDS, MS , Gustavo Creazzo DDS , Ana Paula Macedo BENG, MS, PhD , Marco Aurélio Carvalho DDS, MS, PhD , Angelo José Sócrates Torres-Carrillo DDS, MS , Lautaro Gallardo Altube DDS, MS , Gabrielle Jacob DDS , Guilherme Nilson Alves dos Santos DDS, MS, PhD , Jardel Francisco Mazzi-Chaves DDS, MS, PhD , Manoel D. Sousa-Neto DDS, MS, PhD

Introduction

Non-carious cervical lesions (NCCLs) compromise tooth structure and may cause inflammation requiring endodontic treatment. This study evaluated the influence of endodontic access design on fracture resistance, failure patterns, and stress distribution in maxillary premolars with wedge-shaped NCCLs restored using different restorative strategies.

Methods

One hundred maxillary premolars were divided into ten groups based on access type (sound and NCCL with traditional, minimally invasive, and no access) and restorative material (provisional, conventional composite, high-viscosity bulk-fill resin, or low-viscosity bulk-fill resin combined with conventional resin composite). NCCLs were standardized, endodontic treatments performed, and restorations applied. After thermocycling, specimens underwent fracture resistance testing and failure mode analysis. One tooth was scanned for finite element analysis (FEA).

Results

The sound group and the minimally invasive access group restored with high-viscosity bulk-fill resin had numerically higher fracture resistance. No significant difference was found between traditional and minimally invasive access. Adhesive protocols performed significantly better than temporary restorations (P < .05). Type III (nonrestorable) fractures predominated (50%–90%). FEA revealed stress concentrations in the buccal cusp, central groove, marginal ridges, and cervical region, with similar patterns across groups and slightly lower stress in minimally invasive access.

Conclusions

Endodontic access preparation reduced the fracture resistance of maxillary premolars with noncarious cervical lesions; however, the access design itself did not significantly influence this outcome. FEA revealed similar stress distribution patterns across all groups, regardless of access type. Adhesive restorative protocols, especially those employing bulk-fill composites, enhanced biomechanical performance compared to provisional restorations. These findings underscore the importance of minimally invasive access in preserving structural integrity and highlight the critical role of adhesive strategies in restoring biomechanical function.
简介:非龋齿性宫颈病变(ncls)损害牙齿结构,并可能引起炎症,需要进行牙髓治疗。本研究评估了采用不同修复策略修复楔形ncls的上颌前磨牙时,根管通路设计对其抗骨折性、破坏模式和应力分布的影响。方法:100颗上颌前磨牙按通道类型(传统、微创、无通道)和修复材料(临时、常规复合、高粘度体填充树脂或低粘度体填充树脂联合常规树脂复合)分为10组。对nccl进行标准化,进行根管治疗,并应用修复体。热循环后,试样进行抗断裂测试和破坏模式分析。扫描一颗牙齿进行有限元分析(FEA)。结果:超声组和高黏度块体填充树脂修复的微创通路组在数值上具有更高的抗骨折性。传统手术与微创手术无显著差异。结论:根管通路预备可降低非龋齿颈椎病变上颌前磨牙的抗骨折能力;然而,访问设计本身并没有显著影响这一结果。有限元分析显示,无论访问类型如何,所有组的应力分布模式相似。与临时修复体相比,胶粘剂修复体方案,特别是采用大块填充复合材料的修复体,提高了生物力学性能。这些发现强调了微创通路在保持结构完整性方面的重要性,并强调了粘合策略在恢复生物力学功能方面的关键作用。
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引用次数: 0
Cellular Crosstalk Between Periodontal Ligament Fibroblasts and Macrophages: Insights from 2D and 3D Culture Systems in External Inflammatory Root Resorption 牙周韧带成纤维细胞和巨噬细胞之间的细胞串扰:来自外部炎症根吸收的2D和3D培养系统的见解。
IF 3.6 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-01 DOI: 10.1016/j.joen.2025.07.021
Rajeshwari Hadagalu Revana Siddappa BDS, MDS, PhD , Anil Kishen BDS, MDS, PhD

Introduction

Root resorption following traumatic dental injuries is a complex process involving the breakdown of root dentin and cementum by odontoclasts, which differentiate from precursor macrophages. This differentiation is regulated by periodontal ligament fibroblasts (PDLF). Macrophages can polarize into two types: proinflammatory (M1) and anti-inflammatory (M2), which can influence either disease progression or healing.

Methods

This review considers experimental models that have been utilized to study the interactions between PDLF and macrophages under normal and inflammatory conditions, including bacterial exposure and hypoxia.

Results

Under normal circumstances, PDLFmaintain the balance of periodontal tissues and the surrounding immune environment. However, during inflammatory conditions such as exposure to bacteria or hypoxia, injured PDLF interact with macrophages through signaling mechanisms that promote the differentiation of macrophages into odontoclasts. Various experimental models have been utilized to study the interactions between PDLF and macrophages. These interactions alter the balance of macrophage polarization, with M1 macrophages contributing to disease progression.

Conclusion

This review highlights recent insights into the dynamic relationship between PDLF and macrophages in the context of external inflammatory root resorption, emphasizing the importance of their crosstalk in determining disease outcome.
创伤性牙外伤后的牙根吸收是一个复杂的过程,涉及到牙本质和牙骨质被破牙细胞分解,而破牙细胞与前体巨噬细胞不同。这种分化是由牙周韧带成纤维细胞(PDLF)调节的。巨噬细胞可以分化为两种类型:促炎细胞(M1)和抗炎细胞(M2),它们可以影响疾病的进展或愈合过程。正常情况下,pdf维持牙周组织和周围免疫环境的平衡。然而,在炎症条件下,如暴露于细菌或缺氧,损伤的ppdf通过信号机制与巨噬细胞相互作用,促进巨噬细胞向破牙细胞分化。人们利用各种实验模型来研究PDLF与巨噬细胞之间的相互作用。这篇综述强调了最近对它们在外部炎症根吸收背景下的动态关系的见解。
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引用次数: 0
Guidelines for Authors 作者指南
IF 3.6 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-01 DOI: 10.1016/S0099-2399(25)00673-9
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期刊
Journal of endodontics
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