Journal of endodontics最新文献

{"title":"Inflammatory Cytokines as Mediators of the Association Between Obesity and Chronic Apical Periodontitis.","authors":"Lijing Zhu, Xuechao Yang","doi":"10.1016/j.joen.2026.09.011","DOIUrl":"https://doi.org/10.1016/j.joen.2026.09.011","url":null,"abstract":"<p><strong>Objective: </strong>To assess genetic associations thatsupporta plausible causal interpretation of the obesity-chronic apical periodontitis (CAP) relationship, and to screen mediators including inflammatory cytokines, immune cell profiles and gut microbiota.</p><p><strong>Methods: </strong>Two-sample Mendelian randomization (MR) based on public obesity GWAS and FinnGen CAP data; two-step MR mediation analysis to validate mediation effects of inflammation, gut microbiota and immune cell phenotypes.</p><p><strong>Results: </strong>An association between genetically elevated body mass index (BMI) and increased susceptibility to CAP (ukb-b-2303, OR = 1.298; 95% CI: 1.170-1.439;P= 7.521E-07; FDR = 9.025E-06) was identified, compatible with a plausible causal interpretation. To further characterize the underlying mechanisms, two-step MR mediation analyses were performed. Three inflammatory cytokines were identified as significant mediators of the BMI-CAP relationship: M-CSF levels (OR = 1.107; 95% CI: 1.027-1.193; P = 0.008; FDR = 0.016), IL-6 levels (OR = 1.158; 95% CI: 1.071-1.252; P = 2.476E-04; FDR = 0.001), and TNFSF12 levels (OR = 0.885; 95% CI: 0.819-0.955; P = 0.002; FDR = 0.005). However, gut microbiota traits and immune cell phenotypes showed no significant mediating effects on the BMI-CAP causal association.</p><p><strong>Conclusions: </strong>This MR analysis identified a genetically predicted association between obesity and CAP that appears to be mediated, at least in part, by inflammatory cytokines, supportive of a potential causal interpretation. These findings suggest weight management may represent a plausible strategy for the prevention and management of CAP.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081017","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":"Autotransplantation versus Immediate Implant Placement for Replacement of Non-Restorable Posterior Teeth: A Systematic Review and Meta-Analysis.","authors":"Firas Elmsmari, Reem B Abdelsayed, Nadin Abouseif, Abdul Rahman Saleh, Jorge N R Martins, Abayomi O Baruwa","doi":"10.1016/j.joen.2026.09.009","DOIUrl":"https://doi.org/10.1016/j.joen.2026.09.009","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the present systematic review and meta-analysis was to compare the clinical success rates of immediate dental implants (IMM) and autotransplanted mature teeth (AUT), and to identify patient-related and intraoperative factors that influence short- to mid-term outcomes.</p><p><strong>Methods: </strong>The study protocol was prospectively registered on PROSPERO (CRD420251077420). A systematic electronic search adhering to the 2020 PRISMA guidelines was conducted across PubMed, ScienceDirect, and the Cochrane Library for studies published up to April 2026. Cohort studies reporting clinical success and/or survival rates for IMM and AUT with a minimum follow-up of 12 months were eligible. Methodological quality was assessed using the Newcastle-Ottawa scale. Publication bias was evaluated using Egger's regression test. Pooled success rates were estimated using a random-effects model, and mixed-effects meta-regression was used to assess the independent influence of clinical moderator variables.</p><p><strong>Results: </strong>Thirteen studies (7 IMM, n=153; 6 AUT, n=189) were analyzed. At 12 months, the pooled success rate was 97.0% (95% CI: 93.7% - 100.0%) for IMM and 95.9% (95% CI: 90.1% - 100.0%) for AUT; the difference was not statistically significant (P = .880). At 36 months, the IMM group maintained a success rate of 97.0%, whereas the AUT group demonstrated a decline to 90.3% (95% CI: 77.2% - 100.0%), which also did not reach statistical significance (P = .217). No evidence of publication bias was detected at either interval (Egger's regression test: 12-month IMM: P = .755; AUT: P = .748; 36-month IMM: P = .755, AUT: P = .676). The provision of cuspal coverage was identified as a significant prognostic factor at 36 months (P = .015). Patient sex, age, and molar position did not significantly influence success rates (P > .05). A marginal negative association was observed with the use of wire splints at 12 months (P = .081).</p><p><strong>Conclusions: </strong>Both immediate implant placement and autotransplantation of mature teeth demonstrate high short- to mid-term success rates with no statistically significant difference observed between them and may represent viable treatment options for posterior teeth replacement. The provision of an indirect restoration with cuspal coverage is associated with higher 36-months success rates for autotransplanted teeth.</p><p><strong>Significance: </strong>Immediate implants and autotransplanted mature teeth demonstrate similar short- to mid-term success rates, supporting autotransplantation as a viable, biologically conservative alternative for posterior tooth replacement. However, the treatment modality should be based according to patient characteristics, donor tooth availability, anatomical considerations, clinician expertise, and restorative requirements.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149080543","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":"Injectable and Retrievable Calcium Salicylate Hydrogel Promotes Sustained Periapical Bone Regeneration in a Beagle Dog Model of Apical Periodontitis.","authors":"Fernando Javier Aguilar Perez, Abdel H Mahmoud, Muyun Cui, Karin Hasegawa, Nabila Jaman Tripti, Brenna Ren, Huiting Luo, Shi Fu, Aaron Sloutski, Tatiana Zaliznyak, Chander Sadasivan, Thomas Manders, Yuefan Deng, Stephen G Walker, Marcia Simon, Jerome J Cymerman, Miriam Rafailovich","doi":"10.1016/j.joen.2026.09.010","DOIUrl":"10.1016/j.joen.2026.09.010","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent apical periodontitis remains a clinical challenge requiring both effective disinfection and bone regeneration. This study tested the hypothesis that an injectable, retrievable F127-dimethacrylamide (DMA)/calcium salicylate (CASA) hydrogel facilitates periapical bone healing by combining antimicrobial action with osteogenic induction.</p><p><strong>Methods: </strong>Periapical lesions were induced in 18 single-rooted teeth of 2 beagle dogs. After the periapical lesions were confirmed, teeth were randomly assigned to 3 groups: F127-DMA/CASA, calcium hydroxide (Ca(OH)₂), or an untreated control. For the CASA and Ca(OH)₂ groups, intracanal medicaments were placed and then removed after 4 weeks; in the control group, the root canals were left without the medicament. Periapical lesion volumes were tracked via cone-beam computed tomography and three-dimensional volumetric analysis for up to 10 weeks postmedication. In vitro, human osteoblasts were exposed to the hydrogel to evaluate osteogenic marker expression by reverse-transcription -quantitative polymerase chain reaction and to characterize mineral deposition by spectroscopic analysis and electron microscopy.</p><p><strong>Results: </strong>The F127-DMA/CASA group achieved the highest overall mean lesion volume reduction (54%) and significantly outperformed both control (26%) and Ca(OH)₂ treatment (38%) at 10-weeks (P < .03). Healing progressed at 3 different rates. The fastest occurred at 0-2 weeks, corresponding to initial cleaning of the canal, where Ca(OH)₂ and CASA were similar to each other and only moderately faster than control. Ca(OH)₂ and control reached a plateau after 2 weeks, with only a small subsequent increase (10% and 6%, respectively) at week 10. In contrast, CASA continued to show a significantly higher rate (20%) between weeks 2 and 6, which slowed (6%) between weeks 6 and 10, but remained higher than Ca(OH)₂ and control. A surprising result was the observation of new bone formation in two of the CASA-treated teeth. These results were further supported by auxiliary in vitro experiments in which osteoblasts exposed to CASA showed a 3- to 25-fold increase in mRNA levels of all targeted osteogenic markers and robust bone-like mineral deposition.</p><p><strong>Conclusions: </strong>The F127-DMA/CASA hydrogel achieved superior, sustained periapical healing and demonstrated bone regeneration as compared with conventional medicaments in a clinically relevant animal model. These outcomes were supported in vitro, exposing the molecular upregulation of osteoblast maturation markers and deposition of bone analog minerals, suggesting that the system functions as a bioactive regenerative therapy beyond traditional disinfection.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081002","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 Different Core Build-up Materials on the Fracture Resistance and Failure Patterns of Endodontically Treated Maxillary Premolars.","authors":"Sagar Hiwale, Rashi Kandpal, Dakshita Joy Sinha, Nikhil Puri, Neha Verma, Aabhansh Tomar","doi":"10.1016/j.joen.2026.09.012","DOIUrl":"https://doi.org/10.1016/j.joen.2026.09.012","url":null,"abstract":"<p><strong>Introduction: </strong>This in vitro study evaluated the fracture resistance and failure patterns of endodontically treated maxillary premolars with mesio-occluso-distal (MOD) cavities restored using different core build-up materials.</p><p><strong>Methods: </strong>Seventy-two intact human maxillary premolars were randomly assigned to six groups (n = 12). Endodontic treatment and standardized MOD cavity preparation were performed for all groups except the positive control (Group 1). Group 2 served as the negative control (ETT+MOD), whereas the remaining groups were restored with NC, FRC+NC, HFP+NC , or ACTIVA+NC . Following thermocycling, fracture resistance was evaluated using a universal testing machine under compressive loading, and failure patterns were recorded. Data were analysed using one-way analysis of variance and the Tukey post hoc test (P < .05). Fracture-mode data were treated as categorical variables and were analysed using Fisher's exact test.</p><p><strong>Results: </strong>Fracture resistance differed significantly among the groups (P < .001). The ETT+MOD+FRC+NC group demonstrated fracture resistance comparable to that of intact teeth and significantly greater than ETT+MOD+HFP+NC group (P < .05). No significant differences were observed between the ETT+MOD+FRC+NC and ETT+MOD+ACTIVA+NC groups or between the ETT+MOD+HFP+NC and ETT+MOD+ACTIVA+NC groups (P > .05). All remaining pairwise comparisons were statistically significant (P < .05). Failure-pattern analysis demonstrated a significant difference in the distribution of favourable and unfavourable fractures among the groups where ETT+MOD+FRC+NC group exhibited the highest proportion of favourable/repairable fractures.</p><p><strong>Conclusions: </strong>Within the limitations of this in vitro study, the type of core build-up material significantly influenced fracture resistance. FRC+NC group demonstrated the greatest reinforcing effect, whereas ACTIVA+NC and HFP+NC groups showed comparable performance and superior fracture resistance to NC group.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149074809","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":"Clinical Applications and Outcomes of Static-guided Endodontics in Teeth with Pulp Canal Obliteration: A Scoping Review.","authors":"Waleed Alhawiti, Kamran Ali","doi":"10.1016/j.joen.2026.09.008","DOIUrl":"10.1016/j.joen.2026.09.008","url":null,"abstract":"<p><strong>Introduction: </strong>Pulp canal obliteration presents a significant challenge in endodontic practice because canal location and negotiation may be difficult and associated with an increased risk of procedural errors. Static-guided endodontics combines cone-beam computed tomography, digital surface scanning, and three-dimensional printing to facilitate guided access to calcified canals. This scoping review aimed to map and summarize the available clinical evidence regarding the use of static-guided endodontics in the management of pulp canal obliteration.</p><p><strong>Methods: </strong>This scoping review was conducted in accordance with the Joanna Briggs Institute methodology for scoping reviews and reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). PubMed/MEDLINE, Scopus, Web of Science Core Collection, Embase, Dentistry & Oral Sciences Source, ProQuest, Google Scholar, ClinicalTrials.gov, and WHO ICTRP were searched from inception through June 2026. Two reviewers independently screened records, assessed full texts, and charted data; disagreements were resolved by consensus. Eligible studies were English-language human clinical investigations of nonsurgical static guided access for permanent teeth with pulp canal obliteration or calcified canals. Findings were mapped descriptively without critical appraisal or pooling.</p><p><strong>Results: </strong>Thirteen English-language clinical studies met the eligibility criteria: 4 case series, 3 observational or clinical-validation studies, 1 retrospective study, 3 prospective comparative studies, and 2 randomized clinical trials, published from 2019 to 2026. Reported outcome domains included canal location, procedural errors, trajectory accuracy, tooth structure loss, treatment time, periapical healing, and patient-reported outcomes. Definitions and denominators varied across studies and were not pooled.</p><p><strong>Conclusions: </strong>The clinical literature on static guided endodontics for pulp canal obliteration comprises a heterogeneous set of case series, observational studies, comparative studies, and randomized trials. The evidence maps a broadening range of indications, workflows, and outcome domains, but inconsistent definitions, mixed denominators, small samples, and limited long-term follow-up restrict cross-study comparison. Further prospective studies using standardized outcome definitions and longer follow-up are needed.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149061678","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":"Association between C-shaped Root Canal Configuration in Mandibular Second Molars and Radicular Grooves in Mandibular First Premolars: A CBCT-based Study in a Western Chinese Population.","authors":"Hebah H Al-Awdi, Eissa A Al-Shujaa, Ahmed A Madfa, Li Peng","doi":"10.1016/j.joen.2026.09.007","DOIUrl":"10.1016/j.joen.2026.09.007","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;C-shaped root canal configurations (CSRCs) in mandibular second molars (MSMs) and radicular grooves (RGs) in mandibular first premolars (MFPs) are anatomical variations that may affect endodontic procedures. However, their relationship within the same individual remains unclear. This study investigated the association between CSRCs and RGs using cone-beam computed tomography (CBCT) in a Western Chinese population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective CBCT study enrolled 1,637 participants (682 males and 955 females), and a total of 3,274 MSMs and 3,274 MFPs were assessed. RGs in MFPs were evaluated using the Arizona State University Dental Anthropology Scoring System, whereas CSRCs in MSMs were classified according to the Fan et al. classification system (C1-C5). Examiner reliability was assessed using the Cohen's kappa and weighted kappa coefficients. The prevalence, configuration, and bilateral symmetry of CSRCs and the prevalence, configuration, anatomical location, severity, and bilateral symmetry of RGs were assessed. Cohen's kappa, weighted Cohen's kappa, and McNemar's test were used to assess agreement and bilateral symmetry. The association between CSRCs and RGs was examined using chi-square tests, Cramer's V, and univariable and multivariable binary logistic regression analyses. The multivariable model was adjusted for age group and gender, and a separate multivariable binary logistic regression model was performed to evaluate the associations of age group and gender with the co-occurrence of CSRCs and RGs. Statistical significance was set at P &lt; .05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;At the patient level, CSRCs in MSMs were identified in 46.0% of participants, with C3 being the most prevalent configuration. RGs in MFPs were identified in 38.2% of participants; the mesial surface was the most frequently affected location, and Arizona State University Dental Anthropology Scoring System Grade 3 was the most common groove-positive grade. CSRCs and RGs demonstrated high bilateral symmetry, occurring symmetrically in 86.6% and 88.9% of participants, respectively. Both anatomical variations co-occurred in 21.6% of participants. CSRC presence was significantly associated with RG presence [χ&lt;sup&gt;2&lt;/sup&gt;(1) = 46.087, P &lt; .001], with a weak effect size (Cramer's V = 0.168). After adjustment for gender and age groups, patients with CSRCs had approximately 2.1 times the odds of exhibiting RGs compared with patients without CSRCs (adjusted odds ratio = 2.092, 95% confidence interval: 1.700-2.574, P &lt; .001). Females had higher odds of exhibiting both anatomical variations, whereas participants aged 51-65 years had lower odds of co-occurrence than those aged 13-30 years.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;CSRCs in MSMs were significantly associated with RGs in MFPs. Although the underlying developmental relationship requires further investigation, the presence of a CSRC may provide useful adjunctive clinic","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030523","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":"Cytotoxicity and Genotoxicity of Newly Formulated Bioceramic Sealers: An In Vitro Study.","authors":"Mykolas Varkalis, Cristine Smoczer, Mazin Askar, Laura Young, Joseph Ferracciolo, Susan Paurazas","doi":"10.1016/j.joen.2026.09.006","DOIUrl":"10.1016/j.joen.2026.09.006","url":null,"abstract":"<p><strong>Introduction: </strong>Bioceramic sealers are used for their favorable biocompatibility, yet concerns remain regarding cytotoxicity and genotoxicity when extruded. Recently introduced sealers, C-Root SP (CSP) and BC Sealer Ion Plus (BCIP), incorporate formulations that enhance bioactivity. This study aimed to evaluate and compare the cytotoxicity and genotoxicity of CSP, BCIP, and EndoSequence BC Sealer (ESBC) in human periodontal ligament fibroblasts.</p><p><strong>Methods: </strong>Human periodontal ligament fibroblasts were exposed to full strength and 1:10 dilution media conditioned with ESBC, BCIP, and CSP. Cytotoxicity was assessed using CellTox Green and CellTiter-Glo assays. Genotoxicity was evaluated via immunofluorescence staining for γH2AX and 53BP1. Statistical analysis was performed using one-way or two-way analysis of variance with statistical significance P < .05.</p><p><strong>Results: </strong>At full concentration, CSP was significantly more cytotoxic than ESBC or BCIP (P < .05), with all three falling below the 70% ISO viability threshold. At 1:10 dilution, only CSP maintained cell viability comparable to that of untreated controls. No changes in cytotoxicity were observed for the 3 materials at full strengths at 24, 48, and 72 hours (P > .05); however, at 1:10 dilution, ESBC cytoxicity was higher than CSP and BCIP at 72 hours. Immunofluorescence revealed significantly higher genotoxicity with full-strength ESBC compared to that with CSP and BCIP (P < .05); no significant genotoxic differences were observed at 1:10 dilution (P > .05).</p><p><strong>Conclusions: </strong>These findings highlight the importance of concentration-dependent effects when selecting bioceramic sealers for clinical use.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149030457","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":"Cemental Tear: A Multicenter Retrospective Case Series.","authors":"Karin Zuim, Flávio R F Alves, Helton D D Linhares, Fabio R Pires, Luciana Armada, Liliana P Artaza, Debora P Sellera, Cristiane M Caram, José R F Archilla, Simone N G Favinha, Teresa C Miranda, Sylvina Oyarzabal-Eula, Tereza V M Lorenzoni, José C Provenzano, Isabela N Rôças, José F Siqueira","doi":"10.1016/j.joen.2026.08.035","DOIUrl":"10.1016/j.joen.2026.08.035","url":null,"abstract":"<p><p>Cemental tear (CeT) is an often-overlooked condition that may mimic endodontic and periodontal diseases, leading to misdiagnosis and inappropriate management. This multicenter study reports a series of CeT cases characterized using an integrated clinical, cone-beam computed tomography (CBCT)-based imaging, and tissue-based analytical approach. Twenty-nine teeth from 21 patients were diagnosed with CeT based on clinical and CBCT findings. Fragment location, root third distribution, and extent of the root surface and periradicular bone involvement were assessed. Extracted teeth and surgically removed fragments were subjected to micro-computed tomography, scanning electron microscopy, and histopathologic examination, depending on specimen availability. Demographic, clinical, and imaging variables were recorded and analyzed. CeT predominantly affected older adults (mean age, 66.5 years) and was most frequently observed in anterior teeth (96.6%). Cases presented with a history of dental trauma (41.4%), parafunctional habits (37.9%), and occlusal interference (31%). Radiographic examination failed to identify CeT in 72.4% of cases. CBCT demonstrated fragment detachment in 28 teeth (96.6%), while one case (3.4%) was diagnosed only during surgery. CeTs most frequently involved the apical and middle thirds of the root, with fragment thickness ranging from 0.23 to 0.81 mm and surface area from 0.59 to 28.42 mm². Histopathologic examination revealed acellular or cellular cementum associated with periodontal ligament remnants, fibrous connective tissue, chronic inflammation, and occasional cystic epithelial lining. Micro-computed tomography demonstrated abrupt margins, crater-like defects, and microfractures, while scanning electron microscopy showed irregular fragment planes, exposed periodontal fibers, and biofilm-like deposits.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850413","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":"Radiologic and Immunohistochemical Correlation of Programmed Death 1/Programmed Death Ligand 1 and CD4⁺ T Cells in Periapical Granuloma and Radicular Cyst: An Observational Study.","authors":"Astha Upadhyay, Mala Kamboj, Shweta Mittal, Anjali Narwal, Anju Devi, Adarsh Kumar","doi":"10.1016/j.joen.2026.09.005","DOIUrl":"10.1016/j.joen.2026.09.005","url":null,"abstract":"<p><strong>Introduction: </strong>Chronic Periapical lesions involve persistent inflammation and immune dysregulation, with CD4+ T cells and the PD-1/PD-L1 checkpoint pathway potentially contributing to their pathogenesis. This study quantitatively evaluated CD4⁺ inflammatory cells, programmed death 1 (PD-1), and its ligand (PD-L1) in periapical granuloma and radicular cyst to elucidate their role in chronic periapical inflammation, and correlated marker expression with periapical index, severity of inflammatory infiltrate and cystic lining thickness.</p><p><strong>Methods: </strong>Eighty-one tissue samples comprising periapical granuloma (PG, n = 27), radicular cyst (RC, n = 27), healthy pulp (HP, n = 14), and normal oral mucosa (n = 13) were evaluated. Morphologic and immunohistochemical analyses were performed to quantify CD4, PD-1, and PD-L1 expression with periapical index and histological inflammatory scores. Data were analyzed using nonparametric and Spearman correlation tests (P < .05).</p><p><strong>Results: </strong>Mean CD4 expression was significantly higher in RC than PG (P < .05); both lesions demonstrated higher CD4 levels than HP and normal oral mucosa (P < .05). Conversely, PD-L1 was significantly higher in PG than RC (P < .05), HP, and normal oral mucosa (P < .001). Notably, the PD-1 expression was exclusively observed in PG (P < .05). Higher periapical index scores were associated with RC rather than PG (P < .001), and its comparison with PD-1 expression was significant (P < .001). Severe inflammation equally predominated in the PG and RC (P > .05). In PGs, the inflammatory score correlated significantly with CD4 expression (P = .006).</p><p><strong>Conclusions: </strong>PG exhibits a highly active immune microenvironment, and the observed expression of PD-1 and PD-L1 may indicate a potential role of the PD-1/PD-L1 checkpoint axis in modulating CD4⁺ T cell-associated inflammation. Conversely, the lack of detectable PD-1 in RC may suggest a divergence in regulatory pathways; however, alternative factors like low localized T-cell activation, sampling variability, or technical limits of detection cannot be excluded.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016617","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":"Non-destructive Prediction of Remaining Useful Life for Nickel-Titanium Rotary Files Using Electrochemical Impedance Spectroscopy and Artificial Intelligence.","authors":"Yueling Ma, Kaige Chen, Yuhao Xu, Yichen Yang, Xiangzhu Wang, Xiaoyu He","doi":"10.1016/j.joen.2026.09.004","DOIUrl":"10.1016/j.joen.2026.09.004","url":null,"abstract":"<p><strong>Introduction: </strong>Nickel-titanium (NiTi) rotary files are widely used in modern root canal therapy. Although instrument separation is relatively uncommon, sudden fatigue fracture may lead to serious clinical consequences. Current methods are limited to detecting macroscopic defects and cannot quantitatively assess early-stage microscopic fatigue damage. To address this issue, we combined electrochemical impedance spectroscopy (EIS) with artificial intelligence to develop a framework for the non-destructive prediction of the remaining useful life of NiTi rotary files.</p><p><strong>Methods: </strong>We conducted EIS monitoring on 94 NiTi rotary files from their pristine state until fatigue fracture, and built a dataset containing 864 valid measurements. We designed a frequency point and sliding window joint optimization strategy to select key features and eliminate feature dimensionality redundancy. Using five-fold cross-validation, we evaluated 18 models: nine traditional machine-learning models, eight conventionally trained deep-learning architectures, and the pretrained tabular foundation model TabPFN; we established a three-level clinical risk-warning system.</p><p><strong>Results: </strong>Among the evaluated models, CatBoost, a gradient-boosting decision-tree algorithm, achieved the lowest cross-validated mean absolute error (0.133 ± 0.015) and a mean three-level risk-classification accuracy of 71.1% ± 2.9%. Furthermore, the joint optimization strategy reduced feature dimensionality by 83.0% without significantly compromising the performance. The best-performing traditional machine-learning models outperformed conventionally trained deep-learning architectures and TabPFN on this small tabular dataset.</p><p><strong>Conclusions: </strong>This study confirms that an EIS- and AI-based non-destructive assessment method enables the quantitative evaluation of the fatigue state of NiTi rotary files prior to fracture, providing a clinically meaningful basis for personalized instrument replacement decisions.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149012380","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}