Australian Endodontic Journal最新文献

The management of complicated crown–root fractures of immature permanent teeth requires a multidisciplinary approach to address biological, functional, and aesthetic concerns. A 10-year-old boy suffered a complicated crown–root fracture of tooth 11, an uncomplicated crown fracture, subluxation and pulp necrosis of tooth 21 and subluxation of tooth 22 after falling from a bicycle. The treatment for tooth 11 involved maintaining pulp vitality with partial pulpotomy and re-attachment of the crown-root fragment after modified crown-lengthening surgery. Treatment for tooth 21 included a flexible splint, root canal therapy, placement of an apical barrier and resin composite restoration. During the 4-year follow-up, the root of tooth 11 fully developed, and the patient remained asymptomatic and achieved an aesthetically acceptable outcome. Conservative partial pulpotomy followed by adhesive reattachment of the tooth fragment with the modified crown lengthening technique can be a viable treatment for complicated crown–root fractures in immature permanent teeth.

This study aimed to compare patients' perception of postoperative pain following single- and multiple-visit endodontic therapy, and to evaluate associations between anxiety and genetic polymorphisms in the DRD2, ANKK1 and COMT genes. In this clinical trial, 67 patients were included in the first phase (34 single visit, 33 multiple visits), and 25 participated in the second phase. Saliva was collected for genetic analysis, and the State–Trait Anxiety Inventory was applied preoperatively. Postoperative pain (presence and intensity) was recorded at 24, 48 and 72 h. The number of visits was not associated with postoperative pain (p = 0.806); pain intensity was highest at 24 h in both groups (p < 0.001). Moderate anxiety was significantly associated (p < 0.05) with pain in single- and multiple-visit. A genetic association was observed between the COMT rs174675 polymorphism and the outcome (p = 0.018), with greater pain reported by individuals with the CT genotype. (#RBR-47ngbg3).

This study aimed to investigate whether root canal treatment (RCT) restores muscle symmetry by measuring the thickness of masseter and anterior temporalis muscles using ultrasonography. A self-controlled prospective observational study was conducted with patients experiencing moderate-to-severe endodontic pain and masticatory laterality. Ultrasonographic measurements of masseter and anterior temporalis muscles were taken at rest and during contraction before RCT, 1 week after treatment and 3 months post-treatment. An asymmetry index was calculated to evaluate changes in muscle thickness over time. Significant increases in masseter muscle thickness were observed on the painful side, both at rest and during contraction, while the control side showed a significant increase only during contraction. No statistically significant changes were observed in anterior temporalis muscle thickness, although a similar trend was noted. The asymmetry indices decreased significantly over time, approaching zero by the third month. RCT effectively reduces muscle asymmetry caused by endodontic pain, restoring balanced masticatory function.

Trial Registration: ClinicalTrials.gov identifier: NCT06853028

The purpose was to analyse the efficacy of extracellular vesicles (EVs) used in tissue engineering for regenerative endodontic treatments. The study followed the Guidance's recommendations for conducting systematic scoping reviews. A systematic electronic search was conducted to answer: “Are extracellular vesicles used in tissue engineering effective for regenerative endodontic treatments?”. A total of 393 scientific articles were selected, and after applying the inclusion criteria and excluding duplicate articles, 14 articles were included in this research. The most used EVs were exosomes, which were mostly extracted from stem cells and used in association with biomaterials or cells. All included studies demonstrated the effectiveness of extracellular vesicles in promoting pulp regeneration. The mechanisms involved in tissue formation include odontogenic and angiogenic differentiation, as well as control of the inflammatory process after the use of EVs. It is concluded that therapy with EVs is promising for endodontic clinics.

This study evaluated the long-term inflammatory response in periodontal tissues following intra-coronal bleaching of non-vital anterior teeth using two peroxide-based agents. Fifty participants were randomised to receive either 35% hydrogen peroxide or 37% carbamide peroxide via the walking bleach technique. Gingival crevicular fluid was collected at five time points over 12 months, and inflammatory biomarkers were analysed. Both bleaching protocols resulted in significant and sustained increases in interleukin-1 beta and receptor activator of nuclear factor kappa-B ligand concentrations, without significant differences between agents. Tooth whitening was effective and stable over time. The strong correlation between both biomarkers suggests a persistent low-grade inflammatory state induced by bleaching. These findings highlight the biological impact of intra-coronal bleaching on periodontal tissues, even in the absence of clinical symptoms, and underscore the need for individualised risk assessment when planning aesthetic treatment in endodontically treated teeth.

Trial Registration: ClinicalTrials.gov identifier: NCT02718183