Journal of endodontics最新文献_第7页

Assessment of the Shaping Ability of R-Motion 30 .04 and 25 .06 in Mesial Canals of Mandibular Molars Based on Automated Computational Measurement 基于自动计算测量，评估 R-Motion 30 .04 和 25 .06 在下颌磨牙中轴管中的塑形能力。

IF 3.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of endodontics

Pub Date : 2024-09-01 DOI: 10.1016/j.joen.2024.06.009

Introduction

The aim of this study was to evaluate changes in geometry following root canal preparation using R-Motion instruments with different apical sizes and tapers.

Methods

Fifty-four mesial canals of mandibular molars with single curvature of angles ranging between 20° and 30° were stratified into 3 groups according to their internal anatomy (R-Motion 25/.06, 30/.04, Reciproc Blue) (n = 18 per group). Micro-computed tomography was used to standardize the samples before instrumentation and, after instrumentation, to assess canal transportation, changes in canal volume and centering ability. Canals were irrigated with 17% EDTA and sodium hypochlorite, and the final rinse included subsonic agitation of these solutions. Measurements were analyzed automatically using the Dragonfly software (Come, Montreal, Canada) and were confirmed by a technician and an endodontist, based on a previously validated methodology. The results were analyzed using the Kruskal-Wallis's and Mann-Whitney's tests. The level of statistical significance was set at 5%.

Results

Significant differences were found in the coronal third for canal transportation, with Reciproc Blue R25 having greater values compared with both R-Motion instruments (P < .05) and greater changes in volume when compared with R-Motion 30/.04 (P < .05).

Conclusions

R-Motion of apical size and taper 25/.06 and 30/.04 were associated with similar changes in geometry following root canal preparation in curved mesial canals of mandibular molars, whereas Reciproc Blue was associated with greater canal transportation in the coronal root third.

简介：方法：根据内部解剖结构（R-Motion 25/.06、30/.04、Reciproc Blue）将下颌磨牙的 54 个单曲角介于 20° 和 30° 之间的中轴管分为 3 组（每组 18 个）。显微计算机断层扫描用于在器械植入前对样本进行标准化处理，并在器械植入后评估牙管运输、牙管容积变化和居中能力。用 17% EDTA 和次氯酸钠灌洗牙管，最后的冲洗包括这些溶液的亚音速搅拌。测量结果使用 Dragonfly 软件（Come，加拿大蒙特利尔）自动分析，并由一名技师和一名牙髓病学家根据先前验证的方法进行确认。结果使用 Kruskal-Wallis 检验和 Mann-Whitney 检验进行分析。统计显著性水平设定为 5%：结果：冠状面三分之一处的牙道运输存在显著差异，Reciproc Blue R25与两种R-Motion器械相比，数值更大（p结论：R-Motion 的根尖尺寸和锥度 25/.06 和 30/.04 与下颌磨牙弯曲中轴根管预备后的几何形状变化相似，而 Reciproc Blue 与冠状根三分之一处更大的根管运输有关。

{"title":"Assessment of the Shaping Ability of R-Motion 30 .04 and 25 .06 in Mesial Canals of Mandibular Molars Based on Automated Computational Measurement","authors":"","doi":"10.1016/j.joen.2024.06.009","DOIUrl":"10.1016/j.joen.2024.06.009","url":null,"abstract":"<div><h3>Introduction</h3><p><span>The aim of this study was to evaluate changes in geometry following root canal preparation using </span><em>R-Motion</em> instruments with different apical sizes and tapers.</p></div><div><h3>Methods</h3><p><span>Fifty-four mesial canals of mandibular molars<span> with single curvature of angles ranging between 20° and 30° were stratified into 3 groups according to their internal anatomy (</span></span><em>R-Motion</em> 25/.06, 30/.04, <em>Reciproc Blue</em>) (<em>n</em><span> = 18 per group). Micro-computed tomography was used to standardize the samples before instrumentation and, after instrumentation, to assess canal transportation, changes in canal volume and centering ability. Canals were irrigated with 17% EDTA and sodium hypochlorite, and the final rinse included subsonic agitation of these solutions. Measurements were analyzed automatically using the Dragonfly software (Come, Montreal, Canada) and were confirmed by a technician and an endodontist, based on a previously validated methodology. The results were analyzed using the Kruskal-Wallis's and Mann-Whitney's tests. The level of statistical significance was set at 5%.</span></p></div><div><h3>Results</h3><p>Significant differences were found in the coronal third for canal transportation, with <em>Reciproc Blue</em> R25 having greater values compared with both <em>R-Motion</em> instruments (<em>P</em> < .05) and greater changes in volume when compared with <em>R-Motion</em> 30/.04 (<em>P</em> < .05).</p></div><div><h3>Conclusions</h3><p><em>R-Motion</em> of apical size and taper 25/.06 and 30/.04 were associated with similar changes in geometry following root canal preparation in curved mesial canals of mandibular molars, whereas <em>Reciproc Blue</em> was associated with greater canal transportation in the coronal root third.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 9","pages":"Pages 1327-1332"},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141442837","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

Worldwide Prevalence of Single-rooted with a Single Root Canal and Four-rooted Configurations in Maxillary Molars: A Multi-center Cross-sectional Study with Meta-analysis 上颌臼齿单根与单根管和四根配置的全球流行率：多中心横断面研究与 Meta 分析。

IF 3.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of endodontics

Pub Date : 2024-09-01 DOI: 10.1016/j.joen.2024.06.010

Introduction

To evaluate the prevalence of single root with a single root canal and four-root configurations in the maxillary first and second molars, and analyze how geographic region, ethnicity, sex, and age impact these outcomes.

Methods

Researchers from 44 nations examined 26,400 maxillary molars using cone-beam computed tomography scans to gather data on the proportions of single roots with single canals and four-root configurations. All observers underwent prior calibration regarding the step-by-step assessment protocol and anatomical concepts to ensure consistent evaluations across all assessed locations. Tests were conducted to evaluate the intraobserver and interobserver reliability. Demographic data including ethnicity, gender, and age were collected for each participant. The potential impact of imaging voxel size and field-of-view on bias was also assessed. The primary results were depicted as odds ratios and untransformed proportion forest plots with 95% confidence intervals. Additionally, a meta-analysis was performed to compare various subgroups and identify sources of variation among them. Statistical significance was set at 5%.

Results

The prevalence of single-rooted with a single canal and four-rooted configurations in the maxillary first molar was 0.16% and 0.28%, respectively, while in the maxillary second molar, it was 2.56% and 0.83%. Males tended to exhibit lower percentages of single roots with a single canal (P < .05) and higher percentages of four-rooted configurations (P > .05) in the second molar, whereas the African subgroup displayed lower proportions for both configurations. Additionally, in both teeth, single roots with a single canal were more prevalent among older patients. Voxel size and field-of-view did not significantly influence the results (P > .05).

Conclusions

The proportions of single-rooted with a single canal and four-rooted configurations were low, and demographic factors such as geographic region, ethnicity, sex, and age may have influenced the outcomes for the maxillary second molar.

简介：目的目的：评估上颌第一和第二磨牙中单根单管和四根配置的发生率，并分析地理区域、种族、性别和年龄对这些结果的影响：来自 44 个国家的研究人员使用锥束计算机断层扫描检查了 26,400 颗上颌臼齿，收集了单根单管和四根配置的比例数据。所有观察者都事先接受了有关分步评估方案和解剖概念的校准，以确保对所有评估位置进行一致的评估。对观察者内部和观察者之间的可靠性进行了评估。我们收集了每位参与者的人口统计学数据，包括种族、性别和年龄。此外，还评估了成像体素大小和视野对偏差的潜在影响。主要结果以几率比率和未经转换的比例森林图以及 95% 的置信区间表示。此外，还进行了一项荟萃分析，以比较不同的亚组并确定它们之间的差异来源。统计显著性设定为 5%：结果：在上颌第一磨牙中，单根单管和四根配置的发生率分别为 0.16% 和 0.28%，而在上颌第二磨牙中，这一比例分别为 2.56% 和 0.83%。在第二磨牙中，男性单根单管的比例较低（P < 0.05），而四根配置的比例较高（P > 0.05），而非洲亚组中这两种配置的比例都较低。此外，在这两种牙齿中，单根单管在年龄较大的患者中更为普遍。体素大小和视场对结果没有显著影响（P > 0.05）：结论：单根单管和四根配置的比例较低，人口统计学因素，如地理区域、种族、性别和年龄可能会影响上颌第二磨牙的结果。

{"title":"Worldwide Prevalence of Single-rooted with a Single Root Canal and Four-rooted Configurations in Maxillary Molars: A Multi-center Cross-sectional Study with Meta-analysis","authors":"","doi":"10.1016/j.joen.2024.06.010","DOIUrl":"10.1016/j.joen.2024.06.010","url":null,"abstract":"<div><h3>Introduction</h3><p>To evaluate the prevalence of single root with a single root canal and four-root configurations in the maxillary first and second molars, and analyze how geographic region, ethnicity, sex, and age impact these outcomes.</p></div><div><h3>Methods</h3><p>Researchers from 44 nations examined 26,400 maxillary molars using cone-beam computed tomography scans<span> to gather data on the proportions of single roots with single canals and four-root configurations. All observers underwent prior calibration regarding the step-by-step assessment protocol and anatomical concepts to ensure consistent evaluations across all assessed locations. Tests were conducted to evaluate the intraobserver and interobserver reliability. Demographic data including ethnicity, gender, and age were collected for each participant. The potential impact of imaging voxel size and field-of-view on bias was also assessed. The primary results were depicted as odds ratios and untransformed proportion forest plots with 95% confidence intervals. Additionally, a meta-analysis was performed to compare various subgroups and identify sources of variation among them. Statistical significance was set at 5%.</span></p></div><div><h3>Results</h3><p>The prevalence of single-rooted with a single canal and four-rooted configurations in the maxillary first molar was 0.16% and 0.28%, respectively, while in the maxillary second molar, it was 2.56% and 0.83%. Males tended to exhibit lower percentages of single roots with a single canal (<em>P</em> < .05) and higher percentages of four-rooted configurations (<em>P</em> > .05) in the second molar, whereas the African subgroup displayed lower proportions for both configurations. Additionally, in both teeth, single roots with a single canal were more prevalent among older patients. Voxel size and field-of-view did not significantly influence the results (<em>P</em> > .05).</p></div><div><h3>Conclusions</h3><p>The proportions of single-rooted with a single canal and four-rooted configurations were low, and demographic factors such as geographic region, ethnicity, sex, and age may have influenced the outcomes for the maxillary second molar.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 9","pages":"Pages 1254-1272"},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141468417","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

Use of Mouth Guards to Prevent Injury 使用护齿器防止受伤

IF 3.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of endodontics

Pub Date : 2024-09-01 DOI: 10.1016/j.joen.2024.08.007

引用次数: 0

Access to Care 获得护理

IF 3.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of endodontics

Pub Date : 2024-09-01 DOI: 10.1016/j.joen.2024.08.012

引用次数: 0

Mirogabalin as a Therapeutic Option for Neuropathic Pain Emerging Post-endodontic Treatment: A Two-Case Report 米罗卡宾作为根管治疗后出现的神经病理性疼痛的治疗选择：两例报告

IF 3.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of endodontics

Pub Date : 2024-09-01 DOI: 10.1016/j.joen.2024.06.007

Introduction

Occlusal and percussion pain may manifest occasionally following endodontic treatment, influencing retreatment decisions. Two cases of periapical neuropathic pain, classified as post-traumatic trigeminal neuropathic pain according to the International Classification of Orofacial Pain, are presented. Although mirogabalin is effective in managing neuropathic pain, there is a lack of clinical reports on its use for occasional post-traumatic trigeminal neuropathic pain after endodontic treatment. These cases highlight clinical symptoms and successful treatment with mirogabalin for post-traumatic trigeminal neuropathic pain after endodontic treatment, providing clinicians a “take-away” lesson for improving patient condition.

Methods

The patients, referred by their primary dentist due to postendodontic abnormal pain, found no relief with antibiotics or nonsteroidal anti-inflammatory drugs. Although no findings including swelling or periapical radiolucency were observed around the tooth, they experienced occlusal and percussion pain. Local anesthetic testing showed that the pain originated from the peripheral area around the tooth rather than from central sensitization. Dental radiography and cone-beam computed tomography revealed no abnormal findings. Root canal retreatment was performed by a specialist in endodontic treatment. Although endodontic retreatment drastically decreased visual analog scale pain score, pain persisted. Based on the International Classification of Orofacial Pain criteria, diseases other than post-traumatic trigeminal neuropathic pain were excluded. Mirogabalin (10 mg/d) was prescribed once daily before bedtime.

Results

Visual analog scale scores gradually and drastically decreased 2 weeks after mirogabalin therapy. Several months later, no recurrence of postendodontic pain was observed after tapering off and discontinuing mirogabalin.

Conclusions

These findings suggest the possibility of a new treatment method for post-traumatic trigeminal neuropathic pain after endodontic treatment.

导言：牙髓治疗后偶尔会出现咬合痛和叩击痛，影响再治疗的决定。本文介绍了两例根尖周神经病理性疼痛病例，根据国际口面疼痛分类法（ICOP），这些疼痛被归类为创伤后三叉神经痛。虽然米格巴林能有效控制神经病理性疼痛，但目前还缺乏将其用于牙髓治疗后偶尔出现的创伤后三叉神经痛的临床报告。这些病例突出了牙髓治疗后创伤后三叉神经痛的临床症状和米罗格宾的成功治疗，为临床医生改善患者病情提供了 "外卖 "课程：患者因牙髓治疗后异常疼痛而由其主治牙医转诊，使用抗生素或非类固醇抗炎药物均无法缓解疼痛。虽然没有发现牙齿周围有肿胀或根尖周放射状肿物，但他们出现了咬合痛和叩击痛。局部麻醉测试表明，疼痛源自牙齿周围，而非中枢过敏。牙科放射线检查和锥形束计算机断层扫描未发现异常。牙髓治疗专家进行了根管再治疗。虽然根管再治疗大大降低了视觉模拟量表（VAS）的疼痛评分，但疼痛依然存在。根据 ICOP 标准，排除了创伤后三叉神经痛以外的其他疾病。米罗卡宾（10 毫克/天）每天一次，睡前服用：米瑞巴林治疗两周后，VAS评分逐渐大幅下降。几个月后，在减量并停用米罗卡巴林后，牙髓病后疼痛没有复发：这些研究结果表明了一种治疗牙髓治疗后创伤性三叉神经痛的新方法的可能性。

{"title":"Mirogabalin as a Therapeutic Option for Neuropathic Pain Emerging Post-endodontic Treatment: A Two-Case Report","authors":"","doi":"10.1016/j.joen.2024.06.007","DOIUrl":"10.1016/j.joen.2024.06.007","url":null,"abstract":"<div><h3>Introduction</h3><p><span><span>Occlusal and percussion pain may manifest occasionally following </span>endodontic treatment, influencing </span>retreatment<span><span> decisions. Two cases of periapical neuropathic pain, classified as post-traumatic trigeminal neuropathic pain according to the International Classification of </span>Orofacial Pain, are presented. Although mirogabalin is effective in managing neuropathic pain, there is a lack of clinical reports on its use for occasional post-traumatic trigeminal neuropathic pain after endodontic treatment. These cases highlight clinical symptoms and successful treatment with mirogabalin for post-traumatic trigeminal neuropathic pain after endodontic treatment, providing clinicians a “take-away” lesson for improving patient condition.</span></p></div><div><h3>Methods</h3><p><span>The patients, referred by their primary dentist due to postendodontic abnormal pain, found no relief with antibiotics or nonsteroidal anti-inflammatory drugs. Although no findings including swelling or periapical radiolucency were observed around the tooth, they experienced occlusal and percussion pain. Local anesthetic<span> testing showed that the pain originated from the peripheral area around the tooth rather than from central sensitization. Dental radiography and cone-beam computed tomography revealed no abnormal findings. Root canal retreatment was performed by a specialist in endodontic treatment. Although </span></span>endodontic retreatment<span> drastically decreased visual analog scale pain score, pain persisted. Based on the International Classification of Orofacial Pain criteria, diseases other than post-traumatic trigeminal neuropathic pain were excluded. Mirogabalin (10 mg/d) was prescribed once daily before bedtime.</span></p></div><div><h3>Results</h3><p>Visual analog scale scores gradually and drastically decreased 2 weeks after mirogabalin therapy. Several months later, no recurrence of postendodontic pain was observed after tapering off and discontinuing mirogabalin.</p></div><div><h3>Conclusions</h3><p>These findings suggest the possibility of a new treatment method for post-traumatic trigeminal neuropathic pain after endodontic treatment.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 9","pages":"Pages 1351-1356"},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432104","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

Mastery Learning in Preclinical Endodontics Using Customized 3D-Printed Tooth Models for Deliberate Practice: An Application of Educational Design Research 利用定制的三维打印牙模进行刻意练习，在临床前牙体牙髓病学中掌握学习方法：教育设计研究的应用。

IF 3.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of endodontics

Pub Date : 2024-09-01 DOI: 10.1016/j.joen.2024.06.002

Introduction

This study, conducted within an educational design research (EDR) framework, assessed the use of customized 3D-printed tooth models at various difficulty levels to enhance mastery learning and deliberate practice in preclinical endodontic training.

Methods

The EDR was conducted in a preclinical endodontic training involving 42 third-year students. The study focused on developing and evaluating 3D-printed tooth models customized into 3 difficulty levels to facilitate mastery learning for the access opening procedure on upper anterior teeth. To promote deliberate practice, we ensured ample availability of these models. The evaluation combined quantitative analysis, using Friedman and Wilcoxon Signed-Rank tests to assess practice volume and performance, with qualitative feedback from interviews and focus groups, analyzed via content analysis.

Results

There was a significant reduction in practice time across the different model levels, with students using an average of 1.5–1.8 models per level. No significant differences in performance scores were observed across levels and natural tooth (P = .333). Feedback highlighted the models' educational value in enhancing dental training, indicating their effectiveness in improving learning experiences and skill development in endodontic education.

Conclusions

The innovative design of a 3D-printed tooth model system, which features 3 levels of difficulty and was developed within an EDR framework, allowed for tailored learning progressions and ample practice opportunities. This significantly enhanced the endodontic training experience and skill development by providing varied and realistic challenges.

简介：本研究在教育设计研究（EDR）框架内进行，评估了在临床前牙体管治疗培训中使用不同难度的定制3D打印牙齿模型来加强掌握学习和刻意练习的情况：EDR 在临床前牙体牙髓病学培训中进行，共有 42 名三年级学生参加。研究的重点是开发和评估定制为三个难度级别的 3D 打印牙齿模型，以促进上前牙通路开放程序的掌握学习。为了促进刻意练习，我们确保了这些模型的充足供应。评估结合了定量分析（使用弗里德曼检验和Wilcoxon Signed-Rank检验评估练习量和成绩）、访谈和焦点小组的定性反馈（通过内容分析进行分析）：不同级别的模型练习时间明显减少，学生平均每个级别使用 1.5 到 1.8 个模型。不同级别和天然牙的成绩分数没有明显差异（P = .333）。反馈意见强调了模型在加强牙科培训方面的教育价值，表明其在改善牙髓病学教育中的学习体验和技能发展方面的有效性：三维打印牙齿模型系统的创新设计具有三个难度级别，并在 EDR 框架内开发，可实现量身定制的学习进度和充足的练习机会。通过提供多样化和现实的挑战，这极大地增强了牙髓病学培训体验和技能发展。

{"title":"Mastery Learning in Preclinical Endodontics Using Customized 3D-Printed Tooth Models for Deliberate Practice: An Application of Educational Design Research","authors":"","doi":"10.1016/j.joen.2024.06.002","DOIUrl":"10.1016/j.joen.2024.06.002","url":null,"abstract":"<div><h3>Introduction</h3><p>This study, conducted within an educational design research (EDR) framework, assessed the use of customized 3D-printed tooth models at various difficulty levels to enhance mastery learning and deliberate practice in preclinical endodontic training.</p></div><div><h3>Methods</h3><p>The EDR was conducted in a preclinical endodontic training involving 42 third-year students. The study focused on developing and evaluating 3D-printed tooth models customized into 3 difficulty levels to facilitate mastery learning for the access opening procedure on upper anterior teeth. To promote deliberate practice, we ensured ample availability of these models. The evaluation combined quantitative analysis, using Friedman and Wilcoxon Signed-Rank tests to assess practice volume and performance, with qualitative feedback from interviews and focus groups, analyzed via content analysis.</p></div><div><h3>Results</h3><p>There was a significant reduction in practice time across the different model levels, with students using an average of 1.5–1.8 models per level. No significant differences in performance scores were observed across levels and natural tooth (<em>P</em><span> = .333). Feedback highlighted the models' educational value in enhancing dental training, indicating their effectiveness in improving learning experiences and skill development in endodontic education.</span></p></div><div><h3>Conclusions</h3><p>The innovative design of a 3D-printed tooth model system, which features 3 levels of difficulty and was developed within an EDR framework, allowed for tailored learning progressions and ample practice opportunities. This significantly enhanced the endodontic training experience and skill development by providing varied and realistic challenges.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 9","pages":"Pages 1273-1280"},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437006","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

Dental Dams 牙坝

IF 3.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of endodontics

Pub Date : 2024-09-01 DOI: 10.1016/j.joen.2024.08.009

引用次数: 0

Progress of Artificial Intelligence-Driven Solutions for Automated Segmentation of Dental Pulp Space on Cone-Beam Computed Tomography Images. A Systematic Review 在锥形束计算机断层扫描图像上自动分割牙髓腔的人工智能驱动解决方案的进展。系统综述。

IF 3.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of endodontics

Pub Date : 2024-09-01 DOI: 10.1016/j.joen.2024.05.012

Introduction

Automated segmentation of 3-dimensional pulp space on cone-beam computed tomography images presents a significant opportunity for enhancing diagnosis, treatment planning, and clinical education in endodontics. The aim of this systematic review was to investigate the performance of artificial intelligence-driven automated pulp space segmentation on cone-beam computed tomography images.

Methods

A comprehensive electronic search was performed using PubMed, Web of Science, and Cochrane databases, up until February 2024. Two independent reviewers participated in the selection of studies, data extraction, and evaluation of the included studies. Any disagreements were resolved by a third reviewer. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess the risk of bias.

Results

Thirteen studies that met the eligibility criteria were included. Most studies demonstrated high accuracy in their respective segmentation methods, although there was some variation across different structures (pulp chamber, root canal) and tooth types (single-rooted, multirooted). Automated segmentation showed slightly superior performance for segmenting the pulp chamber compared to the root canal and single-rooted teeth compared to multi-rooted ones. Furthermore, the second mesiobuccal (MB2) canalsegmentation also demonstrated high performance. In terms of time efficiency, the minimum time required for segmentation was 13 seconds.

Conclusion

Artificial intelligence-driven models demonstrated outstanding performance in pulp space segmentation. Nevertheless, these findings warrant careful interpretation, and their generalizability is limited due to the potential risk and low evidence level arising from inadequately detailed methodologies and inconsistent assessment techniques. In addition, there is room for further improvement, specifically for root canal segmentation and testing of artificial intelligence performance in artifact-induced images.

简介锥束计算机断层扫描（CBCT）图像上三维牙髓空间的自动分割为提高牙髓病学的诊断、治疗计划和临床教育提供了重要机会。本系统综述旨在研究人工智能驱动的CBCT图像牙髓空间自动分割的性能：使用 PubMed、Web of Science 和 Cochrane 数据库进行了全面的电子检索，检索期截至 2024 年 2 月。两名独立审稿人参与了研究的筛选、数据提取以及对纳入研究的评估。任何分歧均由第三位审稿人解决。诊断准确性研究质量评估-2（QUADAS-2）工具用于评估偏倚风险：结果：共纳入了 13 项符合资格标准的研究。尽管不同结构（髓室、根管）和牙齿类型（单根、多根）之间存在一些差异，但大多数研究都证明了各自的分割方法具有很高的准确性。与根管相比，自动分割法在分割髓室方面的表现略胜一筹；与多根牙齿相比，自动分割法在分割单根牙齿方面的表现略胜一筹。此外，第二中颊面（MB2）根管分割也表现出很高的性能。在时间效率方面，分割所需的最短时间为 13 秒：结论：人工智能驱动的模型在牙髓空间分割方面表现出色。然而，这些研究结果需要仔细解读，而且由于方法不够详细和评估技术不一致而导致的潜在风险和低证据水平，其可推广性受到了限制。此外，还有进一步改进的空间，特别是在根管分割和人工智能在伪影图像中的性能测试方面。

{"title":"Progress of Artificial Intelligence-Driven Solutions for Automated Segmentation of Dental Pulp Space on Cone-Beam Computed Tomography Images. A Systematic Review","authors":"","doi":"10.1016/j.joen.2024.05.012","DOIUrl":"10.1016/j.joen.2024.05.012","url":null,"abstract":"<div><h3>Introduction</h3><p>Automated segmentation of 3-dimensional pulp space on cone-beam computed tomography images presents a significant opportunity for enhancing diagnosis, treatment planning, and clinical education in endodontics. The aim of this systematic review was to investigate the performance of artificial intelligence-driven automated pulp space segmentation on cone-beam computed tomography images.</p></div><div><h3>Methods</h3><p>A comprehensive electronic search was performed using PubMed, Web of Science, and Cochrane databases, up until February 2024. Two independent reviewers participated in the selection of studies, data extraction, and evaluation of the included studies. Any disagreements were resolved by a third reviewer. The Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to assess the risk of bias.</p></div><div><h3>Results</h3><p>Thirteen studies that met the eligibility criteria were included. Most studies demonstrated high accuracy in their respective segmentation methods, although there was some variation across different structures (pulp chamber, root canal) and tooth types (single-rooted, multirooted). Automated segmentation showed slightly superior performance for segmenting the pulp chamber compared to the root canal and single-rooted teeth compared to multi-rooted ones. Furthermore, the second mesiobuccal (MB2) canalsegmentation also demonstrated high performance. In terms of time efficiency, the minimum time required for segmentation was 13 seconds.</p></div><div><h3>Conclusion</h3><p>Artificial intelligence-driven models demonstrated outstanding performance in pulp space segmentation. Nevertheless, these findings warrant careful interpretation, and their generalizability is limited due to the potential risk and low evidence level arising from inadequately detailed methodologies and inconsistent assessment techniques. In addition, there is room for further improvement, specifically for root canal segmentation and testing of artificial intelligence performance in artifact-induced images.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 9","pages":"Pages 1221-1232"},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0099239924003364/pdfft?md5=ac360410b1f0bd887c10aad199da37cd&pid=1-s2.0-S0099239924003364-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141183890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Effect of Vehicles and Irrigation Solutions and Methods on Removal of Double Antibiotic Paste from Root Canals: Insights from High-performance Liquid Chromatography Analysis 车辆和灌溉溶液及方法对根管中双抗药膏去除效果的影响：高效液相色谱分析的启示。

IF 3.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of endodontics

Pub Date : 2024-09-01 DOI: 10.1016/j.joen.2024.06.001

Introduction

In regenerative endodontics, eradicating antibiotic residues from root canals is imperative, given their detrimental effects on human apical papilla stem cells. Previous antibiotic removal studies lacked precision in identifying types and quantities of residual antibiotics. High-performance liquid chromatography (HPLC) enhances sensitivity and specificity, enabling accurate detection and quantification of residual drugs. Using HPLC analysis, this study explored the influence of vehicles and irrigation solutions and methods on double antibiotic paste (DAP) removal from root canals.

Methods

Two DAP formulations, each containing 5 mg/mL ciprofloxacin and metronidazole, were created using distinct vehicles: macrogol and propylene glycol (MP) or hydroxypropyl methylcellulose (HPMC). Subsequently, 5 μL of DAP was applied to 200 simulated immature teeth with open apices (n = 100 per formulation) and cultured for 28 days at 37°C. Samples were then divided into 11 groups (n = 20 per group), and canals were irrigated with 17% ethylenediaminetetraacetic acid or 10% citric acid, employing a positive pressure syringe or passive ultrasonic irrigation. The irrigation solution and dentin sample from each tooth were evaluated via HPLC for ciprofloxacin and metronidazole quantification.

Results

Citric acid exhibited significantly superior efficacy in antibiotic removal from root canals, with no observable effect of irrigation methods on drug removal. The HPMC-based DAP formulation significantly enhanced ciprofloxacin removal compared with MP-based DAP.

Conclusions

For antibiotic paste removal from root canals, citric acid is effective, and HPMC is a preferable vehicle over MP. Overall, HPLC is a valuable method for detecting, removing, and quantifying residual antibiotics in root canals.

导言：在牙髓再生治疗中，鉴于抗生素对人类根尖乳头干细胞的有害影响，清除根管内的抗生素残留物势在必行。以往的抗生素清除研究无法精确确定残留抗生素的类型和数量。高效液相色谱法（HPLC）提高了灵敏度和特异性，能够准确检测和量化残留药物。本研究利用高效液相色谱分析，探讨了载体、冲洗溶液和方法对根管中双抗生素糊剂（DAP）去除的影响：使用不同的载体：大环内酯和丙二醇（MP）或羟丙基甲基纤维素（HPMC）配制了两种 DAP 配方，每种配方均含有 5 mg/mL 环丙沙星和甲硝唑。随后，将 5 μL 的 DAP 涂在 200 颗尖端开放的模拟未成熟牙齿上（每种配方 100 颗），并在 37°C 下培养 28 天。然后将样本分为 11 组（每组 n = 20），采用正压注射器或被动超声波灌洗法，用 17% 乙二胺四乙酸或 10% 柠檬酸灌洗牙根管。通过高效液相色谱法对每颗牙齿的灌洗液和牙本质样本进行环丙沙星和甲硝唑定量评估：结果：柠檬酸对根管中抗生素的去除效果明显优于其他抗生素，灌洗方法对药物去除效果没有明显影响。与基于 MP 的 DAP 相比，基于 HPMC 的 DAP 配方能显著提高环丙沙星的去除率：结论：柠檬酸能有效去除根管中的抗生素糊剂，HPMC是比MP更理想的载体。总之，高效液相色谱法是检测、去除和量化根管内残留抗生素的重要方法。

{"title":"Effect of Vehicles and Irrigation Solutions and Methods on Removal of Double Antibiotic Paste from Root Canals: Insights from High-performance Liquid Chromatography Analysis","authors":"","doi":"10.1016/j.joen.2024.06.001","DOIUrl":"10.1016/j.joen.2024.06.001","url":null,"abstract":"<div><h3>Introduction</h3><p><span><span>In regenerative endodontics, eradicating </span>antibiotic residues from root canals is imperative, given their detrimental effects on human apical papilla stem cells. Previous antibiotic removal studies lacked precision in identifying types and quantities of residual antibiotics. High-performance liquid chromatography (HPLC) enhances sensitivity and specificity, enabling accurate detection and quantification of residual drugs. Using HPLC analysis, this study explored the influence of vehicles and </span>irrigation solutions and methods on double antibiotic paste (DAP) removal from root canals.</p></div><div><h3>Methods</h3><p><span><span>Two DAP formulations, each containing 5 mg/mL ciprofloxacin<span> and metronidazole, were created using distinct vehicles: </span></span>macrogol<span><span> and propylene glycol (MP) or </span>hydroxypropyl methylcellulose (HPMC). Subsequently, 5 μL of DAP was applied to 200 simulated immature teeth with open apices (</span></span><em>n</em> = 100 per formulation) and cultured for 28 days at 37°C. Samples were then divided into 11 groups (<em>n</em><span> = 20 per group), and canals were irrigated with 17% ethylenediaminetetraacetic acid<span><span> or 10% citric acid, employing a positive pressure syringe or passive ultrasonic irrigation. The irrigation solution and dentin sample from each tooth were evaluated via HPLC for ciprofloxacin and </span>metronidazole quantification.</span></span></p></div><div><h3>Results</h3><p>Citric acid exhibited significantly superior efficacy in antibiotic removal from root canals, with no observable effect of irrigation methods on drug removal. The HPMC-based DAP formulation significantly enhanced ciprofloxacin removal compared with MP-based DAP.</p></div><div><h3>Conclusions</h3><p>For antibiotic paste removal from root canals, citric acid is effective, and HPMC is a preferable vehicle over MP. Overall, HPLC is a valuable method for detecting, removing, and quantifying residual antibiotics in root canals.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 9","pages":"Pages 1307-1313"},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141293470","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

Effects of Endodontic Irrigants on Shear Bond Strength of Mild Universal Adhesives to Dentin 牙髓冲洗剂对温和通用粘合剂与牙本质剪切粘接强度的影响

IF 3.5 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of endodontics

Pub Date : 2024-09-01 DOI: 10.1016/j.joen.2024.07.001

Purpose

The objective of this in vitro study was to evaluate the shear bond strength (SBS) of several universal adhesives to dentin treated with sodium hypochlorite (NaOCl), and NaOCl followed by ethylenediaminetetraacetic acid (EDTA).

Materials and Methods

Adhese Universal, Scotchbond Universal, Prime & Bond Elect, Prime & Bond Active, and Optibond XTR were included in the study. SBS values were determined in self-etch mode with no pretreatment of the dentin, after a 20-minute exposure of the dentin to 6% NaOCl, and after a 20-minute exposure to NaOCl followed by a one-minute exposure to 17% EDTA. Experimental groups were repeated using a total-etch technique (except Optibond XTR).

Results

Adhesives in self-etch mode had significantly reduced SBS following dentin exposure to NaOCl (P < .05), while with a total-etch technique, only Prime & Bond Active was affected (P < .05). SBS in self-etch mode when NaOCl exposure was followed by EDTA were equal to or higher than negative control values (P < .05). For total-etch groups, Adhese Universal was negatively affected by NaOCl + EDTA exposure (P < .05). Prime & Bond Elect exhibited lower SBS following NaOCl + EDTA exposure when compared to just NaOCl exposure but was not different from the negative control (P < .05).

Conclusion

For the adhesives tested, the use of 17% EDTA following NaOCl exposure negated the negative effects of NaOCl on SBS in self-etch mode. When used in total-etch mode, results varied significantly, with some adhesives performing better or worse depending on the specific testing condition.

目的：本体外研究的目的是评估几种通用粘合剂与用次氯酸钠（NaOCl）和先用NaOCl后用乙二胺四乙酸（EDTA）处理过的牙本质的剪切粘接强度（SBS）：研究对象包括 Adhese Universal (ADU)、Scotchbond Universal (SBU)、Prime & Bond Elect (PBE)、Prime & Bond Active (PBA) 和 Optibond XTR (OBX)。分别在牙本质未经预处理的自酸蚀模式下、牙本质暴露于 6% NaOCl 20 分钟后以及暴露于 NaOCl 20 分钟后再暴露于 17% EDTA 1 分钟后测定 SBS 值。实验组重复使用全蚀刻技术（OBX 除外）：结果：在牙本质暴露于 NaOCl 后，自酸蚀模式粘合剂的 SBS 显著降低（pConclusion）：对于测试的粘合剂，在 NaOCl 暴露后使用 17% EDTA 可以消除 NaOCl 在自酸蚀模式下对 SBS 的负面影响。在全蚀刻模式下使用时，结果差异很大，有些粘合剂的性能更好，有些则更差，这取决于具体的测试条件。

{"title":"Effects of Endodontic Irrigants on Shear Bond Strength of Mild Universal Adhesives to Dentin","authors":"","doi":"10.1016/j.joen.2024.07.001","DOIUrl":"10.1016/j.joen.2024.07.001","url":null,"abstract":"<div><h3>Purpose</h3><p>The objective of this <em>in vitro</em> study was to evaluate the shear bond strength (SBS) of several universal adhesives to dentin treated with sodium hypochlorite (NaOCl), and NaOCl followed by ethylenediaminetetraacetic acid (EDTA).</p></div><div><h3>Materials and Methods</h3><p>Adhese Universal, Scotchbond Universal, Prime & Bond Elect, Prime & Bond Active, and Optibond XTR were included in the study. SBS values were determined in self-etch mode with no pretreatment of the dentin, after a 20-minute exposure of the dentin to 6% NaOCl, and after a 20-minute exposure to NaOCl followed by a one-minute exposure to 17% EDTA. Experimental groups were repeated using a total-etch technique (except Optibond XTR).</p></div><div><h3>Results</h3><p>Adhesives in self-etch mode had significantly reduced SBS following dentin exposure to NaOCl (<em>P</em> < .05), while with a total-etch technique, only Prime & Bond Active was affected (<em>P</em> < .05). SBS in self-etch mode when NaOCl exposure was followed by EDTA were equal to or higher than negative control values (<em>P</em> < .05). For total-etch groups, Adhese Universal was negatively affected by NaOCl + EDTA exposure (<em>P</em> < .05). Prime & Bond Elect exhibited lower SBS following NaOCl + EDTA exposure when compared to just NaOCl exposure but was not different from the negative control (<em>P</em> < .05).</p></div><div><h3>Conclusion</h3><p>For the adhesives tested, the use of 17% EDTA following NaOCl exposure negated the negative effects of NaOCl on SBS in self-etch mode. When used in total-etch mode, results varied significantly, with some adhesives performing better or worse depending on the specific testing condition.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"50 9","pages":"Pages 1346-1350"},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141563459","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