Journal of endodontics最新文献

{"title":"Leveraging Pretrained Transformers for Efficient Segmentation and Lesion Detection in Cone-Beam Computed Tomography Scans.","authors":"Rui Qi Chen, Yeonju Lee, Hao Yan, Muralidhar Mupparapu, Fleming Lure, Jing Li, Frank C Setzer","doi":"10.1016/j.joen.2024.07.012","DOIUrl":"10.1016/j.joen.2024.07.012","url":null,"abstract":"<p><strong>Introduction: </strong>Cone-beam computed tomography (CBCT) is widely used to detect jaw lesions, although CBCT interpretation is time-consuming and challenging. Artificial intelligence for CBCT segmentation may improve lesion detection accuracy. However, consistent automated lesion detection remains difficult, especially with limited training data. This study aimed to assess the applicability of pretrained transformer-based architectures for semantic segmentation of CBCT volumes when applied to periapical lesion detection.</p><p><strong>Methods: </strong>CBCT volumes (n = 138) were collected and annotated by expert clinicians using 5 labels - \"lesion,\" \"restorative material,\" \"bone,\" \"tooth structure,\" and \"background.\" U-Net (convolutional neural network-based) and Swin-UNETR (transformer-based) models, pretrained (Swin-UNETR-PRETRAIN), and from scratch (Swin-UNETR-SCRATCH), were trained with subsets of the annotated CBCTs. These models were then evaluated for semantic segmentation performance using the Sørensen-Dice coefficient (DICE), lesion detection performance using sensitivity and specificity, and training sample size requirements by comparing models trained with 20, 40, 60, or 103 samples.</p><p><strong>Results: </strong>Trained with 103 samples, Swin-UNETR-PRETRAIN achieved a DICE of 0.8512 for \"lesion,\" 0.8282 for \"restorative materials,\" 0.9178 for \"bone,\" 0.9029 for \"tooth structure,\" and 0.9901 for \"background.\" \"Lesion\" DICE was statistically similar between Swin-UNETR-PRETRAIN trained with 103 and 60 images (P > .05), with the latter achieving 1.00 sensitivity and 0.94 specificity in lesion detection. With small training sets, Swin-UNETR-PRETRAIN outperformed Swin-UNETR-SCRATCH in DICE over all labels (P < .001 [n = 20], P < .001 [n = 40]), and U-Net in lesion detection specificity (P = .006 [n = 20], P = .031 [n = 40]).</p><p><strong>Conclusions: </strong>Transformer-based Swin-UNETR architectures allowed for excellent semantic segmentation and periapical lesion detection. Pretrained, it may provide an alternative with smaller training datasets compared to classic U-Net architectures.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141889429","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":"Canalis Sinuosus Mimicking Periapical Pathology on, Radiographic Assessment","authors":"","doi":"10.1016/j.joen.2024.04.011","DOIUrl":"10.1016/j.joen.2024.04.011","url":null,"abstract":"<div><p>The canalis sinuosus is an anatomical variation whereby the infraorbital canal sometimes generates a small, lateral branch (canal) close to its midpoint, to allow the passage of the anterior superior alveolar neurovascular bundle in the anterior maxilla<span><span>. This article focuses on an incidental finding of this variant, in a 74-year-old Trinidadian female of Afro-Caribbean descent with an </span>endodontic<span> presenting complaint. The canalis sinuosus shadow on conventional radiography resulted in uncertainty as to the offending tooth until a 3-dimensional scan was undertaken in this region. This report will discuss the implications of the presence of this canal from radiologic, endodontic, and surgical perspectives.</span></span></p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855062","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":"Development of Chlorhexidine-loaded Lipid Nanoparticles Incorporated in a Bioceramic Endodontic Sealer","authors":"","doi":"10.1016/j.joen.2024.04.012","DOIUrl":"10.1016/j.joen.2024.04.012","url":null,"abstract":"<div><h3>Introduction</h3><p>This study aimed to assess BioRoot RCS (BR) incorporating liposomal chlorhexidine digluconate (CHX) for its antibacterial activity, drug release capacity, and physicochemical properties.</p></div><div><h3>Methods</h3><p>Drug release of CHX liposomal formulations in combination with BR was evaluated spectrophotometrically and through mathematical release models for 30 days. A selected combination was evaluated for antimicrobial properties against <em>Enterococcus faecalis</em> biofilm growth on human dentin. Cytotoxicity was assessed following the ISO 10993-5:2019 standard on days 1, 3, and 7. Physicochemical properties were evaluated through setting time, Fourier transform infrared spectroscopy, solubility, contact angle, and film thickness.</p></div><div><h3>Results</h3><p>From BR, liposomal CHX released up to 7-fold higher CHX than CHX solution (<em>P</em> &lt; .05), following a triphasic drug release pattern compared to the CHX solution, which followed a quasi-Fickian diffusion. BR combined with a selected liposomal CHX completely inhibited <em>E. faecalis</em> biofilm growth compared to the combination of BR with CHX solution and the control group (<em>P</em> &lt; .05). Liposomal CHX decreased the contact angle (<em>P</em> &lt; .05) and solubility but increased cytotoxicity (<em>P</em> &lt; .05) of BR, staying above the ISO threshold. None of the other physicochemical characteristics tested differed from BR (<em>P</em> &gt; .05).</p></div><div><h3>Conclusion</h3><p>This liposomal formulation improved CHX release from BR, enhancing the antibacterial effectiveness. It presents a promising approach for local antibiofilm therapy in endodontics without substantially altering the physicochemical characteristics of BR.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0099239924002747/pdfft?md5=75465376d86fc754d53d226108ec3801&pid=1-s2.0-S0099239924002747-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Orthodontic Treatment on the Outcomes of Endodontically Treated Teeth: A Cone-Beam Computed Tomography Analysis","authors":"","doi":"10.1016/j.joen.2024.05.002","DOIUrl":"10.1016/j.joen.2024.05.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Often there is the need of moving endodontically treated teeth. Orthodontic movement may have no effect on the prognosis of teeth with root canal treatment (RCT). To verify this subject, we evaluated the effect of orthodontic movement on the prognosis of RCT teeth using cone-beam computed tomography (CBCT) and further explored the influence of orthodontic movement on the prognosis of RCT teeth with and without apical periodontitis (AP).</p></div><div><h3>Methods</h3><p>This retrospective study was conducted by evaluating 169 RCT teeth of 100 patients who had undergone fixed orthodontic treatment. AP was assessed and classified using the CBCT periapical index. Univariate analysis of RCT outcome was performed for the total RCT group, RCT without AP group and RCT with AP group. Multivariate logistic regression was performed for the total RCT group and RCT without AP group, respectively, but not for the RCT with AP group. Variables related to the prognosis of RCT were included, such as age, gender, tooth position, RCT quality, coronal restoration quality, periodontal condition, orthodontic traction distance, and orthodontic rotation angle.</p></div><div><h3>Results</h3><p>The orthodontic traction distance and rotation angle were not significantly correlated to the RCT outcomes, regardless of the presence of AP. Among the total RCT group, teeth with unqualified RCT (odds ratio = 3.42, <em>P</em> = .004) and inadequate coronal restoration (odds ratio = 4.40, <em>P</em> = .031) had a lower success rate. Of the 97 RCT teeth without AP, unqualified RCT was a risk factor for treatment failure (odds ratio = 3.55, <em>P</em> = .041). Of the 72 RCT teeth with AP, the univariate analysis showed that RCT quality were significantly related to the outcome (<em>P</em> = .042).</p></div><div><h3>Conclusions</h3><p>Orthodontic movement had no effect on the prognosis of RCT teeth regardless of the presence of AP.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0099239924002826/pdfft?md5=1b5a29182102bb6bb35d2f3aec5cd1f7&pid=1-s2.0-S0099239924002826-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulp Survival of Cracked Teeth with Reversible Pulpitis after Orthodontic Banding and Coronal Coverage – A Prospective Cohort Study with One Year Follow Up","authors":"","doi":"10.1016/j.joen.2024.05.006","DOIUrl":"10.1016/j.joen.2024.05.006","url":null,"abstract":"<div><h3>Introduction</h3><p>The aim of this prospective study was to investigate the 1-year pulp survival of cracked teeth with reversible pulpitis<span> managed with initial stabilization using orthodontic bands, followed by coronal coverage restorations.</span></p></div><div><h3>Methods</h3><p><span>One-hundred-and-twenty-five patients with a cracked tooth with reversible pulpitis each were recruited. Preoperative patient and tooth data were collected. After definitive pulp diagnoses were determined following an interim period of orthodontic banding, coronal coverage restorations were placed. Cox and logistic regression analyses were used to assess possible </span>prognostic factors and to correlate initial time to pulp stabilization while in orthodontic bands with eventual outcome. Pulp survival was determined using both clinical and radiographic findings.</p></div><div><h3>Results</h3><p><span>One-hundred-and-six cracked teeth were followed up at 1 year. Pulp survival based on clinical and radiographic findings was found in 81 teeth (76.4%). Out of 25 failures, 11 (44%) required root canal treatment (RCT) in the orthodontic band stage and 10 (40%) required RCT during the process of or after coronal coverage restorations. Four teeth (16%) had incidental findings of periapical radiolucencies at the 1-year review without clinical symptoms. Teeth requiring RCT were found to have required longer periods in orthodontic bands prior to a definitive pulp diagnosis (</span><em>P</em> &lt; .05).</p></div><div><h3>Conclusion</h3><p>A step-by-step approach by using orthodontic banding to monitor pulp status may reduce the incidence of RCT required through definitive coronal coverage restorations for cracked teeth with reversible pulpitis.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141087257","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(24)00370-4","DOIUrl":"10.1016/S0099-2399(24)00370-4","url":null,"abstract":"","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141979157","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":"Dynamic Photoelastic Analysis of Stress Distribution in Simulated Canals Using Rotary Instruments with Varied Tip and Taper Sizes: A Quasi-3D Approach","authors":"","doi":"10.1016/j.joen.2024.05.008","DOIUrl":"10.1016/j.joen.2024.05.008","url":null,"abstract":"<div><h3>Introduction</h3><p>To compare the stress produced on the walls of simulated canals by rotary instruments with varied tip and taper sizes.</p></div><div><h3>Methods</h3><p>Ninety isotropic transparent blocks, each containing a 60-degree curved canal, were distributed into 18 groups (<em>n</em><span> = 5) based on the instrument tip (sizes 10, 15, 20, 25, 30, and 35) and taper (sizes 0.02, 0.04, and 0.06). The blocks were fixed in a circular polariscope setup for dark field analysis. A digital camera was employed to capture the real-time birefringence<span> patterns generated by each instrument. Digital image frames, corresponding to the instrument reaching the end of each canal third, were extracted and evaluated by 2 independent observers for the stress generation on canal walls. The data analysis employed a semi-quantitative scale ranging from 0 to 5. Cohen's Kappa coefficient test was used to determine the inter-observer agreement while the results were compared using Kruskal–Wallis test followed by an all-pairwise posthoc procedure (α = 5%).</span></span></p></div><div><h3>Results</h3><p>Inter-observer agreement was 0.95. A significant influence of the tip size on stress was observed across the coronal (<em>P</em> = .011), middle (<em>P</em> = .006), and apical (<em>P</em> = .026) thirds. In contrast, taper size did not affect the stress induced at the coronal (<em>P</em> = .509), middle (<em>P</em> = .958), or apical (<em>P</em> = .493) thirds. The variations in tip and taper sizes did not result in a significant stress differences among the thirds (<em>P</em> = .181).</p></div><div><h3>Conclusions</h3><p>The stress significantly increased across all canal thirds with larger tip sizes of rotary instruments, whereas the taper sizes did not influence the stress when compared to the canal thirds.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141130335","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":"Endodontic Inflammatory Disease and Future Cardiovascular Events and Mortality: A Report from the PAROKRANK Study","authors":"","doi":"10.1016/j.joen.2024.05.003","DOIUrl":"10.1016/j.joen.2024.05.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Prospective studies assessing the relation between endodontic inflammatory disease and subsequent cardiovascular events are few. The present aim was to explore associations between endodontic variables and future cardiovascular events in patients with myocardial infarction and matched controls participating in the PAROKRANK (Periodontitis and Its Relation to Coronary Artery Disease) study.</p></div><div><h3>Methods</h3><p>Eight-hundred five patients hospitalized for a first myocardial infarction and 805 controls were recruited between 2010 and 2014. Signs of endodontic inflammatory disease were assessed in panoramic radiographs taken at baseline. Mortality and morbidity data during the approximately 8 years of follow up were obtained from national registries. The risk for future cardiovascular events (first of mortality and nonfatal myocardial infarction, stroke, or hospitalization for heart failure) was analyzed with the log-rank test and Cox proportional hazards regression adjusted for the following confounders: sex, age, smoking, myocardial infarction, diabetes, education, marital status, family history of cardiovascular disease, and marginal periodontitis.</p></div><div><h3>Results</h3><p>In total, 285 future events were observed during the follow-up period. Unadjusted analyses revealed that ≥1 root-filled tooth increased the risk of a future event. After adjustment, the number of remaining teeth and non–root-filled teeth decreased the risk of future events, whereas a higher Decayed, Missing and Filled Teeth score increased the risk and ≥1 primary apical periodontitis decreased the risk of suffering cardiovascular events. A higher Decayed, Missing and Filled Teeth score and decayed teeth increased the risk of all-cause mortality.</p></div><div><h3>Conclusions</h3><p>Tooth loss is a strong indicator of an increased risk for future cardiovascular events. Root-filled teeth seem of limited value as a risk indicator when accounting for other risk factors. The potential effect of dental interventions on future events should be assessed in future research.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0099239924002838/pdfft?md5=dc714004fa72ed281857de223b9c9938&pid=1-s2.0-S0099239924002838-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141065727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associate Registry/Donor Roll","authors":"","doi":"10.1016/S0099-2399(24)00390-X","DOIUrl":"10.1016/S0099-2399(24)00390-X","url":null,"abstract":"","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141979186","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":"A Literature Review of the Effect of Heat on the Physical-Chemical Properties of Calcium Silicate–Based Sealers","authors":"","doi":"10.1016/j.joen.2024.04.017","DOIUrl":"10.1016/j.joen.2024.04.017","url":null,"abstract":"<div><h3>Introduction</h3><p>Recently, calcium silicate–based sealers (CSSs) have gained popularity in endodontic practice due to their biocompatibility and antimicrobial properties. They are considered viable alternatives to epoxy resin-based sealers. With the increased use of CSSs and warm vertical compaction techniques in root canal treatment, evaluating the impact of heat on CSSs properties is essential, therefore this review aimed to present a qualitative synthesis of available <em>in vitro</em> studies assessing the impact of heat on the physical-chemical properties of CSSs.</p></div><div><h3>Methods</h3><p>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 guidelines, a systematic advanced electronic search was performed in Scopus, Embase, Medline (via PubMed), Web of Science, and Cochrane databases in November 2023 and updated in April 2024. <em>In vitro</em> studies that evaluated the physical-chemical properties of CSSs were eligible. PRILE 2021 guidelines were used for the assessment of the risk of bias–included studies.</p></div><div><h3>Results</h3><p>The search identified a total of 6421 preliminary results and 10 studies were included for qualitative assessment. Eleven different physiochemical properties were assessed by the included studies. Setting time and flow were the most evaluated property among the studies. A qualitative synthesis of the evidence on each property is presented.</p></div><div><h3>Conclusions</h3><p>Based on the <em>in vitro</em> studies assessed in the present systematic review, results reveal that exposing CSSs to heat can accelerate their setting time, reduce their flow, and increase their film thickness. Concerns persist regarding solubility, viscosity, radiopacity, dimensional change, microhardness, porosity, and compressive strength, requiring further research. Certain CSSs, such as MTA Fillapex and Endosequence BC sealer HiFlow, show minimal changes under heat, making them potential candidates for warm filling techniques.</p></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":null,"pages":null},"PeriodicalIF":3.5,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0099239924002814/pdfft?md5=dd045142c50c7c8b3f7bb7b142b4e345&pid=1-s2.0-S0099239924002814-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}