Journal of endodontics最新文献

{"title":"Biomechanical Characterization of Immature Roots Following Regenerative Endodontic Treatment and MTA Apexification: A Clinical Study","authors":"Ali Nosrat DDS, MS, MDS ,&nbsp;Alireza Kolahdouzan DDS, MS ,&nbsp;Rajeshwari Hadagalu Revana Siddappa BDS, MDS, PhD ,&nbsp;Changjun Cheng MS, PhD ,&nbsp;Fang-Chi Li DDS, MSc, PhD ,&nbsp;Meisam Moradi DDS, MS ,&nbsp;Amir Hossein Khatibi DDS, MS ,&nbsp;Davoud Jamshidi DDS, MS ,&nbsp;Azin Parsa DDS, MSc, PhD ,&nbsp;Jeffery B. Price DDS, MS ,&nbsp;Anibal Diogenes DDS, MS, PhD ,&nbsp;Yu Zou BEng, MEngDrSc ,&nbsp;Anil Kishen BDS, MDS, PhD","doi":"10.1016/j.joen.2025.06.018","DOIUrl":"10.1016/j.joen.2025.06.018","url":null,"abstract":"<div><h3>Introduction</h3><div>This clinical investigation aims to determine and compare the volume, hardness, and elastic modulus of immature roots following regenerative endodontic treatment (RET) and mineral trioxide aggregate (MTA) apexification.</div></div><div><h3>Methods</h3><div>A total of six volunteers aged between 9 and 14 years participated in the study, each providing a pair of mandibular or maxillary premolars with normal pulp and periapex planned for extraction due to orthodontic reasons. After full pulpectomy, each pair received either an MTA obturation or RET using blood clot as scaffold, followed by permanent restoration. Teeth were extracted ∼6.5 months later. Micro–computed tomographic images of teeth were taken for volumetric analyses and roots were subjected to nanoindentation physical testing.</div></div><div><h3>Results</h3><div>Root volumes ranged from 168 mm³–236 mm³ (202.5 ± 31.07) in the MTA group and 178 mm³–251 mm³ (223 ± 28.09) in the RET group (<em>P</em> &lt; .05). The median values of hardness in all regions (apical and middle) and all sites (periphery to canal lumen) ranged from 0.56–1.04 giga pascal (GPa) in the MTA group and 0.32–0.65 GPa in the RET group (<em>P</em> &lt; .05). The median values of elastic modulus in all regions (apical and middle) and all sites (periphery to canal lumen) ranged from 10.4–22.9 GPa in the MTA group and 4.8–12.1 GPa in the RET groups (<em>P</em> &lt; .05). Except the hardness in apical third in the MTA group, the values of hardness and elastic modulus increased from periphery towards lumen in all other regions in both groups (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>After a period of 6.5 months RET resulted in increased root volumes, with the root structure indicative of newly formed hard tissue, which exhibited lower hardness and elastic modulus compared to those treated with MTA apexification.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 10","pages":"Pages 1429-1437"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144564826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sodium Hypochlorite Accidents: A Retrospective Case-series Analysis of CBCT Imaging and Clinician Surveys","authors":"Dan Cho-Kee DDS ,&nbsp;Bettina R. Basrani DDS, MSc, PhD ,&nbsp;Jorge Vera DDS, MS ,&nbsp;Ronald Ordinola-Zapata DDS MS, PhD ,&nbsp;Rubén Rosas Aguilar DDS, MS","doi":"10.1016/j.joen.2025.05.024","DOIUrl":"10.1016/j.joen.2025.05.024","url":null,"abstract":"<div><div>This case series study aims to investigate retrospectively the causes underlying sodium hypochlorite (NaOCl) accidents in endodontic<span><span><span> practices through analysis of cone beam computed tomography (CBCT) imaging and comprehensive clinician surveys. Twenty-four dental practitioners who encountered a NaOCl accident during the treatment of a permanent tooth in adult patients provided deidentified patient data, facial photographs, and a limited field of view </span>CBCT of the involved tooth. Providers also had to report patient's immediate presence of pain and swelling after root canal irrigation to include the dataset into the study. Modified surveys were administered to collect information on other demographic factors including age, sex, tooth involved, apical diagnosis, presence of ecchymosis, pain severity, among others. The CBCT volume was used to identify the presence of </span>fenestration, root perforation, and apical pathosis. CBCT data were evaluated by 4 examiners. Among the 26 NaOCl accidents investigated, a higher incidence was observed in females (65.30%) and maxillary teeth (92.30%). All cases presented immediate swelling and edema; intracanal bleeding and hematoma were observed in 80.70 and 84.60% of the cases respectively. CBCT interpretation revealed that bone fenestrations were evident in all cases studied (100%), iatrogenic perforations were detected in 19.23% of the cases, and apical pathosis was noted in 30.70% of the cases. This case series study highlights that a direct communication between the root apex and surrounding soft tissues is highly prevalent in NaOCl accidents. Early identification of bone fenestrations or perforations identified in maxillary teeth of female patients can play a pivotal role in preventing NaOCl extrusion accidents during endodontic treatment.</span></div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 10","pages":"Pages 1485-1489"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248191","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 Effect of Systemic Statin Intake on Healing of Apical Periodontitis after Nonsurgical Root Canal Treatment: A Retrospective Cohort Study","authors":"Esha Goel BDS, MClinDent (Endodontology), MEndo RCSEd ,&nbsp;Shahrah Mkhreb BDS, MSc ,&nbsp;Elisabetta Cotti DDS, MS ,&nbsp;Francesca Ideo DDS, PhD ,&nbsp;Sadia Niazi BDS, MSc, PhD, MEndo RCSEd, F(Endo) RCSEd, MEndo RCS Eng, FHEA ,&nbsp;Garrit Koller BDS, MSc, PhD ,&nbsp;Samira Farzadi BDS, BSc ,&nbsp;Francesco Mannocci MD, DDS, PhD, FHEA","doi":"10.1016/j.joen.2025.06.010","DOIUrl":"10.1016/j.joen.2025.06.010","url":null,"abstract":"<div><h3>Introduction</h3><div>This retrospective cohort study compared the radiographic healing of apical periodontitis following root canal treatments and retreatments in patients regularly taking statins versus those who had never taken statins.</div></div><div><h3>Methods</h3><div>Patients who underwent root canal treatment or retreatment performed by undergraduate and postgraduate students were included. The patients were divided into 2 age-matched groups: those who reported regularly taking statins and those who had never taken statins. The outcome was assessed using periapical radiographs taken at least at 1-year post-treatment. Teeth with short root canal fillings were excluded. Single and multiple binary logistic regression tested the association between statin use and radiographic treatment outcome while adjusting for root-canal and restoration quality, diabetes mellitus, cardiovascular diseases, patient age, tooth type, and follow-up period.</div></div><div><h3>Results</h3><div>A total of 122 teeth were analyzed: 62 from patients taking statins and 60 from patients not taking statins. Using lenient criteria, logistic regression showed no significant difference in healing rates between the statin and control groups (90.3% vs. 90%; OR = 1.04; <em>P</em> = .952). However, under strict criteria, patients taking statins had a significantly lower probability of success compared to controls (62.9% vs 85%; OR = 0.30; <em>P</em> = .008).</div></div><div><h3>Conclusions</h3><div>Patients taking statins had a lower number of radiographic complete healings than those not taking statins. The results of this study challenge the presumed benefits of systemic statins intake on AP healing.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 10","pages":"Pages 1384-1392"},"PeriodicalIF":3.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340173","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":"Intraoral Sensory Alterations in Myofascial Orofacial Pain Patients: Implications for Clinical Management.","authors":"Kyoko Inamoto, Bruna Motta Minusculi Sander, Fernando Gustavo Exposto, Alberto Herrero Babiloni, Peter Svensson, Yuri Martins Costa","doi":"10.1016/j.joen.2025.09.013","DOIUrl":"https://doi.org/10.1016/j.joen.2025.09.013","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated differences in intraoral sensitivity to thermal and mechanical stimuli, and pulp sensibility between patients with myofascial orofacial pain (MOP) and healthy controls. We hypothesized that patients would exhibit increased sensitivity to these stimuli.</p><p><strong>Methods: </strong>A controlled study was performed, including 50 MOP patients and 104 controls aged 18-65. Intraoral and extraoral sensitivities were assessed at various sites using simple quantitative sensory testing (sQST, numerical ratings of thermal/mechanical stimuli) and qualitative somatosensory testing (QualST, side-to-side differences in sensitivity to touch, cold and pinprick as hyper-, hypo- or normal). Pulp sensibility was evaluated using cold stimuli. Statistical analyses included repeated-measures ANOVA and Fisher's exact test (α= 0.05).</p><p><strong>Results: </strong>Patients exhibited significantly higher intraoral hypersensitivity at the buccal gingiva to touch (14%), cold (34%), and pinprick stimuli (36%) compared to controls (0%, 14%, 15%). Similar trends were observed at extraoral sites including the masseter, temporalis, and thenar region. Pulp testing revealed significantly longer pain durations in patients (mean: 5.9 seconds) compared to controls (mean: 3.7 seconds), although pain intensity did not differ significantly. While sQST showed no significant group differences, QualST effectively identified intraoral and extraoral somatosensory abnormalities.</p><p><strong>Conclusions: </strong>Patients with MOP exhibited heightened intraoral sensitivity and prolonged pain responses. These findings underscore the diagnostic challenge of distinguishing sensitivity associated with MOP from odontogenic pain, such as pulpitis, which may lead to unnecessary dental procedures. Thorough assessments may help clinicians avoid misdiagnosis and improve outcomes, while longitudinal studies are needed to assess the possibility of clinical consequences.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145206570","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":"Inorganic Ion Permeation Through Human Dentinal Tubules: Implications for Bioactive Endodontic and Desensitizing Therapies.","authors":"Tai-Wei Feng, Ming-Fa Hsieh, Shiuh-Tzung Liu, Chun-Pin Lin","doi":"10.1016/j.joen.2025.09.011","DOIUrl":"https://doi.org/10.1016/j.joen.2025.09.011","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the effects of pH, molecular weight, and ion charge on the permeation efficiency of selected inorganic ions through dentinal tubules.</p><p><strong>Methods: </strong>Standardized 0.5 mm-thick human dentin slices were prepared and exposed to various inorganic salt solutions under pH = 4, 7, and 10 conditions. Ion permeation was quantified over a 60-minute period. Morphological changes were examined via scanning electron microscopy (SEM). ANOVA and Spearman's correlation were used to analyze the influence of multiple variables on the diffusion of ions.</p><p><strong>Results: </strong>pH values were found to be the most influential factor: ion permeation is significantly enhanced under acidic environments and is hindered under alkaline conditions. Molecular weight and ion charge also affected diffusion, with lower molecular weight and +1 charge ions showing superior permeation. No significant difference was observed between cations and anions. SEM analysis revealed no crystal deposition or tubule occlusion under the conditions investigated in this work.</p><p><strong>Conclusions: </strong>Ion permeation through dentinal tubules is primarily governed by environmental pH, followed by ion charge and molecular weight. These findings inform the rational design of ion-releasing dental materials tailored for acidic environments. Further research should explore long-term effects and multi-ion interactions to enhance clinical relevance.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145186102","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":"Top 100 most-cited articles in root canal anatomy: A Scopus-based bibliometric study.","authors":"Yu-Chiao Wu, Ho-Sheng Chiang, Zi-Jun Dai, Yi-Jie Chen, Yen-Ching Chao, Hsiao-Wen Yeh, Ren-Yeong Huang, Yi-Shing Shieh","doi":"10.1016/j.joen.2025.09.010","DOIUrl":"https://doi.org/10.1016/j.joen.2025.09.010","url":null,"abstract":"<p><strong>Introduction: </strong>Understanding root canal anatomy is fundamental for successful endodontic treatment. This bibliometric study aimed to identify and analyze the 100 most-cited articles related to root canal morphology to discover research trends, influential publications, and methodological progress in the field.</p><p><strong>Methods: </strong>Data were extracted from the Scopus® database using the search terms \"root canal anatomy\" OR \"root canal morphology\" AND NOT \"Preparation,\" with selection finalized on July 28, 2025. Articles were manually screened, and only English-language original research related to human teeth was included. Citation counts, publication years, journal names, countries of origin, study designs, and methodologies were analyzed.</p><p><strong>Results: </strong>Most of the top-cited studies were published in the Journal of Endodontics (JOE) and International Endodontic Journal (IEJ), which together contributed 80% of the articles. Cone-beam computed tomography (CBCT) was the most used method, followed by dye-injected decalcified teeth and micro-computed tomography (μCT). The most frequently studied teeth were mandibular and maxillary first molars. Geographically, the United States, Brazil, and China led in publication output. Notably, there were no articles from Africa, highlighting a potential area for collaborative development. Over time, research has shifted from invasive in vitro techniques to advanced non-invasive imaging. The most-cited article was Vertucci's 1984 classification study, which remains widely used today.</p><p><strong>Conclusions: </strong>This bibliometric analysis delivers a comprehensive overview of influential studies in root canal anatomy, offering insights into global research patterns and technological advancement.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149249","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":"Individual Risk Factors Associated with Post-traumatic Trigeminal Neuropathy Following Endodontic Procedures: A Systematic Review.","authors":"Larissa Gregório Candido do Prado, Julia Godoi-Lopes, Fabiane Carneiro Lopes-Olhê, Laís Valencise Magri, Jardel Francisco Mazzi-Chaves","doi":"10.1016/j.joen.2025.09.009","DOIUrl":"10.1016/j.joen.2025.09.009","url":null,"abstract":"<p><strong>Introduction: </strong>To identify patient-specific phenotypic, anatomical, psychological, and clinical risk factors associated with the development of post-traumatic trigeminal neuropathy (PTTN) following endodontic procedures.</p><p><strong>Methods: </strong>This systematic review was conducted following PRISMA 2020 guidelines, with the protocol prospectively registered in PROSPERO (CRD420251071354). Searches were performed in PubMed/MEDLINE and LILACS (via BVS) up to June 2025. Studies were eligible if they reported patient-level phenotypic, anatomical, psychological, or clinical features linked to PTTN following endodontic therapy. Three reviewers independently conducted data extraction and quality assessment. An exploratory meta-analysis was performed to estimate the pooled prevalence of PTTN by sex.</p><p><strong>Results: </strong>Nine studies were included. A predominance of female patients among those with PTTN was observed, with a pooled proportion of 67% (95% CI: 63.3%-70.5%). Psychological comorbidities such as anxiety and depression, previous chronic pain conditions, and endodontic procedures in anatomically high-risk areas particularly mandibular molars were also identified as potential risk factors. Some studies proposed predictive frameworks integrating sensory testing and patient history. However, heterogeneity in study designs and limited quantitative data prevented subgroup analyses.</p><p><strong>Conclusions: </strong>This review suggests that female sex, psychological vulnerability, and altered sensory modulation may be individual level-risk factors for PTTN following endodontic treatment. These findings reinforce the importance of risk-based clinical decision-making and underscore the need for prospective studies with standardized diagnostic criteria to develop validated predictive models in endodontics.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102847","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":"Three-dimensional Assessment of Healing Variability after Endodontic Microsurgery Using the Bone Lid Technique: A Case Series.","authors":"Su-Min Lee, Jayden D Kwak, Alex Ruch, Samuel I Kratchman, Bekir Karabucak, Meetu R Kohli","doi":"10.1016/j.joen.2025.09.006","DOIUrl":"10.1016/j.joen.2025.09.006","url":null,"abstract":"<p><p>Cortical bone healing after endodontic microsurgery on molars with apical lesions can be delayed or unpredictable. The bone lid technique offers enhanced surgical access while minimizing bone loss. This case series reports on patients with intact buccal cortical bone thicker than 1 mm, treated surgically using the bone lid technique. Bone lids were created with a piezotome, preserved in Hank's Balanced Salt Solution, and repositioned after root-end surgery using a collagen matrix for stabilization. Healing was assessed using three-dimensional cone beam computed tomography criteria and evaluation of the bone lid integration perimeter. Out of 6 cases, 2 showed complete healing without complications. One case demonstrated limited cortical plate healing, and in two cases, the bone lids became dislodged, necessitating further intervention. These findings indicate that the bone lid technique in endodontic microsurgery may support favorable cortical healing when postoperative stability is maintained. Bone lid integrity appears to be a critical factor in successful outcomes.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064702","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 Influence of Apical Radiolucency Size on Dentists' Decision-making Regarding Adequately Treated Teeth with Asymptomatic Apical Periodontitis using Digitally Simulated Images.","authors":"Ronald Wigler, Ronen Itzhakov, Igor Tsesis, Eyal Rosen","doi":"10.1016/j.joen.2025.09.007","DOIUrl":"10.1016/j.joen.2025.09.007","url":null,"abstract":"<p><strong>Introduction: </strong>Epidemiologic studies have reported a relatively high prevalence of asymptomatic apical periodontitis in endodontically treated teeth. Such teeth, when adequately restored and endodontically treated, present a clinical dilemma regarding whether to intervene or follow-up. The aim of this study was to examine dentists' clinical decision-making for well-treated endodontically and adequately restored teeth with asymptomatic apical periodontitis, presenting various sizes of simulated apical radiolucencies.</p><p><strong>Materials and methods: </strong>Twenty dentists (10 endodontic specialists and 10 prosthodontic specialists) completed a questionnaire containing cases of well-treated asymptomatic teeth, that is, adequately restored and endodontically treated, where some teeth showed normal apical tissues and others presented various sizes of simulated periapical radiolucencies (3 mm, 6 mm, 9 mm, or 12 mm). For each case, participants selected one of 4 treatment options: follow-up, root canal retreatment, endodontic surgery, or extraction.</p><p><strong>Results: </strong>Both specialty groups unanimously recommended follow-up for teeth without apical radiolucency. When apical radiolucency was present, its size was significantly associated with an active treatment decision, in both univariate and multivariate analyses. Among those who opted for treatment, endodontic surgery was the most frequently selected option, followed by retreatment, while extraction was the least chosen.</p><p><strong>Conclusions: </strong>This study suggests that dentists' decision-making regarding asymptomatic, adequately treated teeth with apical periodontitis is influenced by the size of the apical radiolucency. Moreover, there was a general tendency to preserve such teeth and to prefer endodontic surgery over orthograde root canal retreatment.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145064759","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":"Diabetes Increases Residual Stress and Microcrack Length in Dentin: An XRD-SEM Study with AI-assisted Quantification.","authors":"Mohammad Ali Saghiri, Kasra Momeni, Chao-Ho Chien, Michael Conte, Praneetha Pinnaka, Steven M Morgano","doi":"10.1016/j.joen.2025.09.002","DOIUrl":"10.1016/j.joen.2025.09.002","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated the association between residual stress and microcracks length in root dentin using an AI-assisted quantification workflow run in parallel with Fiji/ImageJ.</p><p><strong>Methods: </strong>Twenty mandibular premolars were collected, including ten (n = 10) from diabetic patients and ten (n = 10) from healthy controls. Following standardized rotary instrumentation and irrigation protocols, the roots were longitudinally sectioned. Residual stress was assessed using the sin²ψ X-ray diffraction method. Microcracks were visualized under scanning electron microscopy and quantitatively analyzed using a Fiji-based workflow with an AI-assisted comparator. Statistical analyses included independent t tests, Pearson correlation, and linear regression, using two-sided tests with α = 0.05.</p><p><strong>Results: </strong>Significant differences were observed between diabetic and nondiabetic dentin in terms of residual stress (1.40 ± 0.47 MPa vs -1.10 ± 0.44 MPa, P < .001). Microcracks length was greater in diabetic dentin (54.6 ± 9.4 μm) than in nondiabetic controls (20.0 ± 4.6 μm, P < .001), indicating that higher stress levels were associated with longer microcracks.</p><p><strong>Conclusion: </strong>This study found that residual stress contributes to increased microcracks length in instrumented roots, with diabetic dentin showing longer cracks. These findings may explain the higher failure risk in diabetic patients.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145040242","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}