Journal of endodontics最新文献

{"title":"Identification of Root Canal Morphology in Fused-rooted Mandibular Second Molars From X-ray Images Based on Deep Learning","authors":"","doi":"10.1016/j.joen.2024.05.014","DOIUrl":"10.1016/j.joen.2024.05.014","url":null,"abstract":"<div><p><strong>Introduction:</strong> Understanding the intricate anatomical morphology of fused-rooted mandibular second molars (MSMs) is essential for root canal treatment. The present study utilized a deep learning approach to identify the three-dimensional root canal morphology of MSMs from two-dimensional X-ray images.</p></div><div><h3>Methods</h3><p>A total of 271 fused-rooted MSMs were included in the study. Micro-computed tomography reconstruction images and two-dimensional X-ray projection images were obtained. The ground truth of three-dimensional root canal morphology was determined through micro-computed tomography images, which were classified into merging, symmetrical, and asymmetrical types. To amplify the X-ray image dataset, traditional augmentation techniques from the python package Augmentor and a multiangle projection method were employed. Identification of root canal morphology was conducted using the pretrained VGG19, ResNet18, ResNet50, and EfficientNet-b5 on X-ray images. The classification results from convolutional neural networks (CNNs) were then compared with those performed by endodontic residents.</p></div><div><h3>Results</h3><p>The multiangle projection augmentation method outperformed the traditional approach in all CNNs except for EfficientNet-b5. ResNet18 combined with the multiangle projection method outperformed all other combinations, with an overall accuracy of 79.25%. In specific classifications, accuracies of 81.13%, 86.79%, and 90.57% were achieved for merging, symmetrical, and asymmetrical types, respectively. Notably, CNNs surpassed endodontic residents in classification performance; the average accuracy for endodontic residents was only 60.38% (<em>P</em> &lt; .05).</p></div><div><h3>Conclusions</h3><p>CNNs were more effective than endodontic residents in identifying the three-dimensional root canal morphology of MSMs. The result indicates that CNNs possess the capacity to employ two-dimensional images effectively in aiding three-dimensional diagnoses.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141183950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of the Brushing Motions on the Dynamic Cyclic Fatigue Resistance of the Reciproc Blue Instrument: In vitro Study","authors":"","doi":"10.1016/j.joen.2024.06.013","DOIUrl":"10.1016/j.joen.2024.06.013","url":null,"abstract":"<div><h3>Introduction</h3><p>This study aimed to evaluate the dynamic cyclic fatigue resistance of Reciproc Blue files subjected to brushing motion.</p></div><div><h3>Methods</h3><p><span>Twenty Reciproc Blue files (R25, VDW, Munich, Germany) were employed for chemical-mechanical preparation in root canals of 3D printed replicas of mandibular molars. The instruments were divided into two groups (</span><em>n</em> = 10): Group brushing motion, instrumentation with brushing motions; Group without brushing motion , instrumentation without brushing motions. Subsequently, the same instruments underwent cyclic fatigue testing using artificial canals consisting of a stainless-steel plate and an apical segment with a 45° curvature. Data regarding the time to fracture, number of cycles to fracture, and length of the fractured fragment were collected and subjected to statistical analysis using the t-test or Mann-Whitney test, with a significance level of 5%. Additionally, the fractured fragments were examined under a scanning electron microscope.</p></div><div><h3>Results</h3><p>No statistical differences were observed between the groups in terms of time to fracture (<em>P</em> &lt; .05), number of cycles to fracture (<em>P</em> &lt; .05) and length of the fractured fragment (<em>P</em> &lt; .05).</p></div><div><h3>Conclusion</h3><p>The brushing motion did not affect the dynamic cyclic fatigue resistance of Reciproc Blue files.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141534569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Web-Based Survey on Regenerative Endodontic Practices among Members of the American Association of Endodontists","authors":"","doi":"10.1016/j.joen.2024.05.016","DOIUrl":"10.1016/j.joen.2024.05.016","url":null,"abstract":"<div><h3>Introduction</h3><p>The American Association of Endodontics<span><span> (AAE) Regenerative Endodontics Committee reports here the web-based survey data of regenerative </span>endodontic procedures performed by the AAE members from 2008 to 2019.</span></p></div><div><h3>Methods</h3><p>The web-based survey consisted of 2 questionnaires, a <span><em>revascularization</em></span> and a <em>follow-up</em><span>, including clinical and radiographic data at 3, 6, 12 or &gt;12 months after treatment. Data from demographics, etiology, clinical protocols, radiographic, and clinical outcome as perceived by the clinicians were recorded. From 927 entries, 184 full cases were submitted and 126 were suitable for radiographic analysis. The data were divided into cases with 6–12 months and cases with &gt;12 months recall time. Descriptive statistics and univariate analyses were performed.</span></p></div><div><h3>Results</h3><p><span><span>Predominantly patients were male (63%), average 10 years-old with anterior teeth (77.2%) due to trauma (69.6%). A wide variation in regenerative endodontic procedures protocols was reported by the AAE members. The most common clinical protocols used minimal instrumentation (75.5%), 2.5% or higher concentrations of sodium hypochlorite (83.7%), and antibiotic paste as intracanal medication (58.7%). The majority reported </span>blood clot formation (56%) and most common coronal capping material was white </span>mineral trioxide aggregates (50.5%). Increases in radiographic root length, and radiographic root area were proportional to the time lapsed after treatment. Overall, case outcomes were categorized by clinicians as successful (54.3%), uncertain (23.9%), and unsuccessful (3.8%).</p></div><div><h3>Conclusions</h3><p>This web-based survey provides a valuable perspective on case selection, clinical protocols, and perceived outcomes for regenerative endodontic procedures and supports the need for future higher level evidence studies.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141437007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endodontic Treatment of Chronic Apical Periodontitis Ameliorates Systemic Inflammation and Restores Impaired Cellular Responses to Insulin in an In Vitro Model","authors":"","doi":"10.1016/j.joen.2024.05.013","DOIUrl":"10.1016/j.joen.2024.05.013","url":null,"abstract":"<div><h3>Introduction</h3><p><span><span>A growing body of research supports an association between periapical inflammation and an increased risk of developing systemic diseases. There is currently no scientific evidence to support a causal effect of inflammation on the onset of insulin resistance (IR) in patients with apical </span>periodontitis (AP). The aim of this </span><em>in vitro</em> study was to evaluate any association between AP and levels of serum inflammatory factors potentially associated with the onset of IR, and to investigate the effect of root canal treatment (RCT) on these systemic inflammation markers and on the response <em>in vitro</em> to insulin.</p></div><div><h3>Methods</h3><p>A total of 27 control subjects and 27 patients with AP were enrolled. Patients with AP underwent RCT and were followed-up 6 and 12 months post-treatment. Enzyme-linked immunosorbent assays were used to evaluate serum levels of proinflammatory cytokines interleukin (IL)-1, IL-6, IL-8, and tumor necrosis factor (TNF)-α. The response <em>in vitro</em><span><span> to insulin was assessed by measuring glucose consumption in a human pancreatic epithelioid </span>carcinoma cell line treated with sera from healthy and AP subjects.</span></p></div><div><h3>Results</h3><p>At baseline AP was associated with significant higher levels of IL-1, IL-6, and IL-8 in the serum of untreated (AP) patients vs controls (<em>P</em><span> &lt; .001). Glucose consumption decreased in pancreatic cells incubated with baseline serum from patients with AP, in a manner proportional to total cytokines amount. Notably, endodontic treatment was associated with reduced levels of cytokines (</span><em>P</em> &lt; .001) and improved response to insulin in AP group (<em>P</em> &lt; .001).</p></div><div><h3>Conclusions</h3><p>Our findings suggest that AP may promote inflammatory-driven IR in an <em>in vitro</em><span> model, and that RCT may ameliorate inflammatory mediators </span><em>in vivo</em> and the cellular response to insulin <em>in vitro</em>.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141183839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Diclofenac Potassium versus Prednisolone on Postendodontic Pain and Pulpal Interleukin-8 Expression in Symptomatic Irreversible Pulpitis Cases: A Randomized Placebo-controlled Trial","authors":"","doi":"10.1016/j.joen.2024.05.019","DOIUrl":"10.1016/j.joen.2024.05.019","url":null,"abstract":"<div><h3>Aim</h3><p><span>This prospective, randomized, double-blind clinical trial<span> investigated the impact of diclofenac potassium<span>, prednisolone<span>, and placebo as oral premedication on postendodontic pain and pulpal interleukin (IL)-8 expression in patients with irreversible </span></span></span></span>pulpitis.</p></div><div><h3>Methods</h3><p><span>Thirty-six patients undergoing conventional endodontic treatment were assigned into one of 3 groups (</span><em>n</em><span><span> = 12). Pulpal blood samples were taken after access cavity preparation and stored until they were analyzed using enzyme-linked immunosorbent asssay for quantification of IL-8. Postendodontic pain was scored using the visual analogue scale. Outcome data were statistically analyzed using one-way analysis of variance, Kruskal-Wallis, Friedman's, Dunn's, Chi-square, and </span>Fisher's exact tests and Spearman's correlation coefficient. The significance level (α) was set at 0.05.</span></p></div><div><h3>Results</h3><p>Apart from preoperative pain scores, all groups had similar baseline characteristics (<em>P</em> &gt; .05). Immediate postendodontic pain scores had a significant difference between all groups (<em>P</em> &lt; .05) where placebo group showed the highest score. There was no significant difference between all groups at 6 and 12 hours postoperatively (<em>P</em> &gt; .05). Furthermore, there was no significant difference in the incidence of postendodontic pain and in mean IL-8 levels between the 3 groups (<em>P</em> &gt; .05).</p></div><div><h3>Conclusions</h3><p>The only impact the premedications had was on the immediate postendodontic pain intensity, and they had no influence on the later time points, incidence of postendodontic pain or pulpal IL-8 levels.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141457351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium Hypochlorite Concentration and Postendodontic Pain - Unveiling the Optimal Balance: A Systematic Review and Meta-Analysis","authors":"","doi":"10.1016/j.joen.2024.06.005","DOIUrl":"10.1016/j.joen.2024.06.005","url":null,"abstract":"<div><h3>Introduction</h3><p>This study systematically reviewed literature regarding the effect of different concentrations of sodium hypochlorite (NaOCl) used during root canal treatment (RCT) on postendodontic pain (PEP) and rescue analgesia.</p></div><div><h3>Methods</h3><p>Following registration with PROSPERO (CRD42023388916), a search was conducted using PubMed, Scopus, Web of Science, and Embase databases. Randomized controlled trials<span> of patients receiving RCT which assessed PEP at different time intervals were included. Following data extraction and Cochrane risk of bias assessment 2, meta-analyses were performed to evaluate PEP during the first 48 hours along with rescue analgesic intake. The certainty of the evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation approach.</span></p></div><div><h3>Results</h3><p>Five randomized controlled trials with 674 patients were included. One study exhibited a low risk of bias, while 4 raised some concerns. Patients treated with low concentrations of NaOCl (≤3%) were significantly less likely to report PEP at 24 hours (OR = 2.32; [95% CI, 1.63–3.31]; <em>P</em> &lt; .05) and 48 hours (OR = 2.49; [95% CI, 1.73–3.59]; <em>P</em> &lt; .05) as compared with high concentrations of NaOCl (≥5%). Furthermore, with low concentrations of NaOCl, significantly lesser moderate-severe PEP was reported at 24 hours (OR = 2.32; [95% CI, 1.47–3.62]; <em>P</em> &lt; .05) and 48 hours (OR = 2.35; [95% CI, 1.32–4.16]; <em>P</em> &lt; .05) and lesser analgesia was needed (OR = 2.43; [95% CI, 1.48–4.00]; <em>P</em> &lt; .05).</p></div><div><h3>Conclusions</h3><p>While PEP can be influenced by several factors, low certainty evidence suggests that when NaOCl is used as an irrigant during RCT, PEP may be less likely with lower concentrations of NaOCl. Moderate certainty evidence indicates that lesser analgesia may be required with lower concentrations of NaOCl. These results should be cautiously interpreted.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141331080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guidelines for Authors","authors":"","doi":"10.1016/S0099-2399(24)00416-3","DOIUrl":"10.1016/S0099-2399(24)00416-3","url":null,"abstract":"","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142172228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Construction and Evaluation of an AI-based CBCT Resolution Optimization Technique for Extracted Teeth","authors":"","doi":"10.1016/j.joen.2024.05.015","DOIUrl":"10.1016/j.joen.2024.05.015","url":null,"abstract":"<div><h3>Introduction</h3><p>In dental clinical practice, cone-beam computed tomography<span> (CBCT) is commonly used to assist practitioners to recognize the complex morphology of root canal systems; however, because of its resolution limitations, certain small anatomical structures still cannot be accurately recognized on CBCT. The purpose of this study was to perform image super-resolution (SR) processing on CBCT images of extracted human teeth with the help of a deep learning model, and to compare the differences among CBCT, super-resolution computed tomography (SRCT), and micro-computed tomography (Micro-CT) images through three-dimensional reconstruction.</span></p></div><div><h3>Methods</h3><p>The deep learning model (Basicvsr++) was selected and modified. The dataset consisted of 171 extracted teeth that met inclusion criteria, with 40 maxillary first molars<span> as the training set and 40 maxillary first molars as well as 91 teeth from other tooth positions as the external test set. The corresponding CBCT, SRCT, and Micro-CT images of each tooth in test sets were reconstructed using Mimics Research 17.0, and the root canal recognition rates in the 3 groups were recorded. The following parameters were measured: volume of hard tissue (V1), volume of pulp chamber and root canal system (V2), length of visible root canals under orifice (VL-X, where X represents the specific root canal), and intersection angle between coronal axis of canal and long axis of tooth (∠X, where X represents the specific root canal). Data were statistically analyzed between CBCT and SRCT images using paired sample t-test and Wilcoxon test analysis, with the measurement from Micro-CT images as the gold standard.</span></p></div><div><h3>Results</h3><p><span>Images from all tested teeth were successfully processed with the SR program. In 4-canal maxillary first molar, identification of MB2 was 72% (18/25) in CBCT group, 92% (23/25) in SRCT group, and 100% (25/25) in Micro-CT group. The difference of hard tissue volume between SRCT and Micro-CT was significantly smaller than that between CBCT and Micro-CT in all tested teeth except 4-canal mandibular first molar (</span><em>P</em> &lt; .05). Similar results were obtained in volume of pulp chamber and root canal system in all tested teeth (<em>P</em> &lt; .05). As for length of visible root canals under orifice, the difference between SRCT and Micro-CT was significantly smaller than that between CBCT and Micro-CT (<em>P</em> &lt; .05) in most root canals.</p></div><div><h3>Conclusions</h3><p>The deep learning model developed in this study helps to optimize the root canal morphology of extracted teeth in CBCT. And it may be helpful for the identification of MB2 in the maxillary first molar.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141288185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the Mixing Method of AH Plus Jet Affect its Physicochemical and Mechanical Properties?","authors":"","doi":"10.1016/j.joen.2024.06.006","DOIUrl":"10.1016/j.joen.2024.06.006","url":null,"abstract":"<div><h3>Introduction</h3><p>The purpose of this study was to evaluate whether the mixing method of AH Plus Jet sealer affects its physicochemical and mechanical properties.</p></div><div><h3>Methods</h3><p>The properties of AH Plus Jet sealer were analyzed when mixed using either the Auto Mix Tip or manual mixing. The evaluated properties included radiopacity (<em>n</em> = 5), initial and final setting times (<em>n</em> = 5), flow (<em>n</em> = 5), and solubility (<em>n</em> = 3), following specifications outlined in ISO 6876/2012 and ADA Nº 57/2000. pH levels were measured at intervals of 3, 24, 72, and 168 hours (<em>n</em> = 10). The push-out bond strength test was conducted using a universal testing machine and using bovine teeth (<em>n</em><span> = 30). Failure modes were analyzed with stereomicroscopy. Porosity was evaluated under micro-CT (</span><em>n</em><span> = 5), and scanning electron microscopy was also performed (</span><em>n</em> = 5). One-way analysis of variance and Tukey, unpaired t-tests, or Mann–Whitney tests were used with a significance level of 5%.</p></div><div><h3>Results</h3><p>The Auto Mix exhibited a radiopacity value of 12.11 mmAl, whereas manual mixing resulted in 12.55 mmAl (<em>P</em> &gt; .05). For initial and final setting times, Auto Mix showed 901 minutes and 1779 minutes, respectively, while manual mixing recorded values of 631 minutes and 1504 minutes (<em>P</em> &lt; .05). In terms of flow, Auto Mix demonstrated higher values (25.26 mm) than manual mixing (21.71 mm) (<em>P</em> &lt; .05). No statistical differences were observed between the two methods for solubility and pH (<em>P</em> &gt; .05). Manual mixing presented a higher bond strength value (14.52 MPa) than Auto Mix (9.81 MPa) (<em>P</em> &lt; .05). The mixed failure mode was the most frequent outcome for both methods. The highest porosity was observed for Auto Mix (<em>P</em> &lt; .05). Scanning electron microscopy analysis revealed that manual mixing resulted in a smoother surface with fewer pores and smaller, more evenly distributed agglomerates compared to automatic mixing.</p></div><div><h3>Conclusion</h3><p>The mixing method employed for AH Plus Jet sealer influences some physicochemical and mechanical properties of the material.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141432102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associate Registry","authors":"","doi":"10.1016/S0099-2399(24)00432-1","DOIUrl":"10.1016/S0099-2399(24)00432-1","url":null,"abstract":"","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142171957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}