Journal of endodontics最新文献

{"title":"Optimizing Stem Cell Expansion: The Role of Substrate Stiffness in Enhancing Dental Pulp Stem Cell Quiescence and Regeneration.","authors":"Maryam Ghaffari, Annie Shrestha","doi":"10.1016/j.joen.2025.01.004","DOIUrl":"10.1016/j.joen.2025.01.004","url":null,"abstract":"<p><strong>Introduction: </strong>Quiescent stem cells exhibit unique self-renewal and engraftment abilities vital for regenerative therapies, but these diminish during ex vivo culture. This study investigates how substrate stiffness regulates the balance between dental pulp stem cell (DPSC) quiescence, activation, and senescence and explores the role of extracellular matrix stiffness in modulating DPSC fate via the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) pathway.</p><p><strong>Methods: </strong>Polydimethylsiloxane substrates with varying stiffness in 2D (2 kPa, 50 kPa) and 3D (50 kPa) were fabricated. Mechanical properties and porosity were characterized. Human DPSCs were cultured for 7 and 14 days. Senescence was assessed by senescence β-galactosidase activity, nuclear changes by immunofluorescence staining, and gene expression of quiescence, self-renewal, and senescence markers by reverse transcription quantitative polymerase chain reaction. NF-κB activation was analyzed through p65 nuclear translocation. Statistical analysis employed one-way analysis of variance with post-Tukey tests (P < .05).</p><p><strong>Results: </strong>The porous (310 ± 63 μm) 3D substrate had 50 kPa stiffness. DPSCs on 50 kPa substrates exhibited increased nuclear size and senescence in both 2D and 3D contexts. Softer 2 kPa substrates promoted quiescence, evidenced by reduced chromatin condensation and senescence, alongside upregulation of quiescence associated genes (BMI-1) and pluripotency markers (NANOG, OCT4, SOX2). NF-κB activation was observed on soft substrates, marked by nuclear translocation of p65 and upregulated NF-κB pathway genes, correlating with enhanced stemness and reduced senescence.</p><p><strong>Conclusions: </strong>This study highlights the pivotal role of substrate stiffness in modulating stem cell fate. Softer substrates preserve DPSC quiescence, reduce senescence, and enhance stemness through NF-κB pathway activation, offering insights into optimizing ex vivo DPSC expansion for therapeutic applications.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006327","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":"Minimally Invasive Endodontic Treatment through the Labial/Buccal Cervical Approach - Protocol and Case Series.","authors":"Xinfeng Wang, Jin Zhang, Jiaying Wang, Jing Zhang, Ping Luo, Bingchang Xin","doi":"10.1016/j.joen.2025.01.005","DOIUrl":"10.1016/j.joen.2025.01.005","url":null,"abstract":"<p><strong>Introduction: </strong>Traditional access cavity preparation involves removing the roof of the pulp chamber and smoothing the dentin bulges at the root canal orifice, thereby creating straight-line access. However, this may damage more healthy dental tissue and reduce the tooth's fracture resistance. This case series presents a novel minimally invasive endodontic protocol for 1 maxillary canine and 4 mandibular premolars, which required root canal therapy, due to labial/buccal cervical decay that caused pulpitis or periapical periodontitis.</p><p><strong>Methods: </strong>Our treatment protocol includes the following steps: preoperative assessment, removing decay in the labial/buccal cervical region, preparing an endodontic access cavity utilizing the affected region, establishing a working-length reference line using resin, cleansing the pulp horn with ultrasonic retro-preparation tip, root canal preparation, disinfection, obturation through the labial/buccal cervical access, and final resin restoration.</p><p><strong>Results: </strong>Ideal root canal obturation outcomes were achieved in all cases, while avoiding the abrasion of tooth tissue at the pulp chamber roof, caused by traditional endodontic access cavity methods.</p><p><strong>Conclusions: </strong>Minimally invasive endodontic treatment through the labial/buccal cervical approach offers clinicians new insights and options for endodontic access design.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006323","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":"Performance of 4 Artificial Intelligence Chatbots in Answering Endodontic Questions.","authors":"Saleem Abdulrab, Hisham Abada, Mohammed Mashyakhy, Nawras Mostafa, Hatem Alhadainy, Esam Halboub","doi":"10.1016/j.joen.2025.01.002","DOIUrl":"10.1016/j.joen.2025.01.002","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence models have shown potential as educational tools in healthcare, such as answering exam questions. This study aimed to assess the performance of 4 prominent chatbots: ChatGPT-4o, MedGebra GPT-4o, Meta LIama 3, and Gemini Advanced in answering multiple-choice questions (MCQs) in endodontics.</p><p><strong>Methods: </strong>The study utilized 100 MCQs, each with 4 potential answers. These MCQs were obtained from 2 well-known endodontic textbooks. The performance of the above chatbots regarding choosing the correct answers was assessed twice with a 1-week interval.</p><p><strong>Results: </strong>The stability of the performance in the 2 rounds was highest for ChatGPT-4o, followed by Gemini Advanced and Meta Llama 3. MedGebra GPT-4o provided the highest percentage of true answers in the first round (93%) followed by ChatGPT-4o in the second round (90%). Meta Llama 3 provided the lowest percentages in the first (73%) and second rounds (75%). Although the performance of MedGebra GPT-4o was the best in the first round, it was less stable upon the second round (McNemar P > .05; Kappa = 0.725, P < .001).</p><p><strong>Conclusions: </strong>ChatGPT-4o and MedGebra GPT-4o answered a high fraction of endodontic MCQs, while Meta LIama 3 and Gemini Advanced showed lower performance. Further training and development are required to improve their accuracy and reliability in endodontics.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006332","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 XP-endo Shaper and Its Impact on Posttreatment Discomfort: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.","authors":"Mohammad Sabeti, Julian Gabbay, David Lotfi","doi":"10.1016/j.joen.2024.12.019","DOIUrl":"10.1016/j.joen.2024.12.019","url":null,"abstract":"<p><strong>Introduction: </strong>This systematic review and meta-analysis assess the impact of the XP-endo Shaper (XPS) on postoperative pain following root canal treatment and compare its efficacy with other endodontic systems.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in MEDLINE, Web of Science, Embase, and the Cochrane Library from January 2000-August 2024. Randomized controlled trials using XPS and reporting postoperative pain were included. Pain levels were measured using the Visual Analog Scale at multiple postoperative time points. Data were pooled and analyzed using a random effects model, revealing significant heterogeneity.</p><p><strong>Results: </strong>Six randomized controlled trials involving 731 patients met the inclusion criteria. The pooled analysis revealed that XPS significantly reduced pain scores at the 6, 12, and 24-hour time points (standardized mean difference [SMD] -1.30, 95% confidence interval [CI] [-2.36, -0.24], P = .016; SMD -3.00, 95% CI [-3.54, -2.46], P < .001; SMD -0.91, 95% CI [-1.53, -0.28], P = .005, respectively) compared to other systems, including WaveOne Gold and HyFlex EDM. Pain scores beyond 48 hours were comparable between XPS and other file systems.</p><p><strong>Conclusions: </strong>XPS shows substantial short-term efficacy in reducing postoperative pain following root canal treatments, likely due to its flexible design and reduced debris extrusion. The findings suggest that XPS can potentially improve patient comfort, though long-term pain outcomes remain similar to other systems.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142965296","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":"Evaluation of Cold and Electric Pulp Tests for Assessing the Success of Inferior Alveolar Nerve Block for Mandibular First Molars Diagnosed with Symptomatic Irreversible Pulpitis","authors":"Farzaneh Afkhami DDS, MSc ,&nbsp;Sholeh Ghabraei DDS, MSc ,&nbsp;Nasim Hashemi DDS, MSc ,&nbsp;Ove A. Peters DMD, MS, PhD","doi":"10.1016/j.joen.2024.10.013","DOIUrl":"10.1016/j.joen.2024.10.013","url":null,"abstract":"<div><h3>Introduction</h3><div>Fear of dentistry, often due to past painful experiences, is a significant barrier preventing patients from visiting dentists. Achieving effective pain control, especially during root canal treatments, is crucial. However, inferior alveolar nerve blocks (IANBs) have a low success rate, influenced by factors such as anxiety, anatomical variations, and technique limitations, leading to anesthesia failure. Although numerous studies have examined the cold test and electric pulp test (EPT) in assessing the success of local anesthesia, no standardized method has been established. This study evaluated the effectiveness of EPT and cold tests in assessing the depth of anesthesia in patients with symptomatic irreversible pulpitis in the mandibular first molar teeth.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted on 50 patients with symptomatic irreversible pulpitis who met the inclusion criteria and exhibited lip numbness. Following the administration of the IANBs and confirmation of lip numbness, cold tests and EPT were performed on all patients. Subsequently, the preparation of the access cavity (gold standard test) was initiated, and patients' responses during cavity preparation were recorded as either “presence of pain or discomfort” or “absence of pain or discomfort,” indicating IANB failure and success, respectively. Sensitivity (SN), specificity (SP), positive predictive value (PPV), negative predictive value (NPV), positive and negative likelihood ratios, and accuracy (AC) with 95% confidence intervals were calculated for each test separately as well as for sequential testing.</div></div><div><h3>Results</h3><div>IANB failure was determined in 56% of the patients. A comparative analysis of diagnostic tests (cold test and EPT) showed no significant difference in SN, NPV, and AC; however, the cold test had higher SP, PPV, and positive likelihood ratio. Combining cold test and EPT evaluations improved SN, NPV, PPV, and negative likelihood ratio, but SP and AC were similar to EPT alone. No correlation was found between IANB success and patient age, sex, or initial pain.</div></div><div><h3>Conclusions</h3><div>Despite evidence of lip numbness, a significant number of IANBs failed in cases of painful pulpitis. A positive result from the cold test strongly indicated anesthesia failure. The findings of the current study suggested that when the cold test yielded a negative result, further evaluation with EPT was necessary to confirm anesthetic success and ensure complete pain control.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 1","pages":"Pages 28-34"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621748","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":"Cone-Beam Computed Tomographic Scan–based Assessment of the Correlation between the Location of Caries and Pulp Canal Obliteration: An Aid to Treatment Planning","authors":"Ganesh R. Jadhav MDS ,&nbsp;Priya Mittal MDS","doi":"10.1016/j.joen.2024.10.005","DOIUrl":"10.1016/j.joen.2024.10.005","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to determine the correlation between proximal caries and the extent and site of pulp canal obliteration (PCO) in cone-beam computed tomographic (CBCT) scans of mandibular molar teeth.</div></div><div><h3>Methods</h3><div>A total of 1491 CBCT scans of patients 18–49 years of age were selected from the database (2002–2022). From them, 328 teeth with proximal caries and satisfying inclusion criteria were evaluated by 2 calibrated evaluators. PCO was observed in the sagittal and coronal planes. PCO and proximal caries were compared concerning different age groups, sexes, and sites using an independent sample <em>t</em> test.</div></div><div><h3>Results</h3><div>The prevalence of PCO among patients with proximal caries is 47%. In mesial proximal caries, the extent of PCO is significantly greater in the distal root canal (73.4%), whereas in distal proximal caries, PCO is more often found in the mesial canal (77.3%). The mean extent of intraradicular calcification was higher in the distal canal (<em>P</em> &lt; .001). Moreover, mesial proximal caries showed a greater extent of intraradicular obliteration (<em>P</em> &lt; .001). The probability of developing PCO was significantly higher in females (<em>P</em> = .003).</div></div><div><h3>Conclusions</h3><div>Within the limitations of this study, it can be concluded that the extent of calcification is more common on the opposite side of the location of the proximal caries. Moreover, such intraradicular calcification is greater in a distal canal compared to a mesial canal. Sex plays a significant role in the calcification process, showing higher predilection in females compared to males.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 1","pages":"Pages 15-20"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142467136","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 Analysis of Temperature Changes with Preheated and Intracanal Heated Solutions and Ultrasonic Activation in Immature Teeth","authors":"Öznur Sariyilmaz DDS, MSc ,&nbsp;Evren Sariyilmaz DDS, PhD ,&nbsp;Cangül Keskin DDS, PhD","doi":"10.1016/j.joen.2024.10.009","DOIUrl":"10.1016/j.joen.2024.10.009","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of this study was to examine the temperature changes on root canal and root surface in immature teeth with thin dentinal walls when irrigation solutions are preheated or intracanal heated, as well as the additional effects of passive ultrasonic irrigation (PUI) on these temperature changes.</div></div><div><h3>Methods</h3><div>Sixteen maxillary canine teeth were trimmed to a length of 20 mm and prepared to mimic immature teeth with an apical width of 1.3 mm by enlarging those using Gates Glidden burs. To measure temperatures inside the canal and on the root surface, one thermocouple was placed from the apex into the root canal, while the other thermocouple was positioned outside the root. Irrigation was performed by heating the irrigation solution with different methods (room temperature, preheated to 60°C, 5 sec intracanal heated, 20 sec intracanal heated), and PUI was applied after each method. Temperature changes occurring inside the root canal and on the root surface were recorded and subjected to statistical analysis.</div></div><div><h3>Results</h3><div>Using the irrigation solution preheated and intracanal heated resulted in a significant increase in both intracanal and root surface temperatures compared to using at room temperature (<em>P</em> &lt; .05). The application of PUI significantly increased the temperature of the irrigation solution only at room temperature group (<em>P</em> &lt; .05). None of the applications caused an increase in temperature on the root surface exceeding 10°C.</div></div><div><h3>Conclusions</h3><div>Applying PUI to heated solutions does not significantly increase the temperature in heating methods, but it does prolong heat retention in the canal by slowing down the cooling process. Although using preheated solution for 20 seconds results in higher intracanal temperatures, it should be noted that the solution cools rapidly within the canal. Short-term heating applications, such as 5 seconds, repeated frequently, can help maintain the high temperature during activation.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 1","pages":"Pages 71-77"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142545810","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 Treatment in Patients Undergoing Hematopoietic Stem Cell Transplantation: A Retrospective Cohort Study","authors":"Maria Emília Mota DDS ,&nbsp;José F. Siqueira Jr DDS, MSc, PhD ,&nbsp;Isabela N. Rôças DDS, MSc, PhD ,&nbsp;Fábio Abreu Alves DDS, MSc, PhD ,&nbsp;Graziella Chagas Jaguar DDS, PhD ,&nbsp;Juliana Bertoldi Franco DDS, PhD ,&nbsp;Jayr Schmidt Filho MD ,&nbsp;Maria Stella Moreira DDS, MSc, PhD","doi":"10.1016/j.joen.2024.10.014","DOIUrl":"10.1016/j.joen.2024.10.014","url":null,"abstract":"<div><h3>Introduction</h3><div>This study investigated the implications of root canal treatment (RCT) of infected teeth with apical periodontitis (AP) in patients undergoing hematopoietic stem cell transplantation (HSCT).</div></div><div><h3>Methods</h3><div>One hundred patients were selected. Clinical data, oncologic and endodontic diagnosis and treatment, and type of HSCT were recorded. Data on the exacerbation of AP were investigated. Leukocyte/neutrophil and C-reactive protein levels were evaluated before and after RCT.</div></div><div><h3>Results</h3><div>One hundred patients underwent HSCT (55% autologous). The need for RCT was identified in 41% of the participants. AP was diagnosed in 75.6% of these patients and large lesions (≥5 mm) occurred in 45.2%. A higher prevalence of AP was observed in males (<em>P</em> = .012). RCT was performed in 54.8% of the individuals and no AP exacerbation, pain, swelling, bacteremia, and need for additional medications was observed. Blood cultures were negative for bacteria and fungi. C-reactive protein levels were ≥1 mg/dL in 54.9% of the individuals 1 month before RCT and &lt;1 mg/dL in 64.6% 6 months after treatment (<em>P</em> &gt; .05).</div></div><div><h3>Conclusions</h3><div>RCT was effective in controlling infection with no complications in patients undergoing HSCT. Given the potential for exacerbation of endodontic infections, RCT and patient monitoring are essential and highly recommended.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 1","pages":"Pages 35-42"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142621747","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)00653-8","DOIUrl":"10.1016/S0099-2399(24)00653-8","url":null,"abstract":"","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 1","pages":"Pages A8-A13"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143353820","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(24)00671-X","DOIUrl":"10.1016/S0099-2399(24)00671-X","url":null,"abstract":"","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 1","pages":"Pages 95-102"},"PeriodicalIF":3.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143296756","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}