International endodontic journal最新文献

{"title":"In situ imaging and microbiome analysis of calculus-like deposits at the root apex: A case report of refractory apical periodontitis","authors":"Fernando J. Mota de Almeida,&nbsp;Olena Rakhimova,&nbsp;Nelly Romani Vestman,&nbsp;Natuschka M. Lee,&nbsp;Malin Brundin","doi":"10.1111/iej.14268","DOIUrl":"10.1111/iej.14268","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This case report explored the application of next-generation sequencing (NGS) and fluorescence in situ hybridization (FISH) to visualize and characterize microbial populations in a refractory endodontic infection with apical calculus-like deposits, a rarely reported phenomenon.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Summary</h3>\u0000 \u0000 <p>Histopathologic analysis revealed bacterial biofilms and calcifications on the root surface, with Gram-positive bacteria predominant in both hard and soft tissues. Microbial sequencing showed <i>Pseudomonadota</i> dominated hard tissues, whereas <i>Bacillota</i> were prevalent in soft tissues, with distinct genera like <i>Lactibacterium</i> and <i>Streptococcus</i> identified. FISH imaging confirmed spatially distributed bacterial taxa, including <i>Actinomycetota</i> and <i>Chloroflexota</i>, within the biofilm, aligning with NGS findings. Notably, <i>Bacteroidota</i> was exclusive to soft tissues, whereas <i>Chloroflexota</i> was detected only in hard tissues. The presence of extensive calculus-like deposits on the root surface provided new insights into the microbial complexity of persistent endodontic infections and their management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key learning points</h3>\u0000 \u0000 <div>\u0000 \u0000 <ol>\u0000 \u0000 \u0000 <li>The combination of NGS and FISH provided unprecedented insights into the microbial composition of refractory endodontic infections, revealing a diverse and spatially organized ecosystem.</li>\u0000 \u0000 \u0000 <li>Distinct microbial compositions in hard and soft tissues emphasize the importance of targeted therapeutic strategies for endodontic infections.</li>\u0000 \u0000 \u0000 <li>The presence of unique bacterial taxa and biofilms in calculus-like deposits offers new avenues for research into the pathogenesis and persistence of endodontic infections.</li>\u0000 </ol>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"58 9","pages":"1474-1487"},"PeriodicalIF":7.1,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iej.14268","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302007","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":"Influence of different endodontic treatment protocols on tooth survival: A retrospective cohort study with multistate analysis and group balancing","authors":"Ahmed Elmaasarawi,&nbsp;Mohamed Mekhemar,&nbsp;Andreas Bartols","doi":"10.1111/iej.14271","DOIUrl":"10.1111/iej.14271","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This study aimed to assess how three different treatment protocols affect the survival of teeth and the survival of teeth without further interventions after root canal treatment (RCT), while also considering additional factors that could potentially influence the treatment outcome.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>Data were collected from an outpatient clinic database from July 1999 to January 2024 and 14 233 treated teeth could be included in a retrospective cohort study. Treatment protocols incorporated hand files (Protocol 1), multiple-file rotary NiTi systems added with passive ultrasonic irrigation (PUI), citric acid and occasionally chlorhexidine (Protocol 2) and reciprocating instruments added with PUI, EDTA, warm vertical compaction and calcium silicate-based sealer (Protocol 3). Survival analysis coupled with Cox proportional hazard regression and Kaplan–Meier curves took into account several variables including treatment, patient demographics and experience of the treatment provider. Confounding was addressed by entropy balancing and gradient boosted logistic regression. Multistate analysis was conducted to evaluate the influence of treatment protocols on the transition between various intervention states.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Survival analysis revealed that Protocol 3 significantly enhanced survival rates and survival rates without further interventions by 30%–40% compared to both other protocols. Additionally, higher patient age was identified as a negative predictor of treatment outcomes. Supportive periodontal treatments were a positive predictor. Factors such as tooth type, vitality, number of visits, experienced treatment provider, calcium silicate-based sealer and patient gender did not significantly affect outcomes in the adjusted models. Multistate analysis confirmed that Protocol 3 was associated with significantly reduced incidences of retreatment and extraction.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Protocol 3 significantly enhanced survival and survival without further interventions compared to both other protocols. Patient age and supportive periodontal treatments were significant predictors of outcomes throughout all calculated models.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"58 10","pages":"1529-1550"},"PeriodicalIF":7.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iej.14271","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283834","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":"2D versus 3D radiographic assessment of asymptomatic persistent endodontic lesions","authors":"Klare Chan Shu Wen,&nbsp;Lee Chee Wee,&nbsp;Mingrun Wei,&nbsp;Lim Kian Chong Gerald,&nbsp;Victoria Soo Hoon Yu","doi":"10.1111/iej.14272","DOIUrl":"10.1111/iej.14272","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>This prospective cohort study aimed to study lesion size, proximity to anatomical structures and detection of missed canals using 2D digital periapical (PA) radiographs and 3D cone beam computed tomography (CBCT) radiographic imaging, amongst a cohort of asymptomatic persistent endodontic lesions (APEL), and to develop a radiographic protocol for these asymptomatic lesions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>APEL persisting ≥4 years after endodontic treatment were recruited with informed consent. PA radiographs taken at different angles (KaVo Kerr, Brea, CA) and a limited field-of-view CBCT scan (KaVo Kerr, Brea, CA) of 0.125mm³ voxel size were evaluated. Two calibrated independent endodontic practitioners examined all radiographic images in a random and blinded sequence, under similar viewing conditions. Agreement above chance (kappa) was calculated for parameters of interest (Graphpad by Dotmatics, https://www.graphpad.com/).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-two APEL (15 incisors, 25 premolars, 42 molars; 59.8% treated 4–10 years prior) in 77 patients (34 male, 43 female, median age 51–60) were examined. Root filling quality was acceptable with 14/82 (17.0%) lacking density and homogeneity. Weighted kappa on <i>lesion size</i> (0.5–1.9, 2–4.9 and 5–9.9 mm) between PA radiographs and CBCT was 0.466 – in 24 APEL, lesion size was &gt;2 mm larger on CBCT whilst in 4 APEL, lesions were &gt;2 mm smaller on CBCT. On <i>proximity</i> to maxillary sinus and neurovascular structures (‘yes’, ‘no’, ‘unable to tell’), kappa was 0.237, with 9 APEL scored ‘unable to tell’ on PA radiographs and 0 uncertainty on CBCT. Agreement between PA radiographs and CBCT on <i>missed canals</i> (‘not likely’, ‘somewhat likely’, ‘very likely’, ‘unable to tell’) was 0.349, with 13 teeth scored ‘somewhat likely’ and ‘very likely’ on CBCT and only 6 teeth similarly scored on PA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overall, CBCT provided a more comprehensive examination of teeth with APEL than PA radiographs. Larger lesion sizes were generally observed, especially in posterior teeth. Sinus involvement was more readily identified, and the assessment of the presence of missed canals could be performed with more certainty. Where lesion monitoring is chosen, CBCT imaging should be considered for a more thorough assessment of posterior teeth, and where there is uncertainty in PA radiograph interpretation of anterior teeth.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"58 10","pages":"1551-1564"},"PeriodicalIF":7.1,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iej.14272","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144283833","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":"Mechanistic insights into dental stem cells-derived exosomes in regenerative endodontics","authors":"Paras Ahmad,&nbsp;Nathan Estrin,&nbsp;Nima Farshidfar,&nbsp;Yufeng Zhang,&nbsp;Richard J. Miron","doi":"10.1111/iej.14269","DOIUrl":"10.1111/iej.14269","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dental pulp is a richly vascularised and innervated tissue vital for tooth vitality, sensory function, and structural integrity. While conventional root canal therapy effectively treats necrotic permanent teeth, it irreversibly eliminates pulp vitality, potentially increasing the risk of secondary infections and long-term structural compromise. In response, regenerative endodontics has emerged as a biologically favourable alternative that seeks to restore the pulp–dentine complex using principles of tissue engineering.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This review aims to explore the therapeutic potential and mechanisms of action of exosomes derived from dental stem cells (DSC-Exos), a subclass of mesenchymal stem cells (MSCs), in promoting regeneration of the pulp–dentine complex, while also addressing translational challenges and proposing an integrated regenerative framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A comprehensive literature search was conducted across Web of Science, PubMed, and Scopus databases using keywords associated with “stem cells,” “exosomes,” “extracellular vesicles,” and “dental pulp regeneration.” Titles and abstracts were screened, and eligible studies were selected based on predefined inclusion criteria: (a) original research or case reports focusing on DSC-Exos in regenerative endodontics, (b) in vitro and in vivo studies, and (c) clinical trials or animal studies showing pulp-like tissue development. Studies not fulfilling these criteria were excluded. A total of 67 articles were included for narrative synthesis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>DSC-Exos were found to facilitate multiple regenerative functions: promoting odontoblastic differentiation and dentine mineralisation, enhancing angiogenesis, regulating inflammation, modulating immune responses, promoting cell proliferation and migration, reducing apoptosis and senescence, and supporting neuroprotection. In-vivo studies demonstrated pulp-like tissue formation, revascularisation, and functional restoration. However, heterogeneity in exosome isolation, culture conditions, donor variability, and unclear molecular pathways remain unresolved issues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>DSC-Exos present a promising acellular, immunologically safer approach to regenerative endodontics compared to direct stem cell transplantation. Despite their potential, the lack of standardis","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"58 9","pages":"1384-1407"},"PeriodicalIF":7.1,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iej.14269","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266105","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":"Robotic navigation system for management of pulp canal obliteration: A case report","authors":"Peng Yu,&nbsp;Hao Luo,&nbsp;Xi-wen Zhang,&nbsp;Rui Zhao,&nbsp;Shanon Patel","doi":"10.1111/iej.14270","DOIUrl":"10.1111/iej.14270","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To describe the application and management of robotic navigation system in access cavity preparation of a maxillary central incisor with severe pulp canal obliteration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Summary</h3>\u0000 \u0000 <p>The identification and preparation of root canal(s) in teeth with pulp canal obliteration (PCO) may be challenging, resulting in excessive removal of sound dentine and/or perforation. A static or dynamic navigation system has been demonstrated to be a useful aid to locate obliterated canals with minimal removal of sound dentine. However, navigation systems are not completely infallible, with potentially poorer outcomes when used by an inexperienced operator. This novel case adds to the emerging clinical literature on the robotic navigation system (RNS) in endodontics to increase the accuracy of access cavity preparation and to preserve tooth substance in a tooth with PCO and diagnosed with chronic periapical periodontitis. A 34-year-old male was referred for the management of an endodontic problem. His chief complaint was intermittent, mild discomfort which lingered for over 30 s localized to the upper left central incisor tooth #9 (21) to cold drinks for 1 week. Clinical examination revealed that tooth #9 (21) was tender to percussion and cold thermal testing reproduced the patient's presenting symptoms. A radiograph, including a cone beam computed tomography scan, revealed pulp canal obliteration and widening of the periodontal ligament of the apical third of tooth #9 (21). A diagnosis of symptomatic irreversible pulpitis was reached. The Digital Information and Communication in Medicine (DICOM) dataset was exported into an RNS. The RNS successfully accessed the canal without any human intervention, after which endodontic treatment was completed by an endodontist. At a 12-month review, the tooth was asymptomatic and a radiograph confirmed healthy periapical tissues. This case highlights the potential use of RNS for minimal access and time-saving access cavity preparation of teeth with PCO.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Key learning points</h3>\u0000 \u0000 <div>\u0000 \u0000 <ul>\u0000 \u0000 \u0000 <li>Multiple factors can lead to pulp canal obliteration, making it difficult to locate and negotiate the root canal.</li>\u0000 \u0000 \u0000 <li>Robotic navigation system is a minimally invasive, efficient, and predictable solution for managing calcified root canals.</li>\u0000 </ul>\u0000 </div>\u0000 </section>\u0000 </div>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"58 10","pages":"1659-1665"},"PeriodicalIF":7.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258040","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":"Clinical efficacy of root canal treatment at 2 years using a new ready-to-use injectable calcium silicate-based sealer: A multicentric randomised controlled trial","authors":"Stéphane Simon,&nbsp;Julien Beauquis,&nbsp;Hugues Colombel,&nbsp;Audrey Dorn,&nbsp;Valentin Marchi,&nbsp;Sébastien Robert,&nbsp;Grégoire Souleau,&nbsp;Nadia Ravalec,&nbsp;Florent Huguet-Jaime,&nbsp;Karine Chazaud,&nbsp;Anne-Laure Serandour,&nbsp;Nabila Ournid,&nbsp;Julian G. Leprince","doi":"10.1111/iej.14265","DOIUrl":"10.1111/iej.14265","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Calcium silicate-based sealers (CSSs) have gained popularity in endodontic applications primarily due to their biological properties and ease of use. This study aimed to assess the 24-month efficacy and safety of root canal treatment using a new injectable CSS, BioRoot<i>™</i> Flow, and to demonstrate the non-inferiority compared to the established hand-mixed BioRoot<i>™</i> RCS.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methodology</h3>\u0000 \u0000 <p>This was a multicentric, prospective, randomised, assessor-blinded, controlled, non-inferiority trial (ClinicalTrials.gov: NCT04757753). Patients requiring a primary or a secondary root canal treatment on a single or multi-rooted tooth were block randomly assigned to BioRoot Flow or BioRoot RCS groups. The primary outcome was the 24-month success rate based on clinical and radiological criteria. Secondary outcomes included the 6- and 12-month success rates based on similar radiological and clinical criteria, quality of obturation, resorption of extruded material in case of overfilling assessed at 6, 12 and 24 months, post-operative pain measured using the Visual Analog Scale (VAS) at baseline, 12 h, 24 h, 48 h, 72 h and 7 days, and occurrence of adverse events. A subgroup analysis was also performed based on the type of treatment and on the presence or absence of apical periodontitis (AP) at baseline. Non-inferiority between materials was assessed using Dunnett and Gent's Chi-squared (χ²) test, based on an initial hypothesis with a non-inferiority margin set at 13%, an 80% power and a 5% one-sided alpha risk. Investigators and patients were not blinded to the assigned medical device. Two qualified evaluators performed a blinded independent central review of the retro-alveolar radiographs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 160 patients with a mean age of 48 years were treated (77 in BioRoot Flow and 83 in BioRoot RCS). The 24-month follow-up rate was 85.6%. The overall 24-month success rates were 86.6% and 87.7% (<i>p</i> = .0195), respectively. No significant differences were observed between the groups regarding any of the considered secondary outcomes. No adverse events were reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study demonstrated the non-inferiority of the new injectable CSS (BioRoot Flow) compared to the previous hand-mixed version (BioRoot RCS) in terms of efficacy and safety, supporting the implementation of the new material in clinical practice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"58 9","pages":"1420-1432"},"PeriodicalIF":7.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258014","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 presence of Enterococcus in root canal infections based on next-generation sequencing: A systematic review and meta-analysis","authors":"Run-Ze Liu,&nbsp;Li-An Bai,&nbsp;Yi Luo,&nbsp;Pei Liu,&nbsp;Fang Hua,&nbsp;Wei Fan,&nbsp;Bing Fan","doi":"10.1111/iej.14266","DOIUrl":"10.1111/iej.14266","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Background&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Studies based on next-generation sequencing (NGS) have reported conflicting evidence regarding the presence of &lt;i&gt;Enterococcus&lt;/i&gt; in root canal infections.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objective&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;To determine whether &lt;i&gt;Enterococcus&lt;/i&gt; prevalence differs among secondary root canal infection (SRCI), persistent root canal infection (PRCI) and primary root canal infection (PrRCI).&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Literature search was carried out across databases (PubMed, Web of Science, Scopus and Excerpta Medica Database) and other online resources from 1 September 2005, to 24 October 2024. Studies were selected according to inclusion and exclusion criteria. Risk of bias was evaluated according to the JBI Prevalence Critical Appraisal Checklist. The selection of 28 studies focused on the main and secondary outcomes. Pooled estimates of Odds Ratio (OR), prevalence and 95% Confidence Interval (CI) were determined with a common effect or random effects model. Multivariate meta-regression models were fitted. Subgroup analyses were conducted based on sample collection method, region and NGS platform. Sensitivity analysis was conducted to further investigate the robustness of results and to explore plausible causes for heterogeneity.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Among 28 included studies, 16 studies reporting the detection rate of &lt;i&gt;Enterococcus&lt;/i&gt; were incorporated in the meta-analysis. The detection rate of &lt;i&gt;Enterococcus&lt;/i&gt; was significantly higher in SRCI than in PrRCI (OR = 2.691; 95% CI: 1.234–5.868; &lt;i&gt;p&lt;/i&gt; = .013). The pooled prevalences were 0.400 (95% CI: 0.235–0.565) for SRCI, 0.444 (95% CI: 0.000–0.976) for PRCI and 0.278 (95% CI: 0.087–0.470) for PrRCI, respectively. Within the PrRCI group, the cryogenic pulverization (CP) method yielded a significantly higher detection rate (0.768; 95% CI: 0.642–0.894) than the paper points/hand or rotary instruments (PP) method (0.113; 95% CI: 0.045–0.180). The relative abundance of &lt;i&gt;Enterococcus&lt;/i&gt; ranged from 0.01% to 18.88% in SRCI, 2% to 10.5% in PRCI and 0.0008% to 2.03% in PrRCI.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Discussion&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Although a quantitative synthesis of &lt;i&gt;Enterococcus&lt;/i&gt; prevalence has been conducted, the data of abundance remain insufficient in literatures.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusion&lt;/h3&gt;\u0000 \u0000 ","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"58 9","pages":"1331-1353"},"PeriodicalIF":7.1,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iej.14266","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258041","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":"Cellular dynamics and signalling mechanisms in dentine repair: A narrative review","authors":"Vidhyashree Rajasekar,&nbsp;Mohamed Mahmoud Abdalla,&nbsp;Prasanna Neelakantan,&nbsp;Cynthia K. Y. Yiu","doi":"10.1111/iej.14261","DOIUrl":"10.1111/iej.14261","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Bioactive molecules have gained significant attention in regenerative medicine due to their ability to boost the reparative properties of stem cells, including those in the dental pulp. This narrative review aims to deepen our understanding of the dynamics of bioactive molecules in the dental pulp and their role in enhancing hard tissue reparative processes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>(i) To discuss the role of different cells and the critical pathways involved in dentine formation through direct (reparative) or indirect (infection control and immunomodulatory) mechanisms. (ii) To highlight how innovative therapeutic strategies could be employed to target key molecules for successful dentine repair and regeneration.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The review encompassed all years up to the search period. Databases such as PubMed, Scopus and Medline were utilized to gather relevant studies. The search strategy involved specific signalling molecules such as Transforming growth factor-β1 (TGF-β), Bone Morphogenetic Proteins (BMP), Small Integrin Binding Ligand N-linked Glycoproteins (SIBLING) and growth factors. Cell types including odontoblasts, fibroblasts, immune cells and dental pulp stem cells (DPSCs) were of interest. Additionally, signalling pathways like Wnt, Notch, Shh, amongst others, were investigated for their roles in repair mechanisms. Key terms were combined using Boolean operators [Cell type] AND [signalling molecules] AND/OR [dentine], [Cell type] AND/OR [signalling pathways] AND/OR [dentine] to include studies addressing the interaction of these components in enhancing repair processes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Key molecules such as TGF-β1, BMP and SIBLING proteins effectively enhance the dentine reparative response, whilst other molecules such as complement proteins and antimicrobial peptides primarily activate immune cells and facilitate pathogen clearance to promote the regenerative capabilities of DPSCs. This well-orchestrated interaction emphasizes the need to investigate the effects of these molecules on all cells within the dental pulp. Morphogenic signalling molecules such as BMP-2, -4 and -7, and Wnt show temporal, yet significant regenerative properties, whilst Shh and Notch present inconsistent effects on dentine regeneration, and a consensus on their roles and properties in dentine repair has yet to be reached.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"58 9","pages":"1354-1383"},"PeriodicalIF":7.1,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/iej.14261","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258013","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":"Innovation in endodontic education-cliché or necessity? A perspective on post-graduate training.","authors":"Adham A Azim, Katharina A Azim","doi":"10.1111/iej.14259","DOIUrl":"https://doi.org/10.1111/iej.14259","url":null,"abstract":"<p><p>The concept of innovation in dental education often invites scepticism-is it merely a buzzword, or a true driver of progress? In Endodontics, the answer is clear: innovation is essential. As the field grapples with persistent challenges-including difficulty in recruiting and retaining qualified educators, rising student demand, and the lack of standardized global training-traditional pedagogical models must be reimagined. A transformative educational framework is urgently needed, one that aligns with three foundational pillars of Endodontics: delivering high-quality, patient-centred care; building sustainable educational systems; and promoting research-driven advancement. This article examines the major obstacles confronting endodontic education and proposes a strategic, multi-dimensional approach rooted in disruption and innovation. Key strategies include the integration of digital platforms, incorporation of advanced technologies into the curriculum, use of artificial intelligence in education and assessment, and the development of global standards for endodontic training and evaluation. These solutions aim to address disparities in resources through decentralized learning and mentorship models, ultimately enhancing patient care and supporting lifelong learning. Innovation in Endodontics is not a matter of convenience-or inconvenience-but a professional obligation. It is the pathway to preparing future specialists to thrive in a rapidly evolving, technology-driven landscape. By embracing this imperative, the field can move beyond outdated conventions and current limitations, driving sustainable progress for educators, learners and patients alike.</p>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":" ","pages":""},"PeriodicalIF":5.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208496","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":"Exosomal circ_0003057 promotes osteo/odontogenic differentiation of hDPSCs by binding with EIF4A3 through upregulated parental gene ANKH","authors":"Bingtao Wang,&nbsp;Yuanyuan Kong,&nbsp;Huixian Dong,&nbsp;Feng Lai,&nbsp;Zixin Guo,&nbsp;Liecong Lin,&nbsp;Jingyi Xu,&nbsp;Jingkun Zhang,&nbsp;Yiguo Jiang,&nbsp;Qianzhou Jiang","doi":"10.1111/iej.14262","DOIUrl":"10.1111/iej.14262","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Elucidating the mechanism of osteo/odontogenic differentiation of human dental pulp stem cells (hDPSCs) is crucial for advancing regenerative endodontic procedures (REPs). Circular RNAs (circRNAs) play significant regulatory roles in stem cell differentiation, and exosomes are crucial for intercellular communication. This study investigated the role of exosomal circRNAs in hDPSCs during osteo/odontogenic differentiation using in vitro and in vivo evidence.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Materials and Methods</h3>\u0000 \u0000 <p>We isolated hDPSCs from dental pulp tissues of healthy immature permanent teeth. CircRNA microarray analysis was used to identify differentially expressed circRNAs. Exosomes were extracted from hDPSCs using ultracentrifugation, and circRNA content was detected. Functional validation of exosomal circRNAs was performed using siRNA/overexpression plasmids and subcutaneous transplantation in to nude mice. The biological effects of circ_0003057, EIF4A3 and ANKH were determined using real-time quantitative polymerase chain reaction (qRT-PCR), western blotting (WB), alkaline phosphatase (ALP) staining and activity, alizarin red staining (ARS), quantification and immunofluorescence staining. EIF4A3 was identified as a potential binding protein (RBP) for circ_0003057 in the database, and this binding relationship was confirmed using RNA pull-down and RIP assays. qRT-PCR and WB were performed to determine whether the host gene ANKH of circ_0003057 was activated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>circ_0003057 expression was increased during osteo/odontogenic differentiation of hDPSCs, whereas circ_0003057 downregulation suppressed this process. EIF4A3 was confirmed to be a binding protein of circ_0003057 and was upregulated during osteo/odontogenic differentiation of hDPSCs. Further investigation revealed that circ_0003057 upregulation during osteo/odontogenic differentiation led to the upregulation of its parental gene, ANKH. Co-transfection experiments confirmed that circ_0003057 upregulated ANKH, promoting osteo/odontogenic differentiation of hDPSCs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study demonstrates that exosomal circ_0003057 promotes osteo/odontogenic differentiation of hDPSCs by interacting with EIF4A3 and upregulating ANKH, providing new insights into the molecular mechanisms underlying this process and its potential applications in regenerative endodontics.</p>\u0000 </section>\u0000 </div>","PeriodicalId":13724,"journal":{"name":"International endodontic journal","volume":"58 9","pages":"1433-1455"},"PeriodicalIF":7.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144208495","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}