Australian Endodontic Journal最新文献

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.

This clinical study evaluated four diagnostic approaches for locating the orifice of the second mesiobuccal canal (MB2) during root canal retreatment of maxillary molars: direct visual inspection, the Micro Hole Negotiator electronic device, the dental operating microscope, and their combined use. A stepwise protocol was used in 124 retreatment cases, applying each method sequentially. Detection rates of MB2 canals increased progressively, with the combined use of the microscope and electronic device yielding the highest adjusted diagnostic efficiency, followed by the microscope alone, the electronic device alone, and direct visual inspection. These findings suggest that optical magnification and impedance-based electronic feedback can enhance canal identification, particularly under complex retreatment conditions. The electronic device outperformed direct visual inspection and may enhance the detection of MB2 canals in clinical settings where a microscope is unavailable.

This systematic review has investigated whether the preoperative periapical radiographic status (PPRS) is a predictor of VPT success/survival. Four databases were searched for studies published from inception to November 2024. The studies' characteristics were tabulated, and a meta-analysis was performed to evaluate the correlation between PPRS and the success rate of VPT. The QUIPS tool and the GRADE criteria were used to assess the risk of bias and the certainty of evidence. No significant association between preoperative periapical radiolucency and full pulpotomy success was observed (OR 0.75, 95% CI 0.30-1.87; p = 0.54; Z = 0.61), though heterogeneity among studies was noted (Τ² = 0.41; χ² = 0.29; I² = 59%). Overall high risk of bias was detected. The certainty of evidence was rated as low. The findings suggest that periapical radiolucency should not contraindicate VPT. However, the certainty of evidence regarding this prognostic factor should be improved to refine diagnostic criteria and guide clinical decision-making.

This study aimed to evaluate the quality, reliability, and educational value of YouTube videos related to irrigation activation in endodontics. A total of 70 videos were analyzedusing the keyword 'irrigation activation methods'. Videos were assessed using JAMA, DISCERN and GQS. Additional popularity metrics were recorded. Statistical analyses were performed using the Kruskal-Wallis and Spearman correlation tests (p < 0.05). The majority of videos demonstrated low content quality (68.6%, GQS ≤ 2) and weak accuracy (47%, JAMA ≤ 1). Longer videos were associated with higher quality scores, while popularity metrics did not show significant correlations with educational quality. A weak but statistically significant correlation was found between DISCERN and II (r = 0.261, p = 0.029). Positive correlations among JAMA, DISCERN, and GQS confirmed the consistency of these scales. Overall, the findings indicate that the quality of YouTube videos on irrigation activation varies considerably. While video length may enhance content quality by allowing for more comprehensive explanations, popularity indicators are not reliable measures of educational accuracy.

This study assessed the diagnostic accuracy of periapical radiography and cone-beam computed tomography for detecting external cervical resorption. An electronic search was conducted in seven databases. The protocol was registered in PROSPERO, and the risk of bias was assessed with QUADAS-2. Retrospective studies using human dental images were included. A bivariate random-effects model estimated pooled diagnostic values using MetaDisc v1. Four studies met the inclusion criteria. Three demonstrated a high risk of bias in patient selection. The meta-analysis revealed specificity values of 0.93 for periapical radiography and 1.00 for cone-beam computed tomography, with corresponding sensitivity values of 0.85 and 1.00, respectively. Cone-beam computed tomography showed statistically superior diagnostic accuracy (p = 0.0016). The GRADE assessment rated the overall certainty of the evidence as 'very low.' Cone-beam computed tomography showed superior accuracy to periapical radiography in detecting external cervical resorption, but the very low certainty of evidence highlights the need for further studies.

This study evaluated the association of ambroxol hydrochloride with calcium hydroxide paste as intracanal medication to enhance antimicrobial action on biofilm without affecting pH, solubility and cytotoxicity. Calcium hydroxide (CH) paste and formulations with different ambroxol concentrations were placed into artificial teeth conditioned in distilled water. pH and solubility were measured. Dentine discs infected with E. faecalis were covered with pastes, and biofilm viability was analysed using live/dead assay and confocal microscope. Cytotoxicity was analysed using MTT assay on fibroblast and osteoblast-like cells. Data were statistically compared (p < 0.05). Ambroxol showed an acidic pH after 7 days, compared to CH, but the 30% concentration became more alkaline after 30 days. While CH's pH decreased over time, ambroxol groups maintained stability. Solubility decreased for all groups over time. All groups showed significant antimicrobial differences from the control group. The association did not alter CH's cytotoxicity. Further research is needed for optimal ambroxol concentration.

The sealing performance of endodontic sealers may be influenced by environmental factors such as pH and blood-derived proteins. This in vitro study evaluated the effects of pH variation and protein contamination on calcium ion (Ca²⁺) release and push-out bond strength (BS) of a calcium silicate-based sealer (Bio-C Sealer) and an epoxy resin-based sealer (AH Plus). Standardised bovine root dentine discs were immersed for 28 days in phosphate-buffered saline (PBS) at pH 5, 7 or 12, with or without 10% fetal bovine serum (FBS). Bio-C Sealer showed greater Ca²⁺ release and conductivity than AH Plus, with enhanced ion release in acidic and reduced in alkaline pH. Both sealers exhibited decreased BS in non-neutral pH, though Bio-C Sealer was more affected by FBS. These findings suggest that pH and protein exposure significantly alter sealer performance, with bioceramic materials being more sensitive to environmental changes than epoxy resin-based sealers.

Large language models (LLMs) are increasingly used in healthcare, but their performance in endodontic decision-making remains unclear. This study aimed to compare six LLMs in terms of diagnostic appropriateness for endodontic treatment planning. Fifty clinical scenarios were developed and entered into six LLMs (ChatGPT-4o, ChatGPT-3.5, Claude 4, Copilot, DeepSeek-V3, Gemini 2.5). Two specialists scored responses as appropriate or inappropriate. Repeated measures ANOVA and chi-square tests were used for analysis. Claude showed the highest accuracy (76%), followed by DeepSeek and Gemini. ChatGPT-3.5 had the lowest (40%). Significant differences were found between models (p < 0.05). Performance was better on straightforward cases than on complex scenarios. LLMs vary widely in diagnostic accuracy for endodontic cases. While some models show promise, others may provide confidently incorrect recommendations. Caution and human oversight remain essential until domain-specific, fine-tuned models are developed.

Pulpitis, a common inflammatory dental condition, lacks reliable non-invasive diagnostic methods. This study reviewed transcriptomic analyses of human pulp tissue to identify diagnostic biomarkers for pulpitis. Seven studies were included, revealing key biomarkers such as IL6, CXCL8, MMP9, NLRP3, and METTL3. Five studies validated their findings experimentally (RT-qPCR), while two relied on in silico validation. Functional meta-analysis demonstrated significant enrichment in inflammation-related pathways, including cytokine signaling, neutrophil chemotaxis, and NF-κB activation. Protein-protein interaction (PPI) network analysis further confirmed strong functional clustering among inflammatory mediators like IL6, TNF, STAT3, and CXCL8. These findings underscore the reproducibility of inflammatory and immune-related biomarkers in pulpitis, supporting their potential for developing objective, gene-based diagnostic tools. The study highlights the translational value of bioinformatics in refining pulpitis diagnosis through molecular signatures. Trial Registration: PROSPERO: CRD420251105137.