International endodontic journal最新文献

{"title":"Differences in clinical approaches of endodontists and general dentists when performing non-surgical root canal treatment: A prospective cohort study from the National Dental Practice-Based Research Network PREDICT Project.","authors":"Ali Nosrat, Ellen Funkhouser, Alan S Law, Omar Abusteit, Rahma Mungia, Donald R Nixdorf, Ernest W N Lam, Gregg H Gilbert","doi":"10.1111/iej.14264","DOIUrl":"https://doi.org/10.1111/iej.14264","url":null,"abstract":"<p><strong>Aim: </strong>Information regarding differences between general dentists (GDs) and endodontists in their daily practices is limited. The aim of this prospective cohort clinical study was to compare the details of clinical approaches of GDs and endodontists when performing non-surgical root canal treatments (NSRCT).</p><p><strong>Methodology: </strong>The study was conducted among 153 practitioners (104 GDs and 49 endodontists) in the National Dental Practice-Based Research Network in the United States who performed NSRCT on at least one of 1705 patients. Practitioners completed postoperative forms to document procedural data. Bivariate and multivariable analyses were performed to adjust for the potential effect of confounders. Two different multivariable models were tested to eliminate the impact of unstable variables.</p><p><strong>Results: </strong>Overall, after adjusting for the tooth type, multivariable models showed that endodontists were significantly more likely than GDs to use magnifications >5×, rubber dam isolation, NaOCl irrigation, EDTA or H₂O₂ or chlorhexidine irrigations, ultrasonic/sonic irrigant activation, electronic apex locator and radiographs for working length determination, warm vertical condensation and lateral condensation techniques for obturation, report adequately dense obturation without voids, and to complete NSRCT in a single visit (p ≤ .01). Endodontists were significantly less likely to use lubricants and to report unacceptable obturation length (≥2 mm short or extended beyond the radiographic apex) (p ≤ .01).</p><p><strong>Conclusions: </strong>Based on actual clinical data, this study observed major differences between GDs and endodontists in their clinical approaches when performing NSRCTs. Further studies are needed to assess the effect of these differences on the outcome of NSRCTs.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical validation of a proposed diagnostic classification for pulpitis.","authors":"R N Karrar, S G Craig, H F Duncan, S A Abushouk, S Y Elfiel, F T Lundy, M Clarke, I A El-Karim","doi":"10.1111/iej.14254","DOIUrl":"https://doi.org/10.1111/iej.14254","url":null,"abstract":"<p><strong>Aim: </strong>Determine the reliability and clinical validity of the Wolters classification of pulpitis.</p><p><strong>Methodology: </strong>Prospective diagnostic accuracy study in which patients with pulpitis were included. Based on history, clinical and radiographic examination, participants were categorized into initial, mild, moderate or severe pulpitis based on Wolters classification and received treatment as suggested in the classification. The American Association of Endodontists (AAE) classification was used for comparison. Treatment outcome was evaluated at 12 months. Classification reliability was assessed by measuring the interrater agreement using Fleiss' Kappa. Construct validity was assessed by cluster analysis using an unsupervised machine learning approach. Predictive validity was determined by the association of treatment outcome with the diagnostic category. All statistical analyses were conducted using R v4.3.1; a p-value of <.05 was considered statistically significant.</p><p><strong>Results: </strong>Ninety-two patients were included in the study. The interrater reliability showed fair agreement for Wolters classification (Kappa (κ) = 0.593, 95% confidence interval (CI): 0.592-0.595), compared with substantial agreement (κ = 0.888, 95% CI: 0.887-0.889) for the AAE classification. Association of Wolters classification with output of unsupervised K-mode cluster analysis showed that the use of a three-category model may improve discrimination of pulpitis subdivided into mild, moderate, and severe categories. The revised classification model demonstrated 100% sensitivity and specificity for accurate discrimination between mild and severe pulpitis and 83% sensitivity and 85.7% specificity for classifying moderate pulpitis. There was no significant difference between these revised diagnostic categories considering treatment outcome, suggesting good predictive validity (p > .05). Compared with the AAE classification, the new classification in conjunction with proposed treatments resulted in preserving 87% of the pulps compared with historical treatment.</p><p><strong>Conclusions: </strong>We propose that a revised Wolters classification model is suitable for determining mild, moderate, and severe pulpitis to aid in clinical management of pulpitis.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"TLR-2 gene methylation in peripheral blood monocytes from apical periodontitis individuals: A cross-sectional study.","authors":"María José Bordagaray, Alejandra Fernández, Elizabeth Pellegrini, Mauricio Garrido, Patricia Hernández, David González-Quintanilla, Gabriel Navia, Daniela Rehbein, Mauricio Baeza, Peter Gebicke-Haerter, Marcela Hernández","doi":"10.1111/iej.14255","DOIUrl":"https://doi.org/10.1111/iej.14255","url":null,"abstract":"<p><strong>Aim: </strong>Apical periodontitis (AP) is a chronic inflammatory disease arising from the contamination of the root canal system. Epigenetic regulation plays a pivotal role in controlling monocyte/macrophage-mediated local and systemic responses to bacterial challenges via toll-like receptors (TLRs). We aimed to explore the relationship between the methylation and expression patterns of TLR-2 in peripheral blood monocytes of individuals with AP and controls.</p><p><strong>Methodology: </strong>Cross-sectional study. Otherwise healthy individuals with AP (n = 25) and controls (n = 29) were recruited. Peripheral blood monocytes were isolated from blood samples by Ficoll gradient and negative immunoselection. DNA and RNA were extracted from monocytes. DNA was bisulfite-treated, amplified and sequenced to evaluate the global and cytosine-phosphate-guanine (CpG) single-site methylation pattern of the TLR-2 gene promoter. mRNA relative levels of TLR-2 were assessed by qPCR. The potential associations between AP, TLR-2 DNA methylation and TLR-2 gene expression were explored using generalized structural equation models (GSEM).</p><p><strong>Results: </strong>TLR-2 expression was significantly upregulated in peripheral blood monocytes from individuals with AP compared to controls (p = 0.005). Though no differences were found in the global methylation pattern, CpG single sites from the TLR-2 gene were differentially methylated at positions -40 and +24 (p < 0.05). The methylated positions at -40 and -20 in TLR-2 were associated with TLR-2 transcriptional upregulation (p < 0.05). Further evaluation with GSEM analysis showed that AP promoted the methylation of the -40 CpG single site on the TLR-2 gene, which, in turn, upregulated TLR-2. Conversely, the methylation of the -20 CpG single site did not act as a mediator of TLR-2 transcription in AP.</p><p><strong>Conclusions: </strong>AP diagnosis activates peripheral blood monocytes via -40 CpG single-site methylation, independently promoting TLR-2 expression.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From pulp to cementum: 3D visualization of soft and hard dental tissues using different ex vivo nano-CT contrast-enhancement techniques.","authors":"Torben Hildebrand, Håvard Jostein Haugen, Mario Romandini, Gianluca Plotino, Liebert Parreiras Nogueira","doi":"10.1111/iej.14260","DOIUrl":"https://doi.org/10.1111/iej.14260","url":null,"abstract":"<p><strong>Aim: </strong>To determine the effect of two contrast-enhancement strategies in nano-computed tomography (nano-CT) imaging on the contrast-to-noise ratio (CNR) of various dental tissues, including pulp, dentine and cementum, with the goal of enhancing the visibility of dental soft tissues to a level not yet reported in laboratory nano-CT imaging.</p><p><strong>Methodology: </strong>Ten sound human third molars underwent decalcification and subsequent treatment with Lugol's iodine (n = 5, Group 1) or phosphotungstic acid (PTA) treatment without prior decalcification (n = 5, Group 2) for contrast enhancement. Imaging was performed using the laboratory nano-CT system Skyscan 2211 and the synchrotron radiation for medical physics (SYRMEP) beamline. CNRs were measured for pulpal tissue, dentine and cementum and nano-CT images were compared with classical histology, scanning electron microscopy (SEM) and energy-dispersive X-ray spectroscopy (EDXS).</p><p><strong>Results: </strong>Group 1 significantly enhanced the contrast of pulp tissue, resulting in a 168.2% increase due to decalcification and an additional 148.7% increase after Lugol's iodine treatment. Dentine exhibited higher contrast in Group 2, whereas cementum showed similar contrast across both groups. Laboratory nano-CT enabled the visualization of detailed soft tissue structures, including nerves, blood vessels and odontoblasts within the pulp, but cementocytes remained invisible.</p><p><strong>Conclusions: </strong>Decalcification followed by Lugol's iodine treatment was superior for enhancing soft tissue contrast, especially for pulp visualization. PTA without decalcification yielded better contrast for dentine and facilitated the visualization of attached soft tissues, such as periodontal ligament and predentine. These findings provide insights into selecting the most appropriate protocol to optimize nano-CT imaging for specific dental tissue analyses, including the pulp.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the fatigue resistance of NiTi instruments: A DSC-based approach to understanding temperature effects.","authors":"Emmanuel J N L Silva, Jorge N R Martins, Murilo Priori Alcalde, Marco A Versiani","doi":"10.1111/iej.14257","DOIUrl":"https://doi.org/10.1111/iej.14257","url":null,"abstract":"<p><strong>Aim: </strong>This study aims to demonstrate that phase transformation analysis, assessed via differential scanning calorimetry (DSC), offers a more comprehensive understanding of NiTi instruments' mechanical behaviour than traditional fixed-temperature fatigue testing by evaluating phase transformation temperatures and their impact on cyclic fatigue strength of ProTaper Universal and ProTaper Gold at 20 and 35°C.</p><p><strong>Methodology: </strong>Fifty ProTaper Universal F2 (n = 25) and ProTaper Gold F2 (n = 25) NiTi instruments were compared for geometric design (blade length, helical spirals, spiral density, spiral geometry, tip design and surface quality) and metallurgical properties including elemental analysis (energy-dispersive X-ray spectroscopy) and phase transformation temperatures. Then, cyclic fatigue strength was tested at room (20 ± 1°C) and body (35 ± 1°C) temperatures using a standardized artificial canal and cyclic fatigue resistance test. Time to fracture (in seconds) was recorded, and data were statistically analysed using the independent Student's t-test for intergroup analysis and the paired Student's t-test for intragroup analysis (α = 5%).</p><p><strong>Results: </strong>Both instruments had a 17 mm blade with 10 spirals (0.59 spirals/mm), similar geometry and NiTi wires with near-equiatomic nickel-titanium ratios, differing only in metal alloy colour. DSC analysis showed distinct phase transformation temperatures, with ProTaper Universal exhibiting an R-phase start (Rs) at 16.2°C and finish (Rf) at -12.7°C, while ProTaper Gold had an Rs at 44.0°C and Rf at 28.6°C, though both transitions occurred gradually. Fracture time was significantly longer at 20°C than at 35°C for both instruments (p < 0.05), with ProTaper Gold showing a greater reduction (58%) but maintaining superior cyclic fatigue strength at both temperatures (p < 0.05).</p><p><strong>Conclusion: </strong>The cyclic fatigue strength of NiTi instruments depends on temperature, highlighting the limits of assessing performance at a single predefined temperature. DSC offers key insights into phase transformation, enabling a better interpretation of mechanical properties beyond mechanical testing alone. Integrating metallurgical characterization with cyclic fatigue analysis improves the evaluation of NiTi instruments, ensuring a more accurate understanding of their mechanical performance.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127509","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of calcium hydroxide compared to hydraulic calcium silicate cements for direct pulp capping in managing deep caries in vital permanent teeth: A systematic review and meta-analysis.","authors":"Sascha R Herbst, Vinay Pitchika, Chantal S Herbst, Esra Kosan, Falk Schwendicke","doi":"10.1111/iej.14256","DOIUrl":"https://doi.org/10.1111/iej.14256","url":null,"abstract":"<p><strong>Background: </strong>Direct pulp capping (DPC) is the least minimal approach for maintaining pulp vitality after pulp exposure. Besides calcium hydroxide (CaOH), hydraulic calcium silicate cements (HCSC) have increasingly been used for DPC.</p><p><strong>Objectives: </strong>During the S3 level guideline development for material choice in DPC, we conducted a systematic review and meta-analysis of existing literature comparing CaOH and HCSC for DPC on permanent teeth. We aimed (1) to assess clinical and radiographic outcomes and (2) patient-reported outcomes of DPC.</p><p><strong>Method: </strong>Three databases from 1 January 1990 to 19 February 2025 (MEDLINE via PubMed, EMBASE and Cochrane Database of Systematic Reviews). Prospective comparative clinical studies comparing CaOH to HCSC for DPC in permanent teeth with healthy or reversibly inflamed pulps were included. Studies on primary teeth or teeth indicative of irreversible pulpitis, teeth with unclear diagnoses or pulp exposure of non-cariogenic origin were excluded. The risk of bias and certainty of evidence were evaluated using the GRADE approach. Using the effect sizes and standard errors for every study, pairwise meta-analysis was performed comparing CaOH and different subgroups of HCSC. Success was defined as the absence of any clinical symptoms (e.g. pain, swelling) and any radiographical signs of an apical lesion. Patient-reported outcomes were additionally sought after.</p><p><strong>Results: </strong>Five randomized-controlled trials including 552 teeth with an overall moderate certainty of evidence were included. HCSC showed a significantly higher probability of success compared to CaOH (Odds Ratio (OR): 2.68, 95% confidence interval [1.7, 4.22], I² = 0%). The differences between various HCSC materials were minimal. Meta-regression indicated that neither follow-up nor risk of bias significantly influenced treatment outcomes, and the funnel plot did not reveal evidence of publication bias.</p><p><strong>Conclusion: </strong>HCSC showed significantly higher probability for clinical and radiographic success than CaOH. This finding comes with moderate certainty. The impact of material choice on postoperative pain remains unclear. Future clinical studies should include patient-reported outcomes.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cats and external cervical resorption: Statistical considerations: Letter to editor for 'Potential predisposing features of external cervical resorption: An observational study (Patel et al., 2025)'.","authors":"Nasir Z Bashir, Eduardo Bernabé","doi":"10.1111/iej.14258","DOIUrl":"https://doi.org/10.1111/iej.14258","url":null,"abstract":"","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of the endogenous opioid system in modulating orthodontic-induced neurogenic inflammation of the dental pulp: A comprehensive review of the literature.","authors":"Javier Caviedes-Bucheli, Nestor Raul Ríos-Osorio, Esteban Ulate-Rodríguez, Hernan Dario Muñoz-Alvear, José F Gaviño-Orduña, P Sebastian Ortolani-Seltenerich, Jose F Gomez-Sosa, Hugo Roberto Munoz","doi":"10.1111/iej.14251","DOIUrl":"https://doi.org/10.1111/iej.14251","url":null,"abstract":"<p><strong>Background: </strong>Orthodontic forces may lead to neurogenic inflammation in the dental pulp by triggering the release of somatosensory neuropeptides such as Substance P (SP), Calcitonin gene-related peptide (CGRP) and Neurokinin A (NKA). In the vast majority of patients, acute symptoms are not triggered, probably due to the control of the neurogenic inflammatory process exerted by endogenous opioid systems.</p><p><strong>Objective: </strong>This review aimed to assess the cellular and molecular mechanisms through which the endogenous opioid system modulates the orthodontic-induced neurogenic inflammation of the dental pulp and to identify potential mechanisms for endogenous control of pulp pain.</p><p><strong>Methods: </strong>A literature search was conducted in the databases Pubmed, ISI Web of Science and Scopus to find relevant studies using the keywords: \"orthodontic movement,\" \"opioids\" and \"neurogenic inflammation.\" Following the PRISMA and Amstar recommendations, studies were selected for the literature review.</p><p><strong>Results: </strong>After removing duplicated and irrelevant articles, and those that does not meet the inclusion criteria, 38 articles were selected and classified according to the opioid peptides analysed in relation to orthodontic movement and dental pulp.</p><p><strong>Discussion: </strong>Both peripheral and central pathways, via endogenous opioid systems such as somatostatin (SST), dynorphin, β-endorphin, methionine enkephalin, endocannabinoids and anti-inflammatory cytokines, modulate the neurogenic inflammation elicited by orthodontic movements. The bradykinin and monoaminergic systems also appear to display regulatory effects on pain response. These control mechanisms, however, may be insufficient in cases where severe orthodontic forces are applied, thus leading to asymptomatic irreversible pulpitis or necrosis.</p><p><strong>Conclusion: </strong>The opioid system regulates neurogenic pulpal inflammation and pain at the level of the central and peripheral nervous systems by releasing endogenous substances, including SST, opioid peptides, endocannabinoids and anti-inflammatory cytokines.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diamond-like carbon coating enhances mechanical performance of NiTi rotary instruments: A multimethod analysis.","authors":"Emmanuel J N L Silva, Tereza Vitória Mauri Lorenzoni, Mylena do Rosário Pereira, Victor T L Vieira, Jorge N R Martins, Francisco Manuel Braz Ferndandes, Marco A Versiani","doi":"10.1111/iej.14253","DOIUrl":"https://doi.org/10.1111/iej.14253","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to evaluate the impact of diamond-like carbon (DLC) surface treatment on the mechanical properties of nickel-titanium (NiTi) rotary instruments.</p><p><strong>Methodology: </strong>One hundred and ten nickel-titanium instruments with a size of 25/.06 and a length of 25 mm, both with (n = 55) and without (n = 55) a DLC coating were selected and compared regarding their design (stereomicroscopy, scanning electron microscopy), metallurgy (energy-dispersive X-ray spectroscopy, differential scanning calorimetry), and mechanical performance (time to fracture, bending strength, buckling strength, cutting efficiency, and microhardness). Data were analysed using Mann-Whitney and independent Student's t-test (α = 5%).</p><p><strong>Results: </strong>The design analysis confirmed that both instruments had identical geometric features, similar spiral and tip designs, with DLC-coated instruments showing fewer surface irregularities and a multi-coloured appearance. Metallurgical analysis revealed identical transformation temperatures for both groups, with the R-phase starting at ~32°C, finishing at ~25°C during cooling, and the austenitic finish occurring at ~35°C. DLC-coated instruments demonstrated significantly superior cyclic fatigue resistance (p = 0.0028), lower bending load (p = 0.0294), lower cutting efficiency (p < 0.0001), and higher microhardness (p = 0.0019), whilst no difference was observed in terms of buckling strength (p = 0.3569).</p><p><strong>Conclusions: </strong>Diamond-like carbon surface treatment significantly enhanced cyclic fatigue resistance, flexibility, and microhardness of NiTi rotary instruments without compromising their structural integrity.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143985084","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of using immersive virtual reality in haptic dental simulation for endodontic access cavity training: A comparative crossover study.","authors":"Octave N Bandiaky, Valériane Loison, Christelle Volteau, Raphaëlle Crétin-Pirolli, Sébastien George, Assem Soueidan, Laurent Le Guehennec","doi":"10.1111/iej.14252","DOIUrl":"https://doi.org/10.1111/iej.14252","url":null,"abstract":"<p><strong>Introduction: </strong>The use of haptic virtual reality simulators in preclinical dental education is evolving rapidly. However, the application of immersive haptic simulations for specific dental procedures, such as access cavity preparation, has not been extensively explored.</p><p><strong>Aims: </strong>This study aimed to (i) evaluate the impact of using the VirTeaSy Dental® simulator in conjunction with a virtual reality (VR) headset on student performance during access cavity preparation, with a focus on haptic parameters; (ii) assess students' perceptions of the experience; and (iii) examine the side effects associated with VR headset use.</p><p><strong>Methodology: </strong>The study included 90 third-year dental students from the Dental Faculty of Nantes University, enrolled in January 2023. Participants were divided into two parallel groups. In Phase 1, Group 1 (n = 45) completed two endodontic access cavity exercises on the VirTeaSy Dental® without the VR headset, whilst Group 2 performed the same exercises using the VR headset. In Phase 2, the groups switched conditions and followed the same protocol. Performance was assessed using haptic parameters, and comparisons between groups for each phase were made using parametric and non-parametric tests (p < .05). Students also completed questionnaires to assess their experience and report any side effects from using the VR headset.</p><p><strong>Results: </strong>Across both groups and phases, participants performed better in access cavity preparation without the VR headset. They showed greater accuracy, made fewer errors, and completed the exercises more quickly. Notably, more students failed to complete the exercises within the 10-minute time limit when using the VR headset (27 vs. 12 in Group 1, 23 vs. 13 in Group 2). Most participants expressed a preference for using VirTeaSy Dental® without the VR headset. Approximately, 20% of students reported side effects, including dizziness, nausea, migraines, and neck muscle fatigue.</p><p><strong>Conclusion: </strong>The results suggest that full immersion in haptic simulation, when paired with a VR headset, negatively impacts student performance in complex tasks such as access cavity preparation. These findings underscore the current limitations of immersive virtual reality in dental education and highlight the need for technical refinements before its widespread adoption in preclinical training.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}