Journal of endodontics最新文献

{"title":"Evaluating Outcomes and Prognostic Factors in Endodontic Microsurgery: A Retrospective Cohort Study","authors":"Christina Sperou DDS, MSc, FRCD(C) ,&nbsp;Adam Tepperman DDS ,&nbsp;Ahmed Ben Suleiman BDS, MSc ,&nbsp;Gevik Malkhassian DDS, MSc, FRCD(C) ,&nbsp;Prakeshkumar S. Shah MSc, MBBS, MD, DCH, MRCP, FRCP(C) ,&nbsp;Amir Azarpazhooh DDS, MSc, PhD, FRCD(C)","doi":"10.1016/j.joen.2025.06.005","DOIUrl":"10.1016/j.joen.2025.06.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Outcome studies are essential for evidence-based endodontics. This study evaluates rates of radiographic periapical healing and survival to reintervention in endodontic microsurgery (EMS), along with the prognostic factors associated with these outcomes.</div></div><div><h3>Methods</h3><div>Dental records were reviewed to identify teeth treated with EMS at the University of Toronto between 1999 and 2021. Each tooth was tracked until the final follow-up (minimum of 1 year) or an untoward event. Radiographic periapical healing, survival, and their prognostic factors were analyzed using logistic and Cox regression, respectively. Median (interquartile range [IQR]), odds ratios (ORs), hazard ratios (HRs), and 95% confidence intervals (CIs) were calculated (<em>P</em> &lt; .05).</div></div><div><h3>Results</h3><div>A total of 128 teeth met the criteria for radiographic periapical healing analysis, and 186 teeth were included in the survival analysis. The median follow-up time for radiographic periapical healing was 41.5 months (IQR: 27.8–72.9). At the latest follow-up, the overall radiographic periapical healing rate was 82.8%, and it was significantly associated with the absence of periodontal involvement (OR: 2.8, 95% CI: 1.1–7.7, <em>P</em> = .045) and root-end filling depth &gt;2 mm (OR: 3.5, 95% CI: 1.2–9.6, <em>P</em> = .014). Median survival follow-up time was 37.5 months (IQR: 22.3–61.6); 86.6% of teeth survived without reintervention, 1.6% required treatment, and 11.8% were extracted. Age ≤45 (HR: 3.0, <em>P</em> = .036) and root-end filling ≤2 mm (HR: 4.3, <em>P</em> = .004) increased the risk of intervention.</div></div><div><h3>Conclusions</h3><div>Both radiographic periapical healing and survival rates following EMS are high. Prognostic factors were identified, which require confirmation in future studies.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 9","pages":"Pages 1187-1198"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302211","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":"Locating a Calcified Root Canal with Robotic Assistance: A Case Report","authors":"Xiaoxiang Huang DDS, PhD,&nbsp;Lisha Mao DDS, PhD,&nbsp;Benxiang Hou DDS, PhD","doi":"10.1016/j.joen.2025.01.019","DOIUrl":"10.1016/j.joen.2025.01.019","url":null,"abstract":"<div><div>Precise, minimally invasive, and efficient endodontic<span> treatment of calcified root canals is challenging. Robot-assisted treatment has been applied in the field of implantology and has demonstrated excellent accuracy. This case report presents the methods and steps for locating a calcified root canal using robotic assistance. A 49-year-old female patient was diagnosed with symptomatic apical periodontitis<span><span> and pulp necrosis with pulp canal obliteration in the left </span>maxillary central incisor<span>. Using patient data, we entered a digital model into the preoperative planning software to acquire an operation path design. The robotic system utilized spatial alignment techniques for registration, guiding the robotic arm to autonomously and precisely obtain access to the calcified root canal, based on the path design. After rigorous infection control and root canal filling, the patient's symptoms disappeared. With the robotic assistance, the calcified root canal was accurately and efficiently located in a minimally invasive manner, and the patient experienced symptom relief and functional recovery. The findings reported from this case support robotic assistance as a promising technique for locating calcified root canals.</span></span></span></div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 9","pages":"Pages 1294-1300"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074802","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":"Impact on Pulp Vitality of Affected Teeth after Decompression for Jaw Cystic Lesions","authors":"Yi Zhang ,&nbsp;Jingang Yang ,&nbsp;Elvis Han Cui ,&nbsp;Yiran Tan ,&nbsp;Yun Zhu ,&nbsp;Jie Gao ,&nbsp;Jie Li ,&nbsp;Linfeng Fan ,&nbsp;Lingling Cai ,&nbsp;Yuhua Hu ,&nbsp;Zhengwei Huang ,&nbsp;Shanghui Zhou","doi":"10.1016/j.joen.2025.05.021","DOIUrl":"10.1016/j.joen.2025.05.021","url":null,"abstract":"<div><h3>Introduction</h3><div><span>Jaw cystic lesions are common oral and maxillofacial conditions that may affect teeth and important anatomical structures. Decompression and 2-stage </span>curettage are widely used treatments for this condition. This study aims to compare the pulp vitality of affected teeth in patients with jaw cystic lesions before and after decompression and 2-stage curettage, thereby clarifying the impact on the pulp vitality of the involved teeth.</div></div><div><h3>Methods</h3><div>Thirty patients diagnosed with cystic lesions of the jawbone underwent decompression followed by 2-stage curettage treatment. The pulp vitality of the affected teeth was assessed using an electric pulp test before decompression, 3 months after decompression, and 3 months after curettage.</div></div><div><h3>Results</h3><div>Among 102 teeth from 30 patients initially included in the study, 79 teeth from 24 patients were analyzed after excluding patients lost to follow-up. Before decompression, 64 (81.01%) and 15 (18.99%) teeth showed positive and negative pulp responses, respectively, compared with 69 (87.34%) and 10 (12.66%) teeth 3 months after decompression. After curettage, 68 teeth (86.08%) showed positive pulp responses, while 11 (13.92%) showed negative pulp responses.</div></div><div><h3>Conclusion</h3><div>Decompression not only preserves natural teeth but also helps maintain pulp vitality. A comprehensive evaluation of the affected teeth is recommended before surgery for jaw cystic lesions, and root canal treatment should not be initiated hastily.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 9","pages":"Pages 1170-1176"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199313","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":"Pulpal Deterioration Following Restorative Procedures: A Case – Control Study","authors":"Shivani Desai DDS ,&nbsp;Adam Tepperman DDS ,&nbsp;Ahmed Ben Suleiman BDS, MSc ,&nbsp;Gevik Malkhassian DDS, MSc ,&nbsp;David Chvartszaid DDS, MSc ,&nbsp;Jim Yuan Lai DMD, MSc, EdD ,&nbsp;Amir Azarpazhooh DDS, MSc, PhD","doi":"10.1016/j.joen.2025.06.004","DOIUrl":"10.1016/j.joen.2025.06.004","url":null,"abstract":"<div><h3>Introduction</h3><div>While restorative procedures aim to preserve tooth structure and function, they may contribute to pulpal deterioration, potentially necessitating endodontic intervention. This matched case-control study examined the time lapse from the most recent definitive (terminal) restoration to the onset of pulpal deterioration.</div></div><div><h3>Methods</h3><div>A computerized search of dental records (1999–2023) at the University of Toronto identified 1,360 permanent teeth that received terminal restorations followed by endodontic therapy (cases), matched 1:1 with 1,360 teeth that received terminal restorations without subsequent endodontic therapy (controls). Matching criteria included age at the time of restoration, tooth type, and number of prior restorations. Data were analyzed using descriptive statistics, chi-square tests, and multivariable Cox regression.</div></div><div><h3>Results</h3><div>The median time lapse to pulpal deterioration among cases was 14.3 months. Crowns and bridge retainers had the longest interval (28 months), followed by amalgam (17.4), composite resin (11.9), and glass ionomer (11.4). Earlier deterioration was observed in teeth with restorations involving more than two surfaces (11.5), with more than 2 prior restorations (13.9), and with pulp exposure (6.6). In adjusted analyses, glass ionomer (hazard ratio = 1.6; 95% confidence interval: 1.2–2.2) and multisurface restorations (hazard ratio = 1.5; 95% confidence interval: 1.2–1.7) were statistically significant associated variables.</div></div><div><h3>Conclusions</h3><div>Pulpal deterioration may occur after a median time lapse of 14.3 months following terminal restoration placement. Crowns/bridge retainers and amalgam restorations were associated with slower progression of pulpal deterioration, whereas composite resin, glass ionomer, multisurface restorations, and pulp exposure were linked to an increased likelihood or earlier onset of pulpal deterioration.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 9","pages":"Pages 1177-1186"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302212","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":"Nonsurgical Endodontic Treatment of an Atypical Mandibular First Molar with a dens invaginatus and a Large Periradicular Radiolucency – A Case Report","authors":"Juan Miraglia Cantarini DDS ,&nbsp;Francesc Abella Sans DDS, PhD ,&nbsp;Paul V. Abbott BDS, MDS ,&nbsp;Marc Garcia-Font DDS, PhD","doi":"10.1016/j.joen.2025.05.023","DOIUrl":"10.1016/j.joen.2025.05.023","url":null,"abstract":"<div><div><span>This case report describes the successful management of an atypical mandibular molar<span> with Oehler's Type II dens invaginatus and a large periradicular radiolucency with nonsurgical </span></span>endodontic<span><span> treatment. A 14-year-old male patient reported with pain and swelling associated with tooth #30. Clinical examination revealed that tooth #30 had an unusual coronal morphology. The intraoral periapical radiograph and cone beam computed tomography revealed an Oehler's Type II dens invaginatus with a large periradicular radiolucency. Nonsurgical root canal treatment was performed and the patient was followed-up for 46 months. Following the root canal treatment, the patient had no symptoms, no tenderness to percussion or palpation, and the tooth was not mobile. At 46 months, the </span>radiographic examination<span> confirmed that satisfactory healing of the periapical tissues had occurred.</span></span></div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 9","pages":"Pages 1301-1306"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248189","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":"Computer-assisted Dynamic Navigation for Localizing Severely Calcified Root Canals: An Analysis of Deviations, Task-focused Performance, and Operator Perception","authors":"Felipe A. Restrepo-Restrepo DDS, MDent ,&nbsp;Diana P. Cardona-Alzate DDS, MDent ,&nbsp;Brayan J. Muriel-Urrego DDS, MDent ,&nbsp;Paula A. Villa-Machado DDS, MDent ,&nbsp;Sergio I. Tobón-Arroyave DDS, MDent","doi":"10.1016/j.joen.2025.06.008","DOIUrl":"10.1016/j.joen.2025.06.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Pulp canal obliteration (PCO) presents a significant challenge to the endodontist. This study aimed to evaluate deviations, task-focused performance, and operator perceptions during canal orifice localization using computer-assisted dynamic navigation (C-ADN) in tooth replicas with severe PCO, comparing experienced and less experienced operators.</div></div><div><h3>Methods</h3><div>A total of 120 tooth replicas were assigned to two operators with differing experience levels. To assess variations between planned and actual access preparations, preoperative and postoperative cone-beam computed tomography scans<span> were superimposed using C-ADN software. Operator's task-focused performance and subjective elements resultant from operator's perspective linked to C-ADN were also evaluated. Statistical assessments were conducted using parametric methods, chi-square tests, or Fisher exact tests.</span></div></div><div><h3>Results</h3><div>Correlation analysis indicated a positive relationship among PCO depth and drilling time (<em>r</em> = 0.336, <em>P</em> &lt; .001). Although precision measurements, including linear/angular deviations, were statistically similar among the operators (<em>P</em><span> &gt; .05), the less experienced operator demonstrated significantly greater visuomotor coordination and drilling times, as well as higher proportions of mishaps, leading to a significantly lower task-focused performance (all </span><em>P</em> &lt; .05). Over successive attempts, both operators showed progressive improvement in visuomotor skills and reported enhanced situational awareness, procedural quality, and safety features of C-ADN. The less experienced operator expressed concerns about workload and usability.</div></div><div><h3>Conclusions</h3><div>C-ADN systems are promising tools for locating calcified root canals, offering reliable guidance regardless of operators' experience. However, efficiency and mishap rates depend on experience, as mastering the visuomotor skills requires an adequate learning curve. Positive operators’ perception and usability support its integration into endodontics, provided skill development is emphasized to enhance proficiency.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 9","pages":"Pages 1265-1277"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484614","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":"Dentinal Defects, Cracks, and Fracture Generation during Ultrasonic Root-End Preparation: A Systematic Review and Meta-Analysis of In Vivo Studies","authors":"Aruna K. Veronica MDS, PhD ,&nbsp;Anand V. Susila MDS, PhD ,&nbsp;Venkatachalam Prakash MDS","doi":"10.1016/j.joen.2025.05.015","DOIUrl":"10.1016/j.joen.2025.05.015","url":null,"abstract":"<div><h3>Introduction</h3><div>To evaluate whether ultrasonic root-end preparation in surgical endodontics contributes to the formation of cracks, fractures, or dentinal defects.</div></div><div><h3>Methods</h3><div><span>This systematic review was registered with prospective register of systematic reviews (CRD42021251665) and conducted in accordance with the preferred reporting items for systematic reviews and meta analyses 2020 guidelines. Only clinical studies involving surgical endodontics, human participants, and ultrasonic tips for root-end preparation were included; </span><em>in vitro</em><span><span><span> and animal studies were excluded. A comprehensive search was performed across PubMed, Clinical Trial Registry, and Cochrane databases. Prevalence data on cracks, dentinal defects, and fractures were extracted from the included studies and analyzed using </span>MedCalc (v22.023). The strength of evidence was assessed using Agency for </span>Healthcare Research<span> and Quality standards. Bias in randomized controlled trials<span> was assessed using the Cochrane Risk of Bias-2 tool, while the Joanna Briggs Institute Critical Appraisal tools were used to evaluate bias in cohort studies.</span></span></span></div></div><div><h3>Results</h3><div>Seventeen studies met the inclusion criteria: five investigated cracks, one assessed both cracks and fractures, three evaluated dentinal defects and fractures, and eight focused solely on fractures. A meta-analysis was conducted for thirteen of these studies. Five studies reported a 4.5% prevalence of crack with up to 3 years follow-up, while five other studies reported a 2.6% prevalence of fracture with the same timeframe. Prevalence increased to 5.3% in another three studies with 10 years follow-up. A 40% prevalence of dentinal defects was observed in three studies with up to 3 years of follow-up. Cracks did not significantly impact healing based on the risk ratio but did increase the hazard ratio (HR) for development at 3 years. Dentinal defects significantly affected the healing as per risk ratio but did not increase the HR for development at 3 years; while fractures significantly impacted the risk and HR. Significantly greater fractures were seen in retreatment<span> cases and posterior teeth. A key limitation of this review is that most included studies were cohort design, with only two randomized controlled trials. Moreover, there is a lack of studies directly comparing ultrasonic root-end preparation with other methods, limiting the strength of the conclusions.</span></div></div><div><h3>Conclusions</h3><div>Ultrasonic root-end preparation results in a significantly greater number of dentinal defects than cracks and fractures. Fractures and dentinal defects impacted healing significantly, while cracks did not. Besides, cracks and fractures also increased the HR for any surviving tooth at 3 year analysis.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 9","pages":"Pages 1136-1156.e2"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248174","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":"Impact of Reduced Irrigation and Preparation Time on the Shaping Efficiency of the New SAF Infinitum System in Long Oval Root Canals","authors":"Michael Solomonov DMD ,&nbsp;Gustavo De-Deus DDS, MSc, PhD ,&nbsp;Rebecca R.G. Frota DMD ,&nbsp;Emmanuel J.N.L. Silva DDS, MSc, PhD ,&nbsp;Felipe G. Belladonna DDS, MSc, PhD ,&nbsp;Joe Ben-Itzhak DMD ,&nbsp;Marco A. Versiani DDS, MSc, PhD","doi":"10.1016/j.joen.2025.05.027","DOIUrl":"10.1016/j.joen.2025.05.027","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to evaluate the impact of reduced irrigation and preparation time on the shaping efficiency of the new Self-Adjusting File (SAF) Infinitum system in long oval root canals.</div></div><div><h3>Methods</h3><div><span>Thirty-six extracted mandibular canines with long oval canals were anatomically matched using micro–computed tomography analysis and assigned to three experimental groups (</span><em>n</em><span> = 12) according to the irrigation protocol: (1) 2.5% NaOCl (4 minutes at 4 mL/min); (2) 2.5% NaOCl + etidronate (4 minutes at 2 mL/min); and (3) 2.5% NaOCl + etidronate (2 minutes at 2 mL/min). Root canals were prepared using a 2.0-mm SAF Infinitum instrument under continuous irrigation. Pre- and postoperative micro–computed tomography scans were used to assess canal volume (mm</span>³), surface area (mm²), and the percentage of unprepared canal walls. Data were analyzed using 1-way ANOVA (α = 5%).</div></div><div><h3>Results</h3><div>All preparation protocols increased canal volume (26.4%–32.4%) and surface area (5.3%–8.9%), with no significant differences among groups (<em>P</em> &gt; .05). The extent of unprepared canal walls remained comparable across groups, with mean values ranging from 8.7%–14.7% (<em>P</em> &gt; .05). No significant shaping errors were observed, and no instrument fracture occurred during the preparation procedures. Superimposed color-coded surface models confirmed uniform dentin removal around the canal perimeter.</div></div><div><h3>Conclusions</h3><div>All tested protocols yielded comparable shaping performance. Reducing SAF preparation from 4 minutes–2 minutes using NaOCl or etidronate mixture did not compromise the preparation of long oval canals, achieving comparable increases in volume and surface area while preserving a similar extent of unprepared canal walls.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 9","pages":"Pages 1258-1264"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248188","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":"Impact of Multispecies Biofilm on the Chemical and Mechanical Characteristics of Radicular Dentin from Patients With and Without Diabetes: An In Vitro Study","authors":"Kirtana Gopalasamy BDS, MDS ,&nbsp;Sridevi Krishnamoorthy BDS, MDS ,&nbsp;Jayalakshmi Somasundaram BDS, MDS, PhD ,&nbsp;Tiju Thomas MS, PhD ,&nbsp;Angambakkam Rajasekaran PradeepKumar BDS, MDS, FDSRCSEd, PhD ,&nbsp;Anil Kishen BDS, MDS, PhD","doi":"10.1016/j.joen.2025.05.028","DOIUrl":"10.1016/j.joen.2025.05.028","url":null,"abstract":"<div><h3>Introduction</h3><div>This <em>in vitro</em> study examined the effect of a multispecies biofilm on the chemical characteristics and mechanical properties of root dentin from patients with or without type 2 diabetes mellitus (DM).</div></div><div><h3>Methods</h3><div><span>Intact mandibular molars were obtained from diabetic and nondiabetic donors. Rectangular root dentin beams were prepared and categorized based on age (40–60 and 61–80 years), presence/absence of DM, and the site of dentin beam extraction (mesiodistal or buccolingual). </span>Pentosidine<span>, collagen cross-linking ratio, and mineral-to-collagen ratio were determined by Fourier transform infrared spectroscopy and fatigue resistance was evaluated by the four-point flexure to failure test with or without exposure to a multispecies biofilm for 21 days.</span></div></div><div><h3>Results</h3><div>DM and biofilm exposure significantly increased pentosidine, mineral-to-collagen ratio, and collagen cross-linking ratio in root dentin from both age groups (<em>P</em> &lt; .05). Control root dentin from the 61–80 years group had significantly lower fatigue resistance than root dentin from the 40–60 years group (<em>P</em> &lt; .05). DM reduced the fatigue resistance of root dentin but not significantly (<em>P</em> &gt; .05). After biofilm exposure, root dentin with DM had significantly lower fatigue resistance than root dentin without DM (<em>P</em> &lt; .05). Biofilm exposure significantly reduced the fatigue resistance of root dentin with or without DM when compared with the controls only in the 40–60 years group (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>Aging decreased the fatigue resistance of root dentin. DM and biofilm exposure increased pentosidine, mineral-to-collagen ratio, and collagen cross-linking in root dentin across both age groups. Biofilm exposure further reduced the fatigue resistance of root dentin with DM compared to root dentin without DM.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 9","pages":"Pages 1207-1214.e1"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associate Registry","authors":"","doi":"10.1016/S0099-2399(25)00515-1","DOIUrl":"10.1016/S0099-2399(25)00515-1","url":null,"abstract":"","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 9","pages":"Pages 1307-1315"},"PeriodicalIF":3.6,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048165","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}