International endodontic journal最新文献

{"title":"Modulation of Prickle2 Expression to Facilitate Dentine Formation: A Laboratory Investigation.","authors":"Bandana Rana, Sanjiv Neupane, Yam Prasad Aryal, Elina Pokharel, Tae-Young Kim, Jae-Hee Lee, Je-Hee Jang, Hitoshi Yamamoto, Ji-Youn Kim, Seo-Young An, Chang-Hyeon An, Jae-Kwang Jung, Wern-Joo Sohn, Sung-Jin Cho, Jung-Hong Ha, Jae-Young Kim","doi":"10.1111/iej.70024","DOIUrl":"https://doi.org/10.1111/iej.70024","url":null,"abstract":"<p><strong>Aim: </strong>Prickle planar cell polarity (PCP) protein 2 (Prickle2) encodes a homologue of Drosophila prickle and is involved in the non-canonical Wnt/PCP signalling pathway. However, its exact role in dentinogenesis remains unclear. Dentinogenesis, a key process in tooth morphogenesis, involves the patterned arrangement of odontoblasts and the formation of dentine matrix along the pulp cavity. This study investigates the role of PCP signalling, particularly Prickle2, in odontogenesis and dentine formation. Additionally, this study evaluates the potential application of Prickle2 modulation for dentine regeneration using an animal experimental model.</p><p><strong>Methodology: </strong>The developmental function of Prickle2 in tooth morphogenesis was examined by analysing its precise expression pattern in the primary enamel knot. Gain and loss of function studies were performed using in vitro organ cultivation and renal capsule transplantation. At embryonic day 13 (E13), Prickle2 was knocked down using small interfering ribonucleic acid (siRNA) treatment, and histogenesis, cellular physiology (proliferation and apoptosis), and the expression of PCP pathway-related genes and tooth-related signalling molecules were examined. Furthermore, renal capsule transplantation was conducted for 3 weeks to analyse the morphological changes in tooth crown formation. To evaluate the clinical applicability of Prickle2 modulation in dentine regeneration, a pulp exposure animal model was employed, locally administering siRNA against Prickle2 into the exposed pulp cavity of the maxillary first molar at week 8 for 6 weeks.</p><p><strong>Results: </strong>At E13.5, in situ hybridization revealed the distinctive expression of Prickle2 in the enamel knot area. Knockdown of Prickle2 at E13 led to significant alterations in histogenesis and changes in key signalling molecule expression. Renal capsule transplantation resulted in morphological changes, including a thicker pre-dentine layer and the formation of a more opaque crown. In the pulp exposure model, siRNA treatment facilitated the formation of a dentinal bridge compared to controls.</p><p><strong>Conclusion: </strong>Our findings suggest that Prickle2 regulates dentinogenesis through Wnt/PCP signalling. Modulating Prickle2 expression presents a promising approach for dentine regeneration.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015145","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":"Redefining Root Canal Shaping: From Size to Volume-The Functional Endodontic Volume Concept.","authors":"Mohammed Turky, Ove A Peters","doi":"10.1111/iej.70029","DOIUrl":"https://doi.org/10.1111/iej.70029","url":null,"abstract":"<p><strong>Aim: </strong>This article aims to introduce and elaborate on the innovative concept of Functional Endodontic Volume (FEV), a biologically driven approach to root canal shaping. This concept emphasizes the importance of volumetric preparation aimed at enhancing irrigation dynamics during root canal treatment, all while maintaining the tooth's structural integrity.</p><p><strong>Summary: </strong>In recent years, contemporary endodontics has progressively shifted towards methods that prioritize irrigation-based disinfection. Traditional philosophies surrounding canal preparation have predominantly revolved around standardized apical sizes and tapers, often failing to address the true objectives of modern root canal treatment. This article advocates for the FEV concept-a sophisticated and tailored shaping strategy focused on optimizing the efficacy of irrigants used in treatment, promoting mechanical safety, and conserving the structural framework of the tooth. The FEV approach moves beyond merely considering the diameter or taper of the canal; instead, it emphasizes a comprehensive three-dimensional shaping method that is particularly beneficial in anatomically complex root canal systems. By prioritizing the effective exchange of irrigants and the delivery of energy throughout the entire canal volume, this concept not only enhances disinfection but also minimizes the risk of procedural complications. The implications of adopting the FEV concept extend to the clinical and research realms. It can guide the development and refinement of new shaping protocols, the design of endodontic instruments, and the establishment of standardized reporting metrics in endodontic studies. This holistic approach has the potential to revolutionize the way endodontic procedures are performed and assessed.</p><p><strong>Conclusion: </strong>The FEV approach redefines the objectives of canal shaping by concentrating on achieving an effective disinfection-driven canal volume rather than adherence to fixed apical dimensions. It supports a minimally invasive technique that ensures optimal irrigant exchange and agitation, thereby enhancing overall treatment outcomes. The FEV concept could serve as a valuable clinical and research framework, enabling practitioners and researchers to evaluate and compare various shaping systems with a focus on volumetric efficacy.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145000416","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":"Laboratory Investigation of Lipid Metabolic Reprogramming in Pulpitis: The Linolenic Acid-FASN-NR4A1 Axis in Modulating Dental Pulp Inflammation.","authors":"Mengqi Zhou, Xin Sui, Changyi Li, Qiangqiang Zhou, Xiaoling Wei, Huaxing Xu","doi":"10.1111/iej.70026","DOIUrl":"https://doi.org/10.1111/iej.70026","url":null,"abstract":"<p><strong>Aim: </strong>This study explores how lipid metabolic reprogramming contributes to the pathogenesis of pulpitis and identifies key molecular targets involved in regulating inflammation, with the goal of developing metabolic interventions to preserve dental pulp vitality.</p><p><strong>Methodology: </strong>Primary human dental pulp cells (HDPCs) were stimulated with lipopolysaccharide (LPS) and subjected to integrated transcriptomic and metabolomic profiling to map inflammation-associated metabolic shifts. Functional validation included linolenic acid (LA) supplementation (alone or combined with a Fatty Acid Synthase (FASN) inhibitor, TVB-2640), Nuclear receptor subfamily 4 group A member 1 (NR4A1) knockdown, cytokine/NF-κB assessment (ELISA, Western blot), and lipid droplet/FASN visualisation (immunofluorescence). FASN expression was confirmed in vivo (rat pulpitis model). Key findings were verified in clinical pulpitis samples (histology, immunofluorescence, targeted fatty acid profiling).</p><p><strong>Results: </strong>LPS stimulation significantly upregulated FASN expression and induced lipid accumulation in HDPCs and rat pulpitis models (p < 0.001). Transcriptomic analysis revealed marked downregulation of NR4A1, while metabolomic profiling showed depletion of key anti-inflammatory/pro-resolving PUFA precursors, including LA and γ-linolenic acid (GLA). Integrated transcriptomic-metabolomic analysis identified LA as a metabolite with high centrality in the lipid metabolic network, and NR4A1 as a significantly downregulated transcription factor linked to multiple lipid-related pathways. LA supplementation suppressed pro-inflammatory cytokines (IL-1β, TNF-α, phosphorylated NF-κB p65) and restored NR4A1 expression (p < 0.05). Combining LA with the FASN inhibitor TVB-2640 synergistically enhanced NR4A1 restoration and anti-inflammatory effects (p < 0.001). siRNA-mediated NR4A1 knockdown abolished the benefits of LA. In human pulpitis tissues, FASN upregulation, NR4A1 downregulation, and elevated palmitic acid were observed (p < 0.001), along with increased levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA).</p><p><strong>Conclusions: </strong>This study reveals a pathological FASN-LA-NR4A1 regulatory axis linking lipid metabolism to inflammatory amplification in pulpitis. Dual targeting of fatty acid synthesis and lipid depletion-through FASN inhibition and LA supplementation-attenuates inflammation via NR4A1-dependent mechanisms. These findings lay the groundwork for metabolic approaches to modulate inflammation in endodontics.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952948","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 Cost of Instrument Retrieval on the Root Integrity.","authors":"Marco A Versiani, Hugo Sousa Dias, Emmanuel J N L Silva, Felipe G Belladonna, Jorge N R Martins, Gustavo De-Deus","doi":"10.1111/iej.70027","DOIUrl":"https://doi.org/10.1111/iej.70027","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate dentine loss in mesial canals of mandibular molars following instrument fragment retrieval using two techniques.</p><p><strong>Methodology: </strong>Ten mesial roots of mandibular molars with Type II configuration were selected and scanned in a micro-computed tomography (CT) device. After canal preparation, a 3-mm fragment of a size 35/0.04 rotary instrument was intentionally fractured in the middle third of each mesial canal. In each tooth, one mesial canal was randomly assigned to either ultrasonic retrieval (n = 10) or the combined ultrasonic/lasso technique (n = 10). Removal time was recorded, and pre- and post-retrieval scans were registered to assess changes in dentine thickness, dentine volume, canal volume and cross-sectional area. Data were analysed using Student's t-test, Mann-Whitney U test, Chi-square and Fisher's Exact tests (α = 0.05).</p><p><strong>Results: </strong>All fragments were successfully retrieved. Ultrasonic removal was faster than the combined technique (p = 0.023) but resulted in greater dentine thickness reduction (p = 0.029). No significant differences were observed in canal area increase between groups (p = 0.698). After instrument retrieval, canal volume increased by 23.8%, while dentine volume decreased by 2.2%. Both techniques led to significant reductions in thick dentine regions and increases in thinner regions after preparation and retrieval (p < 0.001), with no significant differences between groups (p > 0.05).</p><p><strong>Conclusions: </strong>Both techniques were effective in retrieving fractured instruments and resulted in similar increases in canal area and volume, as well as comparable proportions of cross-sections exhibiting minimal dentine thickness below 0.5 mm. However, while ultrasonic removal was faster, it caused a greater percentage reduction of dentine thickness compared to the combined ultrasonic/lasso technique.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953060","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":"Outcome Following Complete and Partial Pulpotomy in Managing Cariously Exposed Mature Permanent Molars With Symptomatic Irreversible Pulpitis: A 5-Year Follow-Up of a Randomised Clinical Trial.","authors":"Ankita Ramani, Pankaj Sangwan","doi":"10.1111/iej.70028","DOIUrl":"https://doi.org/10.1111/iej.70028","url":null,"abstract":"<p><strong>Introduction: </strong>Numerous studies have reported favourable outcomes following complete pulpotomy (CP) and partial pulpotomy (PP) in cariously exposed mature permanent teeth with symptomatic irreversible pulpitis (SIP) at 1-year follow-up. However, literature on long-term outcomes is sparse. The European Society of Endodontology and the American Association of Endodontists emphasised the need for long-term evidence before establishing pulpotomy as a definitive treatment. This prospective follow-up study aimed to compare 5-year outcomes of CP and PP performed in such teeth.</p><p><strong>Methodology: </strong>This prospective study followed participants from a previously published superiority randomised trial on CP and PP for managing cariously exposed mature permanent teeth with SIP. The original trial was registered at ClinicalTrials.gov (NCT04397315). Ninety-three participants (CP-49, PP-44) received the allocated intervention. Of these, 88 (CP-45, PP-43) participants who attended the 1-year follow-up were recalled for the 5-year follow-up. The primary outcome was combined clinical and radiographic success. Secondary outcome measures included hard tissue barrier (HTB) formation and pulp canal obliteration (PCO). Cases were analysed for restoration integrity, secondary caries, periodontal status and pulp sensibility responses. The impact of various prognostic factors on 5-year success was analysed. Outcome measures at 5-year were compared with 1-year outcomes. Statistical tests included the Mann-Whitney U test, chi-squared test, Fisher's exact test, McNemar's test, intention-to-treat analysis and binary logistic regression, with significance set at p < 0.05.</p><p><strong>Results: </strong>At 5 years, 59 of 88 participants (CP-28, PP-31) were available for follow-up. The overall success was 83.05%, with no significant difference between groups (p = 0.494, RR = 1.10, 95% CI = 0.88-1.40). While both groups showed comparable evidence of HTB (p = 0.581, RR = 1.06, 95% CI = 0.91-1.23), PCO was significantly more evident in the CP group (p = 0.003, RR = 0.22, 95% CI = 0.07-0.70). The PP group elicited significantly more sensibility responses to cold test (p = 0.015, RR = 2.35, 95% CI = 1.09-7.43). Secondary caries was a significant prognostic factor influencing overall success at 5 years (p < 0.05). No significant differences in success, HTB, or PCO were observed between the 1 and 5 years outcomes in either group (p > 0.05).</p><p><strong>Conclusions: </strong>CP and PP demonstrated comparable success at 5 years. PP may be preferred given its conservative approach, reduced risk of PCO, and more reliable pulp sensibility reoptimizing responses. Adequate restorative seal is crucial for long-term success.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT04397315.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952998","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":"Pre-Operative Factors on Prognosis of Regenerative Endodontic Procedures: A Systematic Review and Meta-Analysis.","authors":"Filipe Colombo Vitali, Alexandre Henrique Dos Reis-Prado, Pablo Silveira Santos, Ana Paula Portes Zeno, Patrícia de Andrade de Risso, Lucianne Cople Maia, Francine Benetti, Cleonice da Silveira da Teixeira","doi":"10.1111/iej.70025","DOIUrl":"https://doi.org/10.1111/iej.70025","url":null,"abstract":"<p><strong>Background: </strong>Although regenerative endodontics has advanced in recent years, the influence of pre-operative factors on treatment outcomes remains poorly understood.</p><p><strong>Objective: </strong>To evaluate the effect of pre-operative factors-including age, gender, tooth type, aetiology of pulp necrosis, stage of root development, clinical signs/symptoms and periradicular status-on the treatment outcomes of regenerative endodontic procedures (REPs) in immature permanent teeth.</p><p><strong>Methods: </strong>A literature search was conducted on six electronic databases and grey literature to identify studies investigating the effect of pre-operative factors on REP outcomes. The risk of bias was assessed using the Newcastle-Ottawa Scale for observational studies and the Cochrane Risk-of-Bias 2 tool for randomised clinical trials (RCTs). Meta-analyses of proportions were conducted to estimate pooled rates for the outcomes 'clinical and radiographic healing', 'root development' and 'apical closure' across different pre-operative factors. Associations between these factors and treatment outcomes were assessed through meta-analyses of effect sizes. The certainty of evidence was evaluated using the GRADE approach.</p><p><strong>Results: </strong>Twenty studies were included, comprising 13 observational studies and seven RCTs. Most studies presented a moderate to high risk of bias. The pooled success rate for clinical and radiographic healing exceeded 81% across all pre-operative factors. Moreover, root development was achieved in 52%-95% of cases, whereas complete apical closure ranged from 32% to 91%. No significant association was found between pre-operative factors and clinical and radiographic healing. It was found that teeth with pulp necrosis due to trauma presented 3.59 times higher relative risk of root development failure compared to those with necrosis due to anatomic anomaly (RR = 3.59, 95% CI 1.21-10.67, p = 0.02). Incisors presented 1.90 times higher relative risk of root development failure (RR = 1.90, 95% CI: 1.37-2.63, p < 0.01) and 1.98 times higher relative risk of incomplete apical closure (RR = 1.98, 95% CI: 1.34-3.13, p = 0.02) compared to premolars. The presence of an apical lesion increased the relative risk of root development failure by 2.55 times (RR = 2.55, 95% CI: 1.63-4.86, p = 0.01). The certainty of evidence was rated as very low.</p><p><strong>Conclusion: </strong>Pre-operative factors were not significantly associated with clinical and radiographic healing in REPs. However, trauma-related pulp necrosis, tooth type (incisors) and the presence of apical lesions were associated with an increased risk of root development failure. These findings should be interpreted with caution due to between-study heterogeneity, the moderate to high risk of bias and the very low certainty of the evidence.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953039","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":"Teaching Vital Pulp Treatment for Permanent Teeth to Undergraduate/Pre-Doctoral Students: A Multinational Survey.","authors":"Venkateshbabu Nagendrababu, Mohannad Nassar, Lokhasudhan Govindaraju, Anil Kishen, Paul V Abbott, Henry F Duncan","doi":"10.1111/iej.70020","DOIUrl":"https://doi.org/10.1111/iej.70020","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the current status of education in vital pulp treatment (VPT) for the management of permanent teeth in relation to undergraduate/pre-doctoral students at a range of dental schools worldwide.</p><p><strong>Methodology: </strong>The web-based survey consisted of 28 questions that had been validated and piloted by a range of experienced endodontists. Faculty members who taught endodontics at one dental school in each selected country participated in the survey, which was completed in March 2025. Simple descriptive statistics were used to present the data.</p><p><strong>Results: </strong>Forty faculty members from various countries completed the survey; the majority of which (82.5%) worked at public universities. All participating dental schools included VPT teaching in their undergraduate/predoctoral curricula. The primary method of teaching VPT in the majority of dental schools was didactic lectures. VPT preclinical exercises were included in only 32.5% of the schools. The vast majority of dental schools did not require students to pass a preclinical or clinical competency examination in relation to VPT prior to graduation. Hydraulic calcium silicate materials were the most commonly used for exposed pulps but not for pulps that were not exposed.</p><p><strong>Conclusions: </strong>VPT has been integrated into the undergraduate/pre-doctoral curriculum of all dental schools that participated in this survey. However, the majority of dental schools that were surveyed lacked preclinical teaching and competency assessments for VPT in both preclinical and clinical scenarios.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952993","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":"Patient Satisfaction and Long-Term Outcomes: A 7- to 9-Year Prospective Cohort Study of Root Canal Treatment in the Swedish Public Dental Service.","authors":"Emma Wigsten, Anita Afkhami, Hosaina Afewerki, Anna Levinsson, Thomas Kvist","doi":"10.1111/iej.70018","DOIUrl":"https://doi.org/10.1111/iej.70018","url":null,"abstract":"<p><strong>Aim: </strong>This prospective follow-up study aimed to assess patient satisfaction with root canal treatment (RCT) 7-9 years after initiation in a general dental practice setting.</p><p><strong>Method: </strong>A study population of 243 patients initiated RCT at 20 public dental clinics in the Västra Götaland Region, Sweden. One to 3 years later, 159 patients (67.4%) responded to an 8-item questionnaire assessing patient satisfaction with RCT and treatment results. The questionnaire was sent out again 7-9 years after treatment initiation. Descriptive and analytical statistics were used to compare respondents and non-respondents, tooth groups and comparison over time.</p><p><strong>Results: </strong>A total of 156 patients (72.2%) responded to the 7-9 years' questionnaire; 82 women (52.6%) and 74 men (47.4%) with a mean age of 59.3 years (SD = ±15.3). Non-respondents were significantly younger (p < 0.001). The majority of RCTs were reported as completed with a root filling (n = 102, 65.4%), although significantly fewer molars were completed (n = 43, 56.6%; p < 0.001). Sixty-six patients (63.5%) reported no current pain, while most of those reporting pain described it as mild (n = 30, 90.9%). More than half of the root filled incisors were associated with current pain (n = 15, 57.7%; p < 0.009). A total of 111 patients (76.0%) recalled the procedure as painful. Chewing ability received the highest satisfaction rating (mean = 1.3). The majority of patients reported they would choose RCT again (n = 114, 77.0%). Among the 17 who answered 'No', 13 had undergone extraction, and 3 reported persistent pain following RCT. Over time, the number of extracted teeth increased (p < 0.001), while current pain intensity decreased and retrospective satisfaction with RCT improved (p < 0.001).</p><p><strong>Conclusions: </strong>Seven to nine years after the initiation of RCT in this general dental practice setting, patient satisfaction remains high despite one-third of treated teeth being reported as extracted. These findings highlight the importance of incorporating patient-reported outcomes in the evaluation of dental procedures, including endodontic treatments.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953072","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 \"Testing Effect\" in Undergraduate Endodontic Education: The Impact of Regular Low Stakes Testing on Learning Outcomes and Student Engagement.","authors":"M Kalyva, K Kavvadia, L Louca, I Televantou, M P Michaelides","doi":"10.1111/iej.70022","DOIUrl":"https://doi.org/10.1111/iej.70022","url":null,"abstract":"<p><strong>Aim: </strong>This study investigates the impact of regular testing on learning outcomes in undergraduate endodontic education. Specifically, it examines whether students perform better at the end of the course on previously tested material compared to non-tested material and explores the role of students' engagement and perceptions of testing in this effect.</p><p><strong>Methodology: </strong>A within-participants experimental design was employed with 81 third-year dental students enrolled in a preclinical endodontics course. Students were tested on half of the course lectures (tested material) immediately after each lecture, while the remaining lectures served as a control (non-tested material). Testing was conducted using multiple-choice questions on the Blackboard Learn platform with immediate automated feedback. Final exam scores for tested and non-tested material were compared, and a subset of students (n = 44) completed a questionnaire assessing cognitive engagement, emotional engagement, and perceptions of testing.</p><p><strong>Results: </strong>Students scored significantly higher on tested material (Mean = 25.284, SD = 4.202) compared to non-tested material (Mean = 21.111, SD = 3.847). The mean difference between the two scores was statistically significant with a very large effect size (F_1,80 = 108.329, p < 0.001, η_p ² = 0.575). The difference remained significant with a moderate to large effect size after accounting for the grade in the previous course and sex (F_1,78 = 9.392, p = 0.003, η_p ² = 0.107). Emotional engagement was found to moderate the effectiveness of testing, with students reporting higher emotional engagement showing greater gains from the intervention.</p><p><strong>Conclusions: </strong>The findings demonstrate a robust testing effect in undergraduate endodontic education, supporting the hypothesis that retrieval practice enhances learning outcomes. These results suggest that integrating regular, low-stakes testing into dental curricula can enhance dental students' learning outcomes at the end of the course.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144953045","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":"Innovative Didactic Learning Formats: Have They Improved Dental Education? A Systematic Review and Meta-Analysis.","authors":"Ana Arias, Min-Seock Seo, Lucia Gancedo-Caravia, Isabel Fernandez-Garcia, Juan José Pérez-Higueras","doi":"10.1111/iej.70006","DOIUrl":"https://doi.org/10.1111/iej.70006","url":null,"abstract":"<p><strong>Background: </strong>New learning methods require higher professor-to-student ratios, increased faculty preparation time, continuous professional development for educators, and expanded physical spaces within university settings.</p><p><strong>Objectives: </strong>This systematic review aimed to answer the following PICO question: In dental students (P), what is the effectiveness of innovative formats of learning (I) in comparison with traditional formats (C) in terms of educational outcomes and satisfaction (O)?</p><p><strong>Methods: </strong>After PROSPERO protocol registration, a literature search was conducted using Web of Science (WoS), Scopus, PubMed and Cochrane Central Register of Controlled Trials. Selection of studies was performed in a three-step process: identification, screening and eligibility. Data was extracted and analysed qualitatively and quantitatively. A random-effects meta-analysis was conducted to provide an estimate of the effect of innovative teaching formats in dental education. Additionally, subgroup analyses were performed to investigate potential differences in effectiveness based on the type of innovative teaching intervention.</p><p><strong>Results: </strong>One hundred and nineteen studies matched the inclusion criteria and were included in the systematic review. A meta-analysis of 23 studies (1074 students in the control and 1021 in the experimental group) revealed significant differences in favour of innovative teaching methods (p < 0.00001) with considerable heterogeneity (χ² = 297.46, p < 0.00001; I² = 93%). Subgroup analysis also revealed significantly different results depending on the innovative teaching approach (p = 0.02). Both asynchronous independent learning and synchronous learning, either in a large group with the whole class of students using blended learning or in small groups, resulted in a significantly better outcome than traditional learning (overall effect: Z = 5.85; p < 0.00001); however, synchronous blended learning showed a significantly better outcome than the rest of the subgroups (mean difference = 16.59; 95% CI = 9.03-24.15). The quality of the studies varied, with some facing methodological challenges such as inconsistent outcome measurement, which can impact the generalisability of the findings.</p><p><strong>Conclusions: </strong>Innovative strategies lead to superior knowledge acquisition in comparison with traditional methods. Subgroup analyses favoured synchronous blended learning, but both asynchronous independent learning and synchronous learning formats, whether implemented in large-group settings via blended approaches or in small-group environments, are more effective than traditional instruction.</p><p><strong>Trial registration: </strong>PROSPERO (CRD42024569691).</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952946","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}