Shirley Granados-Laura, Carlos Liñan-Duran, Carmen Garcia-Rupaya
{"title":"Effect of Formic Acid and Passive Ultrasonic Irrigation on the Removal of Residual Filling Material Containing AH-Plus Bioceramic Sealer.","authors":"Shirley Granados-Laura, Carlos Liñan-Duran, Carmen Garcia-Rupaya","doi":"10.22037/iej.v21i1.52333","DOIUrl":"10.22037/iej.v21i1.52333","url":null,"abstract":"<p><strong>Introduction: </strong>Root canal retreatment is challenged by the strong adhesion of sealers to dentin. AH-Plus Bioceramic, an epoxy resin-based sealer containing calcium silicate components, could present particular difficulty during removal. This study evaluated whether 5% formic acid with passive ultrasonic activation (PUI) is as effective as 10% formic acid and 2% sodium hypochlorite (NaOCl) in the removal of residual filling material of teeth obturated with AH-Plus Bioceramic sealer.</p><p><strong>Materials and methods: </strong>Thirty-three lower premolar roots were obturated with AH-Plus Bioceramic sealer using a single-cone technique. After instrumentation with the Reciproc R40 file, the roots were randomly assigned to three groups of final irrigation: 5% formic acid, 10% formic acid, and 2% NaOCl, all combined with PUI. The volume of filling material was measured using cone-beam computed tomography (CBCT) analysis at three stages: after obturation, after instrumentation for retreatment, and after final irrigation with formic acid or NaOCl combined with PUI. Statistical analysis included Friedman and Wilcoxon tests for intragroup comparisons and the Kruskal-Wallis test with Dunn's post hoc test for intergroup comparisons.</p><p><strong>Results: </strong>All irrigants combined with PUI reduced the filling material volume with no significant differences among them (<i>P</i>>0.05).</p><p><strong>Conclusion: </strong>Ultrasonically activated 5%, 10% formic acid, and 2% NaOCl showed similar removal of residual filling material containing AH-Plus Bioceramic sealer.</p>","PeriodicalId":14534,"journal":{"name":"Iranian Endodontic Journal","volume":"21 1","pages":"e31"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136577","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Building on Twenty Years of Scholarship: Shaping the Future of Endodontics.","authors":"Mohammad Jafar Eghbal, Saeed Asgary","doi":"10.22037/iej.v21i1.51344","DOIUrl":"10.22037/iej.v21i1.51344","url":null,"abstract":"","PeriodicalId":14534,"journal":{"name":"Iranian Endodontic Journal","volume":"21 1","pages":"e1"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12900519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nonsurgical Endodontic Management of Type II Dens Invaginatus Associated with Gemination in a Maxillary Lateral Incisor: A CBCT-Assisted Case Report.","authors":"Maryam Dalaei Moghadam","doi":"10.22037/iej.v21i1.52386","DOIUrl":"10.22037/iej.v21i1.52386","url":null,"abstract":"<p><p>Dens invaginatus (DI) is a developmental dental anomaly characterized by the invagination of the enamel organ into the dental papilla during tooth development, often resulting in complex root canal anatomy and increased susceptibility to pulpal disease. Gemination is another uncommon developmental anomaly resulting from the incomplete division of a single tooth germ, which produces an enlarged or bifid crown. The simultaneous occurrence of these anomalies in a single tooth is extremely rare. This case report describes the diagnosis and nonsurgical endodontic management of a maxillary lateral incisor presenting with both gemination and Oehlers type II dens invaginatus. A 14-year-old female patient was referred for further endodontic management of the maxillary left lateral incisor. Normal apical tissues were diagnosed, and the referring practitioner previously initiated endodontic therapy. Clinical examination revealed a bifid crown morphology, while cone-beam computed tomography (CBCT) demonstrated type II dens invaginatus associated with gemination and a complex root canal system with apical bifurcation. Root canal treatment was performed under dental operating microscope magnification using nickel-titanium rotary instrumentation, passive ultrasonic irrigation, and calcium hydroxide intracanal medication. The root canal system was subsequently obturated using gutta-percha and AH-Plus sealer by the cold lateral compaction technique. At the 12-month follow-up, the tooth remained asymptomatic and exhibited normal clinical and radiographic findings. This case highlights the importance of CBCT and magnification-assisted endodontic treatment in the successful management of rare developmental anomalies with complex internal anatomy.</p>","PeriodicalId":14534,"journal":{"name":"Iranian Endodontic Journal","volume":"21 1","pages":"e23"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13332817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Bridging the Break: Three Approaches to Root Fracture Management Using Bioactive Glass Material, Fiber Post, and Orthodontic Stabilization: A Case Series.","authors":"Saurav Bathla, Saurav Kumar Dutta, Dolma Borah, Tanu Singh","doi":"10.22037/iej.v21i1.51668","DOIUrl":"10.22037/iej.v21i1.51668","url":null,"abstract":"<p><p>Dental trauma is a common clinical presentation and may involve injury to the crown, root, or supporting periodontal tissues. Horizontal root fractures affect dentin, cementum, and the pulp and present significant diagnostic and therapeutic challenges. Inappropriate or delayed management may lead to pulp necrosis, internal or external root resorption, displacement of the affected tooth, and loss of functional arch continuity. The management of horizontal radicular fractures is often complex and frequently requires a multidisciplinary approach involving endodontic, periodontal, prosthodontic, and orthodontic procedures to achieve adequate stabilization and healing. This case series reports three cases of horizontal root fractures, each managed using a different treatment modality, including a bioactive glass-based sealer in putty consistency, fiberglass post reinforcement, and orthodontic wire stabilization. The treatment approach in each case was selected based on fracture location, degree of mobility, and overall clinical presentation. Early diagnosis combined with an individualized and well-planned treatment strategy can enhance healing and preserve the affected tooth. These cases emphasize the importance of case-specific management in achieving favorable and predictable clinical outcomes.</p>","PeriodicalId":14534,"journal":{"name":"Iranian Endodontic Journal","volume":"21 1","pages":"e26"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A Decade of Survival after Intracanal Repair of External Cervical Resorption in Esthetic Zone: A Case Report.","authors":"Mohsen Aminsobhani, Edwin Sarkisians, Ziba Ghorvei Nossrat","doi":"10.22037/iej.v21i1.52855","DOIUrl":"10.22037/iej.v21i1.52855","url":null,"abstract":"<p><p>External cervical resorption (ECR) in anterior teeth poses significant treatment challenges due to esthetic and periodontal considerations. While external surgical repair demonstrates superior survival rates, internal approaches may be preferable for subcrestal lesions in the esthetic zone. This case presents a 25-year-old male with a Heithersay Class 3 and Patel 2Bp lesion. Microscope-assisted internal repair was performed using calcium hydroxide as an interim medicament, followed by mineral trioxide aggregate (MTA) restoration and root canal obturation 12 days later. Clinical and radiographic evaluations at 2, 4, and 9.5 years demonstrated complete healing, stable periodontal health, probing depths of 1-2 mm, and no signs of recurrence on cone-beam computed tomography, despite mild MTA-related crown discoloration that was acceptable to the patient. This nearly 10-year successful outcome highlights the possibility of a long-term successful internal repair with calcium hydroxide and MTA as a viable conservative option for select subcrestal ECR lesions in the esthetic zone.</p>","PeriodicalId":14534,"journal":{"name":"Iranian Endodontic Journal","volume":"21 1","pages":"e29"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644705/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149136604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zahraa Mazin Al-Hawwaz, Zainab Abdulkareem Maktoof, Ahmed Mustafa Abdulrahman
{"title":"Prevalence and Types of Iatrogenic Errors in Root Canal Treatments Performed by Dental Students: A Retrospective Radiographic Study.","authors":"Zahraa Mazin Al-Hawwaz, Zainab Abdulkareem Maktoof, Ahmed Mustafa Abdulrahman","doi":"10.22037/iej.v21i1.51133","DOIUrl":"10.22037/iej.v21i1.51133","url":null,"abstract":"<p><strong>Introduction: </strong>Root canal therapy is an essential part of dental care that has a high success rate, as reported under controlled conditions. Nevertheless, procedural errors can be present when conducted by undergraduate students and have a detrimental impact on treatment outcomes. To better endodontic education and clinical performance, the frequency and types of iatrogenic errors should be evaluated. The study aimed to determine the prevalence and the nature of iatrogenic errors during root canal treatments that are administered by undergraduate dental students in their fifth year.</p><p><strong>Materials and methods: </strong>One hundred and twenty-five endodontically treated teeth were chosen randomly. The fifth-year dental students performed all the treatments using a standardized endodontic protocol. Preoperative, intraoperative, and postoperative radiographs were assessed to find out iatrogenic errors, such as ledge, perforation, canal obstruction, separation of instruments, overfilling, underfilling, and voids. This descriptive study reports the frequency of errors without inferential statistical analysis.</p><p><strong>Results: </strong>Radiographic evaluation indicated that at least one of the iatrogenic errors during treatment was observed in 32.8% of the treated cases. The most common mistake was obturation voids, which were identified 11.2% of the total cases and were found mostly in the second premolars.</p><p><strong>Conclusion: </strong>Root canal treatments that were carried out by undergraduates had a relatively high number of iatrogenic errors, with obturation errors being the most frequent. These results lead to the necessity of more effective clinical training, better supervision, and integration of more sophisticated endodontic procedures to minimize errors in the course of the procedure and enhance the quality of the treatment.</p>","PeriodicalId":14534,"journal":{"name":"Iranian Endodontic Journal","volume":"21 1","pages":"e13"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13136707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benigno Miguel Calderón-Rojas, Diana-Margarita Córdova-Esparza, Julio-Alejandro Romero-González, Oscar Alejandro Gutiérrez-Alvarez, Daniel Durand-Herrera
{"title":"A Bibliometric Analysis of Artificial Intelligence Research Published in Endodontic Journals.","authors":"Benigno Miguel Calderón-Rojas, Diana-Margarita Córdova-Esparza, Julio-Alejandro Romero-González, Oscar Alejandro Gutiérrez-Alvarez, Daniel Durand-Herrera","doi":"10.22037/iej.v21i1.51288","DOIUrl":"10.22037/iej.v21i1.51288","url":null,"abstract":"<p><p>The aim was to identify and analyse publication trends, bibliometric indicators, and research characteristics of artificial intelligence studies published in Endodontic journals. An advanced search was performed in \"Web of Science All Databases\" and \"Scopus\" employing the keywords \"Endodontics\", \"Endodontic\", \"Artificial Intelligence\", and \"AI\". Articles published in journals containing the terms <b>\"</b>Endodontic\", \"Endodontics\", or \"Endodontology\" were included. A total of 214 authors contributed to the 48 analyzed studies. MohammadRahimi, H., and Nosrat, A., were the most productive authors. The United States contributed the highest number of publications. The <i>Journal of Endodontics</i> was the primary outlet. Publications increased sharply between 2024 and 2025. Basic research predominated, with radiology as the dominant study field. Deep learning was the most frequently used AI methodology, particularly convolutional neural networks for radiographic diagnosis and segmentation. AI research in endodontics has expanded markedly in recent years, driven predominantly by advances in deep learning and imaging analysis.</p>","PeriodicalId":14534,"journal":{"name":"Iranian Endodontic Journal","volume":"21 1","pages":"e9"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13111948/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ana Virginia Silva Vilela, Marina da Cunha Isaltino, Carolina Viana Vasco Lyra, Sinara Cunha Lima, Sebastião Pedro Santos Neto, Glauco Dos Santos Ferreira, Natália Gomes de Oliveira
{"title":"Management of Teeth with Large Apical Periodontitis Lesions: A Series of Six Case Reports.","authors":"Ana Virginia Silva Vilela, Marina da Cunha Isaltino, Carolina Viana Vasco Lyra, Sinara Cunha Lima, Sebastião Pedro Santos Neto, Glauco Dos Santos Ferreira, Natália Gomes de Oliveira","doi":"10.22037/iej.v21i1.52641","DOIUrl":"10.22037/iej.v21i1.52641","url":null,"abstract":"<p><p>Large apical periodontitis poses significant challenges for nonsurgical treatment due to the complexity of root canal infection and periradicular tissue destruction. This multicenter case series describes the management of six teeth with extensive apical periodontitis. Diagnosis, treatment planning, and follow-up were supported by cone-beam computed tomography (CBCT). All cases were initially managed with chemomechanical preparation with 2.5% sodium hypochlorite, supplemental irrigant agitation, and calcium hydroxide intracanal medication. Four cases healed following nonsurgical treatment, whereas two cases presented persistent clinical signs of infection, objectively defined by continuous purulent exudate and active sinus tracts, despite repeated nonsurgical management. These cases underwent periradicular surgery with retrograde apical sealing as a tooth-preserving approach. Clinical and CBCT follow-up demonstrated complete periapical healing in all cases. Given the heterogeneity of this case series, outcomes cannot be attributed to any specific protocol. However, these cases demonstrate the potential for successful management of extensive apical periodontitis through individualized treatment approaches.</p>","PeriodicalId":14534,"journal":{"name":"Iranian Endodontic Journal","volume":"21 1","pages":"e27"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Contribution of the Self-adjusting File in Debris Removal in Root Canal Retreatment: A Systematic Review and Meta-analysis of <i>in Vitro</i> Studies.","authors":"Salma El Abbassi, Majid Sakout","doi":"10.22037/iej.v21i1.50916","DOIUrl":"10.22037/iej.v21i1.50916","url":null,"abstract":"<p><strong>Introduction: </strong>To assess the benefit of the adjunctive use of the Self-adjusting File (SAF) system as a final step in root canal retreatment for the removal of residual filling material.</p><p><strong>Materials and methods: </strong>A systematic review of <i>in vitro</i> studies was conducted on extracted mature permanent teeth undergoing endodontic retreatment, comparing residual canal debris before and after supplementary use of the SAF system. The electronic search was performed across nine databases: MEDLINE (<i>via</i> PubMed), the Cochrane Library, Scopus, EBSCOhost, Elsevier, ScienceDirect, Web of Science, LILACS, and Google Scholar. Data from the included studies were extracted and analyzed, and key findings were summarized alongside a risk of bias assessment. A random-effects meta-analysis was performed using Hedges' g as the effect size measure. Studies were stratified into three subgroups according to canal morphology: oval-shaped, curved mesial, and severely curved canals. All statistical analyses were conducted in JASP software using restricted maximum likelihood (REML) estimation.</p><p><strong>Results: </strong>From an initial pool of 517 identified records, 16 studies met the inclusion criteria. No retreatment method achieved complete debridement of the root canal system. Nevertheless, the adjunctive use of the SAF system significantly improved debris removal in eight of the included studies.</p><p><strong>Conclusion: </strong>The adjunctive use of the SAF system following root canal filling removal improves canal cleanliness in anatomically challenging canals, particularly oval-shaped and severely curved configurations. However, the available evidence remains insufficient to support its routine clinical application, and its use should be guided by root canal morphology.</p>","PeriodicalId":14534,"journal":{"name":"Iranian Endodontic Journal","volume":"21 1","pages":"e25"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148812988","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nishmitha N Hegde, Harshitha Somanatha, Chaithra Lakshmi V, Mithra N Hegde
{"title":"Magnesium Phosphate Cements for Endodontic Applications: A Critical Review of Promise and Pitfalls.","authors":"Nishmitha N Hegde, Harshitha Somanatha, Chaithra Lakshmi V, Mithra N Hegde","doi":"10.22037/iej.v21i1.51073","DOIUrl":"10.22037/iej.v21i1.51073","url":null,"abstract":"<p><p>Magnesium phosphate cements (MPCs) have recently gained attention as potential materials for endodontic applications due to their rapid setting, favourable mechanical properties, and bioactive potential. Laboratory and preclinical studies indicate that MPCs can form apatite-like structures, exhibit good compressive strength, and support cell viability, suggesting promising biological interactions. However, several limitations remain unresolved. The acid-base setting reaction of MPCs is strongly exothermic, which may pose a risk to pulp or periapical tissues, and ammonium-containing formulations can release cytotoxic ammonia, although partial mitigation is possible through sodium phosphate substitution. Rapid setting enhances handling in controlled conditions but may complicate placement in complex root canal anatomies. While <i>in vitro</i> studies suggest comparable or superior sealing ability relative to conventional calcium silicate cements, human clinical evidence is minimal or absent. Degradation and resorption profiles of MPCs may further affect their suitability as scaffolds in regenerative endodontics. Overall, MPCs represent promising investigational materials, yet claims regarding clinical readiness are premature. Careful evaluation of their physicochemical behaviour, biological safety, and practical handling is essential before consideration for routine clinical use.</p>","PeriodicalId":14534,"journal":{"name":"Iranian Endodontic Journal","volume":"21 1","pages":"e2"},"PeriodicalIF":0.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12900526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146201646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}