Pub Date : 2025-12-01DOI: 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.
{"title":"Relationship between Craniofacial Skeletal Patterns and the Prevalence of Tooth Fractures","authors":"Julia Jeong DMD , Lucy Kim DMD , Soriul Kim PhD, MPH , Hyeran Helen Jeon DMD, MSD, DScD , Frank C. Setzer DMD, PhD, MS","doi":"10.1016/j.joen.2025.08.013","DOIUrl":"10.1016/j.joen.2025.08.013","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>P</em> = .02). Similarly, previously endodontically treated teeth were more frequently extracted due to fracture in ANGLE-I and ANGLE-III compared to ANGLE-II (<em>P</em> = .02). No significant associations were found in the African-American, Asian, or Hispanic subpopulations.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 12","pages":"Pages 1735-1743"},"PeriodicalIF":3.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956543","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 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.
{"title":"Biocompatibility of a Novel Light-Curable Hydrogel-Based Root Canal Obturation Material: In Vivo and In Vitro Analyses","authors":"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","doi":"10.1016/j.joen.2025.08.017","DOIUrl":"10.1016/j.joen.2025.08.017","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aims to evaluate the biocompatibility of a new light-curable hydrogel-based root canal obturation material, OdneFill, through <em>in vivo</em> and <em>in vitro</em> analyses.</div></div><div><h3>Methods</h3><div>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).</div></div><div><h3>Results</h3><div>Micro–computed tomographic analysis showed no significant difference in bone resorption (<em>P</em> > .05). However, AH Plus exhibited a higher inflammatory score (score: 1%–90%, score: 2%–10%) with increased neutrophil and macrophage infiltration in immunostaining (<em>P</em> < .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 (<em>P</em> > .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.</div></div><div><h3>Conclusions</h3><div>OdneFill demonstrated superior biocompatibility, and a minimal inflammatory response compared to AH Plus.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 12","pages":"Pages 1814-1822"},"PeriodicalIF":3.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956545","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 : 2025-12-01DOI: 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.
{"title":"Investigation of Endodontic Disinfection by Combination of Laser and Nanobubble Technology","authors":"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","doi":"10.1016/j.joen.2025.08.016","DOIUrl":"10.1016/j.joen.2025.08.016","url":null,"abstract":"<div><h3>Introduction</h3><div>To investigate the combined use of laser, nanobubble water (NB-H<sub>2</sub>O), and calcium hydroxide (Ca(OH)<sub>2</sub>) for endodontic disinfection, particularly in regenerative endodontic cases where maximum effectiveness is needed.</div></div><div><h3>Methods</h3><div>The canal of human teeth were prepared, sterilized, and inoculated with <em>Enterococcus faecalis (E. faecalis).</em> 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-H<sub>2</sub>O. Ca(OH)<sub>2</sub> 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.</div></div><div><h3>Results</h3><div>Scanning electron microscopy analysis of the canal disinfection indicated that the NB-H<sub>2</sub>O group (1.25% NaOCl/NB-H<sub>2</sub>O) 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-H<sub>2</sub>O and Ca(OH)<sub>2</sub> largely reduced <em>E. faecalis</em> but did not achieve complete eradication from the canal or in the dentinal tubules.</div></div><div><h3>Conclusions</h3><div>Our comprehensive disinfection protocol reduced the bacteria in the dentinal tubules to a level potentially suited for regenerative endodontic therapy.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 12","pages":"Pages 1803-1813"},"PeriodicalIF":3.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144956516","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 : 2025-12-01DOI: 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.
{"title":"A Novel Robot-Assisted Access in Endodontic Microsurgery Combined with Sinus Floor Elevation for Maxillary First Molar.","authors":"Weiwei Qiao, Li Qin, Chen Chen, Yeyu Lin, Xining Zhang, Yi Zhou, Liuyan Meng","doi":"10.1016/j.joen.2025.11.022","DOIUrl":"10.1016/j.joen.2025.11.022","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145668643","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 : 2025-12-01DOI: 10.1016/j.joen.2025.08.010
{"title":"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]","authors":"","doi":"10.1016/j.joen.2025.08.010","DOIUrl":"10.1016/j.joen.2025.08.010","url":null,"abstract":"","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 12","pages":"Pages 1845-1850"},"PeriodicalIF":3.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145698102","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 : 2025-12-01DOI: 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 , Kasra Momeni DEng, PhD , Chao-Ho Chien DDS, DScD , Michael Conte DDS , Praneetha Pinnaka MPH , 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> < .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> < .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}
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.
{"title":"Clinical Validation of Smartphone-Enabled Pulse Oximetry for Objective Pulp Vitality Assessment: A Diagnostic Accuracy Study","authors":"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","doi":"10.1016/j.joen.2025.09.003","DOIUrl":"10.1016/j.joen.2025.09.003","url":null,"abstract":"<div><h3>Introduction</h3><div>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 (%SpO<sub>2</sub>) 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).</div></div><div><h3>Methods</h3><div>Thirty affected premolars were grouped according to the clinical diagnosis of RP, IP, or PN and compared to vitality diagnosis by %SpO<sub>2</sub> 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.</div></div><div><h3>Results</h3><div>The mean %SpO<sub>2</sub> 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 %SpO<sub>2</sub> were observed among RP, IP, and PN groups (<em>P</em> < .05), but not between healthy control subgroups (adjacent and contralateral). PO1 consistently recorded higher oxygen saturation than PO2 across all clinical conditions (<em>P</em> < .05), demonstrating superior discriminatory capability.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 12","pages":"Pages 1752-1758"},"PeriodicalIF":3.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023488","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 : 2025-12-01DOI: 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.
{"title":"Biomechanical Behavior of Maxillary Premolars with Non-carious Cervical Lesions: Influence of Minimally Invasive Endodontic Access and Restoration Protocols","authors":"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","doi":"10.1016/j.joen.2025.07.019","DOIUrl":"10.1016/j.joen.2025.07.019","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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 (<em>P</em> < .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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 12","pages":"Pages 1783-1792"},"PeriodicalIF":3.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812078","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}
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.
{"title":"Cellular Crosstalk Between Periodontal Ligament Fibroblasts and Macrophages: Insights from 2D and 3D Culture Systems in External Inflammatory Root Resorption","authors":"Rajeshwari Hadagalu Revana Siddappa BDS, MDS, PhD , Anil Kishen BDS, MDS, PhD","doi":"10.1016/j.joen.2025.07.021","DOIUrl":"10.1016/j.joen.2025.07.021","url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 12","pages":"Pages 1702-1718"},"PeriodicalIF":3.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812079","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 : 2025-12-01DOI: 10.1016/S0099-2399(25)00673-9
{"title":"Guidelines for Authors","authors":"","doi":"10.1016/S0099-2399(25)00673-9","DOIUrl":"10.1016/S0099-2399(25)00673-9","url":null,"abstract":"","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 12","pages":"Pages A9-A16"},"PeriodicalIF":3.6,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145698218","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}