International endodontic journal最新文献

{"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}

{"title":"Impact of Haptic Simulators and 3D-Printed Teeth on Dental Students' Self-Assessment of Endodontic Access Cavities: A Comparative Pilot Study.","authors":"Sofía Folguera, Pablo Bayón, Sandra Baena, Alexandra Flesariu","doi":"10.1111/iej.70021","DOIUrl":"https://doi.org/10.1111/iej.70021","url":null,"abstract":"<p><strong>Aim: </strong>This study aimed to compare the impact of two innovative training methods, haptic simulators and 3D-printed teeth, on the self-assessment accuracy of dental students when evaluating endodontic access cavities.</p><p><strong>Methodology: </strong>A prospective, experimental, and comparative educational trial was conducted with undergraduate dental students randomly assigned to two groups: Group S (haptic simulators, n = 12) and Group 3D (3D-printed teeth, n = 10). Participants performed six access cavity preparations over two training sessions and self-assessed their work using a standardised evaluation form. A pre-test and post-test assessment of pre-prepared access cavities was conducted to measure changes in self-assessment accuracy. Evaluations were also performed by experts to establish a gold standard. The percentage of agreement and Cohen's kappa coefficient with 95% confidence intervals (CI) were calculated for both groups. Statistical analyses included McNemar's test, Wilcoxon signed-rank test, and Mann-Whitney U test (p < 0.05).</p><p><strong>Results: </strong>Both groups improved their self-assessment scores over time. However, only Group S showed a statistically significant increase in correct responses in the post-test evaluation (p = 0.009). The overall agreement between participants and experts remained low in both groups, with Cohen's kappa values indicating fair agreement. The primary source of disagreement was overestimation, particularly in Group 3D. While Group S exhibited better alignment with expert assessments over time, differences between the two groups were not statistically significant.</p><p><strong>Conclusions: </strong>Haptic simulators and 3D-printed teeth both contributed to students' self-assessment skills. However, haptic simulators were more effective in improving self-assessment accuracy. Despite these improvements, agreement with expert evaluations remained low; highlighting the need for additional feedback and guidance during training.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952927","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":"Factors Affecting Root Canal Treatment Case Difficulty, Practitioner Rating of Difficulty and Treatment Complications Among General Dentists and Endodontists: A Prospective Cohort Study From National Dental Practice-Based Research Network PREDICT Project.","authors":"Alan S Law, Sanket Nagarkar, Ellen Funkhouser, Rahma Mungia, Donald R Nixdorf, Ernest W N Lam, Ali Nosrat, Robert S Roda, Gregg H Gilbert","doi":"10.1111/iej.70019","DOIUrl":"https://doi.org/10.1111/iej.70019","url":null,"abstract":"<p><strong>Aim: </strong>Successful root canal treatment (RCT) is necessary for managing pulpal and periapical disease. The technical quality of RCT affects its outcome. Recognising complicating factors can be important to optimising outcomes. The aims of this study were to compare the practitioner reported case difficulty before and after completion of RCT; and to determine whether any case difficulty items were associated with complications encountered while performing the RCT.</p><p><strong>Methodology: </strong>One hundred and four general dentists (GDs) and 49 endodontists enrolled 1860 patients needing RCT, April to September 2017. Both before RCT and upon its completion, practitioners used a 10-point scale to rate the RCT's case difficulty (Difficulty Rating [DR]). Then they used a modified Case Difficulty Assessment Form (CDAF) to record the items for difficulty using the form's list of 10 provided choices. We related practitioners' pre-RCT CDAF items to their DR ratings and to the procedural complications that they subsequently experienced during this RCT. General estimating equations (GEE) were used to assess the significance of differences in proportions between GDs and endodontists. Non-parametric tests were used to analyse compositive variables.</p><p><strong>Results: </strong>Data of 1,698 patients were available for CDAF analyses. The mean CDAF was higher for endodontists than GDs (p < 0.001). Pre- and post-RCT DRs were significantly correlated (r = 0.79, p < 0.001), as were pre-RCT DR and the number of reported CDAF difficulties (r = 0.57, p < 0.001). Overall, practitioners encountered complications in treating 16% of patients. The complications were length of obturation > 2 mm from radiographic apex or beyond apex, canals not negotiable within 2 mm of apex, instrument separation, inadvertent filing/file placement past root apex, and perforation. Several CDAF items were independently predictive of complications. Despite the higher CDAF in teeth treated by endodontists, complications were less frequent among endodontists compared to GDs (13% vs. 19%, p < 0.001).</p><p><strong>Conclusions: </strong>Pre-RCT assessments predicted intra-operative difficulties and outcomes. Our work underscores the need for targeted assessment tools and specialised training to improve RCT, especially in complex cases treated by GDs.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144952910","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":"Proteomic Profiling of Dentinal Fluid for the Identification of Biomarkers in Pulpal Inflammation: An Exploratory Study.","authors":"Claudia Brizuela, Alejandra Chaparro, María Ignacia Valencia, María José Bendek, Henry F Duncan, Juan J Segura-Egea, Camila Alhucema, Valeria Ramírez","doi":"10.1111/iej.70017","DOIUrl":"https://doi.org/10.1111/iej.70017","url":null,"abstract":"<p><strong>Aim: </strong>To identify differentially expressed proteins (DEPs) in dentinal fluid across a range of pulpal inflammatory stages-mild, moderate, severe pulpitis-using mass spectrometry.</p><p><strong>Methodology: </strong>This cross-sectional study analysed dentinal fluid from 60 patients categorised into healthy pulp (control), mild, moderate and severe pulpitis groups, based on Wolters' pulp diagnostic criteria. Pulp conditions were assessed through cold sensibility tests and radiographs, with inclusion limited to patients aged 12-40, who were systemically healthy and exhibited no advanced periodontal or apical pathology. Dentinal fluid was collected under aseptic conditions, stored at -80°C and pooled into 12 representative samples for proteomic analysis. Proteins were extracted using lysis buffers and processed via LC-MS/MS with label-free quantification (LFQ) to identify DEPs. Enrichment analysis and protein-protein interaction (PPI) networks were conducted using Gene Ontology (GO), KEGG databases and STRING, with hub proteins identified using cytoscape. Statistical analysis employed Bayesian t-tests and linear models to evaluate protein expression, with a significance threshold of p < 0.05.</p><p><strong>Results: </strong>The severe pulpitis group exhibited the highest prevalence of systemic diseases (40%) compared with other groups (6.6%). LC-MS/MS identified 577 proteins, with 62 consistently quantified across the groups. The number of DEPs increased with inflammation severity, with 13 DEPs in severe pulpitis compared with controls. Principal component analysis (PCA) revealed partial separation between control and severe inflammation groups, with significant overlap between mild and moderate stages. Functional enrichment identified key biological pathways, including immune response, energy metabolism and structural integrity. Proteins such as cofilin-1, haemoglobin subunit alpha and peroxiredoxin-1 were upregulated in severe inflammation, while hornerin and myosin light chain 6 were downregulated. These findings highlight proteomic changes associated with pulpitis progression and identify potential prognostic biomarkers and therapeutic targets.</p><p><strong>Conclusions: </strong>This study identified distinct proteomic differences across pulpitis stages, with unique proteins in severe cases. These findings highlight novel biomarkers for advancing precise, cost-effective, point-of-care diagnostics and therapies, including multiplex platforms or ELISA assays. Proteomic analysis shows promise for understanding disease mechanisms and enabling personalised treatment strategies in endodontics.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855195","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 Comparative Investigation of Undergraduate Dental Student Stress in the Management of Deep and Moderate Carious Lesions.","authors":"V Chevalier, B Honari, H F Duncan","doi":"10.1111/iej.70013","DOIUrl":"https://doi.org/10.1111/iej.70013","url":null,"abstract":"<p><strong>Aim: </strong>The primary objective of this clinical study was to analyse, through physiological and psychological parameters, undergraduate dental student stress during the management of deep compared with moderate carious lesions. Additional objectives aimed to compare student confidence, anxiety and satisfaction during deep and moderate caries management and their perception of the quality of teaching they received regarding these treatments.</p><p><strong>Methodology: </strong>In this crossover study, 35 clinical students treated deep and moderate caries on permanent vital teeth in adult patients with no history of spontaneous pain. The STAI-State (STAI-S) anxiety questionnaire was completed preoperatively. Stress-VAS (visual analogic scale) and confidence-VAS scores were collected during the preoperative (before anaesthesia), perioperative (end of caries excavation) and postoperative (after patient left) phases of both caries management. Cardiovascular parameters (blood pressure and heart rate) were collected during the same stages. A satisfaction-VAS was completed postoperatively. The effects of the depth of the caries, time and student demographics on preoperative anxiety (STAI-S), pre-, peri- and postoperative stress, confidence, blood pressure and heart rate, as well as postoperative satisfaction, were assessed using Mixed ANOVA with multiple pairwise comparisons. The statistical analysis was performed with IBM SPSS. A questionnaire assessing teaching adequacy was completed after each treatment.</p><p><strong>Results: </strong>The treatment of deep caries led to a significantly higher level of stress and a significantly lower level of confidence among students than the treatment of moderate caries, pre-, per- and post-operatively (p ≤ 0.05). Student preoperative anxiety was significantly higher in cases of deep caries, and their post-operative satisfaction was significantly lower. However, there was no significant difference between the two groups in terms of cardiovascular parameters at any stage. There was no influence of the student year of study on the parameters examined; however, gender influenced confidence at all times combined, as well as preoperative stress, with females less confident and more stressed than males. The median level of perceived teaching 'adequacy' was higher for moderate caries than for deep caries.</p><p><strong>Conclusions: </strong>Within the limits of this study, the management of deep carious lesions is associated with a higher level of stress among students compared with moderate caries.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144845886","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":"Multispecies Biofilms Treated With Endodontic Sealers or Calcium Hydroxide: Antimicrobial Activity and Changes in Community Composition.","authors":"Steven K Uttech, Ronald Ordinola-Zapata, W Craig Noblett, Maria Martell, Bruno Lima, Christopher Staley","doi":"10.1111/iej.70015","DOIUrl":"https://doi.org/10.1111/iej.70015","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the antimicrobial activity and changes in community composition in biofilms treated with two root canal sealers or calcium hydroxide.</p><p><strong>Material and methods: </strong>Forty-nine extracted bovine dentine cylinders were inoculated with subgingival dental plaque for 2 weeks in a CDC biofilm reactor. Three treatment groups were assigned: AH Plus, BC Sealer, and calcium hydroxide. Propylene glycol inert vehicle (PG) and untreated contaminated samples were used as controls. The infected root canal space was in direct contact with the materials for 7 days under anaerobic incubation. Anaerobic culture (colony forming units, CFU), quantification PCR (qPCR), and next generation sequencing were used to assess the effect of each material. Differences in the number of molecules (qPCR), CFU, and abundances of genera were evaluated using the Kruskal-Wallis test. The Shannon and Chao1 indices were used to measure alpha diversity. Differences in community composition were evaluated using non-parametric analysis of similarity (ANOSIM).</p><p><strong>Results: </strong>The CFU, Shannon, and Chao1 indices revealed significant differences between BC Sealer, AH Plus, and calcium hydroxide groups versus the untreated control group and PG (p < 0.003). Calcium hydroxide and BC Sealer significantly reduced the qPCR values compared to the control group and PG. The biofilm composition (98.5%) was primarily composed of Peptostreptococcus, Streptococcus, Parvimonas, Fusobacterium, Veillonela, Mogibacterium, Lancefieldella, Eubacterium, Slackia, and Prevotella. Significant differences in overall community composition and beta diversity between untreated controls and AH Plus were observed (ANOSIM R = 0.674, p < 0.001). Parvimonas, Streptococcus, Eubacterium, and Lancefieldella were not affected by any of the materials tested.</p><p><strong>Conclusion: </strong>Calcium hydroxide and BC Sealer significantly reduced the viability and the total number of DNA copies. AH Plus sealer reduced the bacterial viability but did not affect the DNA concentration. AH Plus significantly alters overall biofilm community composition compared to other groups. None of the materials tested eliminated the multispecies biofilm completely.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144845887","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":"Exploring Relationships Within the Microbiome of Root Canal Infections and the Influence of Associated Clinical Parameters.","authors":"Dana Mominkhan, Luciana C N Brito, Abdul-Rakeem Yakubu, Eric Larson, Lynn Martin, Michele Patel, Warley Luciano Fonseca Tavares, Antonio Ribeiro-Sobrinho, Flavia Teles","doi":"10.1111/iej.70011","DOIUrl":"https://doi.org/10.1111/iej.70011","url":null,"abstract":"<p><strong>Aim: </strong>To identify relationships among bacterial species in endodontic infections, to determine their core microbiome, and associated clinical characteristics.</p><p><strong>Methodology: </strong>206 patients with endodontic infections and apical periodontitis were assessed for clinical parameters (periapical lesion, symptomatology, sinus tract). Samples from the apical third of roots were obtained before cleaning and shaping root canals, and microbial composition was analysed using 16S rRNA sequencing and HOMINGS. Correlation Network Analysis (CNA) was performed using the R package igraph, and networks were visualised in Cytoscape with centralities determined by CytoHubba. The core microbiome was identified using the R package Microbiome, listing species comprising at least 1% of samples in over 50% of cases.</p><p><strong>Results: </strong>The endodontic core microbiome included Parvimonas micra, Streptococcus sanguinis, Enterococcus faecalis, Porphyromonas endodontalis, Prevotella nigrescens and Fusobacterium nucleatum. Symptomatic cases had a core microbiome of Bacteroidaceae.G.1. sp oral taxon 272 and Haemophilus parainfluenzae. Sinus cases had a core microbiome of Bacteroidaceae.G.1. sp oral taxon 272, Mogibacterium timidum, Peptostreptococcus stomatis, Pseudoramibacter alactolyticus and Rothia dentocariosa. Lesion cases had a core microbiome of Atopobium rimae, Eubacterium.11.G.1. infirmum, Mogibacterium timidum and Pseudoramibacter alactolyticus. Certain taxa like Bacillus clausii and Eubacterium limosum were never detected.</p><p><strong>Conclusions: </strong>Despite critical gaps in root canal treatment clinical effectiveness, standardisation and understanding of pathogen complexity, our study, utilising next-generation 16S rRNA Sequencing and HOMINGS, provides valuable insights into core microbiome members involved in endodontic infections and their associations with distinct clinical signs and symptoms, offering insights that may guide more precise diagnosis and targeted treatment.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816529","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":"PFKFB3-Inhibitor 3PO-Mediated Glycolytic Reprogramming Promotes Inflammatory Dental Pulp Repair: An In Vitro and In Vivo Study.","authors":"Yanqiang Zhao, Yuqing Peng, Dan Wang, Lixin Zhang, Yijia Qiu, Jingyi Cui, Fei Xie, Ningxin Zhu, Man Qin, Yuanyuan Wang","doi":"10.1111/iej.70016","DOIUrl":"https://doi.org/10.1111/iej.70016","url":null,"abstract":"<p><strong>Aim: </strong>This study explores the role of PFKFB3 in pulpitis and its potential as a therapeutic target by modulating glycolytic reprogramming in dental pulp stem cells (DPSCs). Pulpitis, a common inflammatory disease, causes long-term damage to dental structures. Recent evidence suggests that metabolic reprogramming can modulate inflammatory responses and promote tissue repair. This study aims to investigate the anti-inflammatory and reparative effects of glycolysis inhibitors on inflamed dental pulp through in vivo and in vitro experiments.</p><p><strong>Methodology: </strong>In vitro, hDPSCs were stimulated with lipopolysaccharide (LPS) (1 μg/mL, 3 h) to mimic pulpitis. The effects of the PFKFB3 inhibitor 3PO (10 μM) and siRNA targeting PFKFB3 (50 nM) on glycolysis were assessed using Seahorse analysis, while their impacts on inflammation were evaluated via ELISA and qRT-PCR. A co-culture of DPSCs and macrophages was used to study 3PO's effects on inflammation interactions and glycolytic reprogramming of the inflammatory microenvironment. The influences of 3PO on odontogenic differentiation were examined through qRT-PCR, Western blotting, ALP staining and ARS staining. The related signalling pathways were validated through Western blot (WB) experiments. An SD rat model was employed to validate the in vivo efficacy of 3PO@GelMA pulp capping, and HE staining and immunohistochemistry were used to evaluate the degree of pulp inflammation and reparative dentin formation.</p><p><strong>Results: </strong>In vitro, LPS elevated glycolytic activity and inflammatory factors (IL-6, IL-1β, TNF-α) in DPSCs. 3PO and si-PFKFB3 mitigated these factors and promoted odontogenic differentiation, evidenced by increased DSPP and ALP expression. Metabolic reprogramming mediated by 3PO and si-PFKFB3, as assessed by Seahorse XF analysis, indicated a shift from glycolysis to oxidative phosphorylation. Additionally, 3PO induced metabolic reprogramming of the co-culture system, reduced the levels of pro-inflammatory cytokines, and promoted the polarisation of macrophages towards the M2 phenotype. PFKFB3 inhibition activated the AMPK/SIRT1/PGC-1α/NF-κB and AMPK/mTOR/NF-κB signalling pathways. In vivo, in the rat pulpitis model, 3PO@GelMA hydrogel application resulted in significantly decreased IL-6 and increased DSPP expression compared to the LPS group (p < 0.001), accompanied by reduced inflammation and enhanced reparative dentin formation.</p><p><strong>Conclusion: </strong>The PFKFB3 inhibitor 3PO reduces inflammation and promotes reparative dentin formation in pulpitis via metabolic reprogramming and specific signalling pathways, offering a new therapeutic strategy.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816530","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":"Dental Undergraduate Student Stress, Anxiety and Confidence in Endodontic Education: A Narrative Review.","authors":"K J Fouillen, H F Duncan, V Chevalier","doi":"10.1111/iej.70012","DOIUrl":"https://doi.org/10.1111/iej.70012","url":null,"abstract":"<p><strong>Background: </strong>Endodontics is considered a challenging and stressful area by dental practitioners and particularly by dental undergraduate students. Stress or anxiety is prevalent among dental undergraduates, with academic and clinical factors considered the principal sources. In addition, the lowest level of student confidence is generally observed when undertaking complex procedures such as root canal treatment.</p><p><strong>Objectives: </strong>The aim of this review was to investigate the factors responsible for stress, anxiety and confidence in endodontic education and to identify factors which could potentially moderate undergraduate student stress and enhance confidence, improve well-being before concluding by suggesting potential educational improvements.</p><p><strong>Method: </strong>A narrative review was performed by searching 3 databases (Pubmed, Web of Science and Scopus). Inclusion criteria were original research reports related to undergraduate dental students' stress, anxiety or confidence in endodontics education. Quantitative, qualitative or mixed-method studies were considered.</p><p><strong>Results: </strong>This narrative review included 51 studies, which were subdivided into six categories describing factors that have an influence on student stress, anxiety and confidence in endodontics: the patient, the clinical procedure, the academic staff, the teaching methods, the clinical organisation and the student. The management of the endodontic patient's expectations, personality and sometimes acute pain can be stressful for the student. The clinical endodontic procedure, with its complexity and multiple steps, visualisation difficulties and possible complications can also be challenging. Academic staff experienced in endodontics, who are supportive and provide consistent advice, are crucial in managing student stress and anxiety. Educational methods also play an important role in increasing confidence, with a reflective approach, a special focus on hands-on sessions and clinical support with systematic feedback. The clinic should be well-organised and ideally multi-disciplinary, with adequate endodontic equipment and should ensure that the student has sufficient time to practise. Finally, the student's individual stress level is an important factor. The year of training as well as gender should be considered as having an influence on the student stress level.</p><p><strong>Conclusions: </strong>Undergraduate students find endodontics stressful. Educational improvements in endodontics can contribute to moderating the stress and increasing confidence, while improving endodontic learning and promoting student well-being.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798992","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":"Minimally Invasive Vertical Incision Subperiosteal Tunnelling Technique for Targeted Endodontic Surgery: Technical Overview and a Case Report.","authors":"Francesc Abella Sans, Jaime Barragán Montes, Tomasz Zbozen, Nandini Suresh, Lalli Dharmarajan, Paul M H Dummer, Venkateshbabu Nagendrababu","doi":"10.1111/iej.70014","DOIUrl":"https://doi.org/10.1111/iej.70014","url":null,"abstract":"<p><strong>Aim: </strong>This technical review and case report describes the Minimally Invasive Vertical Incision Subperiosteal Technique (MIVIST) for use in specific targeted endodontic surgical cases.</p><p><strong>Summary: </strong>The proposed MIVIST technique includes a vertical incision along with auxiliary vertical release incisions to enhance soft tissue healing during targeted endodontic surgery for teeth with small periapical lesions. The technique is described in a case report where a patient presented with persistent periapical periodontitis associated with a previously root canal treated tooth (#15). Based on the preoperative intraoral scan and cone beam computed tomography (CBCT) three-dimensional surgical guides were printed. A vertical main incision and additional release incisions were placed in the buccal mucosa of tooth 15 over healthy bone, with subperiosteal tunnelling then being performed to provide adequate access to the lesion and root apex. A guided osteotomy was carried out using the surgical template, followed by root-end cavity preparation and filling. The patient was followed up over 24 months, when excellent soft tissue healing as well as radiographic healing was apparent.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798993","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}