{"title":"Frequency and Performance Analysis of Polymer, Steel, and Titanium Ultrasonic Inserts in Intracanal Medication Removal","authors":"Guilherme Nilson Alves dos Santos DDS, MSc, PhD , Alice Corrêa Silva-Sousa DDS, PhD , Angelo José Sócrates Torres-Carrillo DDS, MSc , Guilherme de Araujo Braz PhD , Thais Oliveira Alves DDS, MSc , Fabiane Carneiro Lopes-Olhê DDS, MSc, PhD , Yara Teresinha Corrêa Silva-Sousa DDS, MSc, PhD , Jardel Francisco Mazzi-Chaves DDS, MSc, PhD , Ricardo Gariba Silva DDS, MSc, PhD , Manoel Damião Sousa-Neto DDS, MSc, PhD","doi":"10.1016/j.joen.2025.06.003","DOIUrl":"10.1016/j.joen.2025.06.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Ultrasonic inserts can be manufactured in various shapes, angles, and materials, this study evaluated the frequencies generated by steel, titanium, and polymer ultrasonic inserts using acoustic wave analysis and assessed the effectiveness of the iVac system and passive ultrasonic irrigation (PUI) compared to conventional irrigation for removing calcium hydroxide-based intracanal medication using micro-computed tomography (microCT).</div></div><div><h3>Methods</h3><div>Steel and titanium inserts from the Ultra X system (blue, silver, gold) and the polymer insert from the iVac system were analyzed using vibroacoustography in Ultra X (45 kHz) and Woodpecker (40 kHz) ultrasonic devices. Inserts were positioned in a water tank for standardized placement. The excitation signal was generated using MATLAB software, and power measurements were conducted in duplicate. After root canal preparation in 30 teeth, calcium hydroxide-based medication was applied and scanned using microCT. After 7 days, initial removal was performed with a K-file (number 45.02), followed by three protocols: conventional irrigation, PUI, or iVac. A second microCT scan was performed. Analysis of variance and Tukey's tests compared ultrasonic power and residual medication volume.</div></div><div><h3>Results</h3><div>The steel, titanium, and polymer inserts exhibited frequencies from 37 to 45 kHz. The iVac group (99.8 ± 0.3%) achieved greater medication removal than the PUI group (97.3 ± 2.9%), both significantly superior to conventional irrigation (73.0 ± 9.4%) (<em>P</em> < .05).</div></div><div><h3>Conclusion</h3><div>The ultrasonic power of the inserts operated within the expected frequency range. The iVac system demonstrated superior effectiveness in removing intracanal medication.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 10","pages":"Pages 1455-1463"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293834","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":"Feasibility and Clinical Efficacy of Minimally Invasive Straight-Incision Endodontic Microsurgery Guided by 3-Dimensional Printed Templates: A Retrospective Case Series","authors":"Lanxi Guan DDS , Xiao Liu DDS , Chen Cai DDS , Cailing Fang BD , Yidi Lao BD , Jiaxin Huang BD , Yuting Huang DDS , Xuechao Yang PhD, DDS , Qianzhou Jiang PhD, DDS","doi":"10.1016/j.joen.2025.06.006","DOIUrl":"10.1016/j.joen.2025.06.006","url":null,"abstract":"<div><h3>Introduction</h3><div><span>Endodontic<span><span> microsurgery (EMS) is a </span>minimally invasive treatment<span> for persistent periapical lesions. This study evaluates the accuracy and outcomes of a straight-incision EMS guided by 3-dimensional (3D)-printed </span></span></span>template, with at least 1 year of follow-up.</div></div><div><h3>Methods</h3><div>Twelve teeth from nine patients underwent minimally invasive straight-incision EMS using 3D-printed templates and a trephine for both osteotomy<span> and root-end resection. Clinical outcomes, deviations in resection length and angle, and mucosal incision healing were retrospectively assessed.</span></div></div><div><h3>Results</h3><div>Trephine-based root-end resection was successful in all cases, with no intraoperative or postoperative complications. Clinical and radiographic evaluations confirmed success in all patients after 1 year. Median resection length deviation was 0.79 mm (95% confidence interval: 0.49–1.16), and angular deviation was 19° (95% confidence interval: 8.03–25.47). All cases showed favorable and rapid wound healing, except for case 12.</div></div><div><h3>Conclusions</h3><div>Straight-incision EMS guided by 3D-printed templates is a precise, minimally invasive, and esthetically favorable technique that enables accurate root-end resection and promotes effective healing.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 10","pages":"Pages 1490-1496.e5"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144325926","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":"hDPSC-derived Secretomes Enhance Odontogenic Differentiation and Suppress Inflammation: A Potential Cell-free Approach for Regenerative Endodontics","authors":"Ji-Soo Kim DDS, MSD , Manfei Qiu DDS, MSD, PhD , Kkot-Byeol Bae DDS, MSD, PhD , Ji-Hyun Jang DDS, MSD, PhD , Won-Jae Kim DDS, MSD, PhD , Jeong-Tae Koh DDS, MSD, PhD , Yun-Chan Hwang DDS, MSD, PhD , Bin-Na Lee DDS, MSD, PhD","doi":"10.1016/j.joen.2025.06.016","DOIUrl":"10.1016/j.joen.2025.06.016","url":null,"abstract":"<div><h3>Introduction</h3><div><span>Secretomes are bioactive molecules secreted by stem cells that contain growth factors, anti-inflammatory agents, and proteins involved in tissue repair. This study aimed to evaluate the anti-inflammatory and odontogenic effects of human </span>dental pulp stem cells (hDPSCs)-derived secretomes.</div></div><div><h3>Methods</h3><div><span><span><span>Secretomes were isolated from hDPSCs through stepwise filtration and centrifugation. </span>Gene ontology<span> analysis was performed to characterize the secretome composition. The effects of secretomes on cell migration were assessed via wound healing assay. Anti-inflammatory and odontogenic effects were evaluated using quantitative real-time polymerase chain reaction and </span></span>western blotting<span><span> for inflammatory markers and odontogenic differentiation markers. Alkaline phosphatase staining was performed to assess </span>mineralization under lipopolysaccharide-induced inflammatory conditions. Data were statistically analyzed using one-way analysis of variance and Tukey's posthoc test (</span></span><em>P</em> < .05 was considered significant).</div></div><div><h3>Results</h3><div>Gene ontology analysis confirmed key functional components of the secretome. The wound healing assay demonstrated that 100 μg/mL secretome treatment significantly enhanced human dental pulp cells migration. Secretome treatment significantly attenuated lipopolysaccharide-induced upregulation of inflammatory markers (<em>P</em><span> < .05) while upregulating odontoblastic differentiation markers and promoting mineralization (</span><em>P</em> < .05).</div></div><div><h3>Conclusion</h3><div>hDPSC-derived secretomes exhibit anti-inflammatory and odontogenic effects, potentially mediated by MAPK signaling<span> pathways. These findings suggest that secretomes may serve as a novel cell-free strategy for regenerative endodontics, offering therapeutic potential for vital pulp therapy and dentin-pulp regeneration.</span></div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 10","pages":"Pages 1420-1428"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528197","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":"Comparative Evaluation of Root Canal Retreatment Techniques and the Effect of Supplementary Cleaning on Curved Canals Obturated with Premixed Bioceramic Sealer","authors":"Tanakrit Sutharoj DDS , Anat Dewi DDS, MSc (Endodontics) , Panupat Phumpatrakom DDS, MSc (Endodontics) , Thanapat Sastraruji PhD","doi":"10.1016/j.joen.2025.06.012","DOIUrl":"10.1016/j.joen.2025.06.012","url":null,"abstract":"<div><h3>Introduction</h3><div>The retreatment<span> of curved root canals remains challenging, particularly with the increased use of premixed bioceramic sealers, which exhibit more difficult retrievability. This study aimed to compare the effectiveness of 2 retreatment systems—RECIPROC blue and VDW.ROTATE retreatment—in removing obturation materials from curved canals filled with either a bioceramic sealer (iRoot SP) or an epoxy resin-based sealer (AH Plus). The study also evaluated the additional cleaning effect of XP-endo Finisher R.</span></div></div><div><h3>Methods</h3><div><span>Sixty extracted mandibular molars<span> with mesiobuccal canals possessing 20–40° curvature were divided into 4 groups based on the sealer and retreatment technique used. Canals were obturated with either AH Plus or iRoot SP, followed by retreatment using either RECIPROC blue or VDW.ROTATE retreatment. Supplementary cleaning with XP-endo Finisher R was used in all groups. </span></span>Microcomputed tomography<span> was used to evaluate the volume of residual filling material and apical transportation.</span></div></div><div><h3>Results</h3><div>RECIPROC blue achieved significantly higher success in regaining apical patency compared to VDW.ROTATE retreatment. Supplementary cleaning with XP-endo Finisher R significantly reduced residual materials in all groups.</div></div><div><h3>Conclusion</h3><div>RECIPROC blue is more effective in retreating curved canals filled with bioceramic sealer, and supplementary cleaning using XP-endo Finisher R further enhances canal cleanliness.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 10","pages":"Pages 1464-1470"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144505869","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}
Nessrin A. Taha BDS, MFDS, GradDipClinDent, DClinDent(Endo), FRACDS, FRACDs (Endo), PhD , Heba B. Jaradat BDS, MClinDent , Alaa DkmaK BDS, MClinDent , Imran Zainal Abidin BDS, MClinDent, MEndo
{"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 , Heba B. Jaradat BDS, MClinDent , Alaa DkmaK BDS, MClinDent , 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> < .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}
Kuan-Wei Tung, Hajime Sasaki, Bruno Cavalcanti, Richard Gardner, Neville McDonald
{"title":"Influence of Anatomical Parameters on the Accuracy of Electronic Apex Locators in C-shaped 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":"10.1016/j.joen.2025.09.012","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the influence of anatomical parameters on the accuracy of 2 electronic apex locators (Raypex 6 and Root ZX II) in C-shaped canal mandibular molars using a novel micro-computed tomography (micro-CT) analysis incorporating Feret diameter.</p><p><strong>Methods: </strong>The actual root canal length was measured using the visual method. The electronic canal length, which determined the apical foramen (AF), and the electronic working length, which determined the apical constriction (AC), were obtained using Raypex 6 and Root ZX II. The root working length, calculated by subtracting the AC-AF distance from the root canal length, served as a reference to evaluate the accuracy of the electronic working length. 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 < .05). After multinomial logistic regression, multiple AC morphology was the only factor negatively affecting AC accuracy in both electronic apex locators.</p><p><strong>Conclusions: </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 electronic apex locators 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}
Shujun Ran PhD , Qiang Wang MEng , Jia Wang PhD , Jing Huang MD , Wei Zhou MD , Pengfei Zhang MS , Keyong Yuan PhD , Yushan Cheng MD , Shensheng Gu PhD , Jingjing Zhu MS , Zhengwei Huang PhD
{"title":"Diagnosis of In Vivo Vertical Root Fracture in Endodontically Treated Teeth Using Machine Learning Techniques","authors":"Shujun Ran PhD , Qiang Wang MEng , Jia Wang PhD , Jing Huang MD , Wei Zhou MD , Pengfei Zhang MS , Keyong Yuan PhD , Yushan Cheng MD , Shensheng Gu PhD , Jingjing Zhu MS , 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 , Samhan Alajmi BDS, MSc, ABE (Diplomate), CAGS , Abdullah Alkandari BDS, MS, ABE (Diplomate), CAGS , Saad Alqahtani BMedSc, BDM, MPH , Amer Alanezi BChd, MDS, ABE (Diplomate), FRDC(C) , 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> < .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":"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 analog 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 < .001). There were no statistically significant differences observed in terms of demographic characteristics (P > .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}