Journal of endodontics最新文献

{"title":"Clinical Parameter-based Evaluation of Restorative Treatment Difficulty in Endodontically Treated Teeth.","authors":"Sakine Sena Konstantoulas, Soley Arslan","doi":"10.1016/j.joen.2026.07.001","DOIUrl":"10.1016/j.joen.2026.07.001","url":null,"abstract":"<p><strong>Introduction: </strong>To evaluate the difficulty levels of restoring endodontically treated teeth across the entire dental arch using a comprehensive multidimensional scoring system.</p><p><strong>Methods: </strong>A total of 1000 teeth (incisors, premolars, and molars) from 654 patients were evaluated through clinical and radiographic examinations. Teeth were scored (1-6) based on the eight parameters of the Restorative Difficulty Evaluation System, which includes endodontic complexity, residual vertical and horizontal structures, marginal seal, interdisciplinary conditions, treatment complexity, and functional/esthetic requirements. Restorative difficulty was categorized into minor, moderate, or high levels. Data were analyzed using the Kruskal-Wallis, Dunn, Pearson's Chi-square, and Fisher-Freeman-Halton tests (P < .05).</p><p><strong>Results: </strong>The sample distribution comprised 10.8% incisors, 39.7% premolars, and 49.5% molars, with 13.7% classified as minor, 36.5% moderate, and 49.8% high difficulty. Statistical analysis revealed significant differences among tooth types for all parameters except horizontal residual structure and interdisciplinary conditions (P > .05). Furthermore, a significant correlation was found between tooth types and parameter difficulty levels across all categories, with the sole exception of interdisciplinary conditions.</p><p><strong>Conclusions: </strong>Restorative difficulty in endodontically treated teeth depends on diverse clinical factors beyond traditional anatomical classification. Endodontic complexity and marginal seal serve as the primary determinants of difficulty. While molars pose higher technical risks, incisors exhibit a distinct multidimensional difficulty profile, with higher scores on specific parameters such as esthetic and wear demands. This 8-parameter index provides a standardized, reliable tool for preoperative assessment, enhancing treatment predictability and clinical outcomes across the entire dental arch.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.9,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148404760","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":"Artificial Intelligence Chatbots Taking American Board of Endodontics Simulated Oral Board Examination","authors":"Poorya Jalali DDS ,&nbsp;Feng-Ming Wang DDS, PhD ,&nbsp;Seyed AmirHossein Ourang DDS ,&nbsp;Samira Zahedrozegar DDS, MPH ,&nbsp;Hossein Mohammad-Rahimi DDS ,&nbsp;Ali Nosrat DDS, MS, MDS","doi":"10.1016/j.joen.2026.02.014","DOIUrl":"10.1016/j.joen.2026.02.014","url":null,"abstract":"<div><h3>Introduction</h3><div>The aim of this study was to assess the overall performance of artificial intelligence (AI) chatbots in taking the American Board of Endodontics simulated Oral Board Examination.</div></div><div><h3>Methods</h3><div>Three oral board cases were constructed by 2 academic board-certified endodontists. Each case included a comprehensive patient profile consisting of medical history, dental history, and results of clinical testing, followed by 20 consecutive open-ended oral board-style questions. Two publicly accessible AI chatbots were selected to take the exam: GPT-4o and Gemini-2.5 Pro. Responses were scored based on a comprehensive rubric on a 4-point ordinal scale (0–3) by the same 2 examiners independently: response validity, citation validity, and overall performance score. A Cumulative Link Mixed Model (proportional odds) was used with fixed effects for chatbot and case, and random intercepts for reviewer and question to analyze and compare the performance of models, that is, inter- and intra-chatbot comparisons.</div></div><div><h3>Results</h3><div>Gemini-2.5 Pro and GPT-4o achieved high mean overall performance scores of 2.83 (±0.42) and 2.73 (±0.51), respectively. Cumulative Link Mixed Model showed no significant difference between the 2 chatbots in probability of receiving an excellent score (ie, 3) in response validity (odds ratio = 2.44, 95% confidence interval [0.98–6.06], <em>P</em> = .054) or in overall performance (odds ratio = 2.04, 95% confidence interval 0.97–4.30, <em>P</em> = .061). There was a positive correlation between response validity and citation validity for GPT-4o (ρ = 0.21, <em>P</em> = .019).</div></div><div><h3>Conclusions</h3><div>Both chatbots scored considerably high in the simulated American Board of Endodontics Oral Board Examination. Results of this study support the concept of using AI chatbots as aid in endodontic education.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"52 7","pages":"Pages 1148-1156"},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Unified Deep Learning Framework for Visual Diagnosis of Palatal Radicular Grooves in CBCT Scans: A Multicenter Validation Study","authors":"Qikui Zhu PhD ,&nbsp;Weitao Fu DDS ,&nbsp;Yeyu Lin MDS ,&nbsp;Jiaxing Li MDS ,&nbsp;Wenhui Tang MDS ,&nbsp;Ying Zhang MDS ,&nbsp;Rui Zhang PhD ,&nbsp;Guanfan Lu PhD ,&nbsp;Yao Lin PhD ,&nbsp;Jing Shen PhD ,&nbsp;Zhuan Bian PhD ,&nbsp;Liuyan Meng PhD","doi":"10.1016/j.joen.2026.01.022","DOIUrl":"10.1016/j.joen.2026.01.022","url":null,"abstract":"<div><h3>Introduction</h3><div>Palatal radicular grooves (PRGs) posed diagnostic challenges due to their complex root anatomy and subtle manifestations in cone-beam computed tomography (CBCT). This study aimed to develop a deep learning framework for the automated three-dimensional visualization, diagnosis, and classification of PRG lesions.</div></div><div><h3>Methods</h3><div>A unified framework (PRG-Net) integrating tooth segmentation, PRG diagnosis, and lesion classification was developed. A retrospective multicenter diagnostic accuracy study was conducted using CBCT datasets with varying fields of view from one internal validation site and 3 external centers to evaluate generalizability and performance for segmentation, diagnosis, and classification tasks. The impact of PRG-Net on dentists' diagnostic accuracy, classification consistency, and workflow efficiency was also assessed.</div></div><div><h3>Results</h3><div>PRG-Net demonstrated strong generalizability across all datasets. For tooth segmentation, it achieved a mean Dice similarity coefficient of 97.1% [95% CI: 96.4, 97.7]. Diagnostic performance yielded area under the curve of 94.4% (internal) and 85.2%–90.0% (external). Classification area under the curve were 91.4% [95% CI: 86.8, 96.1] for Type I, 88.5% [95% CI: 81.1, 95.8] for Type II, and 96.9% [95% CI: 91.6, 100] for Type III, with consistent cross-center reproducibility. In clinical validation, PRG-Net significantly improved dentists' diagnostic accuracy and inter-rater classification agreement while substantially reducing interpretation time.</div></div><div><h3>Conclusions</h3><div>PRG-Net provided a robust, automated solution for PRG assessment in CBCT. It facilitated earlier and more precise diagnosis, improved inter-rater reliability, and streamlined workflow, demonstrating strong potential as a clinically valuable decision-support tool to guide treatment planning and improve patient outcomes.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"52 7","pages":"Pages 1136-1147"},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146142492","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":"An Integrated Chemical, Molecular, Elemental, Structural, and Mechanical Analysis of Er;Cr:YSGG versus Diode Laser-induced Changes in Root Dentin","authors":"Neha N. Rathod BDS ,&nbsp;Aparna Mohan BDS, MDS ,&nbsp;Veronica Kindaro BDSc(Hons), MRACDS(PDS) ,&nbsp;Unni Krishnan MDS, MSc, FRACDS, FRACDS(Endo)","doi":"10.1016/j.joen.2025.12.012","DOIUrl":"10.1016/j.joen.2025.12.012","url":null,"abstract":"<div><h3>Introduction</h3><div>Laser activated irrigation (LAI) has enhanced the cleaning and disinfection of root canals. However, limited evidence exists regarding its effects on dentin's structural integrity. Although proven to enhance cleaning and disinfection results, it was anticipated that LAI use may alter the root dentin surface due to thermal effects.</div></div><div><h3>Methods</h3><div>Forty-two single-rooted human premolars were instrumented and randomly divided into 3 groups: A) control group (<em>n</em> = 14) no laser treatment; B) irrigant activation using diode laser (980 nm, 10 Hz, 200 μm, 21 mm) (<em>n</em> = 14); and C) irrigant activation using Er,Cr:YSGG laser (2940 nm, 25 mJ, 10 Hz, 60 μs 200 μm, 21 mm) (<em>n</em> = 14). The root canal dentin samples were subjected to scanning electron microscopy, energy dispersive X-ray spectroscopy, Fourier transform infrared spectroscopy (FTIR), and nanoindentation analysis. Sample size was calculated using G∗Power, and data were statistically analyzed using one-way ANOVA and post hoc Tukey tests through SPSS software (IBM Corp. IBM SPSS Statistics for Windows, Version 26.0. Armonk, NY).</div></div><div><h3>Results</h3><div>FTIR analysis of diode-treated dentin revealed structural degradation with new hydroxyl groups (3829.74, 3744.47 cm⁻¹) and strong carbonyl peak (1741.30 cm⁻¹). FTIR compositional analysis showed destruction of amide (collagen), phosphate, and carbonate contents in laser groups. Elemental analysis showed significantly increased Ca and P peaks. Structural examination revealed excessive thermal-stress-induced cracking in the diode group and moderate cracking in Er,Cr:YSGG group. Mean hardness (HIT, HVIT) and elastic modulus differed significantly between control and both laser groups. Traditional root canal disinfection produced minimal structural damage across all analyses.</div></div><div><h3>Conclusions</h3><div>LAI significantly altered the tested properties of root dentin. Er,Cr:YSGG showed comparatively lesser structural damage than diode laser based irrigant activation.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"52 7","pages":"Pages 1176-1185.e1"},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145948791","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":"Artificial Intelligence-assisted Periapical Radiographic Assessment: Lesion Detection, Endodontic Complication Analysis, and Review of Clinical Treatment Recommendations","authors":"İpek Eraslan Akyüz DDS,&nbsp;Beyza Ezgi Kıvırcık DDS,&nbsp;Tuğrul Aslan DDS, PhD","doi":"10.1016/j.joen.2026.04.008","DOIUrl":"10.1016/j.joen.2026.04.008","url":null,"abstract":"<div><h3>Introduction</h3><div>Artificial intelligence (AI) systems are increasingly used in dental radiology to support endodontic diagnosis. However, their diagnostic reliability across different clinical categories remains unclear. This study compared 3 vision–language AI models (ChatGPT-5 Plus, Gemini 2.5 Pro, and Copilot Pro) with expert endodontists by assessing sensitivity, specificity, overall diagnostic agreement, and Youden's Index across multiple endodontic conditions.</div></div><div><h3>Methods</h3><div>This retrospective diagnostic accuracy study evaluated the relationship between periapical radiographs and treatment decisions, procedural complications, and lesion detection. Expert endodontists served as the gold standard of reference. Diagnostic categories included primary treatment selection, nonsurgical retreatment, final treatment decisions, perforation, underfilling, overfilling, broken file, calcification, and periapical lesion detection.</div></div><div><h3>Results</h3><div>There was an almost perfect agreement between the endodontists (κ = 0.95). Gemini 2.5 Pro demonstrated the highest diagnostic accuracy, particularly in periapical lesion detection (sensitivity 100%, specificity 88%), while ChatGPT-5 Plus showed similarly strong performance in treatment selection. Copilot Pro exhibited markedly low sensitivity for complications such as perforation and instrument fracture. Kappa values for preoperative and postoperative treatment decisions were high for Gemini and ChatGPT-5 Plus, but low for Copilot Pro. The Friedman test confirmed significant differences among the groups (<em>P</em> &lt; .001).</div></div><div><h3>Conclusions</h3><div>AI systems demonstrated promising diagnostic accuracy in treatment selection tasks and lesion detection, but performed less reliably in identifying complex procedural complications. Gemini 2.5 Pro showed the most balanced performance, whereas Copilot Pro displayed the highest variability across diagnostic categories.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"52 7","pages":"Pages 1194-1205"},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147773134","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":"Association of Occlusal Morphology with Cracked Teeth: A 3D Morphometric Comparative Clinical Study","authors":"Jiahui Deng DDS,&nbsp;Haibo Wang PhD,&nbsp;Zeqian Pan MS,&nbsp;Weidong Lin BDS,&nbsp;Yufeng Huang BDS,&nbsp;Ming Gao BDS,&nbsp;Lin Yue DDS, PhD,&nbsp;Xiaoyan Wang DDS, PhD,&nbsp;Fei Lin DDS,&nbsp;Ronald Ordinola-Zapata DDS, MS, PhD","doi":"10.1016/j.joen.2026.04.007","DOIUrl":"10.1016/j.joen.2026.04.007","url":null,"abstract":"<div><h3>Introduction</h3><div>Tooth morphology may predispose tooth cracking, yet evidence linking occlusal morphology to cracked molars remains limited. This study aimed to investigate the association between them, to establish reference intervals for early risk detection and management of cracked teeth.</div></div><div><h3>Methods</h3><div>Eighty-three cracked molars (68 patients) and 83 matched controls (69 volunteers) were analyzed. Occlusal morphologies (functional/nonfunctional cuspal inclination/height/slope) were measured using intraoral scans (Trios, 3Shape, Denmark) and analyzed using 3D digital design software. The crack initiation side (CIS) and propagation side (CPS) of crack lines were identified. Paired t-tests were used to compare the differences between groups. Multivariate logistic regression was used to assess correlations between occlusal morphology and cracked molars.</div></div><div><h3>Results</h3><div>Maxillary cracked molars exhibited steeper functional cuspal inclinations (CIS: [31.87 ± 7.72]°, CPS: [29.03 ± 7.50]°) than controls ([26.01 ± 7.01]°, [25.61 ± 7.47]°, <em>P</em> &lt; .05), with 4°–6° differences. Mandibular cracked molars showed steeper inclinations only in functional cusps on CIS ([30.79 ± 7.89]° vs [24.53 ± 6.97]°, <em>P</em> &lt; .05). Functional cuspal heights were 0.2–0.4 mm higher in cracked teeth than in controls for both arches (<em>P</em> &lt; .05). Cracked molars exhibited flatter functional cusp slopes. Multivariate analysis identified CIS inclination (OR 1.098) and CPS height (OR 3.407) of functional cusps as maxillary risk factors; CIS functional cuspal height (OR 8.177) showed the highest risk for mandibular cracked molars.</div></div><div><h3>Conclusions</h3><div>Within the limitations of this study, specific occlusal morphologies were correlated with cracked teeth. The identification of an excessively steep or high functional cusp in a molar warrants a thorough examination for crack lines. Morphology-guided occlusal adjustments should be considered in the treatment of cracked molars.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"52 7","pages":"Pages 1105-1113.e2"},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147717014","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(26)00301-8","DOIUrl":"10.1016/S0099-2399(26)00301-8","url":null,"abstract":"","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"52 7","pages":"Pages 1221-1231"},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148429270","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":"Differential Healing Patterns of Odontogenic Maxillary Sinusitis Following Nonsurgical Endodontic Therapy: A Cone-Beam Computed Tomography-Based Case Series","authors":"Guofeng Yang MD, PhD","doi":"10.1016/j.joen.2026.03.013","DOIUrl":"10.1016/j.joen.2026.03.013","url":null,"abstract":"<div><div>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 (&lt;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.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"52 7","pages":"Pages 1206-1213.e6"},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","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":"Morphometric Mapping of Mandibular Incisor Root Canals and Its Implications for Instrument Size-taper Selection","authors":"Carolina Oliveira de Lima DDS, MSc, PhD ,&nbsp;Emmanuel João Nogueira Leal Silva DDS, MSc, PhD ,&nbsp;Laís Vieira Maciel DDS ,&nbsp;Júlia de Brito Montan DDS ,&nbsp;Ana Flávia Almeida Barbosa DDS, MSc, PhD ,&nbsp;Marco Aurélio Versiani DDS, MSc, PhD","doi":"10.1016/j.joen.2026.03.009","DOIUrl":"10.1016/j.joen.2026.03.009","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to characterize the morphology of mandibular incisor root canals and to evaluate their correspondence with commonly used nickel–titanium (NiTi) instruments.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"52 7","pages":"Pages 1186-1193"},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","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":"Regenerative Endodontic Procedures: Mapping and Critical Appraisal of Clinical Trial Evidence","authors":"Felipe Oliveira Nunes MD,&nbsp;Eduardo Borges Sollim MD,&nbsp;Carolynne Ferreira dos Santos MD,&nbsp;Maria Karolina Martins Ferreira PhD,&nbsp;João Daniel Mendonça Moura PhD,&nbsp;Juliana Melo Brandão PhD,&nbsp;Manoel Damião Sousa-Neto PhD,&nbsp;Paulo Jorge Palma PhD,&nbsp;Rafael Rodrigues Lima PhD","doi":"10.1016/j.joen.2026.02.017","DOIUrl":"10.1016/j.joen.2026.02.017","url":null,"abstract":"<div><h3>Introduction</h3><div>Regenerative endodontic procedures (REPs) are biologically based approaches aimed at restoring the vitality of immature teeth with pulp necrosis. Over the past decades, these procedures have gained increasing attention. This study mapped and critically appraised the clinical trial evidence on REPs, providing an overview of research trends and methodological characteristics.</div></div><div><h3>Methodology</h3><div>A comprehensive bibliometric analysis was conducted following Bibliometric Reviews of the Biomedical Literature guidelines using the Web of Science Core Collection database. Randomized and nonrandomized clinical trials available in the database up to 2025 were included, covering the full period of indexed clinical evidence on REPs. Quantitative variables (citations, countries, journals, and keywords) and qualitative aspects (techniques, materials, irrigants, intracanal medications, and barriers) were analyzed.</div></div><div><h3>Results</h3><div>Among the 6,287 retrieved records, 58 clinical studies met the inclusion criteria. The most productive authors were De-Jesus-Soares A, Gomes BPFA, Kang J, Nazzal H, and Elheeny AAH. The most cited author was Xuan K, with 346 citations. Asia was the most productive continent, and the Journal of Endodontics published the highest number of studies. The most frequent keywords were regenerative endodontics, revascularization, and immature teeth. Blood clot induction was the predominant regenerative technique, while sodium hypochlorite, triple antibiotic paste, and mineral trioxide aggregate were the most commonly used irrigant, intracanal medication, and barrier material, respectively.</div></div><div><h3>Conclusions</h3><div>Clinical evidence on REPs suggests a consolidation of biologically based strategies, particularly blood clot induction with mineral trioxide aggregate barriers. However, methodological heterogeneity limits the strength and comparability of findings, highlighting the need for standardized protocols and long-term randomized studies.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"52 7","pages":"Pages 1082-1104"},"PeriodicalIF":3.9,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147326241","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}