Australian Endodontic Journal最新文献

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

This systematic review analysed clinical studies to determine if Biodentine offers improved outcomes for pulpotomy in cariously exposed permanent teeth compared to MTA, supporting its potential recommendation. A systematic search of MEDLINE, Oral and Dental Sciences Source, and EMBASE was conducted. Inclusion and exclusion criteria identified clinical studies comparing MTA and Biodentine for pulpotomy. The outcome measured was ‘overall success,’ based on clinical and radiographic evaluations. Two independent reviewers performed data extraction and quality assessment using the Risk of Bias 2 tool. Four randomised controlled trials with 265 teeth and follow-up up to 6 years met the inclusion criteria. One study had a high risk of bias, whereas only one study was deemed to have a low risk of bias. No statistically significant differences were found between Biodentine and MTA. Based on our findings, Biodentine is a viable alternative to MTA, showing similar outcomes. Further long-term clinical studies are needed to determine optimal biomaterials to improve clinical outcomes.

To compare the truss endodontic cavity (TREC) design against the traditional conservative endodontic cavity (TEC) design in terms of intracanal bacteria removal and the impact on postoperative pain. A randomised controlled trial was conducted involving 100 patients, who were assigned to either the TEC group or the TREC group. Bacteriological samples from the root canals were collected both pre- and post-chemo-mechanical preparation. The total bacterial counts were determined by using qPCR and the postoperative pain intensity was measured using the visual analogue scale (VAS). To analyse bacterial load and postoperative pain levels within groups, the Wilcoxon and Friedman tests were utilised, respectively. The TEC group achieved a 96% reduction in bacterial counts, whereas the TREC group exhibited a 92% reduction, with this difference being statistically significant. These findings highlight the importance of cavity design in endodontic procedures and its potential implications for clinical practice.

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.