Journal of endodontics最新文献

{"title":"Carious Pulp Exposure in Mature Teeth With Reversible Pulpitis: A Randomized Clinical Trial of Direct Pulp Capping and Partial Pulpotomy","authors":"Nessrin A. Taha BDS, MFDS, GradDipClinDent, DClinDent(Endo), FRACDS, FRACDs (Endo), PhD ,&nbsp;Heba B. Jaradat BDS, MClinDent ,&nbsp;Alaa DkmaK BDS, MClinDent ,&nbsp;Imran Zainal Abidin BDS, MClinDent, MEndo","doi":"10.1016/j.joen.2025.06.019","DOIUrl":"10.1016/j.joen.2025.06.019","url":null,"abstract":"<div><h3>Introduction</h3><div>No clear guidelines exist for the selection of vital pulp therapy procedures in carious pulp exposures. This study aimed to compare the outcomes of direct pulp capping and partial pulpotomy in mature permanent teeth with reversible pulpitis.</div></div><div><h3>Methods</h3><div>The study was a parallel double-blind randomized clinical trial of 140 mature permanent teeth. Teeth were asymptomatic or with symptoms of reversible pulpitis and received direct pulp capping (<em>n</em> = 67) or partial pulpotomy (<em>n</em> = 73). After intraoperative assessment under magnification and hemostasis, NeoPUTTY (Avalon Biomed, Bradenton, FL) was placed as the capping material. Baseline variables were recorded. Patients were scheduled for 6- and 12-month clinical and radiographic follow-up. Results were statistically compared using chi-square tests and regression analysis.</div></div><div><h3>Results</h3><div>Approximately half of the teeth (74/140) were symptomatic, with no significant difference in the preoperative pain levels between the 2 groups (<em>P</em> = .75), both treatments resulted in significant pain reduction after 1 week (<em>P</em> &lt; .001). After 6 months, 4 cases of partial pulpotomy and 10 cases of direct pulp capping failed; the success rate was 94.4% versus 84.4%, <em>P</em> = .057 respectively. At 1 year, 2 additional failures occurred in each treatment group with success rates of 91.5% for partial pulpotomy and 81.3% for direct pulp capping (<em>P</em> = .08). There were no significant prognostic factors for pulp capping or partial pulpotomy, multivariate analysis did not reveal any significant interactions.</div></div><div><h3>Conclusions</h3><div>Carious pulp exposure in teeth with reversible pulpitis can be managed successfully by either direct pulp capping or partial pulpotomy depending on the intraoperative assessment of the exposed pulp.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 10","pages":"Pages 1342-1350"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567445","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 Anatomical Parameters on the Accuracy of Electronic Apex Locators in CShaped Canals: A Novel Micro-CT Analysis Incorporating Feret Diameter.","authors":"Kuan-Wei Tung, Hajime Sasaki, Bruno Cavalcanti, Richard Gardner, Neville McDonald","doi":"10.1016/j.joen.2025.09.012","DOIUrl":"https://doi.org/10.1016/j.joen.2025.09.012","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to evaluate the influence of anatomical parameters on the accuracy of two electronic apex locators (Raypex 6 and Root ZX II) in C-shaped canal mandibular molars using a novel Microcomputed tomography (Micro-CT) analysis incorporating Feret diameter.</p><p><strong>Method: </strong>The actual root canal length (RCL) was measured using the visual method. The electronic canal length (ECL), which determined the apical foramen (AF), and the electronic working length (EWL), which determined the apical constriction (AC), were obtained using Raypex 6 and Root ZX II. The root working length (RWL), calculated by subtracting the AC-AF distance from the RCL, served as a reference to evaluate the accuracy of the EWL. Anatomical parameters were derived from Micro-CT scans and included Feret diameters of AC and AF, AC-AF distance, presence/absence of accessory canal, C-shaped type, AF position and AC morphology. Statistical analysis involved Fisher's exact test and multinomial logistic regression.</p><p><strong>Results: </strong>The study included 42 C-shaped molar teeth and 119 canals. Raypex 6 and Root ZX II determined AF within ±0.5 mm in 97.5% and 96.4% of canals, respectively. A statistically significant difference was found in accuracy between detecting AF and AC (P <0.05). After multinomial logistic regression, multiple AC morphology was the only factor negatively affecting AC accuracy in both EALs.</p><p><strong>Conclusion: </strong>Raypex 6 and Root ZX II accurately detected AF but were less reliable for AC in C-shaped canal mandibular molars. Reduced AC accuracy was associated with multiple AC morphology, indicating that EALs may detect the first narrow part of the canal apically rather than the narrowest part.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225451","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":"Diagnosis of In Vivo Vertical Root Fracture in Endodontically Treated Teeth Using Machine Learning Techniques","authors":"Shujun Ran PhD ,&nbsp;Qiang Wang MEng ,&nbsp;Jia Wang PhD ,&nbsp;Jing Huang MD ,&nbsp;Wei Zhou MD ,&nbsp;Pengfei Zhang MS ,&nbsp;Keyong Yuan PhD ,&nbsp;Yushan Cheng MD ,&nbsp;Shensheng Gu PhD ,&nbsp;Jingjing Zhu MS ,&nbsp;Zhengwei Huang PhD","doi":"10.1016/j.joen.2025.05.004","DOIUrl":"10.1016/j.joen.2025.05.004","url":null,"abstract":"<div><h3>Introduction</h3><div><span>This study aimed to diagnose vertical root fracture (VRF) of endodontically treated teeth using clinical features and bone loss information from </span>cone beam computed tomography with machine learning models.</div></div><div><h3>Methods</h3><div><span>A total of 887 patients with 941 teeth undergoing endodontic surgery<span> were included in this retrospective study. The clinical factors and bone defects detected via cone beam computed tomography were measured and recorded. Linear machine learning models, </span></span>logistic regression model and nonlinear models, including XGBoost, LightGBM, and CatBoost were used to diagnose VRF. Model performance was evaluated using 5-fold cross-validation and based on various performance parameters, including the area under the curve, sensitivity, specificity, precision, and F score. Model interpretations were visualized by Shapley Additive Explanations.</div></div><div><h3>Results</h3><div>Of the 941 teeth, 112 VRF teeth (11.9%) were identified during endodontic surgery or after tooth extraction. XGBoost and LightGBM showed excellent performance with area under the curves of 0.98 [0.96, 0.99], specificity of 0.978 and 0.983, sensitivity of 0.883 and 0.803, and precision of 0.846 and 0.865, respectively. Shapley Additive Explanations values showed that lingual/buccal bone defect, the ratio of bone defect height above the root apex to the defect total height, width of bone defect and age were the top 5 contributors.</div></div><div><h3>Conclusions</h3><div>Machine learning models for the diagnosis of VRF using age, sex, tooth type, the quality of root canal filling and bone loss position, height, width, and depth are valuable for clinical decision making after root canal treatment.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 10","pages":"Pages 1393-1404"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078290","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":"The Outcome of Nonsurgical Root Canal Treatment Using Sealer-based Obturation versus Warm Vertical Compaction: A Randomized Controlled Trial","authors":"Fahad Alzoubi BDS, MClinDent Endo, MEndo RCSEd, FDS ,&nbsp;Samhan Alajmi BDS, MSc, ABE (Diplomate), CAGS ,&nbsp;Abdullah Alkandari BDS, MS, ABE (Diplomate), CAGS ,&nbsp;Saad Alqahtani BMedSc, BDM, MPH ,&nbsp;Amer Alanezi BChd, MDS, ABE (Diplomate), FRDC(C) ,&nbsp;Frank C. Setzer DMD, MS, PhD","doi":"10.1016/j.joen.2025.07.003","DOIUrl":"10.1016/j.joen.2025.07.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Calcium silicate sealer (CSS) based obturation (SBO) has gained wide popularity for its relative simplicity and material biocompatibility. Limited information exists how its treatment outcome compares to warm-vertical compaction (WVC). The primary aim of this randomized controlled clinical trial was to compare the outcome of nonsurgical root canal treatment using SBO with CSS versus WVC with a resin-based sealer. The secondary aim was to assess differences in the obturation time between SBO and WVC.</div></div><div><h3>Methods</h3><div>A total of 195 participants with 212 teeth took part in this study and randomly allocated to either SBO or WVC after completion of the bio-mechanical instrumentation. The time required to complete the obturation was recorded. Participants were followed-up after a minimum of 12 months for clinical and radiographic assessment using periapical radiographs with the periapical index (PAI) and cone-beam computed tomography (CBCT) scans using the CBCT-PAI. Statistical evaluation involved descriptive analysis and binary logistic regression.</div></div><div><h3>Results</h3><div>One hundred eighty-one teeth in 167 participants were followed-up (85.4%) after 12-22 months (mean 12.9 months). Using strict criteria, success rates were 76.6% for SBO and 80.5% for WVC based on PAI, and 71.3% for SBO and 65.5% for WVC using CBCT-PAI. The overall success was 78.5% assessed using PA radiographs and 68.5% using CBCT with no significant differences in outcomes. SBO required significantly less time (85.4 ± 44.0s) to complete the root filling compared to WVC (159.7 ± 71.0s) (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>Given comparable clinical outcomes to WVC yet demonstrating faster obturation time, SBO with CSS may be a suitable clinical alternative.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 10","pages":"Pages 1351-1361"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626471","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":"Effects of Different Root Canal Sealers and Irrigation Agitation Methods on Postoperative Pain in the Treatment of Teeth with Chronic Apical Periodontitis: A Randomized Clinical Trial.","authors":"Yakup Üstün, İpek Eraslan Akyüz, İlke Manolya Özdemir","doi":"10.1016/j.joen.2025.09.015","DOIUrl":"https://doi.org/10.1016/j.joen.2025.09.015","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to explore how different combinations of root canal sealers and irrigation activation techniques affect postoperative pain in single-rooted teeth with chronic apical periodontitis.</p><p><strong>Methods: </strong>Eighty teeth with single root and chronic apical periodontitis were randomly assigned into four groups according to the sealer and irrigation activation used: AH Plus sealer+Manuel dynamic irrigation (MDI), AH Plus sealer+Passive ultrasonic irrigation (PUI), NeoSealer Flo+MDI, NeoSealer Flo+PUI. The canals were prepared using Reciproc (R25 and R40) files. Root canals were obturated with gutta-percha cones corresponding in size and taper to the final instrument used. Ah Plus was used in the first and second groups, and NeoSealer Flo was used in the third and fourth groups as the root canal sealer. The 17% Ethylenediaminetetraacetic acid used in the final irrigation was activated using two different agitation methods (MDI, PUI). Postoperative pain was assessed at multiple time points up to 7 days using the Visual Analogue Scale.</p><p><strong>Results: </strong>Pain intensity generally peaked between 6 and 24 hours after treatment. Among the groups, the AH Plus + MDI combination resulted in the lowest pain scores, while the NeoSealer Flo + PUI group showed higher pain levels. A significant difference was noted between early pain levels and the consumption of analgesics (p < 0.001). There were no statistically significant differences observed in terms of demographic characteristics (p > 0.05).</p><p><strong>Conclusions: </strong>The combination of MDI with the AH Plus showed lower levels of pain in the early postoperative period.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225455","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(25)00544-8","DOIUrl":"10.1016/S0099-2399(25)00544-8","url":null,"abstract":"","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 10","pages":"Pages A12-A19"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183423","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(25)00560-6","DOIUrl":"10.1016/S0099-2399(25)00560-6","url":null,"abstract":"","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 10","pages":"Pages 1497-1504"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183557","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":"Micro-CT and Finite Element Analysis of Dentin Preservation and Stress Distribution in Mesial Roots of Mandibular Molars after Shaping with Different Tapers","authors":"Mario Alovisi DDS, PhD ,&nbsp;Andrea Baldi DDS, PhD ,&nbsp;Edoardo Moccia DDS, PhD ,&nbsp;Ivan Gaviglio PhD ,&nbsp;Allegra Comba DDS, PhD ,&nbsp;Lia Giordano DDS ,&nbsp;Nicola Scotti DDS, PhD ,&nbsp;Damiano Pasqualini DDS","doi":"10.1016/j.joen.2025.06.017","DOIUrl":"10.1016/j.joen.2025.06.017","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of this study was to evaluate the dentin preservation and fracture resistance of mandibular molar mesial roots after shaping with different tapers using micro–computed tomography (micro-CT) and finite element analysis (FEA).</div></div><div><h3>Methods</h3><div>Forty-eight mandibular first molars with independent mesial canals were selected. The mesio-lingual and mesio-buccal canals were randomly assigned (<em>n</em> = 12) to ProTaper Gold (PG), ProTaper Next (PTN), ProTaper Ultimate (PTU), and B4U instrumentation systems. Pre- and post-shaping micro-CT scans were performed to compare root canal volume and cervical dentin volume. The centroid shift and the percentage and distribution of the dentin removal in correspondence of the mesial canals were analyzed in coronal, middle, and apical points of analysis and below the furcation at the “danger zone.” The residual dentin thickness in the distal and mesial aspects of the mesial canals was measured. A linear elastic model of a mesial root of a mandibular molar was created through the finite element method (FEM) and a 200N perpendicular load was applied on the root canal coronal third. One-way factorial analysis of variance with Bonferroni correction and post hoc Tukey-Kramer tests were used (<em>P</em> &lt; .05).</div></div><div><h3>Results</h3><div>The mean cervical dentin volume removal was statistically lower for the B4U compared with the PG system (<em>P</em> &lt; .05). The canal centering ability was statistically more accentuated for the B4U group in the coronal and middle third and higher centroid shift variations occurred for PG system (<em>P</em> &lt; .05). The residual dentin thickness appeared statistically higher after shaping with B4U through the mesial and distal root aspect at the coronal point of analysis and at the danger zone (<em>P</em> &lt; .05). PG removed more dentin in the coronal root canal third (<em>P</em> &lt; .05). The FEM analysis showed no statistically significant differences between groups (<em>P</em> &gt; .05).</div></div><div><h3>Conclusions</h3><div>The reduction of the root canal taper may improve the instruments’ centering ability and the preservation of the residual dentin tissue, especially in the coronal and middle third. The root canal taper seems not to influence the stress distribution pattern through the mesial root of the lower molars.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 10","pages":"Pages 1477-1484"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560267","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":"Electroencephalogram as an Objective Method for Recording Pain after Endodontic Noxious Stimuli","authors":"Aysha M. Saad BDS ,&nbsp;Mohamed M. Elashiry BDS, MDS, PhD ,&nbsp;Alia H. Mansour MD, PhD ,&nbsp;Ahmed Elbokl MD, PhD ,&nbsp;Mohamed M. Nagy BDS, MDS, PhD ,&nbsp;Ahmed A. Hashem BDS, MDS, PhD","doi":"10.1016/j.joen.2025.05.019","DOIUrl":"10.1016/j.joen.2025.05.019","url":null,"abstract":"<div><h3>Introduction</h3><div><span>This study evaluated the significance of brain wave activity, particularly theta waves, in detecting noxious </span>endodontic stimuli and to determine their validity as an objective method for monitoring pain severity.</div></div><div><h3>Methods</h3><div><span>The study included 300 patients with symptomatic irreversible pulpitis<span> on 1 side of their jaws. Each participant wore a consumer-grade electroencephalogram (EEG) device, the EMOTIV EPOC X, for 10 minutes while seated in a dental chair. The control and inflamed teeth were evaluated to assess the patient's response to applied stimuli. Patients were asked to rate their pain intensity using a visual analog scale (VAS), while their theta wave brain activity was recorded using the EEG. Pain scores and EEG data were then collected and analyzed. Various comparisons were conducted using the signed-rank test, and correlations were assessed using Spearman's rank-order correlation coefficient. </span></span><em>P</em> values were adjusted for multiple comparisons using Bonferroni's correction, with the significance level set at <em>P</em> &lt; .05 for all tests.</div></div><div><h3>Results</h3><div><span>The results showed that in the inflamed side, theta wave activity (10.57 [6.76]) and VAS pain scores (7 [4]) were significantly higher (</span><em>P</em> &lt; .001) than the control side (6.99 [4.87] and 1 [1.62], respectively). There was a moderate positive correlation between theta wave activity and VAS pain scores across all readings (0.3 &lt; rs &lt; 0.5, <em>P</em> &lt; .001). Females had significantly higher theta band power readings than males on both sides (<em>P</em> &lt; .05). However, females reported significantly higher pain scores than males only on the inflamed side (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>This study illustrates the promising potential of monitoring theta brain wave activity as an objective method for assessing pain levels.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 10","pages":"Pages 1405-1412"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199300","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":"Performance of 7 Artificial Intelligence Chatbots on Board-style Endodontic Questions","authors":"Poorya Jalali DDS ,&nbsp;Hossein Mohammad-Rahimi DDS ,&nbsp;Feng-Ming Wang DDS, PhD ,&nbsp;Fatemeh Sohrabniya DDS ,&nbsp;Seyed AmirHossein Ourang DDS ,&nbsp;Yuke Tian BS, MS ,&nbsp;Frederico C. Martinho DDS, MSc, PhD ,&nbsp;Ali Nosrat DDS, MS, MDS","doi":"10.1016/j.joen.2025.06.014","DOIUrl":"10.1016/j.joen.2025.06.014","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of this study was to assess the overall performance of artificial intelligence chatbots in answering board-style endodontic questions.</div></div><div><h3>Methods</h3><div>One hundred multiple choice endodontic questions, following the style of American Board of Endodontics Written Exam, were generated by two board-certified endodontists. The questions were submitted to the following chatbots, three times in a row: Gemini Advanced, Gemini, Microsoft Copilot, GPT-3.5, GPT-4o, GPT-4.0, and Claude 3.5 Sonnet. The chatbot was asked to choose the correct response and to explain the justification. The response to the question was considered “correct” only if the chatbot picked the right choice in ALL 3 attempts. The quality of reasoning as to why the chatbot selected the answer choice was scored using a three-ordinal scale (0, 1, 2). Two calibrated reviewers scored all 2100 responses independently. Categorical data were analyzed using Chi-square test; ordinal data were analyzed using Kruskal–Wallis and Mann–Whitney tests.</div></div><div><h3>Results</h3><div>The accuracy scores ranged from 48% (Microsoft Copilot) to 71% (Gemini Advanced, GPT-3.5, and Claude 3.5 Sonnet) (<em>P</em> &lt; .05). Gemini Advanced, Gemini, and Microsoft Copilot showed similar performance regardless of the question source (textbook or literature) (<em>P</em> &gt; .05). GPT-3.5, GPT-4o, GPT-4.0 and Claude 3.5 Sonnet performed significantly better with textbook-based questions (<em>P</em> &lt; .05). Reasoning scores showed different distribution among chatbots (<em>P</em> &lt; .05). Gemini Advanced had the highest rate of score 2 (81%) and the lowest rate of score 0 (18.5%).</div></div><div><h3>Conclusions</h3><div>Comprehensive assessment of seven AI chatbots’ performance on board-style endodontic questions revealed their capacities and limitations as educational resources in the field of endodontics.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 10","pages":"Pages 1413-1419"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528198","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}