International endodontic journal最新文献

{"title":"Dentine Regeneration With Calcium Strontium Silicate: In Vitro Odontogenic Differentiation, Antimicrobial Activity, Immunomodulation and In Vivo Pulpotomy in Rat Molars.","authors":"Mohamed Mahmoud Abdalla, Vidhyashree Rajasekar, Heba Ahmed, Mengyu Huang, Cynthia Kar Yung Yiu","doi":"10.1111/iej.70165","DOIUrl":"https://doi.org/10.1111/iej.70165","url":null,"abstract":"<p><strong>Aim: </strong>This study examined the in vitro and in vivo performance of calcium strontium silicate (CSR) as a novel biomaterial for vital pulp therapy (VPT), assessing its odontogenic differentiation, antibacterial activity, immunomodulation, inflammatory response and dentine regeneration potential compared to calcium silicate (CS) and Mineral Trioxide Aggregate (MTA).</p><p><strong>Methodology: </strong>CSR was synthesized via the sol-gel process. For the in vitro study, human dental pulp stem cells (HDPSCs) were assessed for viability, live/dead staining, trans-well migration assays and odontogenic gene expression (ALP, DSPP, DMP-1, RUNX2) using CCK-8, and RT-qPCR. Antibacterial activity against Streptococcus mutans and Lactobacillus acidophilus was assessed via colony- forming unit (CFU) counts. Immunomodulation was evaluated by RT-qPCR for inflammatory cytokines (IL-1β, TNF-α, IL-10). In the in vivo study, inflammatory responses were evaluated in Sprague-Dawley rats subjected to subcutaneous implantation for 7, 14 and 60 days, and pulpotomy procedures were performed on rat maxillary first molars and assessed after 30 and 60 days. The outcomes were analysed using micro-CT imaging and H&E staining. Statistical analyses included one-way ANOVA and non-parametric tests (p < 0.05).</p><p><strong>Results: </strong>CSR significantly enhanced HDPSCs viability, migration and odontogenic gene expression compared to CS and MTA (p < 0.05). It exhibited superior antibacterial activity, with the lowest CFU counts (p < 0.05). CSR upregulated anti-inflammatory cytokine IL-10 and reduced pro-inflammatory cytokines. In vivo, CSR showed milder inflammation than CS and MTA at 7, 14 and 60 days (p < 0.05) and formed consistent calcified bridges in pulpotomy, with no pulp necrosis.</p><p><strong>Conclusions: </strong>CSR demonstrated superior biocompatibility, regenerative potential, and antibacterial properties making it a promising alternative to MTA for VPT, enhancing clinical outcomes.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147722685","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":"Development of a Nano-Hybrid Composite Using Bovine Hydroxyapatite and Montmorillonite for Endodontic Applications-An In Vitro Study.","authors":"P A A S Prasad Kumara, Paul R Cooper, Peter Cathro, Henry F Duncan, Maree Gould, George Dias, Jithendra Ratnayake","doi":"10.1111/iej.70163","DOIUrl":"10.1111/iej.70163","url":null,"abstract":"<p><strong>Aim: </strong>Hydraulic calcium silicate cements are widely employed in endodontics due to their excellent biocompatibility, bioactivity, sealing ability, and remineralisation potential. However, currently used products such as mineral trioxide aggregate (MTA) exhibit several limitations, including discolouration, cost, and poor handling properties. Therefore, this study aimed to develop and characterise a bovine-derived hydroxyapatite (BHA) and montmorillonite (MMT) nanoclay hybrid composite (BHA-MMT), incorporating zirconium oxide as a radiopacifier and calcium silicate phases as setting agents.</p><p><strong>Methodology: </strong>BHA was produced from waste bovine bones using a defatting and deproteination method. MMT clay was exfoliated into nanoclay using shear force with a planetary ball mill. The composite powders were prepared by combining BHA (20% and 25% wt), zirconium oxide (30% wt), setting agents with exfoliated MMT (15% and 20% wt) to produce three composite materials with different BHA and MMT ratios, namely B20, B25, and M20. The resulting powders were mixed with deionised water to form hydraulic cements. The composite materials were tested for chemical, mechanical, and physical properties compared with the commercially available ProRoot MTA. The biocompatibility, bioactivity, and remineralisation potential of the materials were also examined using established in vitro assays.</p><p><strong>Results: </strong>The pH of the material increased above 11 after 24 h and remained constant up to 21 days. The compressive strengths of B20, B25, and M20 were 23.63, 21.2, and 23.8 MPa, respectively, after 21 days. The mean setting time of the composites ranged from 13 to 14 min, and the concentrations of heavy metals were within the permissible limits specified by ISO standards. The experimental composite materials demonstrated radiopacity values within the range, consistent with ISO recommendations. Among the variants, B20 and B25 demonstrated good cell viability, while M20, containing a higher proportion of MMT, showed enhanced apatite formation and remineralization, indicating improved bioactivity.</p><p><strong>Conclusion: </strong>The developed BHA-MMT composites demonstrated promising physicochemical, biological, and remineralisation properties consistent with ISO standard requirements. Overall, the product represents a bioactive composite material system; further investigations, including in vivo studies, are necessary to confirm its clinical applicability in vital pulp treatment (direct/indirect pulp capping, pulpotomy) and root-end filling procedures.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690097","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":"Effect of Oral Corticosteroid Premedication on the Success of Anaesthetising Mandibular Teeth With Irreversible Pulpitis: A Systematic Review With Meta-Analysis and Trial Sequential Analysis of Randomized Clinical Trials.","authors":"Nandini Suresh, Monika Arulalan, Geethanjali Ravindra Raj, Velmurugan Natanasabapathy, Sheela B Abraham, Sajesh K Veettil, Thiago César da Silva Lima, Juliana Vilela Bastos, Shaju Jacob Pulikkotil, Venkateshbabu Nagendrababu","doi":"10.1111/iej.70162","DOIUrl":"10.1111/iej.70162","url":null,"abstract":"<p><strong>Objectives: </strong>This systematic review with meta-analysis and trial sequential analysis (TSA) was conducted with the objective of evaluating the effectiveness of oral corticosteroid premedication to achieve profound mandibular anaesthesia in teeth diagnosed with irreversible pulpitis.</p><p><strong>Methods: </strong>An electronic search was conducted in PubMed/MEDLINE, Cochrane Library, Embase, Scopus and Web of Science to identify randomized clinical trials that evaluated the effect of oral corticosteroid premedication on the success of mandibular anaesthesia in patients with irreversible pulpitis. The search was performed without date restrictions and limited to trials in English. The risk of bias was assessed using the Cochrane risk of bias tool for randomized trials (RoB 2.0). A random-effects meta-analysis was used to calculate pooled effect risk ratios (RRs) with 95% confidence intervals (CIs). The primary meta-analysis was conducted by including all the trials whilst sensitivity analyses were conducted only on trials with a low risk of bias. Sub-group analyses were performed to assess the dose-response effect. A TSA was performed to evaluate the risks of random errors in the meta-analysis. The overall certainty of evidence was evaluated by the Grading of Recommendations Assessment, Development and Evaluation (GRADE).</p><p><strong>Results: </strong>A total of 8 trials were included in the review. The primary meta-analysis demonstrated that oral premedication with dexamethasone significantly increased the success rate of inferior alveolar nerve blocks (IANB) compared with a placebo (RR = 1.80; 95% CI, 1.35-2.41). The sensitivity analysis demonstrated a similar result compared to the primary analysis. The sub-group analysis suggested that doses of both 0.5 mg and 4 mg were effective. Oral premedication with dexamethasone had the same effect on IANB success rates when compared to NSAIDs. The TSA confirmed that the evidence for a beneficial effect of oral dexamethasone premedication when compared to placebo for enhancing the anaesthetic efficacy of IANB in teeth with irreversible pulpitis was conclusive. The GRADE was rated as 'moderate' and 'high' when oral corticosteroids were compared with placebo and NSAID, respectively.</p><p><strong>Conclusion: </strong>Oral corticosteroid premedication improves the efficacy of IANB compared to placebo and has a similar effect when compared to NSAIDs in mandibular teeth diagnosed with irreversible pulpitis.</p><p><strong>Clinical registration: </strong>PROSPERO (CRD42024508463).</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690062","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":"Deep-Learning-Based Automatic Measurement of the Distance Between the Maxillary Sinus and Maxillary Posterior Teeth on CBCT Images.","authors":"Cheng-Ye Li, Ming-Ming Zhang, Ke-Xin Yi, Chen-Bing Zhang, Ping Wang, Kun Yan, Yu-Hong Liang","doi":"10.1111/iej.70141","DOIUrl":"https://doi.org/10.1111/iej.70141","url":null,"abstract":"<p><strong>Aim: </strong>To explore a deep learning (DL) model for determining the relationship between the maxillary sinus (MS) and maxillary posterior teeth (MPT) based on cone beam computed tomography (CBCT) images and measuring the distance automatically between the MS and MPT using a 3D point cloud algorithm.</p><p><strong>Methodology: </strong>A CBCT dataset containing 88 maxillary sinuses (MSs) and 352 maxillary posterior teeth (MPT) was annotated, and the MS-MPT distances were measured by clinicians as the ground truth. A segmentation model for MSs and MPT in CBCT images based on the U-Net convolutional block attention (CBAM) architecture was trained and assessed using a 3-fold cross-validation strategy. Then, calibrated point clouds were reconstructed using segmented anatomical structure data, and the Euclidean distances between the MS and MPT were measured; the minimum distance was identified as the MS-MPT distance. The performance of the model in terms of segmentation and distance measurement was evaluated, and the results were compared with the ground truth.</p><p><strong>Results: </strong>Our segmentation model achieved a mean Dice similarity coefficient (DSC) of 0.959 and a mean Jaccard coefficient of 0.922 for MSs and a mean DSC of 0.913 and a mean Jaccard coefficient of 0.851 for MPT. The MS-MPT distances determined by clinicians and the 3D point cloud method demonstrated strong consistency (ϒ > 0.993, p < 0.01). In terms of the model and clinicians, the mean negative signed error was 0.63 mm (95% CI, 0.59-0.66 mm), and the successful detection rate (SDR) for the root apex of MPT reached 70.3% at the 1 mm threshold.</p><p><strong>Conclusions: </strong>In this study, an automated framework that combines deep learning-driven segmentation and three-dimensional point cloud analysis was developed to quantify the relationship between the maxillary sinus and maxillary posterior teeth and achieved reliable detection accuracy across diverse anatomical variations in CBCT scans.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654043","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":"Foetal Development and Placental Health in Response to Apical Periodontitis Induced in Pregnant Wistar Rats.","authors":"Ana Carla Thalez Ywabuchi Nobumoto, Thais Verônica Saori Tsosura, Maria Sara de Lima Coutinho Mattera, Bianca Elvira Belardi, Anna Clara Cachoni, Rodrigo Martins Dos Santos, Bruna de Oliveira Alves, Lorena Umbelino Rodrigues, Juliane Stephanie Mendonça Rodrigues, Sandra Helena Penha Oliveira, Edilson Ervolino, Luciano Tavares Angelo Cintra, Doris Hissako Matsushita","doi":"10.1111/iej.70155","DOIUrl":"https://doi.org/10.1111/iej.70155","url":null,"abstract":"<p><strong>Aim: </strong>This study investigates the relationship between maternal apical periodontitis (AP) and neonatal health.</p><p><strong>Methodology: </strong>Twenty-four Wistar rats were assigned to three groups: control (CN), one induced apical periodontitis (AP1), and four induced apical periodontitis (AP4). Apical periodontitis was induced for all experimental groups. After 30 days, the rats were mated and sacrificed on the 21st day of gestation. Placental weight, maternal glycemia, insulinemia, insulin resistance, and placental protein levels were analysed. Neonates were evaluated for their number, weight, capillary glycemia, and liver tumour necrosis factor-α (TNF-α) content.</p><p><strong>Results: </strong>The results showed that no significant differences were observed in maternal glycemia. However, insulinemia and homeostatic model assessment for insulin resistance were higher in the AP groups compared with CN and were more pronounced in AP4 than AP1. Placental weight and placental labyrinth area were reduced exclusively in the AP4 group, while the number of fetuses per rat did not differ among groups. The AP4 group exhibited increased placental TNF-α gene expression and protein content compared with CN and AP1. In addition, placental caspase-3 expression was increased in the AP4 group, with no significant differences in nuclear factor-kappaB (p50 and p65) phosphorylation status among groups. Foetal analyses demonstrated a reduction in naso-anal length in fetuses from the AP4 group, lower capillary glycemia in fetuses from AP rats compared with CN, and increased TNF-α content in foetal liver tissue from AP groups.</p><p><strong>Conclusions: </strong>Overall, most alterations were more pronounced with an increasing number of maternal teeth affected by AP, emphasizing the importance of maternal oral health in preventing placental dysfunction and adverse fetal developmental outcomes.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147645211","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":"CXCR2+ Neutrophils Drive Neutrophil Extracellular Traps Formation and Exacerbate Pulpitis in Rats: An In Vitro and In Vivo Laboratory Investigation","authors":"Ruilin Zhang,&nbsp;Leyi Chen,&nbsp;Wancheng Xu,&nbsp;Jingyi Ye,&nbsp;Ziting Wang,&nbsp;Wenan Xu,&nbsp;Buling Wu","doi":"10.1111/iej.70098","DOIUrl":"10.1111/iej.70098","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To characterise neutrophil extracellular traps (NETs) and their regulatory mechanisms in pulpitis, and to evaluate the therapeutic potential of targeting neutrophil subsets:</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>Transcriptomic analyses of microarray (GSE92681) and single-cell RNA sequencing datasets (GSE274562, GSE280528) were performed to delineate immune heterogeneity and intercellular communication. HL-60-derived neutrophils, THP-1 macrophages, and human Dental Pulp Cells (hDPCs) were used for in vitro assays of NETs induction, chemotaxis, osteogenic differentiation and immunofluorescence. Healthy male Sprague–Dawley rats (7–8 weeks, <i>N</i> = 5/group) were used to establish pulpitis models treated with the CXCR2 inhibitor AZD5069 (S6645, Selleck), followed by histology, immunostaining, and micro-CT analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Transcriptomic profiling revealed significant enrichment of NETs-related pathways in inflamed pulp. Immunofluorescence confirmed MPO⁺/CitH3⁺ NETs in inflamed tissues, while NETs significantly impaired hDPCs osteogenesis in vitro. Single-cell analysis identified a distinct CXCR2⁺ neutrophil subset (CXCR2⁺ Neu), representing a mature pro-inflammatory population specialised in NETs release. Cell–cell interaction analysis highlighted CXCL8–CXCR2 signalling from pro-inflammatory macrophages as the major driver of neutrophil recruitment and NETs formation. In vitro, M1 macrophages enhanced neutrophil chemotaxis and NETs release, whereas NETs reciprocally promoted M1-like polarisation. In vivo, CXCR2 inhibition markedly reduced neutrophil infiltration and NETs release, while promoting reparative mineralization in rat pulpitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>CXCR2⁺ neutrophils act as a pro-inflammatory subset in pulpitis, driving NETs release through macrophage-derived signals. Inhibition of CXCR2 attenuates inflammation and enhances dentine repair, supporting CXCR2 as a promising therapeutic target for immune modulation in pulpitis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"59 5","pages":"819-835"},"PeriodicalIF":7.1,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146051954","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":"Microbiome of Apical Intracanal and Extraradicular Biofilms From the Same Roots of Teeth With Persistent Apical Periodontitis: An Observational Study","authors":"Yoko Asahi,&nbsp;Nanako Kuriki,&nbsp;Motoki Okamoto,&nbsp;Daisuke Motooka,&nbsp;Shota Nakamura,&nbsp;Hazuki Maezono,&nbsp;Kittipit Klanliang,&nbsp;Tsuyoshi Shimaoka,&nbsp;Tetsuya Iida,&nbsp;Shigeyuki Ebisu,&nbsp;Yuichiro Noiri,&nbsp;Mikako Hayashi","doi":"10.1111/iej.70113","DOIUrl":"10.1111/iej.70113","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aim&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Bacterial biofilms around the apex are crucial in disease progression and persistence of apical periodontitis. While intracanal biofilms initiate infection, extraradicular biofilms contribute to treatment resistance and persistence. Thus, a comprehensive understanding of these biofilms may help elucidate mechanisms underlying persistent apical periodontitis. Therefore, in this study, we aimed to compare the microbiome and predicted functional profiles in matched apical root canals with those of extraradicular biofilms associated with persistent apical periodontitis.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methodology&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Seventeen root apices from patients with persistent apical periodontitis were collected via surgery. After extraradicular biofilm was collected, intracanal biofilm was obtained by cryopulverisation. Bacterial communities were detected by amplicon sequencing of the V1–V2 region of the 16S rRNA gene. Diversity, microbial composition and predicted bacterial functions were compared between matched intracanal and extraradicular biofilms.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Alpha diversity analysis of the microbiome revealed no significant differences between the two sampling sites. In contrast, the beta diversity of the microbiota of the same root (matched samples) was significantly lower than that of the microbiota of unpaired samples. There were no statistically significant differences in permutational multivariate analysis of variance for the microbiome between paired extraradicular and intracanal biofilms, regardless of the presence of the sinus tract. The abundances of the predominant genera, namely &lt;i&gt;Fusobacterium&lt;/i&gt;, &lt;i&gt;Treponema&lt;/i&gt;, &lt;i&gt;Prevotella&lt;/i&gt;, &lt;i&gt;Porphyromonas&lt;/i&gt; and &lt;i&gt;Bacteroides&lt;/i&gt; as well as gram-positive bacteria, including &lt;i&gt;Actinomyces&lt;/i&gt;, were similar between extraradicular and intraradicular biofilms. Linear discriminant analysis effect size analysis identified bacterial taxa significantly enriched in extraradicular biofilms, whereas no taxa were significantly enriched in intraradicular biofilms. Phylogenetic Investigation of Communities by Reconstruction of Unobserved States analysis revealed several differences in Kyoto Encyclopaedia of Genes and Genomes pathways between these biofilms.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;While comparison of the microbiome between extraradicular and intracanal biofilms of the same root apices revealed differences in bacterial composition, certain similarities were noted, particularly in dominant bacterial species abundan","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"59 5","pages":"806-818"},"PeriodicalIF":7.1,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Pain After Endodontic Treatment in HIV-Positive Patients Under HAART: A Prospective Observational Cohort Study","authors":"Marcos Felipe Iparraguirre Nuñovero,&nbsp;Marco Antonio Hungaro Duarte,&nbsp;Luciana Reis Azevedo Alanis,&nbsp;Bruno Cavalini Cavenago,&nbsp;Ulisses Xavier da Silva Neto,&nbsp;Everdan Carneiro","doi":"10.1111/iej.70110","DOIUrl":"10.1111/iej.70110","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To compare post-operative pain following root canal treatment (RCT) in HIV-positive patients receiving highly active antiretroviral therapy (HAART) and HIV-negative patients and to assess the influence of systemic condition on endodontic pain.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>This investigation was designed as a prospective observational cohort study, following the PROBE 2023 guidance. A total of 60 patients (30 HIV-positive under HAART for at least three years with undetectable viral load, and 30 HIV-negative) with pulp necrosis and asymptomatic apical periodontitis were included. All teeth were treated in a single visit by an endodontic specialist using standardised chemo-mechanical preparation with reciprocating instruments, irrigation with 2.5% sodium hypochlorite and 17% EDTA, and single-cone obturation with AH Plus sealer. Patients without preoperative pain (VAS = 0) were included. Post-operative pain was assessed using a VAS, 0–10 at 6, 12, 24, 48 and 72 h and 7 days post-treatment. Statistical analysis was performed using the chi-square test, Kolmogorov–Smirnov test, and Mann–Whitney <i>U</i> test (95% confidence level).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>No significant differences were found between groups regarding sex, age or tooth location (<i>p</i> &gt; 0.05). Both groups reported postoperative pain in the first 24 h, with no significant differences (<i>p</i> &gt; 0.05). At 48 h, however, all HIV-positive patients reported complete pain relief, whereas the HIV-negative group still presented residual pain, showing a statistically significant difference (<i>p</i> = 0.021). At 72 h and 7 days, both groups reported no pain (VAS = 0). Overall, postoperative pain prevalence exceeded 45% in the first 24 h, regardless of systemic condition.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Postoperative pain patterns were similar in HIV-positive patients under HAART and HIV-negative individuals, except for earlier pain resolution in the HIV-positive group at 48 h. These findings suggest that the systemic condition does not negatively affect the short-term management of endodontic pain.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"59 5","pages":"788-793"},"PeriodicalIF":7.1,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13065944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146118896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Internal Resorption: A Retrospective Cone-Beam Computed Tomography Analysis of 50 Cases With Outcome Assessment","authors":"Schuyler DeLuca,&nbsp;Robert Amato,&nbsp;Matthew Finkelman,&nbsp;Devon Ptak","doi":"10.1111/iej.70112","DOIUrl":"10.1111/iej.70112","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Internal resorption is a rare condition that may complicate endodontic treatment and tooth retention strategies. There is a lack of information in the literature on the nature of these lesions, as well as prognosis after treatment. The aims of this study were to determine which factors may be associated with treatment outcomes, and to identify and characterise clinical and radiographic features of internal resorption lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>A retrospective chart review was conducted to identify cases of internal resorption at the Tufts University School of Dental Medicine Postgraduate Endodontic Clinic between the years of 2010 and 2025. All cases of internal resorption were required to have a periapical radiograph and cone-beam computed tomography (CBCT) scan of the tooth in question. Lesion characteristics were independently judged by two calibrated board-certified endodontists. Inter-observer agreement was calculated using kappa statistics, weighted kappa statistics, and intraclass correlation coefficients. One-, five-, and seven-year outcomes were determined. Statistical analysis was performed to assess associations using Fisher's exact test. No funding was provided for this study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Fifty internal resorption cases were identified. 98% were classified as internal inflammatory resorption and 2% as internal replacement resorption. Lesions were most frequent in first molars and maxillary central incisors. Perforation was present in 36% of cases. Twenty-six teeth had ≥ 1-year of follow-up; survival and success rates were 88% and 83.3%, respectively. Teeth with a pulpal diagnosis of ‘normal pulp’ (<i>p</i> = 0.003) or periapical diagnosis of ‘normal apical tissues’ (<i>p</i> = 0.031), as well as those in female patients (<i>p</i> = 0.032), were significantly more likely to fail at 1 year. No significant association was found between perforation and treatment outcome. Inter-observer agreement was high across all lesion parameters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Internal resorption lesions can be successfully treated with contemporary endodontic techniques. Increased risk of failure may be found in teeth with a vital pulp and absence of periapical signs or symptoms of disease due to their capacity for continued growth, or those found in female patients. Traumatised teeth are more likely to present with lesions in the middle third. Future prospective studies with larger samples will further refine treatment strategies and identify prognostic indicators.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"59 5","pages":"794-805"},"PeriodicalIF":7.1,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157110","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":"Bacterial Diversity of Deep Carious Lesions Analysed by Next-Generation Sequencing Approaches Associated With Different Pulp Diagnoses: A Systematic Review","authors":"Giorgos N. Tzanetakis,&nbsp;Maria-Eleni Markou,&nbsp;Despina Koletsi,&nbsp;Venkateshbabu Nagendrababu,&nbsp;Henry F. Duncan","doi":"10.1111/iej.70114","DOIUrl":"10.1111/iej.70114","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Aim&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;This systematic review aimed to synthesise evidence on the microbiome of deep or extremely deep caries associated with a range of different pulp conditions, by analysing studies using next-generation sequencing (NGS) approaches.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methodology&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The review reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and protocol was registered prospectively at the Open Science Framework (https://osf.io/vnwjh/). A literature search was carried out in the following databases: MEDLINE via PubMed, Scopus, Cochrane Database for Systematic Reviews (CDSR), Web of Science, the clinicaltrials.gov, and the Open Science Framework, in English language without time restriction. The last search was performed on May 1st 2025. An additional online search of the four major journals in the field of endodontics (&lt;i&gt;International Endodontic Journal, Journal of Endodontics, Australian Endodontic Journal and the European Endodontic Journal&lt;/i&gt;) was also carried out independently starting from January 1st, 2010 to May 1st 2025. Only original research articles that used an NGS approach and investigated the microbiome of deep or extremely deep caries associated with different pulp diagnoses, assessed preoperatively, were included. The Johanna Brigg's Institute (JBI's) Critical Appraisal Instrument for Studies Reporting Prevalence Data was used to assess the risk of bias of included studies.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Among 1914 articles initially identified, four were considered eligible for inclusion and further assessed for certain parameters. The overall risk of bias of the three and one included studies was characterised as ‘unclear’ and ‘high’. &lt;i&gt;Firmicutes&lt;/i&gt; were the most prevalent phylum in all cases. In cases of irreversible pulpitis, &lt;i&gt;Firmicutes&lt;/i&gt; prevalence increased compared with cases of normal pulp and reversible pulpitis, while the prevalence of &lt;i&gt;Actinobacteria&lt;/i&gt;, &lt;i&gt;Proteobacteria&lt;/i&gt; and &lt;i&gt;Bacteroidetes&lt;/i&gt; decreased. &lt;i&gt;Lactobacillus&lt;/i&gt; was the most abundant genus in all cases, with its abundance in cases of symptomatic irreversible pulpitis increasing substantially.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The NGS studies evaluated in this review create a preliminary, but comprehensive map of the microbiome of deep caries associated with a range of pulpal diagnoses. Α shift in microbiome as the asymptomatic cases become progressively symptomatic seems to occur, which may be relevant to management of dee","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"59 5","pages":"762-775"},"PeriodicalIF":7.1,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iej.70114","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146165166","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}