Journal of endodontics最新文献

{"title":"Endodontic Microsurgery of Mandibular Molars with an Autonomous Robotic System.","authors":"Haiying Zhang, Zi Yang, Mangnan Liu, Yaoxin Wang, Mei Fu, Benxiang Hou, Chen Zhang","doi":"10.1016/j.joen.2025.08.003","DOIUrl":"https://doi.org/10.1016/j.joen.2025.08.003","url":null,"abstract":"<p><strong>Introduction: </strong>Minimally invasive osteotomy and precise root-end resection (RER) are key factors in endodontic microsurgery (EMS), particularly in the mandibular molars. Autonomous robotic (ATR) systems facilitate accurate pre-surgical planning and real-time robot-guided osteotomy and root resection. Integrating the ATR technique with EMS can enhance the accuracy and effectiveness of the treatment.</p><p><strong>Methods: </strong>This report presents two cases diagnosed with symptomatic apical periodontitis in the mandibular left and right first molar. Cone-beam computed tomography and intraoral scanning data were used to design the surgical plan via planning software. The ATR system guided the robotic arm to autonomously perform precise osteotomy and root resection based on the presurgical plan.</p><p><strong>Results: </strong>At 3-12 months of follow-up, both patients were asymptomatic and radiographic examination revealed complete healing.</p><p><strong>Conclusions: </strong>The ATR technique enabled precise RER despite thick and intact cortical plates, contributing to successful EMS outcomes during the 3- to 12-month follow-up period. This feasibility demonstration warrants further validation in clinical trials with extended follow-ups to assess its potential role in surgical endodontics.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144862243","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 Innovative Injectable and Retrievable Drug Delivery System for Endodontic Therapy.","authors":"Abdel H Mahmoud, Aaron Sloutski, Shi Fu, Huiting Luo, Zoe Katevatis, Robert Wong, Yiwei Fang, Tatiana Zaliznyak, Fernando Aguilar Perez, Marcia Simon, Stephen G Walker, Thomas Manders, Miriam Rafailovich, Jerome J Cymerman","doi":"10.1016/j.joen.2025.08.001","DOIUrl":"10.1016/j.joen.2025.08.001","url":null,"abstract":"<p><strong>Introduction: </strong>Endodontic treatment failures remain a significant treatment challenge. Different bacterial combinations are implicated in posttreatment disease. Enterococcus faecalis is often detected in these biofilms. Calcium hydroxide has many limitations, including low flowability, difficult retrieval, high pH, and limited efficacy against E. faecalis. Here, we show that these difficulties can be overcome using calcium salicylate (CASA) encapsulated in a photocrosslinked thermoreversible F127-dimethacrylamide (DMA) hydrogel.</p><p><strong>Methods: </strong>CASA was prepared by mixing calcium hydroxide and salicylic acid in a 1:6 ratio, respectively and incorporated into F127-DMA at different concentrations. The mixture was photocrosslinked using lithium phenyl (2,4,6-trimethylbenzoyl) phosphinate. Chemical properties were analyzed using X-ray diffraction, Raman spectroscopy, Fourier transform infrared spectroscopy, and differential scanning calorimetry, while injectability and retrievability were assessed using plastic root canal training blocks, bovine teeth cone beam computed tomography scans, and oscillatory rheology. In Vitro antibacterial efficacy against E. faecalis biofilm was probed by injection of the compound, following inoculation on bovine extracted teeth. Cytotoxicity of the compound was measured using dental pulp stem cells.</p><p><strong>Results: </strong>Encapsulation of CASA in F127-DMA reduced the viscosity by three orders of magnitude compared to the paste form, facilitating injection and enabling retrieval. Following retrieval, F127-DMA/CASA showed significantly lower residual medicament (∼6%) compared to Vista-Cal (26%). X-ray diffraction, Raman, and Fourier transform infrared spectroscopy analyses confirmed the formation of CASA and successful integration of CASA into photocrosslinked F127-DMA. Treatment with the F127-DMA/20% CASA following 21-day inoculation with E. faecalis resulted in a 6-log reduction in CFU and complete elimination of biofilm. No significant change in the doubling time of treated dental pulp stem cell was observed.</p><p><strong>Conclusions: </strong>F127-DMA/CASA exhibits superior flowability, retrievability, near-neutral pH (∼6), biocompatibility, and anti-E. faecalis efficacy, which highlights its potential as a significant improvement over calcium hydroxide as an endodontic intracanal medicament.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144859188","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":"Biomechanical Behavior of Maxillary Premolars with Non-carious Cervical Lesions: Influence of Minimally Invasive Endodontic Access and Restoration Protocols.","authors":"Fabiane Carneiro Lopes-Olhê, Helena Cristina de Assis, Gustavo Creazzo, Ana Paula Macedo, Marco Aurélio Carvalho, Angelo José Sócrates Torres-Carrillo, Lautaro Gallardo Altube, Gabrielle Jacob, Guilherme Nilson Alves Dos Santos, Jardel Francisco Mazzi-Chaves, Manoel D Sousa-Neto","doi":"10.1016/j.joen.2025.07.019","DOIUrl":"10.1016/j.joen.2025.07.019","url":null,"abstract":"<p><strong>Introduction: </strong>Non-carious cervical lesions (NCCLs) compromise tooth structure and may cause inflammation requiring endodontic treatment. This study evaluated the influence of endodontic access design on fracture resistance, failure patterns, and stress distribution in maxillary premolars with wedge-shaped NCCLs restored using different restorative strategies.</p><p><strong>Methods: </strong>One hundred maxillary premolars were divided into ten groups based on access type (sound and NCCL with traditional, minimally invasive, and no access) and restorative material (provisional, conventional composite, high-viscosity bulk-fill resin, or low-viscosity bulk-fill resin combined with conventional resin composite). NCCLs were standardized, endodontic treatments performed, and restorations applied. After thermocycling, specimens underwent fracture resistance testing and failure mode analysis. One tooth was scanned for finite element analysis (FEA).</p><p><strong>Results: </strong>The sound group and the minimally invasive access group restored with high-viscosity bulk-fill resin had numerically higher fracture resistance. No significant difference was found between traditional and minimally invasive access. Adhesive protocols performed significantly better than temporary restorations (P < .05). Type III (nonrestorable) fractures predominated (50%-90%). FEA revealed stress concentrations in the buccal cusp, central groove, marginal ridges, and cervical region, with similar patterns across groups and slightly lower stress in minimally invasive access.</p><p><strong>Conclusions: </strong>Endodontic access preparation reduced the fracture resistance of maxillary premolars with noncarious cervical lesions; however, the access design itself did not significantly influence this outcome. FEA revealed similar stress distribution patterns across all groups, regardless of access type. Adhesive restorative protocols, especially those employing bulk-fill composites, enhanced biomechanical performance compared to provisional restorations. These findings underscore the importance of minimally invasive access in preserving structural integrity and highlight the critical role of adhesive strategies in restoring biomechanical function.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812078","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":"Cellular Crosstalk Between Periodontal Ligament Fibroblasts and Macrophages: Insights from 2D and 3D Culture Systems in External Inflammatory Root Resorption.","authors":"Rajeshwari Hadagalu Revana Siddappa, Anil Kishen","doi":"10.1016/j.joen.2025.07.021","DOIUrl":"10.1016/j.joen.2025.07.021","url":null,"abstract":"<p><strong>Introduction: </strong>Root resorption following traumatic dental injuries is a complex process involving the breakdown of root dentin and cementum by odontoclasts, which differentiate from precursor macrophages. This differentiation is regulated by periodontal ligament fibroblasts (PDLF). Macrophages can polarize into two types: proinflammatory (M1) and anti-inflammatory (M2), which can influence either disease progression or healing.</p><p><strong>Methods: </strong>This review considers experimental models that have been utilized to study the interactions between PDLF and macrophages under normal and inflammatory conditions, including bacterial exposure and hypoxia.</p><p><strong>Results: </strong>Under normal circumstances, PDLFmaintain the balance of periodontal tissues and the surrounding immune environment. However, during inflammatory conditions such as exposure to bacteria or hypoxia, injured PDLF interact with macrophages through signaling mechanisms that promote the differentiation of macrophages into odontoclasts. Various experimental models have been utilized to study the interactions between PDLF and macrophages. These interactions alter the balance of macrophage polarization, with M1 macrophages contributing to disease progression.</p><p><strong>Conclusion: </strong>This review highlights recent insights into the dynamic relationship between PDLF and macrophages in the context of external inflammatory root resorption, emphasizing the importance of their crosstalk in determining disease outcome.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812079","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":"Innervation Changes in Apical Periodontitis and its Correlation with Preoperative Symptoms.","authors":"Austah Obadah, Johnathan Fu, David Wong, Anibal Diogenes","doi":"10.1016/j.joen.2025.07.018","DOIUrl":"10.1016/j.joen.2025.07.018","url":null,"abstract":"<p><strong>Introduction: </strong>Previous anatomical studies have demonstrated the cellular composition of apical periodontitis (AP) lesions, primarily focusing on immune cells. Only recently has the innervation of an apical lesion been reported, but evidence regarding the quantity and quality of neural innervation in AP lesions remains largely unknown. Importantly, periapical innervation has been shown to modulate cellular response in AP, and the voltage-gated sodium channels Nav1.8, a marker of nociceptors, and Nav1.9 have been associated with various pain-related conditions. This study aimed to quantify sensory innervation and evaluate the expression of Nav1.8 and Nav1.9 in symptomatic vs asymptomatic AP.</p><p><strong>Methods: </strong>Soft tissue biopsy samples (n = 20) were collected during endodontic microsurgery. Samples underwent protein extraction and immunohistochemistry. Enzyme-linked immunosorbent assay was used to quantify β-tubulin III Nav1.8 and Nav1.9. Immunoreactivity for calcitonin gene-related peptide, neurofilament heavy, PGP9.5, and Nav1.8 was analyzed using confocal microscopy. Data were analyzed using the Mann-Whitney U test with significance set at P < .05.</p><p><strong>Results: </strong>Symptomatic lesions exhibited an approximately 6-fold increase in innervation density (410.6 ± 359.2 vs 63.4 ± 75.7 pg/μg) and significantly higher Nav1.8 (10.3 ± 10.3 vs 2.97 ± 2.5 pg/μg) and Nav1.9 (9.5 ± 8.5 vs 42.5 ± 39.6 pg/μg) expression compared to asymptomatic lesions (P < .05). Neuronal fibers were identified by the co-localization of neurofilament heavy and PGP9.5 immunoreactivity, revealing a higher density of innervation in apical lesions from symptomatic cases. Notably, the majority of these fibers exhibited strong Nav1.8 expression, indicating a predominance of nociceptive innervation within these lesions.</p><p><strong>Conclusions: </strong>This study provides novel evidence of increased sensory innervation and upregulation of Nav1.8 and Nav1.9 in symptomatic AP. These neural changes may contribute to pain mechanisms in AP and challenges in achieving local anesthesia.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799277","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 Aluminum Chloride-based Hemostatic Agents in Endodontic Microsurgery: An In Vitro and In Vivo Preclinical Study.","authors":"Yae Lim Kim, Ukseong Kim, Sukjoon Lee, Sunmi Jang, Euiseong Kim, Sunil Kim","doi":"10.1016/j.joen.2025.07.017","DOIUrl":"10.1016/j.joen.2025.07.017","url":null,"abstract":"<p><strong>Introduction: </strong>While the aluminum chloride-based hemostatic agent Expasyl is proposed for efficient hemostasis in endodontic microsurgery, its high viscosity may hinder removal and lead to adverse tissue reactions. Traxodent, with lower viscosity, is less studied. This study preclinically compared Expasyl and Traxodent to evaluate (1) cellular responses in human osteoblasts (HOBs) and (2) hemostatic efficacy and tissue response in a rabbit calvarial model.</p><p><strong>Methods: </strong>HOBs were cultured in media containing high and low concentrations of each agent to assess short- and long-term effects. Cell viability was assessed using the Cell Counting Kit-8 assay, and osteogenic (ALPL, BGLAP, RUNX2) and inflammatory (interleukin 6, C-X-C motif chemokine ligand 8, transforming growth factor beta 1) gene expression were analyzed via reverse transcription-quantitative polymerase chain reaction. In vivo, six calvarial bone defects were surgically created in each of six rabbits. Defects were randomly assigned to six groups: control, epinephrine, Expasyl, or Traxodent with or without curettage. Hemostasis was evaluated using photographic bleeding scores. Histological analysis assessed tissue response and bone healing.</p><p><strong>Results: </strong>Short-term exposure (2 min - 1 h) to Expasyl or Traxodent reduced HOB viability. Expasyl significantly decreased transforming growth factor beta 1 and increased C-X-C motif chemokine ligand 8 expression. Both agents reduced osteogenic markers. Expasyl showed the highest hemostatic efficacy but also induced more inflammation and delayed bone healing based on histological findings. Traxodent was easier to remove, left minimal residue, and did not impair healing but demonstrated no significant improvement in bleeding control.</p><p><strong>Conclusions: </strong>Expasyl provided effective hemostasis but was associated with delayed healing and inflammation. Both agents showed cytotoxicity and reduced osteogenic gene expression. Residual Expasyl may hinder healing in endodontic microsurgery.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784401","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":"Prevalence of Vertical Root Fractures in Root Filled Teeth and Their Clinical and Radiographic Risk Factors: A Modern Case-Control Analysis Based on Surgical Diagnosis.","authors":"Phachara Promchouy, Kanet Chotvorrarak, Sittichoke Osiri","doi":"10.1016/j.joen.2025.07.020","DOIUrl":"10.1016/j.joen.2025.07.020","url":null,"abstract":"<p><strong>Introduction: </strong>Vertical root fractures (VRFs) are challenging in endodontic diagnosis. This study determined VRF prevalence and risk factors in root-filled teeth (RFT) requiring endodontic surgery.</p><p><strong>Methods: </strong>From 411 RFT that underwent endodontic surgery (2005-2022), 130 VRF cases and 260 randomly selected controls were analyzed. Demographic, clinical, and radiographic data were collected from dental records and images. Multiple imputations addressed missing data. Univariable and multivariable logistic regression analyses with robust standard errors to account for the clustering of multiple teeth within the same patient were performed, with subanalyses for teeth with intraradicular posts and molars. VRF characteristics were analyzed in individuals with available cone beam computed tomography images.</p><p><strong>Results: </strong>VRF prevalence was 31.63% among RFT undergoing endodontic surgery. Significant risk factors included age (adjusted odds ratio [aOR] = 1.02), probing depth ≥5 mm (aOR = 2.37), isolated perilateral radiolucency (aOR = 4.05), halo radiolucency (aOR = 2.70), overfilled root canal (aOR = 2.11), and root canal space-to-root-width ratio >1/3 (aOR = 1.52). For teeth with posts, a post space-to-root-width ratio >1/3 increased VRF risk (unadjusted OR [uOR] = 2.46). Cone beam computed tomography findings revealed the absence of the buccal plate (uOR = 1.74) and space between the cortical plate and root surface (uOR = 2.73) as significant factors.</p><p><strong>Conclusions: </strong>VRFs affected nearly one-third of RFT requiring endodontic surgery; major risk factors included older age, overfilled root canals, and excessive root canal space-to-root-width ratio. VRF-associated clinical and radiographic signs included probing depth ≥5 mm, isolated perilateral radiolucency, and halo radiolucency.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.6,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144794661","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":"Autonomous Robot-Assisted Endodontic Microsurgery on First Molar in Complex Anatomical Scenarios: A Case Series.","authors":"Lishan Huang, Minting Wan, Xiaoxing Li, Siyu Li, Qingsong Wu, Chengji Gong, Yufei Li, Xuechao Yang","doi":"10.1016/j.joen.2025.04.017","DOIUrl":"10.1016/j.joen.2025.04.017","url":null,"abstract":"<p><p>Endodontic microsurgery (EMS) is an important approach for preserving teeth with failed root canal treatment. However, implementing minimally invasive osteotomies and accurate apicoectomies can be challenging in anatomically complex areas, especially posterior teeth close to critical structures. The introduction of autonomous robotic system into EMS represents a pioneering advancement aimed at enhancing digital endodontic surgery. Robot-assisted EMS (RA-EMS) integrates cone-beam computed tomography and intraoral optical scanning data to plan three-dimensional surgical paths, adopting infrared optical motion-tracking technology and robot autonomous drive, enabling precise apicoectomy. This report presents the successful application of RA-EMS in 4 complex molar cases, during which adjacent vital anatomical structures were preserved. Immediate radiographic examination revealed accurate root-end resections. All patients demonstrated satisfactory healing during the follow-up visits at 1-6 months, with periapical radiolucent area decreased in radiographic examination. RA-EMS is a safe and feasible clinical procedure that minimizes the risk of human error and mitigates technique sensitivity. Meanwhile, it provides a valuable alternative for assisting anatomically challenging EMS.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":"1118-1126"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021400","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":"Jasminum-based Nano-reinforced Calcium Hydroxide Reduces Postoperative Pain in Symptomatic Apical Periodontitis: A Randomized Controlled Trial.","authors":"Nehal Amir, Emaan Mansoor, Nabiha Eeman, Muhammad Nouman Ahmed, Ezza Mansoor, Efrah Mansoor, Khadim Hussain, Vera Afreixo, Afsheen Mansoor, João Filipe Brochado Martins, Paulo J Palma","doi":"10.1016/j.joen.2025.05.016","DOIUrl":"10.1016/j.joen.2025.05.016","url":null,"abstract":"<p><strong>Introduction: </strong>This study evaluated the efficacy of a novel Jasminum-based titanium dioxide nano-reinforced calcium hydroxide (Ca(OH)₂) intracanal medicament in reducing postoperative pain (PP) compared to conventional Ca(OH)₂ in patients with symptomatic apical periodontitis.</p><p><strong>Methods: </strong>A triple-blind randomized clinical trial, registered at ClinicalTrials.gov (NCT06653608, 10/19/2024) included patients with single-rooted teeth diagnosed with pulp necrosis and symptomatic AP. Patients referred for endodontic treatment fulfilling the inclusion criteria were included. The patients were grouped into nano-reinforced Ca(OH)₂ group (n = 30) and conventional-Ca(OH)₂ (n = 30). Preoperative pain and PP at 4, 24, 48, 72, and 96 hours were recorded using a visual analog scale. Data were analyzed using linear mixed-effects models (R software, version 4.3.2., R Core Team, Vienna, Austria), with significance set at P < .05.</p><p><strong>Results: </strong>Sixty patients with comparable demographic and clinical characteristics, including preoperative pain scores, were recruited. Both groups exhibited significant pain reduction over 96 hours (P < .001). However, a significant group-time interaction was observed (P < .001), with the nano-reinforced Ca(OH)₂ group reporting consistently lower PP scores and greater reductions in PP compared to the conventional Ca(OH)₂ group at all-time points.</p><p><strong>Conclusion: </strong>The incorporation of Jasminum-based TiO₂ nanoparticles to Ca(OH)₂ significantly improved the reduction in PP intensity and duration compared to conventional Ca(OH)₂, making it a superior option for PP management.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":"996-1005"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225667","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-computed Tomographic Analysis of the Efficacy of 3 Techniques for Removal of Calcium Hydroxide from the Mesial Canals of Curved Mandibular Molars.","authors":"Jenna Gaudio Edwards, John Nusstein, Melissa Drum, Sara Fowler, Al Reader","doi":"10.1016/j.joen.2025.05.013","DOIUrl":"10.1016/j.joen.2025.05.013","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this study was to evaluate the efficacy of 3 irrigation techniques: standard syringe irrigation (SI), ProUltra PiezoFlow (CUI), and EdgeEndo Er,Cr:YSGG (LAI) laser in removing calcium hydroxide from the mesial canals of severely curved mandibular molars using micro-computed tomography (micro-CT) analysis.</p><p><strong>Methods: </strong>Mesial canals of 30 extracted human mandibular molar teeth were prepared to size 30/.04 taper or 35/.04 taper rotary instruments. Teeth were randomly assigned to the 3 experimental groups (n = 10) with evenly distributed degrees of curvature. Calcium hydroxide was placed into prepared canals and sealed for 14 days. A micro-CT scan was taken to determine calcium hydroxide paste volume in each tooth. Canals were irrigated utilizing the 3 techniques and re-scanned. Micro-CT volume and percent change of calcium hydroxide before and after irrigation were calculated and analyzed.</p><p><strong>Results: </strong>Calcium hydroxide paste remained in all groups after irrigation. The SI group removed -0.09% in the apical segment (0-3 mm) and 14% in the middle segment (3-6 mm). CUI removed 15% in the apical segment and 50% in the middle segment. LAI removed 49% in the apical segment and 72% in the middle segment.</p><p><strong>Conclusions: </strong>Irrigation with LAI removed significantly more calcium hydroxide in the middle and apical segments when compared to CUI and SI.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":"1053-1060"},"PeriodicalIF":3.6,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144191804","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}