Journal of endodontics最新文献

{"title":"Diagnostic Accuracy of a Commercial AI-based Platform in Evaluating Endodontic Treatment Outcomes on Periapical Radiographs Using CBCT as the Reference Standard.","authors":"Marwa Allihaibi, Garrit Koller, Francesco Mannocci","doi":"10.1016/j.joen.2025.03.007","DOIUrl":"10.1016/j.joen.2025.03.007","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence (AI) has shown promise in dental diagnostics; however, its accuracy in assessing endodontic treatment outcomes compared to experienced clinicians remains unclear. This study evaluated the performance of an AI-driven platform (Diagnocat) against experienced clinicians in assessing endodontic treatment outcomes on periapical radiographs, using cone-beam computed tomography as the reference standard.</p><p><strong>Methods: </strong>This retrospective diagnostic accuracy study analyzed 376 teeth (860 roots) from 4 prospective clinical trials. Treatment outcomes were assessed using periapical radiographs, independently evaluated by 2 calibrated endodontists and the AI-driven platform. Cone-beam computed tomography scans served as the reference standard. Sensitivity, specificity, accuracy, and area under the receiver operating characteristic curve were calculated.</p><p><strong>Results: </strong>The AI-driven platform demonstrated higher sensitivity but lower specificity than clinicians at both tooth (sensitivity: 67.3% vs 49.3%, P < .001; specificity: 82.3% vs 92.5%, P < .001) and root levels (sensitivity: 54.3% vs 43.8%, P = .003; specificity: 86.7% vs 94.5%, P < .001). Overall accuracy was comparable at the tooth level (AI: 76.3%, clinicians: 75.3%, P = .716) but slightly lower for the AI-driven platform at the root level (78.5% vs 81.6%, P = .021). Receiver operating characteristic curve analysis showed comparable area under the curve values between the AI-driven platform and clinicians at both tooth (0.75 vs 0.71) and root levels (0.71 vs 0.69).</p><p><strong>Conclusions: </strong>While the AI-driven platform demonstrated potential as an adjunctive tool for assessing endodontic treatment outcomes, particularly in detecting lesions that might be missed by human assessment, its lower specificity highlights the need for clinical oversight to prevent overdiagnosis.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780103","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":"Insights into the April 2025 Issue of the JOE","authors":"Anita Aminoshariae DDS, MS,&nbsp;Amir Azarpazhooh DDS, MSc, PhD, FRCD(C),&nbsp;Gerald N. Glickman DDS, MS, MBA, JD,&nbsp;Jianing He DMD, PhD,&nbsp;Sahng G. Kim DDS, MS,&nbsp;Anil Kishen BDS, MDS, PhD,&nbsp;Ariadne M. Letra DDS, MS, PhD,&nbsp;Linda Levin DDS, PhD,&nbsp;Ronald Ordinola-Zapata DDS, MS, PhD,&nbsp;Frank C. Setzer DMD, PhD, MS,&nbsp;Franklin R. Tay BDSc(Hons), PhD,&nbsp;Kenneth M. Hargreaves DDS, PhD","doi":"10.1016/j.joen.2025.03.006","DOIUrl":"10.1016/j.joen.2025.03.006","url":null,"abstract":"","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 4","pages":"Pages 397-398"},"PeriodicalIF":3.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143874447","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":"Patient-Centered Outcome Assessment of Static and Dynamic Navigation-Aided Endodontic Microsurgery: A Randomized Controlled Trial.","authors":"Chen Chen, Rui Zhang, Li Qin, Yeyu Lin, Xining Zhang, Fangzhe Li, Liuyan Meng","doi":"10.1016/j.joen.2025.03.005","DOIUrl":"10.1016/j.joen.2025.03.005","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the quality of life (QoL) and analgesic use 1 week after surgery, as well as the surgical duration, associated with static navigation (SN) and dynamic navigation (DN)-aided endodontic microsurgery (EMS).</p><p><strong>Methods: </strong>Sixty patients were randomly assigned to the SN group (n = 30) or the DN group (n = 30). Both groups underwent EMS based on a presurgical plan. The primary outcomes were patient-reported QoL and analgesic use during the first week, while the secondary outcome was the duration of guided procedures, including osteotomy and root-end resection. QoL was assessed using a visual analog scale-based questionnaire. The questionnaire evaluated symptoms (pain, swelling, bleeding) and functional impact (mouth opening, chewing, talking, sleeping, daily routine), with average scores for each component calculated daily. The Mann-Whitney U test was used to compare QoL scores and surgery duration between groups, with statistical significance set at P < .05.</p><p><strong>Results: </strong>Postoperative adverse reactions within the first week after SN- and DN-aided EMS were short-lived, peaking early in the postoperative period and gradually subsiding. No significant differences were observed in QoL or analgesic use between the SN and DN groups. Participants in the SN group had significantly shorter surgery duration compared to DN group.</p><p><strong>Conclusion: </strong>Both SN and DN enable minimally invasive EMS with equivalent patient-centered outcomes, though SN demonstrates a significant advantage in reducing the duration of guided osteotomy and root-end resection. These findings provide patient-centered reference metrics to guide the selection between the 2 guided approaches in clinical practice.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730298","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":"Optimization of Cone-beam Computed Tomography Protocols to Detect the Second Mesiobuccal Canal in the Presence of Artifacts.","authors":"Janaína Zechin, Érica Pozo Mautone, Claudio Antônio Perottoni, Thiago Oliveira Gamba, Janete Eunice Zorzi","doi":"10.1016/j.joen.2025.03.002","DOIUrl":"10.1016/j.joen.2025.03.002","url":null,"abstract":"<p><strong>Introduction: </strong>There is difficulty in identifying the mesiobuccal canal in clinical routine. The use of cone-beam computed tomography (CBCT) helps overcome this difficulty by providing volumetric details of the teeth and surroundings. Thus, the objective of this study was to determine the effectiveness of different CBCT protocols, with different image resolutions, in visualizing the second mesiobuccal canal in maxillary molars in the presence of artifacts.</p><p><strong>Methods: </strong>To perform the study, the visualization of the second mesiobuccal canal of 28 maxillary molars with root canal preparation and obturation was used, with the exception of the second mesiobuccal canal. The teeth were placed in a dry maxilla and then scanned with the OP300 MAXIO CBCT unit (4 protocols) and 3D Veraview X800 F150P (3 protocols). Five experienced and blinded evaluators analyzed the images to assess accuracy, sensitivity, and specificity. The presence of the second mesiobuccal canal was confirmed by light microscopy (×50 magnification) of cross-sections of the roots.</p><p><strong>Results: </strong>Our data showed that the Veraview X800 CT scanner provided better results for accuracy (96%), sensitivity (100%), and specificity (86%). The 50 × 50/0.085 protocol showed the highest sensitivity (78%), specificity (100%), and accuracy (82%). It was possible to visualize the second mesiovestibular canals in both CT scanners tested; however, the 3D Veraview X800 F150P offered better results for the evaluated patterns.</p><p><strong>Conclusions: </strong>The best protocol in the presence of artifacts was 80 × 40 FOV and 0.125 voxel size of 3D Veraview X800 F150P.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730297","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":"CBCT-Assessed Outcomes and Prognostic Factors of Primary Endodontic Treatment and Retreatment: A Systematic Review and Meta-Analysis.","authors":"Joāo Filipe Brochado Martins, Athina Christina Georgiou, Patrícia Diogo Nunes, Ralph de Vries, Vera Mónica Almeida Afreixo, Paulo Jorge Rocha da Palma, Hagay Shemesh","doi":"10.1016/j.joen.2025.03.004","DOIUrl":"10.1016/j.joen.2025.03.004","url":null,"abstract":"<p><strong>Introduction: </strong>Periapical radiographs have limitations in assessing endodontic treatment outcomes, which can be addressed by cone-beam computed tomography (CBCT). This systematic review evaluates primary root canal treatment and retreatment outcomes using CBCT, focusing on periapical healing, success, and prognostic factors.</p><p><strong>Methods: </strong>A literature search (in PubMed, Embase, and Web of Science) was performed up to March 8, 2024, in collaboration with a medical information specialist. Three reviewers (J.F.B.M., A.C.G, P.D.N.) independently performed article selection and data extraction. Risk of bias was assessed, and evidence quality using the Grading of Recommendations, Assessment, Development, and Evaluation approach. Meta-analysis and meta-regression established pooled periapical healing and outcome rates, 95% confidence intervals (CIs), and identify outcome predictors (P < .05).</p><p><strong>Results: </strong>Nineteen studies were included in the meta-analysis. The pooled periapical healing rate using \"loose criteria\" was 87% (95% CI: 81%-91%) for teeth and 84% (95% CI: 78%-88%) for roots; using \"strict criteria\" was 36% (95% CI: 22%-53%) for teeth, and 44% (95% CI: 16%-76%) for roots. The weighted pooled success rates for teeth were 85% (95% CI: 80%-89%) under \"loose criteria\" and 45% (95% CI: 31%-59%) under \"strict\" criteria. Meta-regression identified outcome predictors include number of visits, irrigant type, tooth type, operator experience, apical preparation size and taper, and obturation technique.</p><p><strong>Conclusions: </strong>CBCT reveals lower success rates under strict criteria compared to loose criteria (36% vs 88%). While CBCT offers greater diagnostic accuracy, its routine use for outcome evaluation may not be necessary, as it yields results similar to periapical radiograph under loose criteria.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143692238","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":"Intentional Replantation of C-shaped Mandibular Second Premolar with Radicular Groove.","authors":"Siwen Wu, Jeen Nee Lui","doi":"10.1016/j.joen.2025.03.003","DOIUrl":"10.1016/j.joen.2025.03.003","url":null,"abstract":"<p><p>C-shaped roots with radicular grooves are uncommon in mandibular premolars. Bacteria residing in the radicular groove and associated accessory canals can contribute to persistent periradicular infections. Eradicating bacteria in these less accessible areas remains a significant challenge in endodontic procedures. This report describes the successful management of a left mandibular second premolar (#20) with a persistent lesion related to a lingual radicular groove through an intentional replantation procedure. A 31-year-old Chinese male complained of a gum swelling related to tooth #20 which was endodontically treated and crowned 6 years ago. Clinical examination revealed a lingually located sinus tract and a clinically intact crown restoration. The tooth was not tender to percussion or palpation, with probing depths not exceeding 4 mm, and showed physiological mobility. A periapical radiograph showed the lingual sinus tract traced to the mid third of the root, which had an adequate root canal filling and an intact periodontal ligament around the apical region. A cone-beam computed tomography image revealed radiolucency at the mid third region and on the lingual aspect related to the radicular groove of this C-shaped premolar. Intentional replantation was performed due to the location of the mid-root lesion related to the lingual radicular groove. Tooth #20 was extracted atraumatically, a stained radicular groove was identified, cleansed and sealed with Biodentine, and the tooth replanted. At 2.5-year follow-up, the patient was clinically asymptomatic. Tooth #20 presented with normal probing depths and mobility and healing was observed on the cone-beam computed tomography images.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674210","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 Morphological and Chemical Composition of Dental Pulp Stones: A Combined Microanalytical Approach.","authors":"Vincenzo Tosco, Riccardo Monterubbianesi, Jose Aranguren, Michele Furlani, Nicole Riberti, Angelo Putignano, Giovanna Orsini","doi":"10.1016/j.joen.2025.02.014","DOIUrl":"10.1016/j.joen.2025.02.014","url":null,"abstract":"<p><strong>Introduction: </strong>Pulp stones (PSs) are mineralized ectopic structures within the dental pulp that vary in morphology, composition, and location. Their etiology remains uncertain and poses clinical challenges in endodontics. This study hypothesized that combined analytical techniques would enhance understanding of PS morphology and composition, facilitating clinical management of complex cases.</p><p><strong>Methods: </strong>Fifteen permanent molars with radiographic evidence of PSs were analyzed using microcomputed tomography (μ-CT), light microscopy, and scanning electron microscopy associated with energy-dispersive spectroscopy (SEM-EDS). The samples underwent qualitative and quantitative assessments to explore their morphology, distribution, and chemical composition. Statistical analysis was conducted using one-way analysis of variance to evaluate differences in Ca/P ratios between PS and dentin, with significance set at P < .05.</p><p><strong>Results: </strong>μ-CT and histological evaluations revealed distinct morphological differences between coronal and radicular PS. Coronal PS exhibited regular nodular or mold shapes, whereas radicular PS showed irregular and diffuse patterns. Histological findings highlighted the nature of PS as mineralized ectopic connective tissue in coronal regions. On the other hand, radicular PSs displayed linear arrangement of collagen fibers intertwined with vascular bundles. SEM-EDS demonstrated no significant differences in mineralization between PS and dentin, with comparable Ca/P ratios.</p><p><strong>Conclusions: </strong>PSs exhibit distinct morphological and structural characteristics depending on their location. Despite these differences, PSs and dentin share similar chemical compositions, as demonstrated by similar Ca/P ratios. The combined microanalytical approach employed provides novel insights into PS morphology and composition, offering a foundation for translational advancements in diagnostic and therapeutic strategies.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630596","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":"Assessment of the Number of Missing Tooth Surfaces and the Molecular Findings on the Outcomes of Vital Pulp Therapy Using 2 Calcium Silicate Materials: A Randomized Clinical Study.","authors":"Mostafa Sami Abdelaziz, Nelly Abdelsalam, Dalia Mukhtar Fayyad","doi":"10.1016/j.joen.2025.03.001","DOIUrl":"10.1016/j.joen.2025.03.001","url":null,"abstract":"<p><strong>Introduction: </strong>This study aimed to evaluate the clinical and radiographic outcomes of full pulpotomy in mandibular molar teeth with symptomatic irreversible pulpitis. It compared class I and class II cavity defects and correlated these outcomes with the quantification of 2 biomolecules (tumor necrosis factor-alpha [TNF-α] and matrix metalloproteinase-9 [MMP-9]) using 2 types of pulpotomy dressing materials (MTA+ and Well-Root PT).</p><p><strong>Methods: </strong>Sixty patients were selected and categorized based on cavity class. Full pulpotomy was conducted under aseptic conditions and rubber dam isolation. Pulpal blood samples were taken for TNF-α and MMP-9 quantification. Sodium hypochlorite was used as a hemostatic agent. The teeth were randomly divided based on the pulpotomy dressing material, MTA+, or Well-Root PT. Clinical and radiographic assessments were conducted after 1 week, 3, 6, and 12 months.</p><p><strong>Results: </strong>The overall clinical and radiographic success rate of pulpotomy procedures after a 1-year follow-up was 88.3%. There were nonsignificant differences in the success rates between the groups and subgroups (93.3% in MTA class I, 86.7% in Well-Root PT class I, 80.0% in MTA class II, and 93.3% in Well-Root PT class II). TNF-α and MMP-9 showed a significant correlation with the outcomes.</p><p><strong>Conclusion: </strong>Class I and II cavity defects do not significantly impact the pulpotomy success rate. TNF-α and MMP-9 levels are potential indicators of pulpotomy outcomes. Well-Root PT offers easier handling and lacks the discoloration effect associated with MTA+.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585934","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 In Vitro Study of the Effect of Different Methods of Removing Calcium Hydroxide From Root Canals.","authors":"Yanzhi Wang, Changjie Xiao, Panpan Zhang, Ying Liu, Jie Li","doi":"10.1016/j.joen.2025.02.015","DOIUrl":"10.1016/j.joen.2025.02.015","url":null,"abstract":"<p><strong>Introduction: </strong>The different rinsing methods would affect the removal efficiency of calcium hydroxide. We aimed to compare the efficiency of 4 methods for removing calcium hydroxide in root canals.</p><p><strong>Methods: </strong>A total of 80 mandibular single-tube permanent premolars were instrumented to ProTaper Universal F4. The teeth were split in 2 lengthwise, standardized grooves, and depressions were prepared on the wall of the root canal and filled with calcium hydroxide. The samples were randomly divided into 4 groups according to different rinsing methods, namely, syringe rinsing group (SYIG), sonic vibration group (SOIG), ultrasonic lancing Group (ULIG), and Er:YAG laser rinsing group (LAIG). The calcium hydroxide was removed from the root canal. The residual calcium hydroxide area percentage was calculated microscopically and photographed before and after rinsing. The removal effect of irregular areas (grooves and depressions) was evaluated by scoring.</p><p><strong>Results: </strong>In the root canal crown, the clearance rate of SOIG, ULIG, and LAIG was better than that of SYIG. ULIG and LAIG had the best clearance rate (P < .05). In the middle root canal and root canal tip, the clearance rate of SOIG, ULIG, and LAIG was better than that of SYIG. Among them, LAIG had the best clearance rate (P < .05). There was no obvious difference in the clearance rate between SOIG and ULIG (P > .05). For the calcium hydroxide removal scores of different flushing techniques in grooves and depressions, LAIG was the best (P > .05).</p><p><strong>Conclusions: </strong>None of the 4 methods can completely remove calcium hydroxide; however, LAIG has greater advantages than other washing methods, with higher cleaning efficiency.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585933","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":"Integration of an Ultrasonic Device into Dynamic Navigation System for a Fully Guided Dynamic Endodontic Microsurgery Workflow: An In Vitro Study.","authors":"Frederico C Martinho, Nicholas H Stroeters, Bruno G Bisi, Giulio Gavini, Ina L Griffin, Patricia A Tordik","doi":"10.1016/j.joen.2025.02.013","DOIUrl":"10.1016/j.joen.2025.02.013","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigates the feasibility of integrating an ultrasonic (US) device into a dynamic navigation system (DNS) for a fully guided dynamic endodontic microsurgery (EMS) workflow. It compares the accuracy and efficiency of fully guided dynamic US + DNS to US + freehand (FH) workflow.</p><p><strong>Methods: </strong>Thirty-eight mandibular molars were divided into 2 groups: US + DNS (n = 19) and US + FH (n = 19). Cone-beam computed tomography scans were taken pre- and postoperatively. Bone window cut (BWC), root-end resection (RER), root-end cavity preparation (RECP), and root-end filling (REF) were planned in the X-guide. BWC, RER, RECP, and REF were all conducted under dynamic navigation. Three-dimensional deviations were measured for BWC. Resected root length and resection angle were calculated for the RER. Frequency long-axis deviation was recorded for RECP, and REF depth was measured. Total operating time was recorded.</p><p><strong>Results: </strong>The fully guided US + DNS was more accurate than US + FH, showing lesser 3-dimensional deviations for BWC (P < .0001). The resected root length was ∼3 mm (P > .05). The RER angle was lower in US + DNS (P < .0001). RECP long-axis deviations were lesser in US + DNS (P < .05). The REF depth average was 3 mm for US + DNS and 2.78 mm for US + FH (P < .05). Both EMS workflows were time efficient for EMS, with US + FH taking less time (P < .05).</p><p><strong>Conclusions: </strong>Within the limitations of this study, it is feasible to integrate US into a DNS for a fully guided dynamic EMS workflow. Fully guided dynamic EMS workflow improved overall EMS accuracy.</p>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143566493","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}