Australian Endodontic Journal最新文献

We compare the success of root-end sealing using new bioceramics versus MTA in endodontic microsurgery. A standardised search strategy was conducted in four databases using predefined terms to identify studies reporting clinical and radiographic success (von Arx criteria). Data selection, extraction and risk of bias assessment were performed independently and in duplicate. Meta-analysis and the certainty of evidence (GRADE) were completed. Five titles meet all eligibility criteria (three RCT and two retrospective cohort studies). The identified new bioceramics were EndoSequence RRM (ERRM) (n = 4) and BioMA (n = 1). Overall, the quality of evidence was considered moderate. A meta-analysis demonstrated no significant differences between new bioceramics versus MTA when assessing the number of teeth classified as success (RR 1.00, 95% CI [0.94, 1.07]) or failure (RR 0.93, 95% CI [0.51, 1.71]) according to von Arx criteria. In conclusion, new bioceramics are not conclusively superior to MTA but may be preferred due to improved handling [PROSPERO-CRD42024534258].

Comprehensive treatment of periodontitis requires to assess the need of endodontic intervention. Histopathological examination is crucial to assess link between periodontitis and pulp condition. The current systematic review aimed to answer the focus question: ‘In patients with periodontitis, does periodontitis have any impact on the condition of dental pulp based on histopathological findings?’. The literature search in PubMed, ScienceDirect, Google Scholar and Cochrane Library included nine analytical cross-sectional studies. Results showed, periodontitis may lead to pulp inflammation, fibrosis, calcification and necrosis. Inflammatory cell infiltration ranged from 34.29% to 93.7%, with higher prevalence in severe periodontitis and gingival recession. Pulp necrosis was more common in the apical (21.7%) and middle thirds (34.8%) of the root, reaching 90% with gingival recession. One study reported inconsistencies between pulp sensibility tests and histological findings. Variability in histopathological alterations suggests additional factors, such as gingival recession, influencing pulp condition in periodontitis patients.

This study evaluated the effectiveness of an experimental dual-action solvent in removing aged bioceramic sealers (EndoSequence BC and AH Plus Bioceramic) from root canals, compared with established solvents. Forty-eight extracted mandibular premolars were obturated and aged for ten months before retreatment using saline (control), Endosolv R, GuttaClear, or an experimental solvent comprising a deep eutectic solvent and enzyme-loaded nanoparticles. Residual filling material was quantified via micro-computed tomography. The type of solvent significantly influenced removal efficiency, particularly at the apical level (p < 0.001). The experimental solvent achieved the highest median material removal in all root thirds, with values exceeding 92% apically and 100% in the middle third. Statistically significant differences were observed among solvents in the apical and middle regions. The experimental solvent demonstrated superior efficacy over conventional agents, highlighting its potential as a more effective option for retreatment procedures involving bioceramic sealers.

Although the inflammation-resolving properties of Resolvin E1 have been characterised, its effect on autophagy during pulpitis resolution remains unclear. We established a rat pulpitis model to investigate the changes in autophagy during Resolvin E1-mediated pulpitis resolution. Histological staining and gene quantification were performed to assess pulp tissue injury and changes in inflammation- and autophagy-related gene expression. In vivo, Resolvin E1 promoted dental tissue repair and reduced the expression of tumour necrosis factor-α, interleukin-1β, and CD68 in dental pulp tissues. Resolvin E1 significantly activated LC3II and Atg12 and decreased Atg5 level. Beclin1 expression was upregulated on day 1 and downregulated on day 3. In vitro, Resolvin E1 enhanced human dental pulp cell proliferation; reduced inflammatory marker expression; and regulated LC3II, Beclin1, Atg5, and Atg12 expression. Resolvin E1 could reduce inflammatory damage and induce autophagy response to protect dental pulp tissue.

This study evaluated the methodological quality and synthesised evidence from systematic reviews on guided tissue regeneration (GTR) in endodontic surgery. A comprehensive search across multiple databases was conducted to identify systematic reviews published up to 21 November 2024, with no language restrictions. Methodological quality was assessed using the AMSTAR-2 tool, and primary study overlap using corrected covered area (CCA) metrics. Fourteen systematic reviews, including eight meta-analyses, were included. The CCA was 12.77%, indicating high overlap, and AMSTAR-2 revealed considerable methodological variability. The use of GTR, especially the combination of bone grafts and resorbable membranes, showed improved healing outcomes in through-and-through lesions. Adjunctive use of platelet concentrates appeared to enhance postoperative recovery. However, heterogeneity in study designs and the absence of long-term follow-up limit the strength of conclusions. Overall, GTR techniques, particularly those combining grafts and membranes, show promise in endodontic surgery, but more rigorous, well-designed studies and systematic reviews are required to reinforce clinical recommendations.

Trial Registration: International Prospective Register of Systematic Reviews (PROSPERO) CRD42024546481

This systematic review evaluated how CBCT impacts diagnosis, treatment planning (TP) and confidence in endodontic cases compared to intraoral radiography (IR). PubMed/MEDLINE, Cochrane-CENTRAL, Embase, Scopus, LILACS, Web of Science and Google Scholar databases were searched. Information regarding changes in the diagnosis, TP and confidence after CBCT was evaluated. The methodological quality was assessed using QUADAS-2. Twenty-six studies were included, 10 classified as having a low risk of bias. Most studies focused on changes in TP (n = 10) or diagnosis in primary treatments (n = 7). Studies evaluating dental trauma showed the most significant improvement. CBCT impacted TP, increasing difficulty in choosing treatment for complex cases (external root resorption and complex root canal morphology) and often resulting in a more invasive treatment (i.e., tooth extraction). CBCT impacts diagnosis, TP and confidence in cases of complex endodontic treatments, often leading to more invasive treatments.

This study evaluated the performance of MTA and ready-to-use cement (Bio C Repair) in dentine repair under different blood contamination conditions. 120 bovine root dentine-disks were divided into control and blood-contaminated groups and then subdivided on the basis of cement type and exposure time (immediate or 15-min delay). The control was stored in a humid environment at 37°C for 28 days, whereas the contaminated group was stored in blood. Push-out bond strength was assessed using a universal testing machine (1 mm/min). Three samples per subgroup underwent EDS-X and SEM analysis. MTA exhibited significantly lower bond strength than Bio C Repair (p < 0.001). Samples exposed to blood showed significantly lower bond strength than controls (p < 0.001). The 15-min delay reduced bond strength only in Bio C Repair samples (p = 0.045). It can be concluded that blood contamination reduced bond strength, with the ready-to-use material demonstrating superior performance compared to the conventional bioceramic cement.

This study aimed to investigate the stress distribution on dentine, supporting tissues and restorative materials in simulated tooth models with various sized internal resorption cavities obturated with gutta-percha, MTA or Biodentine. A 3D finite element model was developed using Wheeler's dental atlas. The cortical and trabecular bone, lamina dura, and periodontal ligament were modelled. A healthy tooth served as the control, while the other models featured internal resorption cavities of various sizes in the middle third. In the treated models, the resorption cavities were restored with gutta-percha, MTA or Biodentine; the apical and coronal thirds were filled with gutta-percha. Seventeen models were subjected to a 100 N force at a 135° angle. Stress increased with resorption size but decreased after treatment. Gutta-percha models showed the highest stress on dentine and bone, while Biodentine had the lowest. However, Biodentine accumulated the most stress within the material. Larger resorption cavities increased stress, while Biodentine and MTA transmitted less stress to dentine than gutta-percha.