Journal of endodontics最新文献

{"title":"Comparative Analysis of Calcium Dynamics in Regular-Set versus Fast-Set Bioceramics: Impact on Cytotoxicity and Apatite Formation","authors":"Wafaa A. Khalil PhD, MSc, BDS,&nbsp;Hanan Alharbi BDS, MMSc, MEndo RCSEd","doi":"10.1016/j.joen.2024.12.002","DOIUrl":"10.1016/j.joen.2024.12.002","url":null,"abstract":"<div><h3>Introduction</h3><div>The objective of this study was to assess the calcium ions (Ca²⁺) release, pH shift, bioactivity, and cytotoxicity of both forms of EndoSequence Root Repair Material: regular set (ES) and fast set (ESF).</div></div><div><h3>Methods</h3><div>ES (<em>n</em> = 10) and ESF (<em>n</em> = 10) forms were tested for their bioactivity. Elemental analysis was done on the fresh material and material immersed in phosphate-buffered saline (PBS) for 30 days. The surface crystal formation was studied. Cytotoxicity was evaluated at different material concentrations using a human hepatocellular cancer cell line (Huh-7).</div></div><div><h3>Results</h3><div>Both materials contain Ca, P, Ta, Zr, and Si as major elements. Both ES and ESF have a limited percentage of ytterbium and neodymium. In the fresh material, compared with the ESF, the ES had a higher Ca²⁺ concentration with a homogeneous surface distribution. However, the ESF released significantly more Ca²⁺ (<em>P</em> &lt; .05) and had a higher pH over the 7-day course. When the material was immersed in PBS, the ESF exhibited a significantly higher Ca/P ratio of 2.95, while ES had 2.16 Ca/P ratio (<em>P</em> &lt; .05). The ESF had a greater capacity to precipitate and grow hydroxyapatite (HA) than ES, resulting in more mature crystals forming on the surface. Both SE and ESF demonstrated low cytotoxicity against Huh-7 cells.</div></div><div><h3>Conclusions</h3><div>When ES and ESF were submerged in simulated bodily fluid, both forms produced apatite crystals at the dentin material interface, releasing high Ca²⁺ and displaying a prolonged high pH with high bioactivity potential. Both forms had comparable low cytotoxicity. A higher Ca²⁺ release in ESF indicates dynamic bioactivity, which should be aligned with the clinical requirements.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 3","pages":"Pages 325-331"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Potential of Nitrofurantoin for Infection Control in Regenerative Endodontics: In Vitro Study","authors":"Fabiano Palmeira Gonçalves DDS, MSD, PhD ,&nbsp;Olney Vieira-da-Motta PhD ,&nbsp;Pantaleo Scelza Neto DDS, MSD, PhD ,&nbsp;Solange Silva Samarão PhD ,&nbsp;Sandro Junio de Oliveira Tavares DDS, MSD, PhD ,&nbsp;Sérgio Henrique Seabra PhD ,&nbsp;Gabriel Bonan Taveira PhD ,&nbsp;Miriam Fatima Zaccaro Scelza DDS, MSD, PhD","doi":"10.1016/j.joen.2024.12.009","DOIUrl":"10.1016/j.joen.2024.12.009","url":null,"abstract":"<div><h3>Introduction</h3><div>This study assessed a new antimicrobial paste formulation containing nitrofurantoin for regenerative endodontics against multispecies biofilms.</div></div><div><h3>Methods</h3><div>Four groups of 11 single-root teeth each were tested: Negative control group (brain-heart infusion broth + micro-organisms); Hoshino 1 conventional tri-antibiotic paste group (1:1:1 ratio); Hoshino 5 group (5:5:5 ratio); Experimental group with nitrofurantoin, ciprofloxacin, and metronidazole. Minimum inhibitory concentrations of each antimicrobial were determined. A polymicrobial biofilm (<em>Enterococcus faecalis</em>, <em>Staphylococcus aureus</em>, <em>Pseudomonas aeruginosa</em>, <em>Candida albicans</em>) was created in root canals, and pastes were inserted for 3 minutes with lentulo. After 7 days, samples were sonicated and spectrophotometrically analyzed. Microbiological assays, plasma membrane permeabilization, confocal laser scanning microscopy, and scanning electron microscopy evaluated biofilm eradication. Statistical significance was set at <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>Spectrophotometry indicated Experimental group outperformed Hoshino 1 group and Negative control group (<em>P</em> &lt; .05), with results similar to Hoshino 5 group (<em>P</em> &gt; .05). Experimental group showed increased membrane damage compared to Hoshino 1 group and Hoshino 5 group. Confocal laser scanning microscopy and scanning electron microscopy revealed fewer microorganisms and no residual biofilm in Experimental group.</div></div><div><h3>Conclusions</h3><div>Substituting minocycline with nitrofurantoin in the paste effectively reduced microorganism counts in root canals system.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 3","pages":"Pages 303-315"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142894858","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":"Mirogabalin as a Therapeutic Option for Neuropathic Pain Emerging Postendodontic Treatment: An Observational Study","authors":"Kohei Shimizu DDS, PhD ,&nbsp;Takuya Yasukawa DDS, PhD ,&nbsp;Takuro Izumida DDS ,&nbsp;Kana Ozasa DDS, PhD ,&nbsp;Keita Takizawa DDS ,&nbsp;Noboru Noma DDS, PhD ,&nbsp;Makoto Hayashi DDS, PhD ,&nbsp;Osamu Takeichi DDS, PhD","doi":"10.1016/j.joen.2024.12.015","DOIUrl":"10.1016/j.joen.2024.12.015","url":null,"abstract":"<div><h3>Introduction</h3><div>We have recently reported the clinical efficacy of mirogabalin for occlusal pain due to post-traumatic trigeminal neuropathic pain (PTTN-occlusal pain) after endodontic treatment according to the International Classification of Orofacial Pain criteria. This study aimed to determine the mirogabalin administration period and timing of dose reduction and suspension for treating this condition based on managing a certain number of cases.</div></div><div><h3>Methods</h3><div>Patients diagnosed with PTTN-occlusal pain after or during endodontic treatment were included in the study. An endodontist retreated if necessary. Patients who initially experienced occlusal pain but gradually adapted to bite well without medication were classified into the provisional restoration group (<em>n</em> = 13). Patients who experienced severe pain during mastication and could not chew with a provisional restoration were classified into the mirogabalin medication group (<em>n</em> = 15). Mirogabalin (10 mg/day) was prescribed once a day before bedtime. The patients receiving visual analog scale (VAS) were instructed to record daily changes in pain intensity in a VAS diary. The practitioners also recorded scores during consultations.</div></div><div><h3>Results</h3><div>In the provisional restoration group, VAS scores significantly decreased from week 6 and plateaued from week 11 (<em>P</em> &lt; .05). This adaptation period was applied to reduction or discontinuation of mirogabalin treatment in the mirogabalin medication group. After initiating mirogabalin, VAS scores significantly decreased gradually from week 1 (<em>P</em> &lt; .05). Although the dose was tapered around week 7 and discontinued by week 11, no recurrence of pain was observed following dose reduction or discontinuation.</div></div><div><h3>Conclusions</h3><div>Mirogabalin was effective in treating PTTN-occlusal pain.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 3","pages":"Pages 279-286"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142907048","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":"Adherence to Registration and Selective Outcome Reporting in Randomized Clinical Trials Published in Endodontic Journals Over the Past 5 Years: A Meta-Research Study","authors":"Filipe Colombo Vitali PhD ,&nbsp;Pablo Silveira Santos PhD ,&nbsp;Aurélio de Oliveira Rocha MS ,&nbsp;Lucianne Cople Maia PhD ,&nbsp;Lucas da Fonseca Roberti Garcia PhD ,&nbsp;Cleonice da Silveira Teixeira PhD","doi":"10.1016/j.joen.2024.12.001","DOIUrl":"10.1016/j.joen.2024.12.001","url":null,"abstract":"<div><h3>Introduction</h3><div>Prospective registration of randomized clinical trials (RCTs) is highly recommended to ensure research transparency and prevent selective outcome reporting (SOR). This study aimed to evaluate the adherence to registration and the presence of SOR in RCTs published in endodontic journals over the past 5 years.</div></div><div><h3>Methods</h3><div>Electronic searches were conducted in PubMed and the libraries of the <em>Journal of Endodontics</em>, <em>International Endodontic Journal</em>, <em>European Endodontic Journal</em>, and <em>Australian Endodontic Journal</em>. Two reviewers were involved in the study selection and evaluation. Publications were assessed for key methodological aspects, including the presence and timing of trial registration. RCT registries were examined to identify discrepancies between publication and registered protocols and the presence of SOR. Logistic regression was used to explore the effect of study variables on registration practices and SOR.</div></div><div><h3>Results</h3><div>Of the 144 RCTs included, 104 (72.2%) were registered. Among those registered, only 19 (18.3%) adhered to prospective registration. Registration practice increased by 53% per year (OR 1.53; 95% CI: 1.34–2.08; <em>P</em> &lt; .01). Discrepancies between publication and protocol were identified in 55.8% of studies, primarily related to sample size (33.7%). SOR was identified in 41 trials (39.4%), mainly due to discrepancies in the outcome time frame (18.3%). Studies evaluating multiple outcomes had 4.95 times higher odds of exhibiting SOR (OR 4.95; 95% CI: 1.63–12.95; <em>P</em> &lt; .01). Furthermore, studies that were registered retrospectively or exhibited discrepancies between publication and protocol accounted for 6.10 times (OR 6.10; 95% CI: 1.81–18.96; <em>P</em> = .03) and 5.61 times (OR 5.61; 95% CI: 2.93–16.58; <em>P</em> &lt; .01) higher odds of exhibiting SOR, respectively.</div></div><div><h3>Conclusions</h3><div>RCTs published in endodontic journals over the past 5 years presented low adherence to prospective trial registration and a high prevalence of SOR.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 3","pages":"Pages 258-267.e7"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791943","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":"Vital Pulp Therapy Outcomes in Children's First Permanent Molars Under General Anesthesia: A Retrospective Study","authors":"Shlomo Elbahary DMD, PhD ,&nbsp;Bradford Ray Johnson DDS, MHPE ,&nbsp;Yara Nimer DMD ,&nbsp;Shaked Cohen Lerner BSc ,&nbsp;Sigalit Blumer DMD ,&nbsp;Hagay Slutzky DMD ,&nbsp;Ronald Wigler DMD","doi":"10.1016/j.joen.2024.12.003","DOIUrl":"10.1016/j.joen.2024.12.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Pulpotomy is a proven treatment option for permanent teeth with pulp involvement, showing high success rates similar to root canal treatment. General anesthesia (GA) is used when traditional dental procedures are not feasible, especially in pediatric cases. Despite its effectiveness, limited data on endodontic treatments under GA is available, with many guidelines favoring extractions. This study aimed to evaluate the success rate of pulpotomies performed under GA on children's first permanent molars and to identify factors influencing treatment outcomes.</div></div><div><h3>Methods</h3><div>The study involved 171 pediatric patients, aged 8 to 12, who underwent pulpotomy procedures on 197 teeth at a public dentistry clinic between January 2018 and July 2022. Clinical and radiographic follow-ups were conducted at different intervals to assess the effectiveness of the treatments, achieving a recall rate of 83%.</div></div><div><h3>Results</h3><div>The overall success rate of pulpotomies performed under GA was 93.36%. Success rates varied according to the follow-up period: 100% at 1–12 months, 97.70% at 13–24 months, and 87.76% at 25–36 months. The etiology of the tooth's condition significantly affected outcomes, whereas patient age, sex, and tooth maturity did not have a significant impact.</div></div><div><h3>Conclusion</h3><div>Pulpotomy in permanent molars is an effective treatment option for managing carious lesions, especially when performed under GA.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 3","pages":"Pages 287-294"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142822278","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(25)00101-3","DOIUrl":"10.1016/S0099-2399(25)00101-3","url":null,"abstract":"","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 3","pages":"Pages 373-379"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619472","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":"Efficacy of Laser Activated versus Sonic Activated Irrigation for Debris Removal in Conservatively Instrumented Root Canals","authors":"Alexander Huynh DDS, MS,&nbsp;Ane Poly DDS, PhD,&nbsp;Megan Yamaguchi DDS, MS,&nbsp;Poorya Jalali DDS","doi":"10.1016/j.joen.2024.12.006","DOIUrl":"10.1016/j.joen.2024.12.006","url":null,"abstract":"<div><h3>Introduction</h3><div>To compare the efficacy of laser activated and sonic activated irrigation on the removal of debris in mesial root canal systems of mandibular molars using micro-computed tomographic analysis.</div></div><div><h3>Methods</h3><div>Forty-eight mesial roots of extracted mandibular molars with isthmus were selected and randomly allocated into 2 groups: Sonic Group and Laser Group. The root canals were minimally instrumented to a maximum apical file size of 20/06v (DCTaper, SSWhite, NJ). The Sonic Group received irrigant activation using the SmartLite Pro EndoActivator (Dentsply Tulsa, OK) with a 15/02 tip. The Laser Group received irrigant activation using the WaterLase iPlus (Biolase, CA) with a RFT2 tip. The teeth were activated for the same time with the same volume of irrigants. Micro-computed tomographic scans were obtained preinstrumentation, preirrigation, and postirrigation. To quantify debris removal, the air-filled volume was measured preirrigation and postirrigation, and the percentage increase in air-filled volume was calculated. Data were analyzed statistically (independent samples t-test, significance set at 5%).</div></div><div><h3>Results</h3><div>The Laser Group demonstrated a significantly higher mean percentage increase in air-filled volume (37.4%) compared to the Sonic Group (20.2%). This difference was statistically significant (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>The Laser Group was significantly more effective in removing debris compared to the Sonic Group in minimally instrumented root canal systems. However, due to the limitations of this study, further research is needed to assess the impact of laser activated irrigation on clinical outcomes.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 3","pages":"Pages 332-339"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872205","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 March 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,&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.2025.02.005","DOIUrl":"10.1016/j.joen.2025.02.005","url":null,"abstract":"","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 3","pages":"Pages 255-257"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143619236","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":"Continuous Chelation Reduces Instrumentation Time and Straightening of Double-curved Simulated Root Canals in Bovine Dentin","authors":"Kevin Hofpeter Dr. med. dent. ,&nbsp;Matthias Zehnder Dr. med. dent., PhD ,&nbsp;Michael Solomonov DMD ,&nbsp;Shengjile Deari Dr. med. dent.","doi":"10.1016/j.joen.2024.12.011","DOIUrl":"10.1016/j.joen.2024.12.011","url":null,"abstract":"<div><h3>Introduction</h3><div>Adding a compatible chelator to the sodium hypochlorite (NaOCl) solution applied during instrumentation may affect shaping efficacy and canal transportation. This was studied in simulated double-curved root canals.</div></div><div><h3>Methods</h3><div>High-precision computer numerical control milling was used to recreate standardized S-shaped canals from a resin training block in longitudinally sectioned bovine incisor roots. These simulated root canals were instrumented chemo-mechanically at 37°C using a single-length rotary file system (ProTaper Gold). An etidronate powder (Dual Rinse HEDP) was dissolved (0.9 g per 10 mL) in a 1% NaOCl solution in the test group (<em>n</em> = 15), while the plain NaOCl solution was applied in the control group. Instrumentation was performed by one operator blinded to the irrigating solution. Instrumentation time was measured using a stop watch. Pre- and postoperative images were obtained by a second (blinded) investigator using a digital microscope, and super-imposed to assess canal straightening by totalizing transportation from 8 predefined locations. Data were compared between groups using Student's t-test, <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>Adding the chelator, total instrumentation time was reduced to 75 ± 12 s as compared to 86 ± 14 s with plain NaOCl (<em>P</em> &lt; .05). This time difference was related to the first rotary instrument in the system (S1). Canal straightening was also reduced significantly with the chelator compared to the plain 1% NaOCl solution (<em>P</em> &lt; .05), while transportation at working length was similar between groups.</div></div><div><h3>Conclusion</h3><div>Under current conditions, continuous chelation expedited canal instrumentation and maintained simulated canal curvatures.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 3","pages":"Pages 367-372"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning Curve for Dynamic Navigation Procedure during Endodontic Management of Permanent Maxillary Anterior Teeth with Pulp Canal Calcification: A Risk-Adjusted Cumulative Summation Analysis of a Single Operator's Experience","authors":"Sidhartha Sharma MDS ,&nbsp;Partha Haldar MD, MSc ,&nbsp;Vijay Kumar MDS ,&nbsp;Amrita Chawla MDS ,&nbsp;Ajay Logani MDS","doi":"10.1016/j.joen.2024.12.008","DOIUrl":"10.1016/j.joen.2024.12.008","url":null,"abstract":"<div><h3>Introduction</h3><div>The dynamic navigation system (DNS) in endodontics presents a significant learning curve. This cross-sectional study aimed to assess the number of cases required to achieve consistent performance in DNS-assisted treatment of maxillary anterior teeth with pulp canal calcification.</div></div><div><h3>Methods</h3><div>A series of DNS procedures were performed on 45 calcified maxillary anterior teeth with pulp necrosis by a single endodontist who had no prior clinical DNS experience. Preoperative cone-beam computed tomography was obtained. After trace registration and calibration, drilling was executed using a low-speed bur. Once the canal was located and scouted to the working length, a postoperative cone-beam computed tomography was taken immediately. Angular deviation (AD), linear deviation (LD), and operating time (OT) were measured. The learning curve was evaluated using the risk-adjusted cumulative sum analysis method.</div></div><div><h3>Results</h3><div>The overall success rate in locating canals was 93.33% (95% CI 80.7, 98.3). The mean (±SD) for AD, LD and OT was 3.21 ± 2.23°, 0.52 ± 0.33 mm and 34.14 ± 13.18 minutes, respectively. For AD, 2 distinct peaks were observed at the 5th and 18th cases, identifying 3 learning phases: Phase I (cases 1–5), Phase II (cases 6–18), and Phase III (cases 19–45). Similarly, LD exhibited peaks at the 13th and 28th cases. Two peaks for OT were identified at the 7th and 26th cases.</div></div><div><h3>Conclusions</h3><div>Achieving technical proficiency in locating calcified canals using DNS required approximately 18 to 28 cases, indicating a significant learning curve that must be overcome for optimal accuracy.</div></div>","PeriodicalId":15703,"journal":{"name":"Journal of endodontics","volume":"51 3","pages":"Pages 295-302"},"PeriodicalIF":3.5,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872207","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}