Journal of endodontics最新文献

{"title":"Differential Healing Patterns of Odontogenic Maxillary Sinusitis Following Nonsurgical Endodontic Therapy: A Cone-Beam Computed Tomography-Based Case Series.","authors":"Guofeng Yang","doi":"10.1016/j.joen.2026.03.013","DOIUrl":"10.1016/j.joen.2026.03.013","url":null,"abstract":"<p><p>This case series evaluated the differential healing patterns of maxillary sinus mucosa and periapical bone following nonsurgical root canal treatment for odontogenic maxillary sinusitis to propose a prognostic perspective based on distinct radiographic features. Ten cases of odontogenic maxillary sinusitis managed by primary nonsurgical root canal treatment or retreatment were categorized into 4 radiographic patterns based on periapical and sinus lesions. Clinical symptoms were recorded, and radiographic healing was assessed using cone-beam computed tomography (CBCT) at baseline and during follow-up periods ranging from approximately 3-17 months. All cases showed clinical symptoms recovery and sinus opacities radiographic resolution. Maxillary sinus mucosal lesions, including extensive opacification and sinus floor perforations, resolved to a normal physiological thickness (<2 mm) within approximately 3 months. Conversely, periapical alveolar bone regeneration required a longer progress (approximately 3-17 months) to demonstrate radiographic healing. Cases with extensive bone destruction or periosteal displacement (periapical osteoperiostitis/halo sign) showed delayed bone healing. Within the limits of this case series, maxillary sinus mucosa appears to heal faster than periapical tissues, typically resolving within 3 months. Although periapical radiographs remain useful for evaluating sinus floor perforation and extensive bone destruction, CBCT offers superior three-dimensional assessment in anatomically complex cases or when radiographs are inconclusive. We suggest that, in selected cases, early postoperative CBCT evidence of mucosal resolution (approximately 3 months) may be considered as an adjunctive early indicator of treatment response, while acknowledging that periapical bone regeneration often lags and requires longer follow up.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574239","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":"Micro-CT Study of Shaping Behavior of ProTaper Ultimate, TruNatomy and Reciprocating WaveOne Gold in Severely Curved Root Canals.","authors":"Ivona Bago, Marko Katić, Maša Milanović-Litre, Gianluca Gambarini, Ivana Vidović Zdrilić","doi":"10.1016/j.joen.2026.03.008","DOIUrl":"10.1016/j.joen.2026.03.008","url":null,"abstract":"<p><strong>Introduction: </strong>To analyze the canal transportation and centering ability of rotary, ProTaper Ultimate (PTU) and TruNatomy (TRN), and reciprocating WaveOne Gold (WOG) instrumentation systems in curved root canals.</p><p><strong>Methods: </strong>Forty-two upper human molars with curved mesiobuccal canals (30°-40°) were selected. The samples were assigned into 3 groups based on the instruments used: Group 1. PTU up to F2, 25/08; Group 2. TRN Primary file 26/04; Group 3. WOG Primary file 25/07. For irrigation, 3% sodium hypochlorite (NaOCl) was used throughout the instrumentation. Final irrigation protocol included 3% NaOCl, followed by 15% ethylenediaminetetraacetic acid and NaOCl. Each sample was scanned by micro-computed tomography (μCT) before and after the chemomechanical instrumentation. On μCT scans, the canal transportation and centring ability of the instrumentation systems were calculated at the levels of 3, 5, and 7 mm from the apex. Analysis of variance with Bonferroni test were used for the statistical analysis with the P value set at 0.05.</p><p><strong>Results: </strong>There were no significant differences between the instrumentation systems regarding their centering ability and transportation (P > .05). PTU showed significantly better centering in the coronal third (mean 0.595 mm) compared with WOG (mean 0.329 mm; P = .035). Regarding canal transportation at different canal levels, no significant difference between the groups was found (P > .05).</p><p><strong>Conclusions: </strong>All tested instrumentation systems showed similar canal transportation, with one exception; PTU showed better centring ability in the coronal third. The study confirmed that different manufacturing and design features, if properly combined, may all result in valid operative sequence and proper shaping.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147520932","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":"Morphometric Mapping of Mandibular Incisor Root Canals and Its Implications for Instrument Size-taper Selection.","authors":"Carolina Oliveira de Lima, Emmanuel João Nogueira Leal Silva, Laís Vieira Maciel, Júlia de Brito Montan, Ana Flávia Almeida Barbosa, Marco Aurélio Versiani","doi":"10.1016/j.joen.2026.03.009","DOIUrl":"10.1016/j.joen.2026.03.009","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to characterize the morphology of mandibular incisor root canals and to evaluate their correspondence with commonly used nickel-titanium (NiTi) instruments.</p><p><strong>Methods: </strong>One hundred extracted human mandibular incisors were scanned using high-resolution micro-computed tomography. Minor and major canal diameters and aspect ratios were measured at 1-mm intervals from the apical foramen to 10 mm coronally. Canal cross-sections were classified as round, long-oval, or flat based on aspect ratio. A supplementary analysis determined the percentage frequency of canals with diameters equal to or smaller than a wide range of size-taper combinations of constant-taper NiTi instruments. An 80% frequency threshold was applied to identify meaningful correspondence between canal dimensions and instrument sizes. Descriptive statistics were calculated, and the association between major and minor diameters was assessed using Pearson's correlation coefficient.</p><p><strong>Results: </strong>Both minor and major canal diameters increased progressively in the coronal direction, although enlargement of the major diameter was more pronounced from the middle third coronally. Round canals predominated in the apical region, whereas long-oval canals were most prevalent in the middle and coronal thirds; flat canals occurred mainly between 6 and 7 mm from the apex. Correspondence between NiTi instruments and the minor canal diameter depended strongly on instrument taper, with larger tapers required for smaller tip sizes to reach the 80% threshold. In contrast, correspondence with the major canal diameter was markedly limited across all instrument sizes and tapers, with no instrument achieving ≥80% correspondence along the entire root length. The correlation between minor and major canal diameters was weak, indicating disproportionate enlargement of canal dimensions.</p><p><strong>Conclusions: </strong>Mandibular incisors present pronounced anatomical asymmetry, particularly in the middle and coronal thirds, resulting in limited correspondence between conventional NiTi instruments and the major canal diameter.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147520981","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":"Filling Capability of Different Obturation Techniques for the Sealing of Internal Root Resorption Located in the Middle Root Canal Third - An In Vitro Study.","authors":"Teresa Belén García-Gavilá, Celia Ruiz-Sánchez, Carlos Gutiérrez Ortega, Tomás Muñoz-Santoro, Xabier Morales Urteaga, Iván Cortés-Domínguez, Francesc Abella Sans, Álvaro Zubizarreta-Macho, Vicente Faus-Matoses","doi":"10.1016/j.joen.2026.03.010","DOIUrl":"10.1016/j.joen.2026.03.010","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of this study was to compare the filling ability of different root canal obturation techniques for the sealing of internal root resorption (IRR) located in the middle root canal third.</p><p><strong>Methods: </strong>Thirty maxillary central incisors were printed based on the standard tessellation language digital file obtained from a preoperative cone beam micro-computed tomography, which was edited to design IRRs in the middle root canal third (n = 30). Subsequently, the group was randomly subdivided according to the following obturation techniques: Group A: rigid carrier-based technique (n = 10) (GuttaCore); Group B: warm vertical condensation technique (n = 10) (Calamus); and Group C: single-cone technique with bioceramic cement (n = 10) (Bioceramic). Subsequently, postoperative micro-computed tomography scans were performed and extracted files were quantified using Fiji/ImageJ software The following volumetric parameters were quantified: channel resin volume (mm3), IRR \"sphere\" resin volume (mm3), \"root\" volume (without sphere) (mm3), residual resin volume (mm3) and total resin volume (mm3). Differences among the root canal filling techniques were evaluated using analysis of variance (ANOVA).</p><p><strong>Results: </strong>ANOVA revealed statistically significant differences in the resin penetration volumes between the different obturation techniques evaluated for the \"channel,\" resorptive cavity \"sphere,\" \"root,\" and \"residual\" resin volumes (mm³) (P = .0001, P = .0001, P = .0065, and P < .0001, respectively).</p><p><strong>Conclusions: </strong>The warm vertical condensation technique demonstrated a sealing ability comparable to that of the single-cone bioceramic technique in cases of IRR located in the middle third of the root canal system, as well as the overall root canal system, when compared to the GuttaCore carrier-based obturation technique.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147520903","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":"Post-treatment Apical Periodontitis: Histobacteriologic and Histopathologic Findings.","authors":"Domenico Ricucci, Andrea F Campello, Irina Milovidova, Isabela N Rôças, José F Siqueira","doi":"10.1016/j.joen.2026.03.007","DOIUrl":"10.1016/j.joen.2026.03.007","url":null,"abstract":"<p><strong>Introduction: </strong>Occurrence of post-treatment apical periodontitis characterizes the failure of endodontic treatment. This study described the histobacteriologic and histopathologic features of biopsy specimens of teeth with post-treatment apical periodontitis.</p><p><strong>Methods: </strong>The material comprised sequential biopsy specimens of 71 human root canal-treated teeth with apical periodontitis. Specimens were obtained by apical surgery or extraction and consisted of root apexes with attached lesions, which were processed for histobacteriologic and histopathologic evaluation of the cause of failure, infection distribution, and the type of lesion. Different aspects of infection were evaluated for associations with demographic, clinical, radiographic and histopathologic parameters.</p><p><strong>Results: </strong>Intraradicular bacteria were found in the apical root canal system of 94% of the specimens, often organized in biofilm structures (79% of the cases). Infection extended to dentinal tubules and ramifications in many cases. The occurrence of biofilms in the main apical canal lumen was significantly more frequent in teeth with underfillings and inadequate root canal treatment (P < .05). An extraradicular infection occurred in 37% of the cases; in all but one case, it was associated with an intraradicular infection. Extraradicular bacteria were observed as a biofilm (sometimes with calcification foci) attached to the outer root surface and as planktonic cells or flocs at the lesion body or in the cyst lumen. Extraradicular infection was significantly more present in cases with symptoms and sinus tracts, abscesses, large lesions, and retreatment (P < .05). Nonepithelialized granuloma was the most frequent type of post-treatment apical periodontitis (42%).</p><p><strong>Conclusions: </strong>Intraradicular infection was the major factor associated with post-treatment apical periodontitis. Extraradicular infection was observed in about one-third of the cases, and in the large majority of them associated with concomitant intraradicular infection. Granuloma was the most common histopathologic diagnosis of posttreatment lesions.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147498933","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":"Biological Matrices Promote Odontoblastic Markers Expression in Stem Cells from Apical Papilla: An In Vitro Study.","authors":"Juan Carlos Caro, Cristina Bucchi, Nikol Ponce, Juan Villena, Angelina Palacios-Muñoz, Isaac E García","doi":"10.1016/j.joen.2026.03.006","DOIUrl":"10.1016/j.joen.2026.03.006","url":null,"abstract":"<p><strong>Introduction: </strong>Odontoblastic differentiation is a cellular process that requires signaling molecules and extracellular matrix components provided by the dentin-pulp microenvironment. Several scaffolds have been proposed to induce odontoblast differentiation for pulp regeneration. This study evaluated the ability of collagen sponge and decellularized dental pulp, along with dentin, to promote the expression of odontoblastic markers in stem cells from the apical papilla (SCAPs).</p><p><strong>Methods: </strong>Experimental groups consisted of 2 different biological matrices: (1) human decellularized dental pulp seeded with SCAP cells in the presence or absence of dentin discs (n = 3), and (2) commercial collagen sponge seeded with SCAP cells in the presence or absence of dentin discs (n = 3), and their respective controls (no seeded matrices). Cultures were placed on a dentin disc model and maintained in a 3-dimensional cell culture for 4 weeks. Thereafter, the samples were processed for histological analysis. Cell expression of odontoblastic markers was assessed on hematoxylin-eosin staining and immunohistochemistry using anti-dentin sialophosphoprotein (DSPP), anti-dentin matrix protein 1 (DMP1), and anti-alkaline phosphatase (ALPL) antibodies. Both qualitative and exploratory quantitative analysis were performed.</p><p><strong>Results: </strong>SCAPs cultured in the decellularized human dental pulp matrix and in the collagen sponge expressed DSPP, DMP1, and ALPL markers. Based on qualitative analysis and exploratory numerical data, the presence of dentin disc appeared to enhance DMP1 expression in the decellularized matrix and collagen sponge groups, while reducing ALPL levels in the decellularized matrix group.</p><p><strong>Conclusions: </strong>Within the limitations of this study, both decellularized pulp scaffolds and collagen scaffolds supported odontoblastic marker expression in SCAPs. Considering its cost-effectiveness and widespread availability, commercial collagen may be considered a suitable scaffold for regenerative applications. However, further studies are required to confirm these findings.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491207","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":"Six-month Evaluation of Tooth Discoloration Induced by Bioceramic Sealers using Spectrophotometer and Digital Image Analysis: An In Vitro Study.","authors":"Ayse Karadayi, Hatice Beyza Uzun, Gülsüm Kutlu Basmaci, Ezgi Tüter Bayraktar, Hesna Sazak Ovecoglu","doi":"10.1016/j.joen.2026.03.004","DOIUrl":"10.1016/j.joen.2026.03.004","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the discoloration potential of 3 calcium silicate-based endodontic sealers using spectrophotometer and cross-polarized digital image analysis.</p><p><strong>Materials and methods: </strong>Twenty-eight extracted maxillary anterior teeth were randomly allocated to 3 sealer groups (VDW.1Seal, Bio-C Sealer, and CeraSeal) and a control group (n = 7). Color measurements were performed before treatment, immediately after treatment, and at 1 day, 1 week, 1 month, 2 months, 3 months, and 6 months post-treatment using spectrophotometer and standardized digital image analysis with cross-polarization. Measurements were obtained from the cervical, middle, and incisal regions. Color differences were calculated using the CIEDE2000 (ΔE00) formula. Repeated-measures data were analyzed using Aligned Rank Transform analysis of variance (ANOVA) followed by Bonferroni-adjusted post hoc tests (α = 0.05).</p><p><strong>Results: </strong>Both measurement methods demonstrated a significant increase in ΔE values over time in all groups (P < .05). The control group consistently showed significantly lower ΔE values than all material-treated groups at all time points. Spectrophotometric analysis revealed no significant differences among the experimental sealers. In contrast, digital image analysis detected significant inter-material differences at selected time points, with the Bio-C Sealer group exhibiting the highest overall discoloration. Measurements also revealed greater discoloration in the cervical region compared with the middle and incisal regions.</p><p><strong>Conclusion: </strong>Within the limitations of this in vitro study, all evaluated calcium silicate-based sealers were associated with tooth discoloration. Color changes became more evident after the third month and remained within clinically perceptible limits at 6 months. While both spectrophotometric analysis and cross-polarized digital imaging demonstrated similar trends, digital imaging showed greater sensitivity in detecting color changes.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147486297","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":"Herpes Zoster of the Maxillary Division of the Trigeminal Nerve Presenting as Endodontic Post-treatment Pain: Case Report and Review of the Literature.","authors":"Junjie Lin, Poorya Jalali, Fabricio B Teixeira, Yuhong Lin, Sarah Parker Allen, Jemma Hanson, Feng-Ming Wang","doi":"10.1016/j.joen.2026.03.005","DOIUrl":"10.1016/j.joen.2026.03.005","url":null,"abstract":"<p><p>Herpes zoster (HZ), caused by the reactivation of varicella zoster virus, presents a major diagnostic challenge in dentistry, particularly when involving the trigeminal nerve. The prodromal symptoms of HZ can closely resemble endodontic pain, leading to misdiagnosis and delayed appropriate treatment. This case report described a 54-year-old male who presented to the emergency dental clinic with severe unilateral, radiating maxillary pain originating from posterior to anterior teeth. Initially diagnosed with symptomatic apical periodontitis on a previously endodontically treated tooth #3, the patient's condition underwent a shift in diagnosis 2 days later when a unilateral vesicular rash appeared along the maxillary division of the trigeminal nerve. The patient's acute nonodontogenic pain attributed to HZ was successfully managed through systemic antiviral and adjunctive therapies without endodontic intervention on tooth #3. While the acute symptoms of HZ were resolved, the patient subsequently developed postherpetic neuralgia and enduring sensory disturbances. A comprehensive review of the literature revealed that beyond postherpetic neuralgia, patients may experience other complications manifesting years after the HZ episode, including pulp necrosis, root resorptions, and osteonecrosis. It is evident that early recognition and diagnosis are paramount in the treatment of HZ. Understanding orofacial manifestations and effective management of HZ are crucial to prevent diagnostic mistakes, ensure optimal patient care and mitigate potential complications.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147491273","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":"Blood Metallomic and Histologic Organs Analysis in Induced Periapical Lesion Model: In Vivo Animal Study.","authors":"Anna C N Leutz, Mariliza C V da Costa, Maritana M Prodocimo, Jennifer S Pereira, Ana C P Janini, Adriana J Soares, Brenda P F A Gomes, Talita Tartari, Lauter E Pelepenko, Marina A Marciano","doi":"10.1016/j.joen.2026.03.003","DOIUrl":"10.1016/j.joen.2026.03.003","url":null,"abstract":"<p><strong>Introduction: </strong>Ten essential metallic elements play key roles in metabolic and biological processes, and their levels may vary in pathologic conditions. Apical periodontitis is a common endodontic disease with systemic repercussions; however, no studies have assessed its influence on systemic metallic element concentrations compared with healthy conditions. This study aimed to investigate such variations in whole blood and evaluate liver and kidney histopathologic alterations.</p><p><strong>Methods: </strong>Thirty-eight animals were allocated into periapical lesion (n = 19) and sham (n = 19) groups. Lesions were induced for 40 days, while the sham group underwent same procedures without induction. Whole blood was collected via intracardiac puncture for biochemical and metallomic analysis by inductively coupled plasma optical emission spectrometry, calibrated for sodium, potassium, magnesium, calcium, iron, manganese, cobalt, copper, zinc, and molybdenum. Liver and kidney samples were processed for histology with different staining protocols. Statistical analyses were performed at a 5% significance level.</p><p><strong>Results: </strong>Radiographic analysis confirmed lesion formation. Inductively coupled plasma optical emission spectrometry revealed significantly higher calcium concentrations in the lesion group (P < .05). Biochemical tests showed reduced total bilirubin (P < .05) and direct bilirubin (P < .05), along with elevated alanine aminotransferase (P < .05) and creatinine (P < .05). Histology demonstrated mild hepatic inflammation and pronounced renal injury, including tubular necrosis, indicating systemic repercussions.</p><p><strong>Conclusions: </strong>Periapical lesions systemically alter metallomic and haematologic homeostasis, with calcium dysregulation in whole blood and histopathologic organ damage confirming their systemic inflammatory impact. Within animal model limitations, findings indicate potential association between apical periodontitis and systemic alterations.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147458042","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":"Healing of Perforating Inflammatory Root Resorption by Allogeneic Bone Marrow Mesenchymal Stromal Cells Transplantation: A Case Report.","authors":"Jose Francisco Gomez-Sosa, Olga Wittig, Dylana Diaz-Solano, Jose E Cardier","doi":"10.1016/j.joen.2026.03.001","DOIUrl":"10.1016/j.joen.2026.03.001","url":null,"abstract":"<p><strong>Introduction: </strong>Perforating inflammatory root resorption (PIRR) in permanent teeth can cause extensive dentin loss, periodontal breakdown, and eventual tooth loss. Regenerative endodontic procedures (REPs) have been proposed to treat PIRR. Among them, cellular therapy based on transplantation of mesenchymal stromal cells (MSCs) has been suggested as a potential option for treating PIRR, because of their paracrine and anti-inflammatory effects during tissue repair.</p><p><strong>Methods: </strong>A 13-year-old girl presented with a traumatized tooth #9 showing discoloration, a buccal sinus tract, 8-mm probing depth, tenderness to percussion, and nonresponse to thermal and electric tests; after unsuccessful REP. Radiography and cone-beam computed tomography (CBCT) revealed a large PIRR extending from the cervical to apical third of the root, communication with the periodontium, lateral perforation, and complete loss of buccal alveolar bone in the apical third. All of this was consistent with the presence of PIRR, pulp necrosis, and chronic apical abscess. The canal was disinfected with NaOCl, EDTA, and intracanal calcium hydroxide. Allogeneic MSCs were thawed, cultured, expanded, included in platelet-rich plasma clot, and transplanted into the canal, followed by a Biodentine coronal plug and composite restoration. The tooth was followed-up for 48 months.</p><p><strong>Results: </strong>The sinus tract resolved after 1 month, and buccal probing depth normalized and remained stable throughout follow-up. Radiographs and CBCT showed infilling of the resorptive defect with mineralized tissue, re-establishment of the periodontal ligament space, and buccal bone healing over 4 years. The tooth became asymptomatic and consistently responded to electric pulp testing, while responses to cold testing were variable.</p><p><strong>Conclusions: </strong>This single case shows that allogeneic MSC transplantation may promote long-term healing of PIRR with pulp necrosis and chronic apical abscess in young permanent teeth. Controlled clinical studies are required to confirm the capacity of healing PIRR by MSCs.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147433053","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}