International endodontic journal最新文献

{"title":"Endoplasmic Reticulum Stress Inhibits the Neuronal Differentiation of Human Stem Cells From Apical Papillae by Attenuating the Activity of ERK-IRE1α Axis In Vitro.","authors":"Zhaodan Wang, Junqing Liu, Shulan Lin, Jingyi Ye, Leyi Chen, Chengfei Zhang, Buling Wu","doi":"10.1111/iej.70003","DOIUrl":"https://doi.org/10.1111/iej.70003","url":null,"abstract":"<p><strong>Aim: </strong>Stem cells from apical papillae (SCAPs) are promising seed cells for angiogenesis, neurogenesis and dental pulp regeneration, which are contingent upon endoplasmic reticulum (ER) homeostasis. Due to the narrow anatomical structure of the root canal system and slow ingrowth of vasculatures, the presence of hypoxia and nutrient-deficient microenvironment within the sterilised root canal space may induce ER stress in the transplanted cells and affect their differentiation into neural lineages. This study aimed to investigate the role of ER stress in the neuronal differentiation of human SCAPs and its underlying mechanisms.</p><p><strong>Methodology: </strong>Thapsigargin (TG) was employed to induce ER stress in SCAPs. ER Ca²⁺ level was quantified by Mag-Fluo 4 AM. Quantitative real-time PCR (qRT-PCR) and western blot were conducted to detect ER stress markers. SCAPs, with or without ER stress, were guided towards neuronal differentiation. We measured the expression of neuronal markers and the activation of the extracellular signal-regulated kinase (ERK1/2) and the unfolded protein response (UPR) signalling. Immunofluorescence staining was applied to observe SCAP-derived neuron-like cells. The kinetic Ca²⁺ influx of SCAP-derived neuron-like cells was monitored using a fluorescence microscope. SCH772984 and MKC8866 were used to selectively inhibit ERK1/2 and inositol-requiring enzyme 1α (IRE1α) activation, respectively. Statistical analyses were conducted using the GraphPad Prism 10 software.</p><p><strong>Results: </strong>After TG stimulation, ER Ca²⁺ levels in all TG-treated SCAP groups were markedly reduced, the ER stress markers were significantly upregulated and UPR activation was found. Following neuronal induction, ER stress induced by 20 nM TG did not inhibit SCAP neuronal differentiation. However, ER stress induced by 40 or 80 nM TG significantly inhibited neuronal marker expression, neurite outgrowth and Ca²⁺ influx in SCAP-derived neuron-like cells. The phosphorylated ERK1/2 decreased during neuronal differentiation, along with the reduction of phosphorylated-IRE1α (p-IRE1α). Inhibition of ERK1/2 activation led to neuronal marker protein reduction, neurite outgrowth restraint and p-IRE1α decrease. Selective inhibition of IRE1α activity suppressed NeuN expression and neurite outgrowth.</p><p><strong>Conclusion: </strong>Severe ER stress inhibits the neuronal differentiation of SCAPs via decreasing ERK1/2 and IRE1α activity, whereas ER stress at an appropriate level is essential for the neuronal differentiation of SCAPs.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753288","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 therapeutic potential of naringenin, a natural citrus flavonoid, on pulpal pain and pain-related cognitive dysfunction.","authors":"Mojdeh Hashemi, Fatemeh Hosseini Raouf, Manijeh Dogani, Fatemeh Shahsavari, Mehdi Abasnejad, Saeed Esmaili-Mahani, Amin Khezri, Hesam Mirmohammadi, Omid Dianat","doi":"10.1111/iej.14267","DOIUrl":"https://doi.org/10.1111/iej.14267","url":null,"abstract":"<p><strong>Aim: </strong>Orofacial pain, characterized by discomfort originating from areas such as the tooth pulp, trigeminal nerve and temporomandibular joint, poses substantial challenges in dentistry. Notably, pulpal and periapical pain profoundly impact the quality of life for affected individuals. Recent studies have highlighted a concerning association between pulpal pain and cognitive dysfunction, highlighting the intricate interplay between sensory distress and cognitive processes. Naringenin, a natural flavonoid, has garnered attention for its diverse physiological effects, including pain modulation. This investigation aims to elucidate the therapeutic potential of naringenin in mitigating capsaicin-induced pulpal pain and concomitant cognitive impairments. Additionally, we endeavour to unravel the underlying molecular mechanisms responsible for these observed effects, thereby contributing to a deeper understanding of naringenin's therapeutic utility in the management of orofacial pain syndromes.</p><p><strong>Methodology: </strong>Pulpal pain induction was achieved through intrapulpal injection of capsaicin (100 μg) in rat subjects. Central administration of naringenin was carried out at doses of 5, 10 and 15 μg per rat. Assessment of learning and memory performance was conducted using the Morris water maze task. Evaluation of inflammatory cytokine expression levels, including TNF-α, IL-1α, IL-1β, COX-2 and IL-6, as well as BDNF and TrkB expression, was performed using real-time PCR analysis.</p><p><strong>Results: </strong>Capsaicin administration resulted in a notable escalation of nociceptive responses alongside a concurrent decrement in cognitive function within the experimental rat model. Molecular analysis unveiled an upregulation of inflammatory cytokines coupled with a downregulation of BDNF and TrkB expression levels within the hippocampal region following pulpal pain induction. Remarkably, naringenin administration demonstrated a palliative effect against capsaicin-induced pain sensitivity and cognitive impairments, while also attenuating alterations in the aforementioned gene expressions induced by pain stimuli.</p><p><strong>Conclusions: </strong>Naringenin appears to exert decreasing effects on both dental pain and pain-induced cognitive deficits, likely mediated through its ability to attenuate neuroinflammation and enhance growth factor signalling pathways. Consequently, it emerges as a promising natural therapeutic agent for the management of pain and associated cognitive impairments. Moreover, the intertwined neural pathways governing cognition and pain processing further underscore the complexity of orofacial pain syndromes.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742040","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":"Efficacy of Combined Versus Supplementary Injection Techniques With Inferior Alveolar Nerve Block for Mandibular Molars With Symptomatic Irreversible Pulpitis: A Systematic Review and Network Meta-Analysis.","authors":"Thanatpong Rujirawan, Sittichoke Osiri, Kanet Chotvorrarak","doi":"10.1111/iej.70007","DOIUrl":"https://doi.org/10.1111/iej.70007","url":null,"abstract":"<p><strong>Background: </strong>Achieving effective anaesthesia in mandibular molars with symptomatic irreversible pulpitis is challenging. Various strategies involving the inferior alveolar nerve block (IANB) have been investigated, such as supplementing with additional injections after IANB failure (SUPP) or combining injections with IANB as primary injections (COMB). However, studies directly comparing SUPP and COMB are still lacking.</p><p><strong>Objectives: </strong>This study aims to assess and compare the anaesthetic effectiveness of different IANB strategies-SUPP and COMB-in mandibular posterior teeth with symptomatic irreversible pulpitis using a systematic review and network meta-analysis.</p><p><strong>Method: </strong>A comprehensive search was conducted in the PubMed, Embase, Cochrane Library, CINAHL and Scopus databases to identify relevant studies up to October 2024. Eligible randomised clinical trials (RCTs) were analysed using pairwise meta-analysis and network meta-analysis with a random-effects model to estimate treatment effects. Results were reported as risk ratios (RRs) with 95% confidence intervals (CIs) and surface under the cumulative ranking curve (SUCRA) values. The quality of the evidence was assessed using the CINeMA (Confidence in network meta-analysis) software (University of Bern, Bern, Switzerland).</p><p><strong>Results: </strong>A total of 28 studies involving five interventions were identified. Compared with IANB alone, both SUPP (RR = 2.02; 95% CI: 1.55-2.30; SUCRA: 85.1%) and COMB (RR = 1.86; 95% CI: 1.50-2.30; SUCRA: 64.9%) significantly improved anaesthetic success. However, there was no significant difference in effectiveness between SUPP and COMB.</p><p><strong>Conclusion: </strong>The quality of evidence ranging from low to high suggests that both SUPP and COMB are comparable in anaesthetic efficacy during endodontic treatment of mandibular molars with symptomatic irreversible pulpitis. However, both SUPP and COMB strategies showed significantly superior effectiveness compared to IANB alone.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742017","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":"Progranulin (PGRN) Facilitates Anti-Inflammation and Pulpitis Repair In Vivo and In Vitro Through TNFR2/14-3-3ε Signalling Complex.","authors":"Jinhong Ju, Caijiao Wang, Fujiao Nie, Haoyang Tian, Qiuyue Yin, Jiayi Liu, Suli Wang, Pishan Yang, Yi Du","doi":"10.1111/iej.70000","DOIUrl":"https://doi.org/10.1111/iej.70000","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the role and mechanism of progranulin (PGRN) in reparative dentinogenesis and inflammation control for rat pulpitis and inflammatory human dental pulp stem cells (hDPSCs).</p><p><strong>Methodology: </strong>Eight-week-old male Wistar rats with irreversible pulpitis were treated with pulpotomy and divided into five groups: No treatment; Control; iRoot BP plus (BP); GelMA and recombinant human PGRN (rhPGRN) + GelMA (rhPGRN). Micro-computed tomography (Micro-CT) scans and histological and immunohistochemical staining were conducted to evaluate rhPGRN' anti-inflammation and pro-healing properties. The effects of rhPGRN on hDPSC inflammatory response, proliferation and dentinogenic differentiation and potential signalling pathways were assessed through CCK-8, alkaline phosphatase (ALP) staining, alizarin red staining, quantitative reverse transcription polymerase chain reaction (qRT-PCR), enzyme-linked immunosorbent assay (ELISA), immunofluorescence staining and western blotting.</p><p><strong>Results: </strong>In vivo, PGRN expression obviously increased in both the Control and GelMA groups compared to healthy pulp (p < 0.05). The BP and rhPGRN groups showed a significant decrease in inflammatory scores and expression of M1 macrophage markers CD86 and tumour necrosis factor alpha (TNF-α) while increasing M2 markers CD206 and interleukin 10 (IL-10) compared with the controls (p < 0.05). Enhanced dentine bridge formation and dentine sialophosphoprotein (DSPP) expression were observed in the BP and rhPGRN groups versus the controls (p < 0.05). Moreover, the rhPGRN group presented higher expressions of CD206, IL-10 and DSPP than the BP group (p < 0.05). In vitro, PGRN expression significantly increased in lipopolysaccharide (LPS)-stimulated hDPSCs (p < 0.05). rhPGRN significantly reduced the release of TNF-α, interleukin 1 beta (IL-1β) and IL-6 in LPS-stimulated hDPSCs and enhanced ALP activity, mineralized nodule formation and expression of ALP, Runt-related transcription factor 2 (RUNX2) and DSPP in LPS-stimulated or unstimulated hDPSCs (p < 0.05). Mechanistically, co-immunoprecipitation showed that PGRN bound to tumour necrosis factor receptor-2 (TNFR2), interacting with 14-3-3 epsilon (14-3-3ε) in hDPSCs. PGRN significantly inhibited LPS-activated phosphorylation of NF-κB/p65 and its nuclear translocation, and the use of a TNFR2 neutralising antibody or the 14-3-3 protein inhibitor R18 reversed these effects (p < 0.05).</p><p><strong>Conclusion: </strong>These findings suggest that PGRN plays a crucial role in anti-inflammation, immunomodulation and reparative dentinogenesis in rat pulpitis via the TNFR2/14-3-3ε-NF-κB pathway, highlighting its potential as a strategy for vital pulp therapy.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730297","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":"A Critical Review of In Vitro Methodologies for Studying Inflammatory Responses in Human Dental Pulp Cell Cultures.","authors":"Shelly Arora, Finn Gilroy, Lara T Friedlander, Haizal M Hussaini, Henry F Duncan, Peter Cathro, Paul R Cooper","doi":"10.1111/iej.70004","DOIUrl":"https://doi.org/10.1111/iej.70004","url":null,"abstract":"<p><strong>Background: </strong>The pulp responds to disease and trauma through inflammation which modulates the tooth's ability to instigate healing mechanisms. In vitro human dental pulp cell (HDPC) culture models are widely used to study the tooth's response to pro-inflammatory stimuli.</p><p><strong>Objectives: </strong>The purpose of this review is to generate a structured appraisal of in vitro research methodologies to study HDPC cultures in a state of inflammation.</p><p><strong>Method: </strong>In this narrative review the Scopus, PubMed and Google Scholar databases were searched to identify studies reporting the use of HDPC cultures in vitro in inflammation-associated research until December 2024. The dataset initially identified 642 publications, which were manually screened to identify 246 relevant studies for inclusion and methodologically mined for information on: (i) study purpose, (ii) source and characterisation of cells, (iii) pro-inflammatory stimuli used and (iv) assays and markers used to characterise the inflammatory response. The collected data underpinned this review.</p><p><strong>Results: </strong>Most published studies aimed to characterise HDPC responses to a range of pro-inflammatory stimulants which included bacterial components (lipopolysaccharides [LPS] and lipoteichoic acids [LTA]), cytokines and biomaterials. These stimulations were studied: to characterise their effect in the development of new scaffolds and dental (bio)materials and to mimic the in vivo environment. Various tooth sources were used to establish HDPC cultures, and predominantly, cells were isolated using the pulp tissue explant technique. The most frequently used stimulant and concentrations were LPS at 1 and 10 μg/mL. The time for cell stimulation prior to inflammatory response assay varied from 15 min to 10 days. Inflammatory assessments were performed using quantitative polymerase chain reaction (qPCR), Western Blotting, enzyme-linked immunosorbent assay (ELISA) and high-throughput assays targeting archetypical cytokines and dentinogenic and mineralisation-associated molecules.</p><p><strong>Discussion: </strong>This review highlights the broad range of experimental conditions used to study HDPC inflammatory responses in vitro and combines these data to identify a framework for a consensus and a more uniform experimental approach.</p><p><strong>Conclusion: </strong>Standardisation of in vitro experimental conditions to evaluate the pulps response to inflammatory stimuli would enhance research rigour and improve clinical translation to ultimately inform patient treatment and outcomes.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707412","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":"Endodontic diagnostics training in undergraduate dental education: An observational pilot study on AI-driven virtual patient e-learning.","authors":"Marian Prinz, Edgar Schäfer, Sebastian Bürklein, David Donnermeyer","doi":"10.1111/iej.14277","DOIUrl":"https://doi.org/10.1111/iej.14277","url":null,"abstract":"<p><strong>Aim: </strong>To develop and evaluate an e-learning tool utilizing a generative pre-trained transformer (GPT), a form of artificial intelligence (AI), to allow for realistic conversation on virtual patients when undergoing training on how to diagnose diseases of endodontic origin, and to evaluate improvements in self-perceived skills.</p><p><strong>Methodology: </strong>A web app consisting of three components [website for user access, database server with patient case information, GPT-4-turbo model (OpenAI)] was designed to serve as the e-learning platform. Undergraduate students from 4th and 5th year at the dental school of the University of Münster, Germany, were asked to solve eight cases of virtual patients presenting with pain from endodontic or periodontal origin. Before, a questionnaire applying a 5-point Likert scale served to evaluate the current self-perceived state regarding the education, experience and skills in endodontic diagnostics and emergency treatment. After a 3-month timeframe of working with the programme individually, the students were asked to answer a second questionnaire which focused on their experience and self-perceived skills improvement after using the training software.</p><p><strong>Results: </strong>Ninety-two students participated in the first questionnaire and 72 students finished the second questionnaire, resulting in a drop-out rate of 21.7%. Students in the 5th-year reported more experience in dealing with emergency patients. Initially, both cohorts mainly did not feel confident to perform endodontic diagnostics independently. The evaluation of confidence to perform endodontic diagnostics independently, both by 4th- and 5th-year students, seemed improved after the training on the e-learning tool. The tool was recommended to be available for endodontic education by 72.2% of the students, who strongly agreed to such a statement. 76.4% of the participants strongly agreed to recommend the use of the tool to other students.</p><p><strong>Conclusions: </strong>AI-based interactive e-learning programmes allowing for complex conversational patient encounters present a possibility to improve diagnostic and interactive skills of undergraduate students.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682597","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":"Comprehensive Comparative Analysis of the Efficiency of Two Clearing Agents in Natural Transparent Teeth Preparation for Dental Education.","authors":"Ana Kostenkova, Yuliia Onashko, Algimantas Kriščiukaitis, Robertas Petrolis, Tadas Venskutonis, Greta Lodienė","doi":"10.1111/iej.70005","DOIUrl":"https://doi.org/10.1111/iej.70005","url":null,"abstract":"<p><strong>Aim: </strong>To assess the effectiveness of the benzyl benzoate and benzyl alcohol (BABB) solution in transparent teeth preparation compared to methyl salicylate using comprehensive digital and radiographic quantitative values analysis.</p><p><strong>Methodology: </strong>Freshly extracted 32 single-rooted teeth were immersed in 10% formalin for 24 h. They were then processed following a standard demineralization and dehydration protocol. The teeth were then divided into two groups: the first group, consisting of 12 teeth, was immersed in the BABB solution for 24 h; the second group of 20 teeth underwent the traditional protocol, which involved soaking the teeth in 99% methyl salicylate for the same duration. The optical properties of the processed teeth's translucency were evaluated by transluminant light imaging using a collimated light source and digital camera. Radiographic images of each tooth included in the study, along with a control group consisting of a freshly extracted natural tooth, were acquired under standardised computer settings, exposure conditions and X-ray tube positioning. The segmentation of the radiographic images into superpixels and the selection of areas of interest were conducted in the same manner as with visible light images. Image processing algorithms within the MatLab computational environment were utilised to assess the colour and intensity of the translucent light at the apical region of the root for each tooth.</p><p><strong>Results: </strong>The optical properties of selected anatomical locations were consistent across both groups of teeth when evaluating hue, saturation and value of pixels. The X-ray absorption in the translucent teeth was significantly lower than that in the non-translucent teeth, with notable differences observed between the groups; specifically, teeth affected by BABB material exhibited greater permeability to X-rays than those affected by methyl salicylate.</p><p><strong>Conclusions: </strong>The BABB solution demonstrates comparable efficacy to methyl salicylate regarding the optical properties of translucent teeth. When examining X-ray absorption, teeth treated with the BABB solution exhibited greater permeability to X-ray absorption than those treated with methyl salicylate.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682596","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":"Game-Based Learning: A Pilot Educational Strategy to Foster the Learning of Endodontic Terminology.","authors":"Isabel Fernandez-Garcia, Paula Riaza, Ana Arias","doi":"10.1111/iej.70001","DOIUrl":"https://doi.org/10.1111/iej.70001","url":null,"abstract":"<p><strong>Aim: </strong>Exploring the effectiveness of a game-based pilot educational strategy for learning endodontic terminology and assessing satisfaction among postgraduate students.</p><p><strong>Methodology: </strong>The study was conducted on the first- and second-year students of the postgraduate program in Endodontology (n = 12). A game-based activity, modelled on a television quiz show, was designed to facilitate the learning of endodontic terminology. Students were randomly allocated into four teams based on their course year. Each team answered 26 questions corresponding to definitions of endodontic terms, with correct answers beginning with or containing consecutive letters of the alphabet. Teams within the same cohort competed, and the team with the most correct answers was declared the winner. Students completed three tests at different time points (2 weeks, 1 month and 1 year) after the game-based educational session. A trained rater blindly scored the tests. Additionally, participants completed an anonymous satisfaction web-based survey. The survey included multiple-choice questions to be answered with a 5-point Likert scale to address satisfaction with the content and instructional methods and four questions assessing overall satisfaction on a scale from 0 to 10, along with open-ended questions for additional feedback. Scores of students and numerical responses in the satisfaction survey were compared between first- and second-year students with the Mann-Whitney U test. Scores obtained 2 weeks and 1 month/1 year after the instructional activity were compared with the Wilcoxon paired test. Responses to the multiple-choice questions, based on a 5-point Likert scale, regarding the impact of content and instructional methods were compared between first- and second-year students with the ordinal chi-squared test.</p><p><strong>Results: </strong>Students demonstrated high test scores and reported high satisfaction with the game-based learning strategy. No statistically significant differences in test scores or satisfaction levels were observed between cohorts. Additionally, test scores remained consistent regardless of the time elapsed between the activity and testing (p > 0.05).</p><p><strong>Conclusions: </strong>The high scores and satisfaction reported by both cohorts suggest that game-based educational strategies are an innovative practical approach that may serve as an additional method to memorise endodontic terminology.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667589","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":"Perceptions and Procedural Errors in the Use of a Patient-Specific 3D-Printed Model for MTA Apexification Technique Training.","authors":"H Plascencia, M A Contreras-Preciado, J F Brito-Ortiz, M Díaz, R Solis, G Gascón","doi":"10.1111/iej.70002","DOIUrl":"https://doi.org/10.1111/iej.70002","url":null,"abstract":"<p><strong>Aim: </strong>Patient-specific 3D-printed dental models present innovative opportunities in endodontic education, offering a bridge between theoretical learning and clinical practice. This study aimed to compare the effectiveness of such models versus extracted natural teeth for training postgraduate residents in the MTA apexification technique, focusing on procedural accuracy and perception.</p><p><strong>Methodology: </strong>This mixed in vitro study (QUAL-quant) involved 21 postgraduate endodontic residents who were randomly assigned to two groups: The control group (CG), using 63 extracted natural teeth, and the experimental group (EG), using 63 patient-specific 3D-printed open-apex models derived from in vivo CBCT scans. After proper calibration, the participants performed the training sessions including identical procedural steps. Subsequently, the residents completed two Likert scale surveys: Academic Satisfaction Scale and Open-Apex Model Questionnaire. Additionally, an observer reviewed the radiographs of all practices and rated the executed procedures. Statistical analyses included descriptive statistics, Spearman's correlation, confirmatory factor analysis (CFA), chi-square and Fisher's exact tests (p ≤ 0.05).</p><p><strong>Results: </strong>Patient-specific 3D-printed teeth achieved high acceptance rates among residents, with approval scores of 96.6% on the Academic Satisfaction Scale and 70.79% on the Open-Apex Model Questionnaire. Procedural accuracy was comparable across groups, with 86.14% of treatments free of errors in both. Significant correlations were identified among key procedural variables, such as dental radiographic aspect, access and negotiation of the root canal, determination of working length, and creation of the apical barrier with MTA, highlighting the internal consistency of performance patterns of the 3D model. Inferential analyses revealed significant differences in specific procedural steps: the CG outperformed the EG in determining working length (p = 0.043) and achieving a homogeneous apical barrier (p = 0.004). Minor concerns regarding the tactile sensation and radiographic properties of the artificial prototypes were noted but considered addressable.</p><p><strong>Conclusion: </strong>Patient-specific 3D-printed open-apex teeth demonstrated high acceptance and supported technically proficient treatments during MTA apexification training. Although overall performance was comparable to that with natural teeth, specific procedural differences suggest that further refinement of the artificial models may enhance their effectiveness as alternative training tools in postgraduate endodontic education.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649386","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":"Sympathetic nerves inhibit dental pulp stem cell differentiation and tertiary dentine formation via α1B-adrenergic receptor.","authors":"Chengcan Yang, Qian Gao, Nuo Xu, Xiaona Song, Zhuan Bian, Kai Yang","doi":"10.1111/iej.14281","DOIUrl":"https://doi.org/10.1111/iej.14281","url":null,"abstract":"<p><strong>Aim: </strong>The dental pulp is extensively innervated. Our previous study showed that the α1B-adrenergic receptor ADRA1B is the primary sympathetic neurotransmitter receptor in human dental pulp stem cells (hDPSCs) and its expression was enhanced in inflamed pulp tissues. The sympathetic nerve system (SNS) negatively impacts the proliferation and migration capacities of hDPSCs via ADRA1B. In this study, we aimed to explore the role of the SNS in odontoblast differentiation of hDPSCs and tertiary dentine formation during dentine-pulp injury repair.</p><p><strong>Methodology: </strong>We investigated in vitro function of ADRA1B activity in regulating odontoblast differentiation of hDPSCs by evaluating protein and RNA expression levels of DSPP and DMP1, alkaline phosphatase (ALP) activity and alizarin red S (ARS) staining in control, ADRA1B-overexpression and ADRA1B-knockdown groups. The underlying mechanisms were further examined by assessing the oxygen consumption rate (OCR), glucose consumption and mitochondrial morphology. In vivo, a rat model with superior cervical ganglionectomy (SCGx) followed by direct pulp capping was established to assess the effects of the SNS on tertiary dentinogenesis. Additionally, Adra1b^flox/flox, Prx1-cre mice, combined with a severe dentine exposure model, were used to explore the effects of the SNS on mesenchymal cells via ADRA1B during tertiary dentine formation. Tertiary dentine was determined by histological staining.</p><p><strong>Results: </strong>Adrenergic signalling through ADRA1B was a crucial signal that inhibits the odontoblast differentiation ability of hDPSCs in vitro by suppressing mitochondrial metabolism via PGC-1α. Sympathectomy enhanced dentine formation in the direct pulp capping rat model. Furthermore, the ablation of Adra1b in mesenchymal cells led to increased odontoblast differentiation and tertiary dentine formation in a mouse model with severe dentine exposure.</p><p><strong>Conclusion: </strong>Here, we show a new link between the SNS and the odontoblast differentiation capacity of hDPSCs through the adrenergic receptor ADRA1B. Our findings indicate that the SNS impedes the odontoblast differentiation capacity of hDPSCs by suppressing mitochondrial metabolism, which further hampers tertiary dentine formation via ADRA1B.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636953","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}