Australian Endodontic Journal最新文献

Head and neck radiotherapy (HNRT) can expose teeth to moderate radiation doses, yet the effects on root dentine under clinically relevant conditions remain unclear. This in vitro study compared dentine subjected to 0, 30, or 50 Gy IMRT. Palatal roots from 35 maxillary molars were allocated to non-irradiated, 30 Gy (oropharyngeal simulation), or 50 Gy (maxillary simulation). Flexural strength, Vickers microhardness, and Raman spectroscopy were assessed, while SEM was qualitatively evaluated. Mechanical and chemical properties did not differ among groups (p > 0.05). SEM, however, revealed dose-dependent microstructural changes: fissures and partial tubule obliteration at 30 Gy, and more frequent cracks and complete obliteration at 50 Gy. Under these in vitro simulated conditions, radiotherapy doses preserved bulk properties despite structural alterations. These findings should be interpreted within the limitations of the model, as interactions among experimental factors may influence how microstructural changes affect dentine mechanics.

This systematic review analysed the analgesic efficacy of low-level laser therapy (LLLT) compared to conventional drug therapy and placebo for postoperative pain in endodontics. PubMed, PubMed Central, Scopus, LILACS, SciELO, Virtual Health Library, Embase and Open Gray were searched. Clinical trials assessing pain intensity were included. Risk of bias was assessed using the RoB 2.0 tool. Nine studies were included, five classified as having low risk of bias. Eight studies demonstrated that LLLT was more effective in modulating postoperative pain compared to control interventions. Meta-analysis of five studies (I² = 31%) showed statistically significant pain reduction with LLLT in comparison with placebo after 1 day (VAS mean difference = -0.56; 95% CI = [-0.74 to -0.38]; p < 0.001). LLLT may improve postoperative pain control after endodontic treatment. Additional high-quality studies are necessary to strengthen the evidence base for LLLT's analgesic efficacy in endodontic applications.

Selective root canal retreatment preserves well-filled canals by treating only roots showing clinical or imaging evidence of failure, providing a minimally invasive alternative to conventional full retreatment. This scoping review, supported by metasynthesis through thematic analysis, synthesised clinical and imaging evidence in multirooted teeth. Five studies, including experimental research and case reports, were analysed. Thematic analysis revealed four core themes: clinical outcomes, imaging assessment, procedural features, and methodological limitations. Short-term outcomes of selective retreatment were comparable to full retreatment, with high tooth survival and low incidence of new lesions. Three-dimensional imaging played a pivotal role in detecting root-confined pathology, planning selective access, and supporting structural preservation. Evidence remains limited by small sample sizes, retrospective designs, and heterogeneity in study protocols. This review offers a structured synthesis of selective retreatment, integrating clinical and imaging insights to inform minimally invasive endodontic practice in a research and clinical context.

This study evaluated the effects of chelating agents on the shear bond strength (SBS) of resin-modified calcium-silicate (RMCS) to dentine, as well as their impact on smear layer removal. Flat dentine surfaces from human molars were conditioned using 1% chitosan nanoparticles (CNP), 6% CNP, 9% etidronic acid (EA), 2.5% phytic acid (IP6), 7% malic acid (MA), 7% maleic acid (MeA), 10% citric acid (CA), 17% EDTA, 5.25% sodium hypochlorite (NaOCl), or distilled water (control). RMCS were applied and tested for SBS. Smear layer removal was examined using SEM, and tubule patency was digitally analysed. EDTA and IP6 showed the highest SBS, while NaOCl and EA were lowest without statistical significance. MeA, CA, IP6, and MA removed more smear layer; MA and IP6 resulted in higher dentinal tubules patency than the control group. Bond strength partly depends on the conditioning agent, and complete smear layer removal did not ensure the highest values.

Accurate diagnosis is the cornerstone of successful endodontic care, yet it often remains a challenge in daily practice. Artificial intelligence (AI), particularly large language models (LLMs), is being explored as a possible support tool for clinicians. In this study, we compared the diagnostic ability of three LLMs: ChatGPT-5, Gemini, and Perplexity with the judgment of an experienced endodontist across 40 anonymized clinical cases. ChatGPT-5 reached perfect agreement with the expert (100% accuracy, κ = 1.00). Gemini (97.5% accuracy, κ = 0.95) and Perplexity (92.5% accuracy, κ = 0.85) also performed well but showed different error patterns: Gemini made one false positive, while Perplexity missed three positive cases. Overall, ChatGPT-5 and Gemini showed the best sensitivity, and ChatGPT-5 and Perplexity maintained full specificity. These results show that the latest LLMs can approach expert-level diagnostic performance, but further testing is needed before they can be relied upon in everyday clinical practice.

This study retrospectively evaluated the outcomes of regenerative endodontic treatment (RET) of necrotic immature permanent teeth. Twenty teeth treated between 2015 and 2019 were included. RET was performed by disinfecting the canals, inducing apical bleeding, and placing platelet-rich fibrin (PRF) or concentrated growth factor (CGF) as a scaffold. Peri-apical radiographs were analysed using ImageJ software. The relationships between aetiology, gender, root development, apical closure and response to electrical pulp testing were statistically evaluated. Peri-apical healing was observed in all patients. Twelve teeth showed an increase in root length, whereas 16 exhibited an increase in root width. Eight teeth responded positively to the electric pulp test (EPT). A statistically significant correlation was found between apical closure and response to pulp sensibility testing (p = 0.019). The maximum increases in root length and width were 2.984 and 0.729 mm, respectively. The results confirm the potential of RET to promote continued root development and restore pulp vitality.

The aim was to critically evaluate the reporting quality of randomised clinical trials (RCTs) on vital pulp treatments (VPT) published before the introduction of the Preferred Reporting Items for Randomised Trials in Endodontics (PRIRATE) 2020 guidelines. Forty-seven RCTs were identified, scored for 58 items and presented on a percentage scale. A score of '1' was given when the item was fully reported, a score of '0' when it was not reported, and '0.5' in case of inadequately reported items. Fifteen and 32 trials were given a 'High' or 'Moderate' score respectively, corresponding to > 75% and between 25%-75% scores, respectively. A large number of authors, manuscripts by authors from Europe, and endorsement of registration practices were associated with high scores. RCTs on VPT published before the introduction of the PRIRATE 2020 guidelines had suboptimal reporting quality. Future studies should adhere more strictly to guidelines to ensure high reporting quality and credibility.

The objective of this study was to assess the hydration, crystalline structure, and setting of bioceramic ready-to-use and powder/liquid sealers in dry and wet root canal dentine. Thirty-two single-rooted human teeth were embedded in acrylic resin and sectioned into 2-mm segments. Canals were filled under dry or moist conditions using BioRoot RCS or Bio-C Sealer. Setting time was assessed using a modified Gilmore needle. Hydration was analyzed via Raman and FT-IR spectroscopy and X-ray diffraction (XRD) after 28 days. Data were analysed using two-way ANOVA and Tukey test (α = 5%). Bio-C Sealer had shorter setting times in moist canals (p < 0.01), while BioRoot showed no significant difference (p > 0.05). Raman identified a calcite peak (1150 cm^-1), and FT-IR showed water reduction over time. XRD detected calcium hydroxide in moist Bio-C Sealer and apatite/calcite in BioRoot. Dentine moisture is crucial for the setting of ready-to-use calcium silicate-based sealers.

This study compared the shaping ability and remaining dentine thickness in mandibular molars prepared with traditional (TradAC) or ultraconservative (UltraAC) access cavities using Reciproc or XP-endo Shaper instruments. Thirty-two molars were scanned with micro-CT before and after preparation to assess canal surface, volume, untouched walls, and dentine thickness. Both access cavity designs showed a significant reduction in dentine thickness after preparation, but no differences were found between TradAC and UltraAC in either mesial or distal roots (p > 0.05). In the distal root, Reciproc produced a greater reduction in dentine thickness compared with XP-endo Shaper (p < 0.05), whereas shaping ability parameters did not differ significantly between instruments (p > 0.05). Some canals exhibited residual dentine thickness below 0.5 mm, particularly when preoperative thickness was already minimal. Within the limitations of this laboratory study, access cavity design had no influence on dentine preservation, while the choice of instrument affected dentine reduction only in the distal root.