International endodontic journal最新文献

{"title":"Characterising 12 NiTi Reciprocating Systems: An Integrative Laboratorial Analysis of Design, Mechanics, Metallurgy, Fluid Dynamics and Finite Element Analysis.","authors":"Jorge N R Martins, Emmanuel João Nogueira Leal Silva, Mário Rito Pereira, Duarte Marques, Ricardo Pinto, Abayomi O Baruwa, Rui F Martins, Francisco Manuel Braz Fernandes, Marco Aurélio Versiani","doi":"10.1111/iej.70010","DOIUrl":"https://doi.org/10.1111/iej.70010","url":null,"abstract":"<p><strong>Aim: </strong>To comprehensively compare 12 nickel-titanium (NiTi) reciprocating single-file systems from eight manufacturers by integrating geometric, mechanical, metallurgical and in silico analyses.</p><p><strong>Methodology: </strong>A total of 276 NiTi reciprocating instruments, representing 12 types across 8 brands, were selected, including Easy-File Flex Regular 25, EdgeOne Fire Primary, Flash 25.06vt, One Files R25 and Blue R25, One RECI N25, Perfect RC R25 (Blue, Gold and Silver), Reciproc R25 (Blue and M-Wire) and WaveOne Gold Primary. They were evaluated using stereomicroscopy, scanning electron microscopy, 3D optical scanning, energy-dispersive X-ray spectroscopy and differential scanning calorimetry to assess design and metallurgical properties. Mechanical performance was tested via buckling resistance and microhardness. A micro-CT-based premolar model was virtually prepared for each instrument to simulate canal shaping. Computational fluid dynamics (CFD) assessed irrigant penetration, wall shear stress and apical pressure. Finite element analysis (FEA) evaluated stress distribution in prepared roots. Data were analysed using the Shapiro-Wilk test for normality and the Kruskal-Wallis test for group comparisons (p < 0.05).</p><p><strong>Results: </strong>The systems differed considerably in spiral density, cross-sectional design, size, volume and phase transformation temperatures. Instruments with larger apical cores (One Files and Reciproc M-Wire) and austenitic-phase dominance (Perfect RC Silver and One Files) showed greater buckling strength. Files with martensitic phases (Perfect RC Gold, WaveOne Gold and One Files Blue) or hybrid cross-sections (One RECI and Flash) were more flexible. CFD revealed that conservative shaping (Easy-File Flex, EdgeOne Fire, One RECI, WaveOne Gold) increased wall shear stress but reduced apical irrigant exchange. FEA showed similar stress patterns across all groups, with lower stress in restored roots.</p><p><strong>Conclusions: </strong>Substantial variation exists among current NiTi reciprocating systems in terms of design, mechanics, fluid dynamics and metallurgy. Instruments with large cores and austenitic-phase structure provide superior buckling resistance. Conservative shaping improves shear stress but limits apical cleaning. Root stress remained consistent across systems. These findings highlight the importance of optimising instrument design and clinical protocols to balance shaping efficacy and irrigant delivery.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144788865","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 Endodontic Disease on Oral Health-Related Quality of Life in the Elderly.","authors":"Karen Ruiwen Sim, Wen Yi Lim, Clement Wei Ming Lai, Victoria Soo Hoon Yu, Jeen-Nee Lui","doi":"10.1111/iej.70008","DOIUrl":"https://doi.org/10.1111/iej.70008","url":null,"abstract":"<p><strong>Aim: </strong>The silver tsunami poses a global healthcare challenge, and this study aimed to assess the impact of endodontic disease on oral health-related quality of life (OHRQOL) in an elderly population who received non-surgical root canal treatment (NSRCT). The appropriateness of the Oral Health Impact Profile (OHIP-17) and General Oral Health Assessment Index (GOHAI) as OHRQOL assessment tools for this population was also assessed.</p><p><strong>Methodology: </strong>Patients aged ≥ 65 years who received NSRCT were recruited. OHRQOL assessments were conducted using OHIP-17, GOHAI and an oral health perception questionnaire. The severity of impact was assessed by summing the numeric response codes for all questions, producing a total score for each participant potentially ranging from 0 to 68 for OHIP-17 and 0 to 48 for GOHAI, with higher scores indicating poorer OHRQOL. Potential influencing factors for OHRQOL scores were investigated. Internal consistency, concurrent validity and discriminant validity of both tools were evaluated.</p><p><strong>Results: </strong>One hundred and twenty-two patients were recruited. The mean total OHIP-17 and GOHAI scores were 16.35 ± 11.81 (maximum possible score = 68) and 16.85 ± 7.04 (maximum possible score = 48) respectively. The percentage of patients reporting no impact was lower with GOHAI (0.8%) than OHIP-17 (9.8%). Multivariate analyses showed that higher OHRQOL scores were significantly associated with higher levels of education, full/part-time employment and more teeth that received NSRCT. Internal consistency was high for both tools. Concurrent validity assessment demonstrated a significant association of satisfaction with oral health for GOHAI, and perceived importance of keeping one's own teeth and perceived oral health for both OHIP-17 and GOHAI. Neither tool significantly correlated patient-reported impact with clinicians' assessment of oral health.</p><p><strong>Conclusions: </strong>In elderly patients who received NSRCT, OHRQOL is negatively associated with higher education level, being employed, and more teeth that received NSRCT. GOHAI appears more successful than OHIP-17 in detecting the impact of endodontic disease on OHRQOL.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775294","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":"Mechanical and Metallurgical In Vitro Evaluation of Electropolished Versus Non-Electropolished Rotary and Reciprocating Instruments.","authors":"Victor T L Vieira, Emmanuel J N L Silva, Jorge N R Martins, Alejandro Jaime, Carlos Garcia Puentes, António Roma Torres, Francisco Manuel Braz Fernandes, Marco A Versiani, Gustavo De-Deus, Felipe G Belladonna","doi":"10.1111/iej.70009","DOIUrl":"https://doi.org/10.1111/iej.70009","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the effect of electropolishing on the mechanical properties of One RECI and One Curve mini nickel-titanium (NiTi) instruments by comparing electropolished and non-electropolished versions of each instrument type.</p><p><strong>Methodology: </strong>Electropolished and non-electropolished One RECI (reciprocating) and One Curve mini (rotary) NiTi instruments, all manufactured with identical geometry and heat treatment, were evaluated. Instrument design was analysed by light microscopy and scanning electron microscopy, while metallurgical characterisation was performed using energy-dispersive X-ray spectroscopy (EDS) and differential scanning calorimetry (DSC). Mechanical performance was assessed through torsional resistance, bending and buckling load, surface microhardness, and cutting efficiency. Statistical comparisons were performed using the independent samples t-test or the Mann-Whitney U-test, with significance set at p < 0.05.</p><p><strong>Results: </strong>Design and metallurgical analyses confirmed that electropolished and non-electropolished instruments within each group were equivalent in terms of geometry, cross-sectional design, tip configuration, elemental composition, and phase transformation temperatures. Electropolishing significantly enhanced flexibility in both instrument types, as indicated by reduced bending loads and lower buckling resistance (p < 0.05). However, torsional strength was significantly reduced in the electropolished One RECI instruments, reflected by lower maximum torque and angle of rotation prior to fracture (p < 0.05). No significant torsional differences were observed in the One Curve mini group (p > 0.05). Surface microhardness and cutting efficiency remained unaffected by electropolishing in both systems (p > 0.05).</p><p><strong>Conclusions: </strong>Electropolishing improved the flexibility of both One RECI and One Curve mini NiTi instruments without compromising their surface microhardness or cutting efficiency. However, its impact on torsional resistance was system-dependent, resulting in reduced strength only in the reciprocating One RECI instruments.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144775295","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":"Endoplasmic Reticulum Stress Inhibits the Neuronal Differentiation of Human Stem Cells From Apical Papillae by Attenuating the Activity of ERK-IRE1α Axis In Vitro.","authors":"Zhaodan Wang, Junqing Liu, Shulan Lin, Jingyi Ye, Leyi Chen, Chengfei Zhang, Buling Wu","doi":"10.1111/iej.70003","DOIUrl":"https://doi.org/10.1111/iej.70003","url":null,"abstract":"<p><strong>Aim: </strong>Stem cells from apical papillae (SCAPs) are promising seed cells for angiogenesis, neurogenesis and dental pulp regeneration, which are contingent upon endoplasmic reticulum (ER) homeostasis. Due to the narrow anatomical structure of the root canal system and slow ingrowth of vasculatures, the presence of hypoxia and nutrient-deficient microenvironment within the sterilised root canal space may induce ER stress in the transplanted cells and affect their differentiation into neural lineages. This study aimed to investigate the role of ER stress in the neuronal differentiation of human SCAPs and its underlying mechanisms.</p><p><strong>Methodology: </strong>Thapsigargin (TG) was employed to induce ER stress in SCAPs. ER Ca²⁺ level was quantified by Mag-Fluo 4 AM. Quantitative real-time PCR (qRT-PCR) and western blot were conducted to detect ER stress markers. SCAPs, with or without ER stress, were guided towards neuronal differentiation. We measured the expression of neuronal markers and the activation of the extracellular signal-regulated kinase (ERK1/2) and the unfolded protein response (UPR) signalling. Immunofluorescence staining was applied to observe SCAP-derived neuron-like cells. The kinetic Ca²⁺ influx of SCAP-derived neuron-like cells was monitored using a fluorescence microscope. SCH772984 and MKC8866 were used to selectively inhibit ERK1/2 and inositol-requiring enzyme 1α (IRE1α) activation, respectively. Statistical analyses were conducted using the GraphPad Prism 10 software.</p><p><strong>Results: </strong>After TG stimulation, ER Ca²⁺ levels in all TG-treated SCAP groups were markedly reduced, the ER stress markers were significantly upregulated and UPR activation was found. Following neuronal induction, ER stress induced by 20 nM TG did not inhibit SCAP neuronal differentiation. However, ER stress induced by 40 or 80 nM TG significantly inhibited neuronal marker expression, neurite outgrowth and Ca²⁺ influx in SCAP-derived neuron-like cells. The phosphorylated ERK1/2 decreased during neuronal differentiation, along with the reduction of phosphorylated-IRE1α (p-IRE1α). Inhibition of ERK1/2 activation led to neuronal marker protein reduction, neurite outgrowth restraint and p-IRE1α decrease. Selective inhibition of IRE1α activity suppressed NeuN expression and neurite outgrowth.</p><p><strong>Conclusion: </strong>Severe ER stress inhibits the neuronal differentiation of SCAPs via decreasing ERK1/2 and IRE1α activity, whereas ER stress at an appropriate level is essential for the neuronal differentiation of SCAPs.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The therapeutic potential of naringenin, a natural citrus flavonoid, on pulpal pain and pain-related cognitive dysfunction","authors":"Mojdeh Hashemi,&nbsp;Fatemeh Hosseini Raouf,&nbsp;Manijeh Dogani,&nbsp;Fatemeh Shahsavari,&nbsp;Mehdi Abasnejad,&nbsp;Saeed Esmaili-Mahani,&nbsp;Amin Khezri,&nbsp;Hesam Mirmohammadi,&nbsp;Omid Dianat","doi":"10.1111/iej.14267","DOIUrl":"10.1111/iej.14267","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;Orofacial pain, characterized by discomfort originating from areas such as the tooth pulp, trigeminal nerve and temporomandibular joint, poses substantial challenges in dentistry. Notably, pulpal and periapical pain profoundly impact the quality of life for affected individuals. Recent studies have highlighted a concerning association between pulpal pain and cognitive dysfunction, highlighting the intricate interplay between sensory distress and cognitive processes. Naringenin, a natural flavonoid, has garnered attention for its diverse physiological effects, including pain modulation. This investigation aims to elucidate the therapeutic potential of naringenin in mitigating capsaicin-induced pulpal pain and concomitant cognitive impairments. Additionally, we endeavour to unravel the underlying molecular mechanisms responsible for these observed effects, thereby contributing to a deeper understanding of naringenin's therapeutic utility in the management of orofacial pain syndromes.&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;Pulpal pain induction was achieved through intrapulpal injection of capsaicin (100 μg) in rat subjects. Central administration of naringenin was carried out at doses of 5, 10 and 15 μg per rat. Assessment of learning and memory performance was conducted using the Morris water maze task. Evaluation of inflammatory cytokine expression levels, including TNF-α, IL-1α, IL-1β, COX-2 and IL-6, as well as BDNF and TrkB expression, was performed using real-time PCR analysis.&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;Capsaicin administration resulted in a notable escalation of nociceptive responses alongside a concurrent decrement in cognitive function within the experimental rat model. Molecular analysis unveiled an upregulation of inflammatory cytokines coupled with a downregulation of BDNF and TrkB expression levels within the hippocampal region following pulpal pain induction. Remarkably, naringenin administration demonstrated a palliative effect against capsaicin-induced pain sensitivity and cognitive impairments, while also attenuating alterations in the aforementioned gene expressions induced by pain stimuli.&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;Naringenin appears to exert decreasing effects on both dental pain and pain-induced cognitive deficits, likely mediated through its ability to attenuate neuroinflammation and enhance growth factor signalling pathways. Consequently, it emerges as a promising natural therapeutic agent for the management of pain and associated cognitive impairments. Moreover, the intertwined neural pathways governing cognition and pain ","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"58 10","pages":"1644-1658"},"PeriodicalIF":7.1,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Combined Versus Supplementary Injection Techniques With Inferior Alveolar Nerve Block for Mandibular Molars With Symptomatic Irreversible Pulpitis: A Systematic Review and Network Meta-Analysis.","authors":"Thanatpong Rujirawan, Sittichoke Osiri, Kanet Chotvorrarak","doi":"10.1111/iej.70007","DOIUrl":"https://doi.org/10.1111/iej.70007","url":null,"abstract":"<p><strong>Background: </strong>Achieving effective anaesthesia in mandibular molars with symptomatic irreversible pulpitis is challenging. Various strategies involving the inferior alveolar nerve block (IANB) have been investigated, such as supplementing with additional injections after IANB failure (SUPP) or combining injections with IANB as primary injections (COMB). However, studies directly comparing SUPP and COMB are still lacking.</p><p><strong>Objectives: </strong>This study aims to assess and compare the anaesthetic effectiveness of different IANB strategies-SUPP and COMB-in mandibular posterior teeth with symptomatic irreversible pulpitis using a systematic review and network meta-analysis.</p><p><strong>Method: </strong>A comprehensive search was conducted in the PubMed, Embase, Cochrane Library, CINAHL and Scopus databases to identify relevant studies up to October 2024. Eligible randomised clinical trials (RCTs) were analysed using pairwise meta-analysis and network meta-analysis with a random-effects model to estimate treatment effects. Results were reported as risk ratios (RRs) with 95% confidence intervals (CIs) and surface under the cumulative ranking curve (SUCRA) values. The quality of the evidence was assessed using the CINeMA (Confidence in network meta-analysis) software (University of Bern, Bern, Switzerland).</p><p><strong>Results: </strong>A total of 28 studies involving five interventions were identified. Compared with IANB alone, both SUPP (RR = 2.02; 95% CI: 1.55-2.30; SUCRA: 85.1%) and COMB (RR = 1.86; 95% CI: 1.50-2.30; SUCRA: 64.9%) significantly improved anaesthetic success. However, there was no significant difference in effectiveness between SUPP and COMB.</p><p><strong>Conclusion: </strong>The quality of evidence ranging from low to high suggests that both SUPP and COMB are comparable in anaesthetic efficacy during endodontic treatment of mandibular molars with symptomatic irreversible pulpitis. However, both SUPP and COMB strategies showed significantly superior effectiveness compared to IANB alone.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144742017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progranulin (PGRN) Facilitates Anti-Inflammation and Pulpitis Repair In Vivo and In Vitro Through TNFR2/14-3-3ε Signalling Complex.","authors":"Jinhong Ju, Caijiao Wang, Fujiao Nie, Haoyang Tian, Qiuyue Yin, Jiayi Liu, Suli Wang, Pishan Yang, Yi Du","doi":"10.1111/iej.70000","DOIUrl":"https://doi.org/10.1111/iej.70000","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the role and mechanism of progranulin (PGRN) in reparative dentinogenesis and inflammation control for rat pulpitis and inflammatory human dental pulp stem cells (hDPSCs).</p><p><strong>Methodology: </strong>Eight-week-old male Wistar rats with irreversible pulpitis were treated with pulpotomy and divided into five groups: No treatment; Control; iRoot BP plus (BP); GelMA and recombinant human PGRN (rhPGRN) + GelMA (rhPGRN). Micro-computed tomography (Micro-CT) scans and histological and immunohistochemical staining were conducted to evaluate rhPGRN' anti-inflammation and pro-healing properties. The effects of rhPGRN on hDPSC inflammatory response, proliferation and dentinogenic differentiation and potential signalling pathways were assessed through CCK-8, alkaline phosphatase (ALP) staining, alizarin red staining, quantitative reverse transcription polymerase chain reaction (qRT-PCR), enzyme-linked immunosorbent assay (ELISA), immunofluorescence staining and western blotting.</p><p><strong>Results: </strong>In vivo, PGRN expression obviously increased in both the Control and GelMA groups compared to healthy pulp (p < 0.05). The BP and rhPGRN groups showed a significant decrease in inflammatory scores and expression of M1 macrophage markers CD86 and tumour necrosis factor alpha (TNF-α) while increasing M2 markers CD206 and interleukin 10 (IL-10) compared with the controls (p < 0.05). Enhanced dentine bridge formation and dentine sialophosphoprotein (DSPP) expression were observed in the BP and rhPGRN groups versus the controls (p < 0.05). Moreover, the rhPGRN group presented higher expressions of CD206, IL-10 and DSPP than the BP group (p < 0.05). In vitro, PGRN expression significantly increased in lipopolysaccharide (LPS)-stimulated hDPSCs (p < 0.05). rhPGRN significantly reduced the release of TNF-α, interleukin 1 beta (IL-1β) and IL-6 in LPS-stimulated hDPSCs and enhanced ALP activity, mineralized nodule formation and expression of ALP, Runt-related transcription factor 2 (RUNX2) and DSPP in LPS-stimulated or unstimulated hDPSCs (p < 0.05). Mechanistically, co-immunoprecipitation showed that PGRN bound to tumour necrosis factor receptor-2 (TNFR2), interacting with 14-3-3 epsilon (14-3-3ε) in hDPSCs. PGRN significantly inhibited LPS-activated phosphorylation of NF-κB/p65 and its nuclear translocation, and the use of a TNFR2 neutralising antibody or the 14-3-3 protein inhibitor R18 reversed these effects (p < 0.05).</p><p><strong>Conclusion: </strong>These findings suggest that PGRN plays a crucial role in anti-inflammation, immunomodulation and reparative dentinogenesis in rat pulpitis via the TNFR2/14-3-3ε-NF-κB pathway, highlighting its potential as a strategy for vital pulp therapy.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":7.1,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144730297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Critical Review of In Vitro Methodologies for Studying Inflammatory Responses in Human Dental Pulp Cell Cultures.","authors":"Shelly Arora, Finn Gilroy, Lara T Friedlander, Haizal M Hussaini, Henry F Duncan, Peter Cathro, Paul R Cooper","doi":"10.1111/iej.70004","DOIUrl":"https://doi.org/10.1111/iej.70004","url":null,"abstract":"<p><strong>Background: </strong>The pulp responds to disease and trauma through inflammation which modulates the tooth's ability to instigate healing mechanisms. In vitro human dental pulp cell (HDPC) culture models are widely used to study the tooth's response to pro-inflammatory stimuli.</p><p><strong>Objectives: </strong>The purpose of this review is to generate a structured appraisal of in vitro research methodologies to study HDPC cultures in a state of inflammation.</p><p><strong>Method: </strong>In this narrative review the Scopus, PubMed and Google Scholar databases were searched to identify studies reporting the use of HDPC cultures in vitro in inflammation-associated research until December 2024. The dataset initially identified 642 publications, which were manually screened to identify 246 relevant studies for inclusion and methodologically mined for information on: (i) study purpose, (ii) source and characterisation of cells, (iii) pro-inflammatory stimuli used and (iv) assays and markers used to characterise the inflammatory response. The collected data underpinned this review.</p><p><strong>Results: </strong>Most published studies aimed to characterise HDPC responses to a range of pro-inflammatory stimulants which included bacterial components (lipopolysaccharides [LPS] and lipoteichoic acids [LTA]), cytokines and biomaterials. These stimulations were studied: to characterise their effect in the development of new scaffolds and dental (bio)materials and to mimic the in vivo environment. Various tooth sources were used to establish HDPC cultures, and predominantly, cells were isolated using the pulp tissue explant technique. The most frequently used stimulant and concentrations were LPS at 1 and 10 μg/mL. The time for cell stimulation prior to inflammatory response assay varied from 15 min to 10 days. Inflammatory assessments were performed using quantitative polymerase chain reaction (qPCR), Western Blotting, enzyme-linked immunosorbent assay (ELISA) and high-throughput assays targeting archetypical cytokines and dentinogenic and mineralisation-associated molecules.</p><p><strong>Discussion: </strong>This review highlights the broad range of experimental conditions used to study HDPC inflammatory responses in vitro and combines these data to identify a framework for a consensus and a more uniform experimental approach.</p><p><strong>Conclusion: </strong>Standardisation of in vitro experimental conditions to evaluate the pulps response to inflammatory stimuli would enhance research rigour and improve clinical translation to ultimately inform patient treatment and outcomes.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144707412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endodontic diagnostics training in undergraduate dental education: An observational pilot study on AI-driven virtual patient e-learning.","authors":"Marian Prinz, Edgar Schäfer, Sebastian Bürklein, David Donnermeyer","doi":"10.1111/iej.14277","DOIUrl":"https://doi.org/10.1111/iej.14277","url":null,"abstract":"<p><strong>Aim: </strong>To develop and evaluate an e-learning tool utilizing a generative pre-trained transformer (GPT), a form of artificial intelligence (AI), to allow for realistic conversation on virtual patients when undergoing training on how to diagnose diseases of endodontic origin, and to evaluate improvements in self-perceived skills.</p><p><strong>Methodology: </strong>A web app consisting of three components [website for user access, database server with patient case information, GPT-4-turbo model (OpenAI)] was designed to serve as the e-learning platform. Undergraduate students from 4th and 5th year at the dental school of the University of Münster, Germany, were asked to solve eight cases of virtual patients presenting with pain from endodontic or periodontal origin. Before, a questionnaire applying a 5-point Likert scale served to evaluate the current self-perceived state regarding the education, experience and skills in endodontic diagnostics and emergency treatment. After a 3-month timeframe of working with the programme individually, the students were asked to answer a second questionnaire which focused on their experience and self-perceived skills improvement after using the training software.</p><p><strong>Results: </strong>Ninety-two students participated in the first questionnaire and 72 students finished the second questionnaire, resulting in a drop-out rate of 21.7%. Students in the 5th-year reported more experience in dealing with emergency patients. Initially, both cohorts mainly did not feel confident to perform endodontic diagnostics independently. The evaluation of confidence to perform endodontic diagnostics independently, both by 4th- and 5th-year students, seemed improved after the training on the e-learning tool. The tool was recommended to be available for endodontic education by 72.2% of the students, who strongly agreed to such a statement. 76.4% of the participants strongly agreed to recommend the use of the tool to other students.</p><p><strong>Conclusions: </strong>AI-based interactive e-learning programmes allowing for complex conversational patient encounters present a possibility to improve diagnostic and interactive skills of undergraduate students.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Comparative Analysis of the Efficiency of Two Clearing Agents in Natural Transparent Teeth Preparation for Dental Education.","authors":"Ana Kostenkova, Yuliia Onashko, Algimantas Kriščiukaitis, Robertas Petrolis, Tadas Venskutonis, Greta Lodienė","doi":"10.1111/iej.70005","DOIUrl":"https://doi.org/10.1111/iej.70005","url":null,"abstract":"<p><strong>Aim: </strong>To assess the effectiveness of the benzyl benzoate and benzyl alcohol (BABB) solution in transparent teeth preparation compared to methyl salicylate using comprehensive digital and radiographic quantitative values analysis.</p><p><strong>Methodology: </strong>Freshly extracted 32 single-rooted teeth were immersed in 10% formalin for 24 h. They were then processed following a standard demineralization and dehydration protocol. The teeth were then divided into two groups: the first group, consisting of 12 teeth, was immersed in the BABB solution for 24 h; the second group of 20 teeth underwent the traditional protocol, which involved soaking the teeth in 99% methyl salicylate for the same duration. The optical properties of the processed teeth's translucency were evaluated by transluminant light imaging using a collimated light source and digital camera. Radiographic images of each tooth included in the study, along with a control group consisting of a freshly extracted natural tooth, were acquired under standardised computer settings, exposure conditions and X-ray tube positioning. The segmentation of the radiographic images into superpixels and the selection of areas of interest were conducted in the same manner as with visible light images. Image processing algorithms within the MatLab computational environment were utilised to assess the colour and intensity of the translucent light at the apical region of the root for each tooth.</p><p><strong>Results: </strong>The optical properties of selected anatomical locations were consistent across both groups of teeth when evaluating hue, saturation and value of pixels. The X-ray absorption in the translucent teeth was significantly lower than that in the non-translucent teeth, with notable differences observed between the groups; specifically, teeth affected by BABB material exhibited greater permeability to X-rays than those affected by methyl salicylate.</p><p><strong>Conclusions: </strong>The BABB solution demonstrates comparable efficacy to methyl salicylate regarding the optical properties of translucent teeth. When examining X-ray absorption, teeth treated with the BABB solution exhibited greater permeability to X-ray absorption than those treated with methyl salicylate.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}