Journal of endodontics最新文献

{"title":"Guidelines for Authors","authors":"","doi":"10.1016/S0099-2399(26)00283-9","DOIUrl":"10.1016/S0099-2399(26)00283-9","url":null,"abstract":"","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"52 7","pages":"Pages A13-A20"},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148565536","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":"Hydrophilic Polymer–Modified Poly(ε-caprolactone)/Hydroxyapatite Three-dimensional-Printed Scaffolds with Enhanced Hydrophilicity and Biodegradability for Regenerative Endodontic Applications","authors":"Young-Ran Kim MS ,&nbsp;Ye-Seul Kim MS ,&nbsp;Jin-Ho Kang PhD ,&nbsp;Chan Park DDS, MSD, PhD ,&nbsp;Bin-Na Lee DDS, MSD, PhD","doi":"10.1016/j.joen.2026.03.014","DOIUrl":"10.1016/j.joen.2026.03.014","url":null,"abstract":"<div><h3>Introduction</h3><div>Poly(ε-caprolactone) (PCL) is widely used as a scaffold material for tissue regeneration; however, its intrinsic hydrophobicity and slow biodegradation limit cell adhesion and tissue remodeling. This study aimed to improve the hydrophilicity and biodegradability of PCL-based scaffolds by incorporating the hydrophilic polymer poloxamer 407 (P407) while maintaining mechanical stability through hydroxyapatite (HA) reinforcement. The composite system was designed as a bioactive platform for dentin–pulp complex regeneration and other regenerative endodontic applications.</div></div><div><h3>Methods</h3><div>Disc-shaped scaffolds with approximately 65% porosity were fabricated via fused deposition modeling-based 3D printing at varying PCL/HA/P407 ratios (P, PH, PHP1, PHP2, and PHP3). Physicochemical and biological properties—including printability, hydrophilicity, degradation, and mechanical strength—were analyzed using rheology, contact angle measurement, degradation testing, field-emission scanning electron microscopy, thermogravimetric/differential thermal analysis, compressive testing, and Fourier transform infrared spectroscopy. Human dental pulp stem cells (hDPSCs) were cultured to assess cell adhesion, proliferation, and osteo/odontogenic differentiation through alkaline phosphatase activity and alizarin red S staining.</div></div><div><h3>Results</h3><div>P407 incorporation significantly enhanced scaffold hydrophilicity and degradation while maintaining mechanical strength. The optimal P407 concentration (PHP2) showed improved hDPSCs adhesion, proliferation, and mineralized matrix formation without cytotoxicity. Increased alkaline phosphatase activity and calcium deposition indicated a favorable microenvironment for early osteo/odontogenic differentiation.</div></div><div><h3>Conclusion</h3><div>The P407-incorporated PCL/HA composite scaffold exhibited balanced mechanical stability, enhanced hydrophilicity, and tunable biodegradability, supporting favorable hDPSCs responses. These results suggest its potential as a promising scaffold for dentin–pulp complex regeneration and broader tissue engineering applications in regenerative endodontics.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"52 7","pages":"Pages 1166-1175"},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574173","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":"Artificial Intelligence Prognostic Models in Endodontics: Scoping Review and Clinical Gap Analysis for Retreatment versus Microsurgery Decision Support.","authors":"Mohammad A Sabeti, Golsar Torabi","doi":"10.1016/j.joen.2026.06.008","DOIUrl":"10.1016/j.joen.2026.06.008","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence (AI) prognostic models in endodontics may estimate treatment outcomes, but single-pathway prediction does not provide comparative decision support for failed cases in which nonsurgical retreatment (NS-ReTx) and endodontic microsurgery (EMS) may both be considered. This scoping review mapped AI prognostic models in endodontics and evaluated their alignment with prespecified clinical decision domains relevant to NS-ReTx-versus-EMS selection.</p><p><strong>Methods: </strong>A dual-track scoping review was conducted according to PRISMA-ScR. PubMed, Embase, Web of Science, Cochrane CENTRAL, IEEE Xplore, ACM Digital Library, and arXiv were searched from inception through February 23, 2026. Track 1 identified AI models developed to estimate future endodontic outcomes. Track 2 synthesized clinical decision domains relevant to NS-ReTx-versus-EMS selection. Risk of bias and applicability were assessed with PROBAST + AI; reporting was evaluated using TRIPOD + AI and CLAIM where applicable. Because of heterogeneity and limited evidence across outcomes, predictors, and performance metrics, findings were synthesized narratively.</p><p><strong>Results: </strong>Six AI prognostic studies met Track 1 eligibility, and 11 clinical studies informed Track 2 decision domains. Included models used radiographic, structured-variable, or hybrid approaches. All models used internal validation only; calibration, external validation, and clinical utility analyses were absent. No model generated treatment-conditional predictions comparing NS-ReTx and EMS within the same clinical scenario. Restorability, technical retrievability, and surgical-access variables were inconsistently represented.</p><p><strong>Conclusions: </strong>Current AI prognostic models in endodontics remain early-stage single-pathway prediction tools and are not yet structured for comparative NS-ReTx-versus-EMS decision support.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338864","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":"Class 2, Stage A Cemental Tear Mimicking Apical Periodontitis: A Case Report.","authors":"Katsuhiro Takeda, Daisuke Furutama, Takuya Arita, Tomoya Naruse, Yohei Takahashi, Reina Kawai, Kimiaki Yuhi, Hideki Shiba","doi":"10.1016/j.joen.2026.06.004","DOIUrl":"10.1016/j.joen.2026.06.004","url":null,"abstract":"<p><p>A cemental tear is a rare condition that can closely mimic endodontic and periodontal diseases, making accurate diagnosis challenging. Early identification is essential to ensure appropriate treatment and to avoid unnecessary or ineffective interventions. A 75-year-old woman presented with discomfort and a sinus tract associated with the mandibular right lateral incisor (tooth 42 (Universal #26)). Clinical examination showed no periodontal pocket, and conventional periapical radiographs showed a periapical radiolucency. Based on these findings, the initial diagnosis was symptomatic apical periodontitis, and root canal therapy was performed. However, the lesion did not improve. Cone-beam computed tomography (CBCT) then showed a cemental tear on the labial aspect of the root, classified as Class 2, Stage A, and the treatment plan was revised to include surgical intervention. Root-end surgery and removal of the cemental fragment resulted in good healing. Histopathologic examination demonstrated granulation tissue consistent with a periapical granuloma and bacterial colonies on the detached cemental fragments. This case highlights the diagnostic difficulty of differentiating apical periodontitis from Class 2, Stage A cemental tears located on the buccolingual aspect without a periodontal pocket, particularly in elderly patients and in cases involving incisors. Clinicians should maintain a high index of suspicion for a cemental tear when clinical signs and symptoms fail to improve after root canal treatment and consider the use of CBCT to improve diagnostic accuracy. In addition, in elderly patients with incisors and suspected occlusal trauma, CBCT imaging before starting root canal treatment should also be considered in selected cases to facilitate early and accurate diagnosis.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295330","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":"MTA versus Biodentine in Root Perforation Repair: Influence of Obturation Strategy on Fracture Risk in Maxillary First Premolars — A FEA and Weibull Analysis","authors":"Ling Li DDS, MSc ,&nbsp;Yu Zhao DDS, PhD ,&nbsp;Hui Deng DDS, PhD ,&nbsp;Yihuai Pan DDS, PhD ,&nbsp;Jun Li DDS, MSc","doi":"10.1016/j.joen.2025.12.011","DOIUrl":"10.1016/j.joen.2025.12.011","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of this study was to compare the biomechanical effects of mineral trioxide aggregate (MTA) and Biodentine for repairing root perforations in conjunction with 2 obturation strategies (complete versus partial gutta-percha obturation) on the fracture resistance of maxillary first premolars. The incidence of these treatment modalities on the probability of fracture risk was evaluated quantitatively.</div></div><div><h3>Methods</h3><div>Seven three-dimensional finite element models were constructed from cone-beam computed tomography data. The tooth models that were used consisted of a sound tooth model (SD), a root canal-filled model, an unrepaired perforation model, and four treatment models consisting of MTA/Biodentine combined with complete (All GP) or partial gutta-percha obturation being Part GP. The stress distribution under a 300 newton (N) occlusal load was then analyzed, and the fracture probability (<span><math><mrow><msub><mi>P</mi><mi>f</mi></msub></mrow></math></span>) was assessed using a Weibull analysis over a load range of 0–600 N.</div></div><div><h3>Results</h3><div>Under a 300 N load, the unrepaired perforation model showed a significantly higher <span><math><mrow><msub><mi>P</mi><mi>f</mi></msub></mrow></math></span> (10.15%), which was 10.6 times greater than SD's. All treatment models restored dentin stress to near-SD levels (9.71–10.01 MPa). When combined with the All GP strategy, both MTA and Biodentine achieved <span><math><mrow><msub><mi>P</mi><mi>f</mi></msub></mrow></math></span> values comparable to root canal-filled model (2.84% at 300 N). In contrast, the Part GP strategy resulted in higher stress values in the coronal enamel and midroot dentin, and higher <span><math><mrow><msub><mi>P</mi><mi>f</mi></msub></mrow></math></span> values (3.24%–3.99% at 300 N).</div></div><div><h3>Conclusion</h3><div>Both MTA and Biodentine are effective at restoring the biomechanical performance of perforated teeth. The obturation strategy significantly influences the long-term fracture risk. The All GP strategy combined with either repair material optimizes fracture resistance and minimizes failure risk. As a result, it is recommended as the preferred clinical technique.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"52 6","pages":"Pages 988-996"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145944527","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":"Healing of Perforating Inflammatory Root Resorption by Allogeneic Bone Marrow Mesenchymal Stromal Cells Transplantation: A Case Report","authors":"Jose Francisco Gomez-Sosa DDS, PhD ,&nbsp;Olga Wittig MSc ,&nbsp;Dylana Diaz-Solano PhD ,&nbsp;Jose E. Cardier MD, PhD","doi":"10.1016/j.joen.2026.03.001","DOIUrl":"10.1016/j.joen.2026.03.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Perforating inflammatory root resorption (PIRR) in permanent teeth can cause extensive dentin loss, periodontal breakdown, and eventual tooth loss. Regenerative endodontic procedures (REPs) have been proposed to treat PIRR. Among them, cellular therapy based on transplantation of mesenchymal stromal cells (MSCs) has been suggested as a potential option for treating PIRR, because of their paracrine and anti-inflammatory effects during tissue repair.</div></div><div><h3>Methods</h3><div>A 13-year-old girl presented with a traumatized tooth #9 showing discoloration, a buccal sinus tract, 8-mm probing depth, tenderness to percussion, and nonresponse to thermal and electric tests; after unsuccessful REP. Radiography and cone-beam computed tomography (CBCT) revealed a large PIRR extending from the cervical to apical third of the root, communication with the periodontium, lateral perforation, and complete loss of buccal alveolar bone in the apical third. All of this was consistent with the presence of PIRR, pulp necrosis, and chronic apical abscess. The canal was disinfected with NaOCl, EDTA, and intracanal calcium hydroxide. Allogeneic MSCs were thawed, cultured, expanded, included in platelet-rich plasma clot, and transplanted into the canal, followed by a Biodentine coronal plug and composite restoration. The tooth was followed-up for 48 months.</div></div><div><h3>Results</h3><div>The sinus tract resolved after 1 month, and buccal probing depth normalized and remained stable throughout follow-up. Radiographs and CBCT showed infilling of the resorptive defect with mineralized tissue, re-establishment of the periodontal ligament space, and buccal bone healing over 4 years. The tooth became asymptomatic and consistently responded to electric pulp testing, while responses to cold testing were variable.</div></div><div><h3>Conclusions</h3><div>This single case shows that allogeneic MSC transplantation may promote long-term healing of PIRR with pulp necrosis and chronic apical abscess in young permanent teeth. Controlled clinical studies are required to confirm the capacity of healing PIRR by MSCs.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"52 6","pages":"Pages 953-961"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433053","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":"From Evidence-based Endodontics to Generative AI: A Comparative Study of 11 Large Language Models","authors":"Lucas Peixoto de Araújo DDS, MS, PhD ,&nbsp;Laura Barreto Moreno DDS ,&nbsp;Bruna Cavalcante Chaves de Araújo DDS ,&nbsp;Eduardo Trota Chaves DDS, MS, PhD ,&nbsp;Tatiana M. Botero DDS, MS ,&nbsp;Vitor Henrique Digmayer Romero DDS, PhD","doi":"10.1016/j.joen.2026.01.009","DOIUrl":"10.1016/j.joen.2026.01.009","url":null,"abstract":"<div><h3>Introduction</h3><div>Generative large language models (LLMs) are increasingly used in dentistry, yet their guideline-based diagnostic accuracy and reproducibility remain uncertain. Position statements from the American Association of Endodontists and the European Society of Endodontology provide rigorous, evidence-based standards, making them an ideal benchmark to assess alignment of LLM outputs with endodontic best practices.</div></div><div><h3>Methods</h3><div>This study was conducted according to Transparent Reporting of a Multivariable Model for Individual Prognosis or Diagnosis—Large Language Models guidelines, evaluated 11 LLMs: ChatGPT 5, ChatGPT 4o, ChatGPT o3, Gemini 2.5 Flash, Gemini 2.5 Pro, Claude Sonnet 4, Claude Opus 4, Perplexity R1 1776, Perplexity Sonar, DeepSeek, and DeepSeek DeepThink R1. Sixty multiple-choice questions derived from American Association of Endodontists and European Society of Endodontology position statements were administered to each model in 5 rounds, generating 3300 responses. The primary outcome was all-correct accuracy and the secondary outcome was intra-model consistency. Comparisons were performed with chi-square tests and Bonferroni adjustment.</div></div><div><h3>Results</h3><div>All-correct accuracy varied significantly (χ² = 50.56, df = 10, <em>P</em> &lt; .001). ChatGPT 4o and Claude Opus 4 achieved 95.0% accuracy, followed by ChatGPT 5, Claude Sonnet 4, Gemini 2.5 Flash, and Gemini 2.5 Pro (93.3%), and ChatGPT o3 (90.0%). DeepSeek DeepThink R1 scored 86.7%, Perplexity R1 1776 83.3%, Perplexity Sonar 81.7%, and DeepSeek 63.3%. Consistency exceeded 90% for most models, peaking at 98.3% for top performers but falling to 75.0% for DeepSeek.</div></div><div><h3>Conclusions</h3><div>Most LLMs demonstrated high accuracy and reproducibility when benchmarked against authoritative endodontic guidelines. Despite notable progress over earlier generations, performance variability and confidently incorrect outputs highlight the need for rigorous validation and expert oversight before clinical integration.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"52 6","pages":"Pages 1010-1015"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146040861","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":"Effect of Restoration Strategy and Cavity Location on the Fracture Resistance of Teeth with External Cervical Resorption","authors":"Saadet Elpe DDS, MSc,&nbsp;Öznur Sarıyılmaz DDS, MSc","doi":"10.1016/j.joen.2025.10.001","DOIUrl":"10.1016/j.joen.2025.10.001","url":null,"abstract":"<div><h3>Introduction</h3><div>The restoration of external cervical resorption (ECR) defects requires materials capable of withstanding functional stresses. This study aimed to compare the fracture resistance of different restorative approaches applied to buccal versus palatal ECR defects under simulated clinical conditions.</div></div><div><h3>Methods</h3><div>Eighty-one extracted human maxillary central incisors were used. Nine intact teeth served as the positive control group (<em>n</em> = 9). The remaining 72 teeth were randomly assigned to standardized buccal or palatal ECR defect groups (<em>n</em> = 36 each). Each subgroup (<em>n</em> = 9) received one of the following treatments: negative control (no restoration), Biodentine alone, Ribbond + Biodentine, or EverX Flow + Biodentine (<em>n</em> = 9 per subgroup). Standardized ECR cavities were created 4 mm apical to the cementoenamel junction, with dimensions of 3 mm in width and 3 mm in depth and connected to the pulp chamber. All specimens underwent chewing simulation (240,000 cycles, 50 N load) and thermocycling (5°C–55°C) prior to fracture testing. The fracture test was performed using a universal testing machine by applying force at a 45° angle, and the maximum load was recorded in Newtons (N). Statistical analysis was performed using parametric or nonparametric tests based on data distribution, with significance set at <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>The restorative material significantly influenced fracture resistance (<em>P</em> &lt; .05). In buccal defects, the Ribbond + Biodentine group demonstrated significantly higher fracture resistance compared to negative controls. For palatal defects, Biodentine alone showed significantly greater resistance than negative controls. No significant differences were observed between buccal and palatal locations (<em>P</em> &gt; .05).</div></div><div><h3>Conclusions</h3><div>While the choice of restorative material had a significant effect on the performance of restorations in ECR defects, the location of the cavity (buccal or palatal) did not significantly influence the outcomes.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"52 6","pages":"Pages 980-987"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145280397","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":"Evaluation of Organic Debris Removal by 2 Irrigant Activation Systems using a Novel Chairside Quantitative Assay","authors":"Sean Kennelly DDS ,&nbsp;Derek Lin DDS ,&nbsp;Hacer Aksel DDS, PhD ,&nbsp;Mohini Ratakonda BDS, MDS ,&nbsp;Jorge Vera DDS, MS","doi":"10.1016/j.joen.2026.02.015","DOIUrl":"10.1016/j.joen.2026.02.015","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to investigate a novel quantitative adenosine triphosphate assay, to evaluate organic debris/bacterial reduction after irrigation activation with passive ultrasonic irrigation and the XP-endo Finisher (XPF), and to compare its efficacy with traditional colony-forming unit (CFU) detection <em>in vitro</em>.</div></div><div><h3>Methods</h3><div>The root canals of 40 extracted single-canal teeth were shaped to a 30.04 using NiTi files. Following inoculation of the root canals with <em>Enterococcus faecalis</em> for 3 weeks, the teeth were randomly allocated into 2 experimental groups (<em>n</em> = 20): (1) activation of 5.25% NaOCl using passive ultrasonic irrigation, or (2) activation using the XPF. The quantitative adenosine triphosphate assay (Endocator) was used before and after the irrigant activation protocols to determine the amount of bacteria/organic debris present. Data were analyzed using the Student t test and the Mann–Whitney U test (<em>P</em> = .05).</div></div><div><h3>Results</h3><div>The Endocator raw score exhibited a strong correlation with the number of bacteria present, as determined by CFU counts (R² = 0.99). In contrast, Endoscore values showed a high correlation with the logarithmically transformed CFU counts (R² = 0.95). The amount of intracanal organic debris/bacteria remaining after the passive ultrasonic irrigation and XPF protocols was approximately 1.7% and 1.2%, respectively. No statistically significant differences were observed between the groups regarding the amount of residual bacteria remaining in the canals after the irrigation protocols (<em>P</em> &gt; .05).</div></div><div><h3>Conclusion</h3><div>Both irrigation activation systems were similarly effective in removing organic debris/bacteria from the root canal system following final irrigation. None of the tooth samples was completely free of bacterial or organic debris residues after treatment with either of the tested systems.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"52 6","pages":"Pages 913-918"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326226","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":"Taxonomy and Virulence Factors in the Root Canal Microbiome: Metagenomic Insights by Lesion Size and Clinical Factors in Primary Endodontic Infections","authors":"Blake C. Clarke DDS, MS ,&nbsp;Ronald Ordinola-Zapata DDS, MS, PhD ,&nbsp;W. Craig Noblett DDS, MS ,&nbsp;Michael Gould BA ,&nbsp;Christopher Staley PhD","doi":"10.1016/j.joen.2026.02.016","DOIUrl":"10.1016/j.joen.2026.02.016","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to investigate the taxonomic and functional profiles of the root canal microbiome in teeth with large versus small periapical lesions, examining the influence of clinical variables on microbial composition and functional pathways.</div></div><div><h3>Methods</h3><div>Samples from 25 teeth with large (&gt;8 mm) and 20 with small periapical lesions (&lt;2 mm) were analyzed. Quantitative polymerase chain reaction, 16S next-generation and whole genome sequencing were used to assess microbial load, diversity, and composition. Functional predictions were performed using the Kyoto Encyclopedia of Genes and Genomes and MetaCyc databases. Alpha diversity was calculated using Shannon and Chao1 indices. Beta diversity was assessed using ANOSIM and PERMANOVA. Significant variables were explored using MaAsLin3. Kruskal–Wallis tests were used for univariate comparisons.</div></div><div><h3>Results</h3><div>Teeth with large lesions exhibited significantly higher bacterial load (<em>P</em> = .011), but comparable alpha diversity and number of species per group in 16S and whole genome analysis (<em>P</em> &gt; .05). Lesion size showed significance by ANOSIM (<em>P</em> = .04) but not in PERMANOVA (<em>P</em> = .36). Age was significant in both beta diversity tests, but the effect size only explained 3.6% of the variance. All clinical variables were not significant in 16S analysis for beta diversity. MetaCyc pathway analysis identified percussion sensitivity as the most influential clinical variable in both tests (ANOSIM <em>R</em> = 0.182, <em>P</em> = .012; PERMANOVA <em>R</em>^<em>2</em> = 0.063, <em>P</em> = .046). MaAsLin3 modeling revealed enrichment of enzymatic pathways involved in methionine and cysteine-related metabolism.</div></div><div><h3>Conclusions</h3><div>Large periapical lesions contain significantly higher bacterial load, but similar diversity compared to small lesions. Functional predictions suggest bacterial metabolic activity may contribute to mechanical allodynia in endodontic infections.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"52 6","pages":"Pages 919-928"},"PeriodicalIF":3.6,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326192","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}