Journal of endodontics最新文献

{"title":"Development of a Core Outcome Set for Endodontics (COS-ENDO). Part 4: COS-ENDO for Studies of Vital Pulp Therapy in Permanent Teeth.","authors":"Maryam Zanjir, Elaine Cardoso, Nicola L Harman, Ava Khansari, Hamid Jafarzadeh, Gevik Malkhassian, Mike Sabeti, Anita Aminoshariae, Anil Kishen, Joanna E M Sale, Prakesh S Shah, Amir Azarpazhooh","doi":"10.1016/j.joen.2025.01.009","DOIUrl":"10.1016/j.joen.2025.01.009","url":null,"abstract":"<p><strong>Introduction: </strong>Methodological heterogeneity and reporting bias complicate interpreting endodontic outcomes. Supported by the American Association of Endodontists and its Foundation, this study developed the Core Outcome Set for Endodontics (COS-ENDO) to standardize reporting for studies of Nonsurgical Root Canal Treatment/Retreatment, Surgical Endodontics, Vital Pulp Therapy, Apexification, and Regenerative Endodontics. This article, Part 4 of a 5-part series, focuses on COS-ENDO for Vital Pulp Therapy, while other parts address the remaining treatments.</p><p><strong>Methods: </strong>Outcomes were identified through a scoping review and a web-based survey of American Association of Endodontists practicing members. In a 2-round Delphi survey, clinicians, patients, and researchers rated outcomes on a 9-point scale. Ratings were assessed against consensus criteria, and a virtual meeting finalized COS-ENDO.</p><p><strong>Results: </strong>Of the 97 invited participants to Round 1, 77 registered, and 73 (24 Academicians/Researchers, 26 Clinicians, and 23 Patients or their parents/caregivers) assessed 46 outcomes, with 17 excluded. The remaining outcomes-4 achieving consensus for inclusion and 25 lacking consensus-advanced to Round 2 for re-rating by 70 participants. This resulted in 10 outcomes achieving consensus for inclusion, and 19 lacking consensus. In the final meeting, 16 participants finalized the COS-ENDO for Vital Pulp Therapy studies, including Tooth survival, Pain, Signs of infection, Radiographic evidence of maintained periradicular health, Continued root development, Success, Functional tooth, Need for further intervention, and Adverse events/Complications.</p><p><strong>Conclusion: </strong>COS-ENDO is an important step in standardizing outcome reporting in endodontics, ensuring consistent reporting and enhancing research utility. Further efforts are needed to establish optimal measurement methods.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074789","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 a Core Outcome Set for Endodontics (COS-ENDO): Part 3 - COS-ENDO for Studies of Surgical Endodontics in Permanent Teeth.","authors":"Maryam Zanjir, Elaine Cardoso, Nicola L Harman, Ava Khansari, Hamid Jafarzadeh, Gevik Malkhassian, Mike Sabeti, Anita Aminoshariae, Anil Kishen, Joanna E M Sale, Prakesh S Shah, Amir Azarpazhooh","doi":"10.1016/j.joen.2025.01.011","DOIUrl":"10.1016/j.joen.2025.01.011","url":null,"abstract":"<p><strong>Introduction: </strong>Methodological heterogeneity and reporting bias complicate interpreting endodontic outcomes. Supported by the American Association of Endodontists and its Foundation, this study developed the Core Outcome Set in Endodontics (COS-ENDO) to standardize reporting for studies of nonsurgical root canal treatment/retreatment, surgical endodontics, vital pulp therapy, apexification, and regenerative endodontics. This article, part 3 of a 5-part series, focuses on COS-ENDO for surgical endodontics, while other parts address the remaining treatments.</p><p><strong>Methods: </strong>Outcomes were identified through a scoping review, a qualitative study with patients, and a web-based survey of American Association of Endodontists practicing members. In a 2-round Delphi survey, clinicians, patients, and researchers rated outcomes on a 9-point scale. Ratings were assessed against consensus criteria, and a virtual meeting finalized COS-ENDO.</p><p><strong>Results: </strong>Of the 97 invited participants to round 1, 77 registered, and 73 (24 academicians/researchers, 26 clinicians, and 23 patients or their parents/caregivers) assessed 46 outcomes, with 17 excluded. The remaining outcomes-7 achieving consensus for inclusion and 22 lacking consensus-advanced to round 2 for rerating by 70 participants. This resulted in 1 outcome achieving consensus for exclusion, 10 for inclusion, and 18 lacking consensus. In the final meeting, 16 participants finalized the COS-ENDO for surgical endodontics, including Tooth survival, Pain, Signs of infection, Radiographic evidence of periradicular healing, Success, Functional tooth, Need for further intervention, and Adverse events/Complications.</p><p><strong>Conclusions: </strong>COS-ENDO is an important step in standardizing outcome reporting in endodontics, ensuring consistent reporting and enhancing research utility. Further efforts are needed to establish optimal measurement methods.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074644","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 a Core Outcome Set for Endodontics (COS-ENDO). Part 5: COS-ENDO for Studies of Apexification and Regenerative Endodontics in Permanent Teeth.","authors":"Maryam Zanjir, Elaine Cardoso, Nicola L Harman, Ava Khansari, Hamid Jafarzadeh, Gevik Malkhassian, Mike Sabeti, Anita Aminoshariae, Anil Kishen, Joanna E M Sale, Prakesh S Shah, Amir Azarpazhooh","doi":"10.1016/j.joen.2025.01.012","DOIUrl":"10.1016/j.joen.2025.01.012","url":null,"abstract":"<p><strong>Introduction: </strong>Methodological heterogeneity and reporting bias complicate interpreting endodontic outcomes. Supported by the American Association of Endodontists and its Foundation, this study developed the Core Outcome Set in Endodontics (COS-ENDO) to standardize reporting for studies of Nonsurgical Root Canal Treatment/Retreatment, Surgical Endodontics, Vital Pulp Therapy, Apexification, and Regenerative Endodontics. This article, the last in a 5-part series, focuses on COS-ENDO for Apexification and Regenerative Endodontics, while other parts address the remaining treatments.</p><p><strong>Methods: </strong>Outcomes were identified through scoping reviews and a web-based survey of American Association of Endodontists practicing members. In a 2-round Delphi survey, clinicians, patients, and researchers rated outcomes on a 9-point scale. Ratings were assessed against consensus criteria, and a virtual meeting finalized COS-ENDO.</p><p><strong>Results: </strong>Of the 97 invited participants to Round 1, 77 registered, and 73 (24 Academicians/Researchers, 26 Clinicians, and 23 Patients or their parents/caregivers) assessed 51 outcomes, with 18 excluded. The remaining outcomes-7 achieving consensus for inclusion and 26 lacking consensus-advanced to Round 2 for re-rating by 70 participants. This resulted in 14 outcome achieving consensus for inclusion, and 19 lacking consensus. In the final meeting, 16 participants finalized the COS-ENDO for Apexification and Regenerative Endodontics, including Tooth survival, Pain, Signs of infection, Radiographic evidence of periradicular healing, Continued root development, Success, Functional tooth, Need for further intervention, and Adverse events/Complications.</p><p><strong>Conclusion: </strong>COS-ENDO is an important step in standardizing outcome reporting in endodontics, ensuring consistent reporting and enhancing research utility. Further efforts are needed to establish optimal measurement methods.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074794","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 a Core Outcome Set in Endodontics (COS-ENDO): Part 1 - General Methods for Developing COS-ENDO for Studies of Nonsurgical Root Canal Treatment, Retreatment, Surgical Endodontics, Vital Pulp Therapy, Apexification, and Regenerative Endodontics in Permanent Teeth.","authors":"Amir Azarpazhooh, Maryam Zanjir, Elaine Cardoso, Nicola L Harman, Ava Khansari, Hamid Jafarzadeh, Gevik Malkhassian, Mike Sabeti, Anita Aminoshariae, Anil Kishen, Joanna E M Sale, Prakesh S Shah","doi":"10.1016/j.joen.2025.01.008","DOIUrl":"10.1016/j.joen.2025.01.008","url":null,"abstract":"<p><strong>Introduction: </strong>Methodological heterogeneity and reporting bias complicate interpreting endodontic outcomes. Supported by the American Association of Endodontists and its Foundation, this study developed the Core Outcome Set in Endodontics (COS-ENDO) to standardize reporting for studies of nonsurgical root canal treatment/retreatment, surgical endodontics, vital pulp therapy, apexification, and regenerative endodontics. This article, the first in a 5-part series, outlines the methods for developing COS-ENDO, with detailed findings for each treatment presented in subsequent parts.</p><p><strong>Methods: </strong>Outcomes were identified through scoping reviews, a qualitative study with patients, and a web-based survey of American Association of Endodontists practicing members. In a 2-round Delphi survey, clinicians, patients, and researchers rated outcomes on a 9-point scale. Ratings were assessed against consensus criteria, and a virtual meeting finalized COS-ENDO.</p><p><strong>Results: </strong>Of the 97 invited participants to round 1, 77 (79%) registered and 73 (95%) completed the survey, including 24 academicians/researchers, 26 clinicians, and 23 patients (or their caregivers/parents). They rated 64 outcomes, totaling 182 occurrences across treatments: 39 for nonsurgical root canal treatment/retreatment, 46 for surgical endodontics, 46 for vital pulp therapy, and 51 for apexification/regenerative endodontics. The outcomes that achieved consensus for inclusion and those lacking consensus (either for inclusion or exclusion) advanced to round 2 for rerating by 70 participants. During the final consensus meeting, 16 participants discussed the outcomes and finalized the COS-ENDO.</p><p><strong>Conclusion: </strong>COS-ENDO is an important step toward standardizing outcome reporting in endodontics. Its implementation will ensure consistent reporting, enhancing research utility and evidence synthesis. Further efforts are needed to establish optimal measurement methods.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074800","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, Lisha Mao, Benxiang Hou","doi":"10.1016/j.joen.2025.01.019","DOIUrl":"https://doi.org/10.1016/j.joen.2025.01.019","url":null,"abstract":"<p><strong>Introduction: </strong>Precise, minimally invasive, and efficient endodontic 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.</p><p><strong>Methods: </strong>A 49-year-old female patient was diagnosed with symptomatic apical periodontitis and pulp necrosis with pulp canal obliteration in the left maxillary central incisor. 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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>The findings reported from this case support robotic assistance as a promising technique for locating calcified root canals.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-30","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":"Robot-Assisted Endodontic Retreatment: A Case Report with Clinical Considerations.","authors":"Li Qin, Weiwei Qiao, Chen Chen, Yeyu Lin, Xining Zhang, Liuyan Meng","doi":"10.1016/j.joen.2025.01.015","DOIUrl":"10.1016/j.joen.2025.01.015","url":null,"abstract":"<p><p>Fiber posts present significant challenges for nonsurgical endodontic retreatment, as improper removal may result in iatrogenic root perforation or even root fracture. Recently, robotic technology has attracted considerable attention in dentistry and active dental robotic (ADR) systems can perform procedures based on preset instructions, minimizing reliance on the dentist's experience. This case report describes the application of an ADR system for fiber post removal through an existing zirconia crown. A 26-year-old female was diagnosed with previously treated, symptomatic apical periodontitis of the mandibular left second premolar. Based on cone-beam computed tomography (CBCT) and intraoral scanning, the ADR system was used to achieve precise fiber post removal through a zirconia crown with minimally invasive coronal access under rubber dam isolation. The robotic arm executed flexible pumping motions to simulate the hand movements of dentists. This was achieved by establishing preset force and distance thresholds tailored to the characteristics of the materials being drilled. Residual gutta-percha was removed, followed by canal preparation and obturation. The tooth was then restored with a fiber post and composite resin. At the 2.5-month follow-up, the patient was completely asymptomatic, and the radiograph displayed evidence of periradicular healing. In this case, robotic technology proved effective and feasible for the endodontic retreatment of a mandibular second premolar, suggesting its potential for similar applications in other teeth where there is adequate inter-arch space. Further research is needed to simplify procedures for robot-assisted endodontic retreatment.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066111","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":"Anesthetic Effectiveness of Mental/Incisive Nerve Block versus Inferior Alveolar Nerve Block in Mandibular First and Second Premolars with Symptomatic Irreversible Pulpitis: A Randomized Clinical Trial.","authors":"Tolga Sülek, Aysin Dumani, Cihan Küden, Helin Kussever, Oguz Yoldas","doi":"10.1016/j.joen.2025.01.016","DOIUrl":"10.1016/j.joen.2025.01.016","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to compare the effectiveness of mental/incisive nerve block (MINB) and conventional inferior alveolar nerve block (IANB) anesthesia during endodontic treatment of mandibular first and second premolars with symptomatic irreversible pulpitis.</p><p><strong>Methods: </strong>In this randomized, double-blind, clinical trial, 120 patients undergoing endodontic treatment of mandibular premolars were randomly assigned to IANB (n = 60) or MINB (n = 60) using 1.8 mL 4% articaine with 1:100,000 epinephrine hydrochloride. Pain levels were evaluated preoperatively and during cold tests, cavity preparation, and pulp extirpation using the Numerical Rating Scale. Statistical analyses included the independent t test, chi-square test, and Mann-Whitney U test (α = 0.05).</p><p><strong>Results: </strong>Both groups showed a success rate of 70% for anesthesia (P = 1.000). While IANB demonstrated similar efficacy between first (71.4%) and second (68.8%) premolars (P > .05), MINB was significantly more effective for first premolars (76.9%) than second premolars (64.7%) (P < .05).</p><p><strong>Conclusions: </strong>MINB and IANB provide comparable pain control for mandibular premolars during endodontic procedures. However, MINB was observed to be less effective for second premolars compared to first premolars. The study suggests that, despite the comparable success rates of both anesthesia techniques, supplemental anesthesia may still be required to achieve adequate pain management for mandibular premolars with symptomatic irreversible pulpitis.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066108","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":"Assessing Endodontic Treatment Feasibility for Cracked Teeth Using Quantitative Light-Induced Fluorescence: A Retrospective Clinical Study.","authors":"Soyeon Yang, Mi-Jeong Jeon, Baek-Il Kim, Su-Jung Shin, Jeong-Won Park","doi":"10.1016/j.joen.2025.01.013","DOIUrl":"10.1016/j.joen.2025.01.013","url":null,"abstract":"<p><strong>Introduction: </strong>Cracked teeth present diagnostic and treatment challenges due to their complex etiology and uncertain prognoses. This study evaluated the potential of quantitative light-induced fluorescence (QLF) technology for diagnosing cracked teeth and its utility in predicting the need for root canal treatment (RCT).</p><p><strong>Methods: </strong>A total of 207 cracked teeth from 149 patients diagnosed between April 2019 and April 2023 were analyzed. QLF parameters (ΔF, ΔFmax, ΔR, ΔRmax) were measured using a Qraypen C device and analyzed with specialized software. Clinical characteristics, including age, sex, symptoms, tooth number, restoration type, pulp vitality, and crack direction, were recorded. The patients were monitored until August 2023, with an average follow-up of 19.1 months. Statistical analyses included t tests, analysis of variance, correlation analysis, and logistic regression analyses.</p><p><strong>Results: </strong>Of the 207 cracked teeth, 44 (21.3%) underwent RCT and 4 (1.9%) were extracted during the follow-up period. The QLF parameters differed significantly between teeth receiving restorative treatment and those requiring RCT (P < .0001). Cracked teeth with ΔF <-10, ΔFmax <-30, ΔR >15, or ΔRmax >30 had approximately 60% probability of undergoing RCT (P < .05). Logistic regression analysis confirmed that all QLF parameters correlated with RCT probability (P < .0001).</p><p><strong>Conclusions: </strong>This study demonstrated the utility of QLF technology in diagnosing cracked teeth and aiding treatment decision-making. The results suggest that careful monitoring, based on clinical evidence, is necessary before definitive restoration, particularly for cracked teeth with QLF parameters that exceed certain thresholds. Further studies with standardized protocols are required to validate the clinical application of QLF.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143066109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Intra-canal Medicaments on Infrared Light Energy Transmission Through Enamel and Dentin During Photobiomodulation: An In Vitro Study.","authors":"Sachin Kulkarni, Laurence J Walsh, Yash Bhurani, Roy George","doi":"10.1016/j.joen.2025.01.014","DOIUrl":"10.1016/j.joen.2025.01.014","url":null,"abstract":"<p><strong>Introduction: </strong>This in vitro study assessed how shade changes induced by endodontic medicaments affect the transmission of single and multiples wavelengths of infrared light through enamel and dentin.</p><p><strong>Methods: </strong>Eighteen extracted single-rooted permanent teeth were prepared, removing all extrinsic staining, and cementum. Tooth slices were treated for 4 weeks with UltraCal XS, Ledermix, or were untreated controls. Light transmission through enamel-dentin and dentin regions was assessed using diode lasers (660, 808, 904 nm) and a multi-wavelength light-emitting diode (LED) light source (700-1100 nm). Absorption studies were performed to evaluate light absorption by components of medicaments.</p><p><strong>Results: </strong>Samples treated with Ledermix showed the greatest shade change, with a corresponding reduction in visible and near infrared light transmission (P < .001) in dentin, whereas UltraCal XS had a milder effect (P < .01). Across different substrates, the greatest light transmission was seen for the multi-wavelength LED light source, followed by 904 nm, 808 nm, and finally 660 nm. Spectrophotometric studies revealed light absorption by turbid and saturated calcium hydroxide solutions.</p><p><strong>Conclusions: </strong>This study shows that medicaments may influence transmission of visible red and near infrared light. Photobiomodulation protocols used in regenerative endodontics should take this effect into account, by incorporating longer near infrared wavelengths (up to 1100 nm) and using multi-wavelength light sources to account for this absorption.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028961","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":"Management of Persistent Post-Endodontic Pain With a Standardized Gabapentin Pyramid Protocol: A Case Series and Clinical Guidelines.","authors":"Zakery James, Biraj Patel, Jianing He, Kenneth M Hargreaves, Nikita B Ruparel","doi":"10.1016/j.joen.2025.01.007","DOIUrl":"10.1016/j.joen.2025.01.007","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent postendodontic pain following endodontic therapy is a rare but substantial clinical challenge. Mechanisms that mediate peripheral neuropathy and/or central sensitization likely play a pivotal role in its development and chronification. The objective of this case series is to describe a management plan for persistent postendodontic pain and provide prescription guidelines using a standardized \"Gabapentin Pyramid Protocol\" for clinical practice.</p><p><strong>Methods: </strong>Four cases of persistent postendodontic pain are presented. A peripheral etiology for pain was eliminated in all 4 cases. All patients were also refractory to conventional analgesics. Patients received the \"Gabapentin Pyramid Protocol.\"</p><p><strong>Results: </strong>Three of the 4 cases experienced complete resolution of symptoms within the prescribed treatment period. In 1 case, symptoms were greatly reduced but recurred upon discontinuation of the drug.</p><p><strong>Conclusions: </strong>The \"Gabapentin Pyramid Protocol\" represents an effective treatment option for persistent postendodontic pain, demonstrating significant symptom relief and potential for complete resolution.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006306","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}