Iranian Endodontic Journal最新文献

{"title":"Paresthesia and Dysesthesia after Root Canal Therapy of a Mandibular Molar: Diagnosis and Management in a Clinical Case Report.","authors":"Mahta Fazlyab, Ali Hassani, Siavash Kamali","doi":"10.22037/iej.v20i1.49800","DOIUrl":"10.22037/iej.v20i1.49800","url":null,"abstract":"<p><p>Inferior alveolar nerve (IAN) injury is a rare but serious complication of root canal treatment (RCT), typically caused by mechanical over-instrumentation, chemical irritation from extruded sealers, or thermal damage. We report the case of a 42-year-old woman who developed persistent burning pain, numbness, and dysesthesia of the right lower lip and gingiva after RCT of the right mandibular second molar. Initial management by a general dentist involved retreatment and calcium hydroxide medicament; however, early CBCT was misinterpreted, and referral was delayed. High-quality CBCT and clinical testing later revealed obturation material within the IAN canal and a horizontal fracture of the distal root. Endodontic retreatment, followed by maxillofacial microsurgery for removal of extruded gutta-percha/sealer, combined with neuroprotective therapy (dexamethasone, vitamin B, and adjunctive low-level laser therapy). The patient achieved complete resolution of pain and sensory disturbances within one month, and remained asymptomatic with radiographic periapical healing at 12-month follow-up. Comprehensive preoperative imaging, cautious canal instrumentation, independent CBCT interpretation by the endodontist, and timely specialist referral are essential to minimize the risk of IAN injury. Even with delayed intervention, targeted microsurgical removal of extruded material can result in favorable neurological recovery.</p>","PeriodicalId":14534,"journal":{"name":"Iranian Endodontic Journal","volume":"20 1","pages":"e36"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12554236/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145377328","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":"Evaluation of the Radiopacity, pH, and Calcium Ion Release of Calcium Silicate and Epoxy Resin-based Endodontic Cements.","authors":"Milagros Judith Loyola-Cano, Carmen Rosa García-Rupaya","doi":"10.22037/iej.v20i1.48935","DOIUrl":"10.22037/iej.v20i1.48935","url":null,"abstract":"<p><strong>Introduction: </strong>Endodontic cements are essential materials for achieving successful root canal treatment. Therefore, they must present adequate physicochemical properties to ensure optimal clinical performance. This study aimed to evaluate radiopacity, pH, and calcium ion release of calcium silicate- and epoxy resin-based cements/sealers.</p><p><strong>Materials and methods: </strong>Four materials were evaluated: Vioseal, AH-Plus, AH-Plus Bioceramic Sealer, and MTA Angelus. Ten cylindrical specimens (10 mm diameter, 1 mm height) per group were prepared for each tested property, totaling 80 samples. The same specimens were used for pH and calcium ion release, while separate specimens were used for radiopacity. All samples were stored at 37^°C and 95% humidity. Radiopacity was assessed by digital radiography using an aluminum step wedge (1-10 mm). pH was measured at 1, 7, and 14 days using a calibrated digital pH meter. Calcium ion release was determined using atomic absorption spectrophotometry. Data were analyzed using Kruskal-Wallis and Dwass-Steel-Critchlow-Fligner post hoc tests (<i>P</i><0.05).</p><p><strong>Results: </strong>Vioseal and AH-Plus showed the highest radiopacity values (9.98±0.42 mm Al and 10.00±0.38 mm Al, respectively), while AH-Plus Bioceramic Sealer (9.04±0.28 mm Al) and MTA Angelus (4.72±0.40 mm Al) showed lower values. Regarding pH, AH-Plus Bioceramic presented the highest and most sustained alkaline value (up to 12.5), and AH-Plus the lowest (6.25±0.26). In calcium ion release, Vioseal showed the highest release on day 7 (29.4±3.12 ppm), while AH-Plus Bioceramic Sealer also peaked on day 7 (18.60±5.54 ppm); MTA Angelus presented its highest release on day 1 (11.80±1.00 ppm).</p><p><strong>Conclusion: </strong>All evaluated cements/sealers met the ISO 6876 standard for radiopacity. Calcium silicate-based cements showed an alkaline pH and sustained calcium ion release, whereas Vioseal presented an initially high and transient release.</p>","PeriodicalId":14534,"journal":{"name":"Iranian Endodontic Journal","volume":"20 1","pages":"e40"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12554232/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145377362","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 Treatment of Type IIIa Dens Invaginatus in an Immature Maxillary Central Incisor: A Case Report.","authors":"Fatemeh Rezaei, Mahta Fazlyab","doi":"10.22037/iej.v20i1.46440","DOIUrl":"10.22037/iej.v20i1.46440","url":null,"abstract":"<p><p>Dens invaginatus is a developmental anomaly resulting from the infolding of enamel and dentin into the dental pulp. Oehlers' Type IIIa dens invaginatus poses significant challenges due to its intricate anatomy and frequent association with immature teeth. This case report outlines the nonsurgical management of a nonvital immature maxillary central incisor with Type IIIa dens invaginatus, presenting with a chronic apical abscess and a history of trauma to the associated primary incisor. Treatment involved thorough chemomechanical debridement followed by bio-obturation using calcium-enriched mixture cement. Regular follow-ups revealed complete resolution of the periapical lesion. This case underscores the importance of precise diagnosis, individualized treatment planning, and the application of advanced biomaterials in addressing complex presentations of dens invaginatus. The successful outcome emphasizes the efficacy of nonsurgical techniques in preserving immature teeth while restoring function and aesthetics.</p>","PeriodicalId":14534,"journal":{"name":"Iranian Endodontic Journal","volume":"20 1","pages":"e9"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399197","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":"Influence of Limited Mouth Opening on Guided Endodontic Access and Its Clinical Management: A Case Report.","authors":"Gil Moreira Junior, Lucas Moreira Maia, Camila de Freitas Morais Barbosa, Kênia Maria Pereira Soares de Toubes, Vinicius de Carvalho Machado, Warley Luciano Fonseca Tavares, Antônio Paulino Ribeiro Sobrinho","doi":"10.22037/iej.v20i1.48424","DOIUrl":"10.22037/iej.v20i1.48424","url":null,"abstract":"<p><p>This case report presents the innovative application of ultrasonic points combined with a graphite-marked endodontic guide in a case of restricted vertical space. A 71-year-old female patient with root canal obliteration in the second left mandibular molar was referred for treatment. The patient was experiencing spontaneous pain. Using data from cone-beam computed tomography and surface scans, a virtual 3D guide was developed and positioned. As the patient presented limited interocclusal space, black graphite was inserted through the drill path to mark the pathway. The guide was withdrawn, shorter ultrasonic points were inserted 2 mm into the marked dentin, and this process was repeated until the root canals were localized. The root canals were subsequently shaped and filled. The guide drill path effectively served as a reference for ultrasonic points, enabling successful localization of the root canals. Graphite-marked guide path facilitated access to obliterated root canals in the presence of limited interocclusal space.</p>","PeriodicalId":14534,"journal":{"name":"Iranian Endodontic Journal","volume":"20 1","pages":"e32"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12554234/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145377342","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":"Guided Endodontic Management of Pulp Canal Obliteration in a Maxillary Canine with Root Resorption and Prior Iatrogenic Deviation: A Case Report.","authors":"Mohammad Naqibeiranvand, Babak Zandi, Mandana Naseri, Nazanin Foroozandehfar","doi":"10.22037/iej.v20i1.50216","DOIUrl":"10.22037/iej.v20i1.50216","url":null,"abstract":"<p><p>This case report describes the successful guided endodontic treatment of a maxillary left canine (#23) with pulp canal obliteration (PCO) in a 30-year-old female patient. The patient had a history of orthodontic treatment and Le Fort I orthognathic surgery, both recognized as potential factors contributing to canal calcification. The patient had a history of a failed root canal treatment, contributing to incomplete canal instrumentation and iatrogenic damage (gouging) during access cavity preparation. The case was referred for completion of treatment. Upon referral, clinical and radiographic examinations revealed advanced canal obliteration, procedural gouging from the prior attempt, and a radiolucent line suggestive of a horizontal root fracture. Cone-beam computed tomography (CBCT) confirmed the extent of canal calcification, ruled out the suspected fracture, and showed a localized palatal external root resorption, likely related to previous orthodontic forces. Given the complexity of the case, a static-guided endodontic technique was selected as the preferred treatment approach. A custom 3D-printed guide, generated from merged CBCT and intraoral scan data, enabled conservative and accurate access to the calcified canal. Although a hand K-file fractured during canal negotiation, the fragment was successfully retrieved using ultrasonic devices under magnification. The tooth was treated successfully. Clinical and radiographic follow-ups at six and twelve months confirmed resolution of the periapical lesion and complete symptom relief, demonstrating that guided endodontics can serve as a safe and effective treatment option in teeth with PCO.</p>","PeriodicalId":14534,"journal":{"name":"Iranian Endodontic Journal","volume":"20 1","pages":"e42"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12682322/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707985","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":"Non-surgical Management of a C-shaped Mandibular Second Molar with Apical Periodontitis and External Root Resorption: A Case Report.","authors":"Sorour Saeidi, Ali Hamedi, Zakie Kheradmand","doi":"10.22037/iej.v20i1.48177","DOIUrl":"10.22037/iej.v20i1.48177","url":null,"abstract":"<p><p>This case report describes the successful nonsurgical endodontic management of a mandibular second molar with a confirmed C-shaped canal configuration complicated by chronic apical periodontitis and active external inflammatory root resorption in a 16-year-old female patient. The patient presented with pain on biting, deep localized periodontal probing, and radiographic evidence of a large periapical radiolucency and resorptive changes in the distal root. Diagnostic tests confirmed pulpal necrosis and an endodontic-periodontal communication. Following access under magnification, the complex C-shaped canal system was negotiated and disinfected using 5.25% sodium hypochlorite, activated irrigation, and calcium hydroxide dressing. Because of apical resorption and an open apex, a 4-5 mm mineral trioxide aggregate apical plug was placed, followed by warm vertical obturation of the remaining canal system. The tooth was restored and monitored clinically/radiographically. At the 8-month follow-up, the patient was asymptomatic, probing depths had normalized, and radiographs demonstrated complete resolution of the periapical lesion with arrest of external root resorption. This case highlights that conservative endodontic therapy, supported by modern materials and careful disinfection, can achieve predictable healing even in teeth with complex morphology and resorptive defects. Early diagnosis and meticulous management are essential for a favorable outcome.</p>","PeriodicalId":14534,"journal":{"name":"Iranian Endodontic Journal","volume":"20 1","pages":"e45"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12682325/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145708033","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":"Management of Cracked and Weakened Endodontically Treated Teeth Using Fiber-reinforced Composites: A Case Series.","authors":"Kênia Soares de Toubes, Fabiana Dantas Meirelles, Gilberto Antônio Borges, Amauri José Lima Mendes, Mauricio Gustavo Oliveira, Frank Ferreira Silveira","doi":"10.22037/iej.v20i1.46536","DOIUrl":"https://doi.org/10.22037/iej.v20i1.46536","url":null,"abstract":"<p><p>Restoring endodontically treated teeth (ETT) that exhibit cracks, enlarged roots, or weakened root walls is a frequent challenge in dental practice. The present study describes three cases in which contemporary restorative techniques were employed and suggests that applying Ribbond tape (RT) to ETT can improve fracture resistance and better prevent the propagation of cracks compared with traditional methods. Although extensive <i>in vitro</i> research has been conducted on fiber-reinforced composites, studies evaluating the clinical use and durability of fiber-reinforced composites to restore ETT are limited. This report strictly adhered to the case report (CARE) guidelines, and the treatments were initiated only after signed informed consents were obtained from the patients. Therefore, the old restorations were removed from the teeth that required intervention and composite resin core build-up was created, followed by endodontic treatments or retreatment. Subsequently, the endodontic accesses were reinforced with RT. The protective restorations were performed and bonded. The two-year follow-ups showed that the patients had complete remission of signs and symptoms, and they remain under monitoring. The study emphasizes the importance of internal reinforcement of ETT and strengthening weakened walls with a resin core build-up reinforced with fibers like RT. This approach enhances mechanical retention, inhibit fracture propagation, and establish a strong chemical bond between RT and resin. It is suggested to be a promising strategy for increasing the longevity and strength of the teeth, providing a conservative and effective alternative to traditional methods.</p>","PeriodicalId":14534,"journal":{"name":"Iranian Endodontic Journal","volume":"20 1","pages":"e13"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11980996/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144001148","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":"Partial Pulpectomy with Bio-Obturation for Internal Root Resorption: A Case Report.","authors":"Saeed Asgary","doi":"10.22037/iej.v20i1.50400","DOIUrl":"10.22037/iej.v20i1.50400","url":null,"abstract":"<p><p>Internal root resorption (IRR) is an uncommon but clinically significant condition traditionally managed with complete pulpectomy and root canal therapy. Advances in vital pulp therapy and bioactive calcium silicate-based cements have enabled conservative strategies aimed at preserving residual pulp vitality. A 33-year-old woman presented with an asymptomatic, unperforated IRR in the maxillary left lateral incisor, confirmed by periapical radiography and cone-beam computed tomography. The tooth responded positively to sensibility testing and showed healthy periapical tissues. A partial pulpectomy was performed: diseased coronal and mid-root pulp was removed, while approximately 5 mm of vital apical pulp was preserved. The resorptive cavity and root canal were bio-obturated with calcium-enriched mixture cement, which also served as a capping biomaterial for the apical pulp stump. Postoperative imaging confirmed complete filling/sealing of the resorptive defect and root canal while maintaining the apical pulp segment. At 2-year follow-up, the tooth remained functional, symptom-free, and radiographically stable, with intact lamina dura and no evidence of progressive resorption. This case demonstrates that partial pulpectomy combined with bio-obturation using an endodontic biomaterial may successfully arrest IRR and preserve apical pulp vitality in carefully selected cases. While the outcome supports the biological feasibility of this approach, further studies with larger samples and longer follow-up are required before it can be considered a routine alternative to conventional treatment.</p>","PeriodicalId":14534,"journal":{"name":"Iranian Endodontic Journal","volume":"20 1","pages":"e34"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12554231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145377335","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":"Maxillary Second Molar with Five Root Canals and a Root-Like Enamel Pearl: A Rare Case Report.","authors":"Mahdi Zerafat, Maryam Enteghad, Saman Baghaei, Alireza Asadi, Yasamin Ghahramani","doi":"10.22037/iej.v20i1.45700","DOIUrl":"10.22037/iej.v20i1.45700","url":null,"abstract":"<p><p>Permanent maxillary second molars' root canal treatment due to their root configurations complexity and high root canal systems variations, are one of the most problematic teeth. Accordingly, clinicians should consider unusual canal morphology to reduce the rate of missed canals. A thirty-year-old female was referred for root canal treatment of her maxillary right second molar tooth with obvious recurrent caries under restoration and necrotic pulp. Pre-operative radiographs showed the unusual morphology and cone-beam computed tomography was ordered for precise evaluation of the root canal anatomy. The principal aim of this paper is to report a five-root canals maxillary second molar, with two palatal root canals and a palatal root-like enamel pearl canal.</p>","PeriodicalId":14534,"journal":{"name":"Iranian Endodontic Journal","volume":"20 1","pages":"e6"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11808330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399081","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 Novel Niosomal Doxycycline/Triamcinolone Medicament Matches Calcium Hydroxide for Low Tooth Staining: A 4-Week <i>in Vitro</i> Study.","authors":"Rahim Fereidooni, Arash Shahravan, Hamed Manochehrifar, Abbas Pardakhty, Homa Kamyabi, Amir Hossein Nekouei","doi":"10.22037/iej.v20i1.46288","DOIUrl":"10.22037/iej.v20i1.46288","url":null,"abstract":"<p><strong>Introduction: </strong>Tooth discoloration remains a significant concern in endodontic treatment, particularly with the use of intracanal medicaments. This study investigated the discoloration potential of niosomal doxycycline and triamcinolone, a novel nanotechnology-based drug delivery system, in comparison to conventional medications.</p><p><strong>Materials and methods: </strong>Fifty extracted single-rooted human teeth were assigned to five groups: (1) calcium hydroxide, (2) calcium hydroxide+triamcinolone, (3) niosomal doxycycline+triamcinolone, (4) doxycycline+triamcinolone, and control groups (positive: blood; negative: saline). All samples were prepared using standardized endodontic procedures, filled with medicaments, and incubated for one month. Discoloration values (∆E) were measured at baseline, 1 week, and 1 month using the CIE Lab system and a spectrophotometer. A ∆E>3.3 was considered clinically unacceptable.</p><p><strong>Results: </strong>All groups exhibited discoloration values within clinically acceptable limits (∆E<3.3). At one month, significant differences were observed among groups (ANOVA, <i>P</i><0.05). The niosomal doxycycline+triamcinolone group showed the lowest ∆E values, similar to the calcium hydroxide group, while the doxycycline+triamcinolone and calcium hydroxide+triamcinolone groups exhibited higher discoloration values.</p><p><strong>Conclusion: </strong>Emphasize that at 4 weeks, all medicaments induced clinically acceptable ∆E, with niosomal performing similarly to calcium hydroxide alone and significantly better than the conventional doxycycline+triamcinolone combination.</p>","PeriodicalId":14534,"journal":{"name":"Iranian Endodontic Journal","volume":"20 1","pages":"e43"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12682323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145707733","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}