Australian Endodontic Journal最新文献

The aim of this study was to compare postoperative pain levels in patients with necrotic teeth after non-surgical root canal treatment (NSRCT) using or not using a dental operating microscope (DOM). One hundred patients with pulp necrosis and symptomatic apical periodontitis were randomly assigned to two groups (n = 50): Group 1 (DOM) and Group 2 (no DOM). Postoperative pain was measured using the Numeric Rating Scale (NRS) at 6 h, 12 h, 1 day, 3 days, and 7 days. The pain intensity was determined by calculating the mean pain score at each interval and was statistically analysed. The results showed no significant difference in pain intensity between the two groups. However, gender and tooth type affected pain levels at 6 h, 12 h, and 1 day. In conclusion, using a DOM during NSRCT did not significantly reduce postoperative pain.

This study aims to compare the accuracy of modern AI chatbots, including Gemini 1.5 Flash, Gemini 1.5 Pro, ChatGPT-3.5 and ChatGPT-4, in responding to endodontic questions and supporting clinicians. Forty yes/no questions covering 12 endodontic topics were formulated by three experts. Each question was presented to the AI models on the same day, with a new chat session initiated for each. The agreement between chatbot responses and expert consensus was assessed using Cohen's kappa test (p < 0.05). ChatGPT-3.5 demonstrated the highest accuracy (80%), followed by ChatGPT-4 (77.5%), Gemini 1.5 Pro (72.5%) and Gemini 1.5 Flash (60%). The agreement levels ranged from weak (ChatGPT models) to minimal (Gemini Flash). The findings indicate variability in chatbot performance, with ChatGPT models outperforming Gemini. However, reliance on AI-generated responses for clinical decision-making remains questionable. Future studies should incorporate more complex clinical scenarios and broader analytical approaches to enhance the assessment of AI chatbots in endodontics.

This study evaluated the retreatability of two bioceramic-based sealers in oval-shaped canals and the effectiveness of supplementary cleaning techniques for removing sealer remnants. Mandibular premolars were obturated with either NeoSEALER Flo or AH Plus Bioceramic. After obturation, specimens were retreated followed by supplementary cleaning with XP-Endo Finisher R, EasyClean, or passive ultrasonic irrigation. Sealer remnants were analysed using confocal laser scanning microscopy and scanning electron microscopy. AH Plus Bioceramic showed a significantly lower residual sealer percentage than NeoSEALER Flo in the coronal and middle thirds. XP-Endo Finisher R was more effective for NeoSEALER Flo in the apical third, while passive ultrasonic irrigation was superior for AH Plus Bioceramic in the coronal and middle thirds. Scanning electron microscopy revealed sealer remnants in all groups, with partial obstruction of dentinal tubules. Bioceramic sealers exhibit different retreatability, and supplementary cleaning protocols improved sealer removal, but none achieved complete canal wall cleanliness.

Cell homing and stem cell transplantation offers promising approaches for pulp regeneration. This study investigated the efficacy of an injectable concentrated growth factor gel for dental pulp regeneration in beagles. Six groups of beagle teeth were studied: Blank control group, CGF group, Collagen sponge group, CGF + Collagen sponge group, Dental pulp stem cells group, CGF + Dental pulp stem cells group. Specimens were examined by CBCT and histological analysis. No obvious change was identified in the periapical condition. Fewest inflammatory cells were found in the CGF + CS group. Odontoblast-like cells and dentin-like tissue were identified in the root canals of experimental groups, and the thickness of dentin-like tissue was positively correlated with the number of odontoblast-like cells. CD31-positive cells appeared in root canals containing pulp-like tissue. Injectable concentrated growth factor (CGF) can induce in situ pulp-dentin complex regeneration either on its own or in combination with collagen sponge and dental pulp stem cells.

This study aimed to compare the incidence of postoperative pain after single-visit retreatment and two-visit retreatment, assessing pain both after the inter-appointment and post-obturation periods in teeth with asymptomatic periapical lesions. 100 single-rooted endodontically treated teeth were randomly assigned to single-visit or two-visit groups. Postoperative pain was assessed at 12, 24, 48 h and 7 days after obturation and the inter-appointment period. Data were analysed using the Chi-square, Fisher's Exact, McNemar and McNemar–Bowker tests. Postoperative pain after obturation was similar between the groups at 12, 24 h (p > 0.05), but higher at 48 h in single-visit (p < 0.05). No differences were observed between single-visit and inter-appointment periods (p > 0.05). Within the two-visit group, pain decreased in the post-obturation period compared to the inter-appointment period at 12, 24, 48 h (p < 0.05). These findings suggest that the pain experienced between appointments was greater than post-obturation and single-visit retreatment is clinically feasible in terms of postoperative pain.

This review evaluates the effectiveness and clinical applicability of guided endodontics (GE) in managing dental anomalies, which present challenges for conventional endodontics. The primary objective is to assess how GE enhances treatment predictability and minimises errors in cases such as dens invaginatus (DI), dentinogenesis imperfecta (DGI), dentinal dysplasia (DD), dens evaginatus (DE) and dental fusion. A narrative review was conducted using a comprehensive search across PubMed/MEDLINE, Scopus, Web of Science, EMBASE and Cochrane Library databases for studies published 2015–2025. Nine studies met the inclusion criteria. GE was found to offer high success rates in the treatment of DI, DGI and DD. The integration of CBCT and 3D-printed guides allowed for minimally invasive access cavity preparation, reduced iatrogenic complications and improved precision. Despite these advantages, challenges include increased cost, being time-consuming and limitations in curved canals. Guided endodontics holds promise as a transformative technique in modern endodontic practice.

This pilot study explores how Endodontists make decisions regarding the adoption of rapidly evolving technologies in clinical practice, an area with little existing literature. Graduates of an Advanced Endodontics Program were surveyed to assess the importance of 23 decision-making factors using a 5-point Likert scale. The survey was distributed via Qualtrics and remained open for 3 months, with reminders sent to participants. A total of 46 responses were received, yielding a 37% response rate. The most highly ranked factors influencing technology adoption were evidence (100%), safety/risk (97.8%), health benefits (91.3%), quality (89.1%) and post-implementation patient care quality improvement. In contrast, company representative input (15.8%), initial disruption (33.3%) and training duration (45.5%) were rated as least important. These findings provide valuable insight into the priorities of Endodontists, emphasising a strong commitment to patient-centered care and clinical rigour in technology adoption decisions.