International endodontic journal最新文献

{"title":"Game-Based Learning: A Pilot Educational Strategy to Foster the Learning of Endodontic Terminology.","authors":"Isabel Fernandez-Garcia, Paula Riaza, Ana Arias","doi":"10.1111/iej.70001","DOIUrl":"https://doi.org/10.1111/iej.70001","url":null,"abstract":"<p><strong>Aim: </strong>Exploring the effectiveness of a game-based pilot educational strategy for learning endodontic terminology and assessing satisfaction among postgraduate students.</p><p><strong>Methodology: </strong>The study was conducted on the first- and second-year students of the postgraduate program in Endodontology (n = 12). A game-based activity, modelled on a television quiz show, was designed to facilitate the learning of endodontic terminology. Students were randomly allocated into four teams based on their course year. Each team answered 26 questions corresponding to definitions of endodontic terms, with correct answers beginning with or containing consecutive letters of the alphabet. Teams within the same cohort competed, and the team with the most correct answers was declared the winner. Students completed three tests at different time points (2 weeks, 1 month and 1 year) after the game-based educational session. A trained rater blindly scored the tests. Additionally, participants completed an anonymous satisfaction web-based survey. The survey included multiple-choice questions to be answered with a 5-point Likert scale to address satisfaction with the content and instructional methods and four questions assessing overall satisfaction on a scale from 0 to 10, along with open-ended questions for additional feedback. Scores of students and numerical responses in the satisfaction survey were compared between first- and second-year students with the Mann-Whitney U test. Scores obtained 2 weeks and 1 month/1 year after the instructional activity were compared with the Wilcoxon paired test. Responses to the multiple-choice questions, based on a 5-point Likert scale, regarding the impact of content and instructional methods were compared between first- and second-year students with the ordinal chi-squared test.</p><p><strong>Results: </strong>Students demonstrated high test scores and reported high satisfaction with the game-based learning strategy. No statistically significant differences in test scores or satisfaction levels were observed between cohorts. Additionally, test scores remained consistent regardless of the time elapsed between the activity and testing (p > 0.05).</p><p><strong>Conclusions: </strong>The high scores and satisfaction reported by both cohorts suggest that game-based educational strategies are an innovative practical approach that may serve as an additional method to memorise endodontic terminology.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144667589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions and Procedural Errors in the Use of a Patient-Specific 3D-Printed Model for MTA Apexification Technique Training.","authors":"H Plascencia, M A Contreras-Preciado, J F Brito-Ortiz, M Díaz, R Solis, G Gascón","doi":"10.1111/iej.70002","DOIUrl":"https://doi.org/10.1111/iej.70002","url":null,"abstract":"<p><strong>Aim: </strong>Patient-specific 3D-printed dental models present innovative opportunities in endodontic education, offering a bridge between theoretical learning and clinical practice. This study aimed to compare the effectiveness of such models versus extracted natural teeth for training postgraduate residents in the MTA apexification technique, focusing on procedural accuracy and perception.</p><p><strong>Methodology: </strong>This mixed in vitro study (QUAL-quant) involved 21 postgraduate endodontic residents who were randomly assigned to two groups: The control group (CG), using 63 extracted natural teeth, and the experimental group (EG), using 63 patient-specific 3D-printed open-apex models derived from in vivo CBCT scans. After proper calibration, the participants performed the training sessions including identical procedural steps. Subsequently, the residents completed two Likert scale surveys: Academic Satisfaction Scale and Open-Apex Model Questionnaire. Additionally, an observer reviewed the radiographs of all practices and rated the executed procedures. Statistical analyses included descriptive statistics, Spearman's correlation, confirmatory factor analysis (CFA), chi-square and Fisher's exact tests (p ≤ 0.05).</p><p><strong>Results: </strong>Patient-specific 3D-printed teeth achieved high acceptance rates among residents, with approval scores of 96.6% on the Academic Satisfaction Scale and 70.79% on the Open-Apex Model Questionnaire. Procedural accuracy was comparable across groups, with 86.14% of treatments free of errors in both. Significant correlations were identified among key procedural variables, such as dental radiographic aspect, access and negotiation of the root canal, determination of working length, and creation of the apical barrier with MTA, highlighting the internal consistency of performance patterns of the 3D model. Inferential analyses revealed significant differences in specific procedural steps: the CG outperformed the EG in determining working length (p = 0.043) and achieving a homogeneous apical barrier (p = 0.004). Minor concerns regarding the tactile sensation and radiographic properties of the artificial prototypes were noted but considered addressable.</p><p><strong>Conclusion: </strong>Patient-specific 3D-printed open-apex teeth demonstrated high acceptance and supported technically proficient treatments during MTA apexification training. Although overall performance was comparable to that with natural teeth, specific procedural differences suggest that further refinement of the artificial models may enhance their effectiveness as alternative training tools in postgraduate endodontic education.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144649386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sympathetic nerves inhibit dental pulp stem cell differentiation and tertiary dentine formation via α1B-adrenergic receptor","authors":"Chengcan Yang,&nbsp;Qian Gao,&nbsp;Nuo Xu,&nbsp;Xiaona Song,&nbsp;Zhuan Bian,&nbsp;Kai Yang","doi":"10.1111/iej.14281","DOIUrl":"10.1111/iej.14281","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>The dental pulp is extensively innervated. Our previous study showed that the α1B-adrenergic receptor ADRA1B is the primary sympathetic neurotransmitter receptor in human dental pulp stem cells (hDPSCs) and its expression was enhanced in inflamed pulp tissues. The sympathetic nerve system (SNS) negatively impacts the proliferation and migration capacities of hDPSCs via ADRA1B. In this study, we aimed to explore the role of the SNS in odontoblast differentiation of hDPSCs and tertiary dentine formation during dentine-pulp injury repair.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>We investigated in vitro function of ADRA1B activity in regulating odontoblast differentiation of hDPSCs by evaluating protein and RNA expression levels of DSPP and DMP1, alkaline phosphatase (ALP) activity and alizarin red S (ARS) staining in control, ADRA1B-overexpression and ADRA1B-knockdown groups. The underlying mechanisms were further examined by assessing the oxygen consumption rate (OCR), glucose consumption and mitochondrial morphology. In vivo, a rat model with superior cervical ganglionectomy (SCGx) followed by direct pulp capping was established to assess the effects of the SNS on tertiary dentinogenesis. Additionally, <i>Adra1b</i>^{<i>flox/flox</i>}, <i>Prx1-cre</i> mice, combined with a severe dentine exposure model, were used to explore the effects of the SNS on mesenchymal cells via ADRA1B during tertiary dentine formation. Tertiary dentine was determined by histological staining.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Adrenergic signalling through ADRA1B was a crucial signal that inhibits the odontoblast differentiation ability of hDPSCs in vitro by suppressing mitochondrial metabolism via PGC-1α. Sympathectomy enhanced dentine formation in the direct pulp capping rat model. Furthermore, the ablation of <i>Adra1b</i> in mesenchymal cells led to increased odontoblast differentiation and tertiary dentine formation in a mouse model with severe dentine exposure.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Here, we show a new link between the SNS and the odontoblast differentiation capacity of hDPSCs through the adrenergic receptor ADRA1B. Our findings indicate that the SNS impedes the odontoblast differentiation capacity of hDPSCs by suppressing mitochondrial metabolism, which further hampers tertiary dentine formation via ADRA1B.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"58 10","pages":"1629-1643"},"PeriodicalIF":7.1,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging trends of injectable hydrogels for vital pulp therapy: A comprehensive review","authors":"Md Refat Readul Islam,&nbsp;Rafiqul Islam,&nbsp;Hidehiko Sano,&nbsp;Yu Toida,&nbsp;Shuhei Hoshika,&nbsp;Hany Mohamed Aly Ahmed,&nbsp;Atsushi Tomokiyo","doi":"10.1111/iej.14279","DOIUrl":"10.1111/iej.14279","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Injectable hydrogels are widely used in biomedicine and tissue engineering. Recently, they have been introduced as promising capping materials for vital pulp therapy (VPT) owing to their biocompatibility, in situ adaptability, minimal immunogenicity, and ability to modify the cellular activities of dental pulp exposed to caries or accidental injuries. Although injectable hydrogel-based biomaterials facilitate pulp healing and reparative dentine formation, their clinical utility has not been fully explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This review highlights the gaps in current research, including the lack of studies on the long-term in vivo effects of injectable hydrogels and comprehensive interactions between injectable hydrogel and the dentine–pulp complex, which impede clinical translation, especially for VPT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature search was conducted in PubMed and Scopus in April 2024 using relevant keywords related to injectable hydrogels and VPT. Eligible articles published between 2014 and 2024 included laboratory, animal and clinical studies, addressing the biological function, design, or clinical applicability of injectable hydrogels for VPT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This review covers various biomaterial-based injectable hydrogels developed using hyaluronic acid, gelatine methacryloyl, chitosan, collagen, decellularized extracellular matrix, self-assembling peptides, and nanoparticles for VPT, highlighting possibilities for future clinical translation and innovation. Laboratory studies on injectable hydrogels provide promising results, including enhanced pulp healing, reduced inflammation, homogeneous reparative dentine formation, and also key innovations to enhance the functionality, adaptability, and characteristics of novel injectable hydrogels developed for VPT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Hydrogels functionalized with advanced biomaterials and bioengineering approaches can overcome the existing shortcomings, enabling their smooth transition into clinical practice. Nevertheless, further research is required to elucidate their long-term effects and optimal application methods.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"58 10","pages":"1490-1528"},"PeriodicalIF":7.1,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iej.14279","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144617417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Activation of G protein-coupled parathyroid hormone receptors in rat incisor odontoblasts promotes mineralization via cyclic adenosine monophosphate, not Ca2+ signalling: In vitro study","authors":"Natsuki Saito,&nbsp;Takehito Ouchi,&nbsp;Maki Kimura,&nbsp;Ryuya Kurashima,&nbsp;Yoshiyuki Shibukawa","doi":"10.1111/iej.14280","DOIUrl":"10.1111/iej.14280","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Parathyroid hormone (PTH) and its Gα_s-coupled receptors, PTH receptor, mediate odontoblast differentiation; however, the detailed intracellular adenylyl cyclase-mediated signalling pathway mediated by the PTH–PTH receptor axis remains to be elucidated. Therefore, we measured the intracellular levels of cyclic adenosine monophosphate (cAMP) in living single odontoblasts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>We obtained acutely isolated odontoblasts from newborn Wistar rats and analysed the mineralization ability by Alizarin red staining. Intracellular-free Ca²⁺ concentration was measured using a fluorescent Ca²⁺ indicator, whereas intracellular cAMP levels were examined by a mNeon Green–based cAMP sensor.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Granulated PTH was detected in the vascular area of the dental pulp periphery. Application of the non-selective PTH receptor agonist DPC AJ1951 increased cAMP levels in odontoblasts. This increase was significantly inhibited by the non-selective PTH receptor antagonist 4185-v and the adenylyl cyclase inhibitor SQ 22536. However, applying the non-selective PTH receptor agonist DPC AJ1951 did not increase the intracellular Ca²⁺ concentration without extracellular Ca²⁺. In mineralization assays, PTH promoted mineralization by odontoblasts. The mineralization was inhibited by SQ 22536 and 4185-v but not by the phospholipase C inhibitor U73122.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Thus, the present study suggests that PTH from the bloodstream functionally activates the Gα_s-coupled PTH receptor in odontoblasts, which plays an essential role in dentinogenesis.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"58 10","pages":"1616-1628"},"PeriodicalIF":7.1,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iej.14280","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144617416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"3D prototyped macro-models as educational aid for teaching endodontic access in preclinical training: Assessment of students' learning experience, confidence and performance.","authors":"Lucila Piasecki, Kayla Schwartz, Charlene Tsou, Praveen Arany, Mohini Ratakonda, Monica Romero, Jorge Vera, Kallyane Navarrete, Everdan Carneiro","doi":"10.1111/iej.14276","DOIUrl":"https://doi.org/10.1111/iej.14276","url":null,"abstract":"<p><strong>Aim: </strong>This study evaluated the effectiveness of three-dimensional prototyped macro-models (3DPMM) as an educational aid for teaching endodontic access to dental students.</p><p><strong>Methodology: </strong>A total of 72 students were randomly assigned to three groups (n = 24) and participated in study sessions with 3DPMM at different stages: before, during (intermediate) or after performing laboratory projects. The timing of the 3DPMM study sessions rotated across groups for different tooth types (anterior, premolar and molar). Each student performed endodontic access on nine teeth (four anterior, three premolars and two molars). Students completed a questionnaire evaluating their learning experience and confidence. Endodontic access projects were graded by masked instructors, and the data were statistically analysed (α = 0.05).</p><p><strong>Results: </strong>Students rated their learning experience with the 3DPMM positively, regardless of their differences based on group assignment, tooth type or timing of the study session (p > .05). Procedural errors were observed in 47% of the teeth, with 35.6% exhibiting one error and 11.4% exhibiting two errors. The most common errors included gouging (26.6%) and oversized access cavities (23.5%). Students who completed endodontic access before using the 3DPMM had a significantly higher frequency of multiple errors, oversized access cavities and retained pulp chamber roof (p < .05). Approximately 60% of participants reported increased confidence after using the models, regardless of group assignment, tooth type or study session timing (p > .05).</p><p><strong>Conclusion: </strong>The findings suggest that integrating 3DPMM enhanced students' understanding of internal tooth anatomy, increased their confidence and reduced procedural errors. Students appreciated the hands-on, interactive learning experience offered by the models, reinforcing the value of innovative educational tools in endodontic training.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564762","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":"Metallomic characterization of induced periapical lesions—In vivo study","authors":"Jennifer Santos Pereira,&nbsp;Brenda Fornazaro Moraes,&nbsp;Anna Carolina Neves Leutz,&nbsp;Hellen Carolliny de Souza Nicolau,&nbsp;Rafaela Caires Santos,&nbsp;Talita Tartari,&nbsp;Brenda Paula Figueiredo de Almeida Gomes,&nbsp;Adriana de Jesus Soares,&nbsp;Ana Cristina Padilha Janini,&nbsp;Lauter Eston Pelepenko,&nbsp;Marina Angélica Marciano","doi":"10.1111/iej.14274","DOIUrl":"10.1111/iej.14274","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Metals are essential for metabolism and play a crucial role in various biological processes. Therefore, the aim of this study was to characterize and compare the metallomic profiles of periapical lesions and healthy alveolar bone in rats using complementary analytical techniques.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>This study included 76 lower first molars (from 38 Wistar rats) where induced periapical lesions and controls (sham) were compared. Periapical lesion induction was performed by pulp exposure of these teeth, allowing infection development. After 40 days, the animals were reweighed, euthanised and their hemimandibles analysed by periapical radiography, histological analysis, micro-computed tomography (μ-CT), X-ray fluorescence microscopy (μ-XRF), scanning electron microscopy with energy dispersive spectroscopy (SEM/EDS), inductively coupled plasma optical emission spectrometry (ICP-OES) and inductively coupled plasma mass spectrometry (ICP-MS). Ten essential metals for metabolism were analysed (sodium, potassium, magnesium, calcium, iron, manganese, cobalt, copper, zinc and molybdenum). The analyses observed a significance level of 5%.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Radiographic analysis confirmed the induction of periapical lesions, without difference in animal weight between the conditions (<i>p</i> &gt; .05). Histologically, the periapical lesions showed intense inflammatory infiltrate, cells with bluish cytoplasmic granules, alveolar resorption and scores ranging from moderate to intense. The μ-CT analysis of the induced lesion revealed a significant difference in the periapical region volume (12.74 mm³, <i>p</i> = .0017). SEM/EDS showed limited sensitivity for the investigated chemical elements; however, μ-XRF identified diminished intensities for calcium and zinc and increased intensities for iron. ICP-MS and ICP-OES identified increased concentrations of sodium (<i>p</i> = .0137), potassium (<i>p</i> = .0005), calcium (0.0059), magnesium (<i>p</i> = .0004), iron (<i>p</i> &lt; .001), ⁵⁶iron (<i>p</i> = .0078), ⁵⁷iron (<i>p</i> = .0315) and manganese (<i>p</i> &lt; .001) within the induced periapical lesion, suggesting a direct impact on mineral homeostasis following this pathology.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrated differences in the levels of various essential elements between conditions with periapical lesions and healthy controls.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"58 10","pages":"1594-1615"},"PeriodicalIF":7.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iej.14274","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Periapical lesions: Assessment of clinical diagnostic accuracy and prevalence of nonendodontic lesions mimicking endodontic pathoses","authors":"Weeraya Boonkasemsanti,&nbsp;Chavisa Padungkarn,&nbsp;Saruth Tewtipsakul,&nbsp;Ekarat Phattarataratip","doi":"10.1111/iej.14278","DOIUrl":"10.1111/iej.14278","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Endodontic periapical lesions are prevalent in routine dental practice, yet a substantial proportion of these lesions may not be directly attributable to pulpal infection. This study aimed to assess the diagnostic accuracy of periapical lesions and the prevalence and demographic profiles of nonendodontic lesions misdiagnosed as endodontic in origin.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>The clinical and pathologic diagnoses of periapical lesions associated with the apex of nonvital or endodontically treated teeth over a 20-year period were systematically collected. These diagnoses were categorized into endodontic and nonendodontic lesions. Endodontic diagnoses included radicular cyst, periapical granuloma, periapical abscess and periapical scar. The diagnostic accuracy, receiver operating characteristics curves and the differences in clinical characteristics of these lesions were subsequently analysed. Additionally, the frequency and clinical data of nonendodontic periapical lesions were tabulated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 1611 periapical lesions included, 1521 cases (94.4%) were endodontic lesions, whilst 90 cases (5.6%) were nonendodontic in origin. The overall diagnostic accuracy was 91.4%, with areas under curve (AUCs) for diagnosing endodontic and nonendodontic periapical lesions being 0.955 and 0.767, respectively. Clinicians correctly diagnosed endodontic lesions with 95.5% sensitivity, whilst the specificity of diagnosing nonendodontic lesions was 23.3%. Endodontic lesions exhibited a significantly higher prevalence of cases presenting with a size less than 2 cm, exhibiting no swelling and presenting with a rounded radiographic appearance. The frequency of nonendodontic periapical lesions clinically misdiagnosed as endodontic in origin was 69 out of a total sample of 1521 (4.5%). Most lesions (47.8%) affected the anterior maxilla. Odontogenic keratocyst (27.5%) and ameloblastoma (24.6%) were the most common pathoses mimicking endodontic lesions clinically. Malignant neoplasms constitute 5.8% of all nonendodontic periapical lesions, the most common of which were intraosseous squamous cell carcinoma.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite the high overall diagnostic accuracy, the specificity of recognizing nonendodontic periapical lesions is relatively low. Clinicians often overdiagnose endodontic lesions clinically. In the presence of periapical lesions with a diameter of 2 cm or more, clinical swelling or a nonrounded radiographic appearance, clinicians should consider the possibility of nonendodontic lesions. Diverse benign and mal","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"58 10","pages":"1582-1593"},"PeriodicalIF":7.1,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540100","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":"Symptom correlation and spatial distribution of inflammatory mediators in pulpitis—A preliminary study","authors":"Ai Leen Shu Jen Loo,&nbsp;Rong Cen,&nbsp;Junwen Wang,&nbsp;Zhaoming Wu,&nbsp;Henry Fergus Duncan,&nbsp;Angeline Hui Cheng Lee,&nbsp;Chengfei Zhang","doi":"10.1111/iej.14275","DOIUrl":"10.1111/iej.14275","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To evaluate the association of inflammatory mediators with clinical signs and symptoms and their spatial distribution in teeth with pulpitis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>Fifty permanent teeth from adults with clinical diagnoses of normal pulp (<i>n</i> = 17), reversible pulpitis (<i>n</i> = 13) and symptomatic/asymptomatic irreversible pulpitis (<i>n</i> = 20), were recruited. Two pulp blood samples from each tooth, one at the pulp exposure site (coronal blood) and one at the orifice level (radicular blood), were collected and analysed using multiplex immunoassay. The expression of 52 inflammatory mediators was analysed to compare regional variations within teeth, between groups and amongst teeth with pulpitis regrouped by symptom severity. Statistical comparisons were made using paired comparison tests at <i>p</i> &lt; 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>TGFα and FGF-2 were significantly downregulated in teeth with reversible and irreversible pulpitis compared with healthy controls (<i>p</i> &lt; 0.05). IL-1β was significantly upregulated in the radicular blood of teeth with irreversible pulpitis compared with reversible pulpitis (<i>p</i> &lt; 0.05). Higher concentrations of inflammatory markers were found in the coronal blood of reversibly inflamed teeth, whilst irreversibly inflamed teeth exhibited elevated fractalkine and IL-2 in radicular regions (<i>p</i> &lt; 0.05). The spatial distribution of biomarkers in teeth with pulpitis after regrouping by symptom severity demonstrated increased IL-22 in coronal blood and IL-13 in radicular blood in symptomatic teeth (<i>p</i> &lt; 0.001, <i>p</i> &lt; 0.05). Radicular blood of teeth with mild symptomatic pulpitis showed significantly increased levels of IL-17A but decreased concentrations of TGFα and MMP-2 compared to asymptomatic teeth (<i>p</i> &lt; 0.05). Teeth with severe symptomatic pulpitis exhibited significantly higher levels of IL-1α and TGFα in coronal blood compared with asymptomatic irreversible pulpitis (<i>p</i> &lt; 0.05). Symptomatic teeth generally exhibited more pronounced coronal inflammatory mediator expression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>IL-1β is a promising biomarker for distinguishing between reversible and irreversible pulpitis. TGFα and FGF-2 demonstrate significant potential as diagnostic biomarkers in discriminating between states of pulpitis and health. IL-1α, IL-13, IL-17A, IL-22, TGFα and MMP2 also showed potential to differentiate between teeth with symptomatic and asymptomatic","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"58 10","pages":"1565-1581"},"PeriodicalIF":7.1,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iej.14275","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144496146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ensuring integrity in dental education: Developing a novel AI model for consistent and traceable image analysis in preclinical endodontic procedures.","authors":"Mohamed Ibrahim, Meisam Omidi, Arndt Guentsch, Joseph Gaffney, Jennifer Talley","doi":"10.1111/iej.14273","DOIUrl":"https://doi.org/10.1111/iej.14273","url":null,"abstract":"<p><strong>Aim: </strong>Academic integrity is crucial in dental education, especially during practical exams assessing competencies. Traditional oversight may not detect sophisticated academic dishonesty methods like radiograph substitution or tampering. This study aimed to develop and evaluate a novel artificial intelligence (AI) model utilizing a Siamese neural network to detect inconsistencies in radiographic images taken for root canal treatment (RCT) procedures in preclinical endodontic courses, thereby enhancing educational integrity.</p><p><strong>Methododology: </strong>A Siamese neural network was designed to compare radiographs from different RCT procedures. The model was trained on 3390 radiographs, with data augmentation applied to improve generalizability. The dataset was split into training, validation, and testing subsets. Performance metrics included accuracy, precision, sensitivity (recall), and F1-score. Cross-validation and hyperparameter tuning optimized the model.</p><p><strong>Results: </strong>Our AI model achieved an accuracy of 89.31%, a precision of 76.82%, a sensitivity of 84.82%, and an F1-score of 80.50%. The optimal similarity threshold was 0.48, where maximum accuracy was observed. The confusion matrix indicated a high rate of correct classifications, and cross-validation confirmed the model's robustness with a standard deviation of 1.95% across folds.</p><p><strong>Conclusions: </strong>The AI-driven Siamese neural network effectively detects radiographic inconsistencies in RCT preclinical procedures. Implementing this novel model will serve as an objective tool to uphold academic integrity in dental education, enhance the fairness and reliability of assessments, promote a culture of honesty amongst students, and reduce the administrative burden on educators.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325612","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}