Odontology最新文献

{"title":"Evaluation of the effects of prenatal exposure to pregabalin and postnatal analysis of dental and mandibular bone tissue development in rat offspring.","authors":"Viviane de Fátima Mestre, Eduardo Inocente Jussiani, Caio Cezar Nantes Martins, Aline Campos Zeffa, Camila Salvador Sestário, Maria José Sparça Salles","doi":"10.1007/s10266-025-01090-9","DOIUrl":"10.1007/s10266-025-01090-9","url":null,"abstract":"<p><p>Pregabalin is a gabapentinoid indicated for the treatment of peripheral neuropathic pain, fibromyalgia, and as an adjuvant therapy for epilepsy. The aim of this study was to evaluate the effects of pregabalin on postnatal development, odontogenesis, and mandibular trabecular tissue using computed microtomography. Pregnant rats (N = 24) were divided into two groups: control group/placebo (C), and treated group (PGB). The PGB group received 200 mg/kg of pregabalin via gavage during the embryonic period and the C group received distilled water under the same design. On the 21st day of pregnancy, delivery occurred naturally. On the first postnatal day, the litters were reduced to four pups (2 males and 2 females) and followed up for 30 days. On postnatal day 30, eight animals from each group were randomly selected for analysis of the lower right first molar and adjacent trabecular bone. In the maternal parameters, the data revealed a significant decrease in body weight gain in addition to a smaller number of live pups. In the postnatal analysis, the exposed pups showed a significant decrease in weight and length and a delay in the eruption of the incisor teeth. Microtomography analysis revealed a significant reduction in enamel volume, a lower volume and percentage of open pores, lower total porosity, and a higher percentage of bone volume. The findings of this study showed that pregabalin altered the eruption chronology of the incisors, decreased enamel volume, affected the microarchitecture of mandibular trabecular bone, and impaired postnatal development. CONCEA-CEUA-UEL n. 11,174.2018.36, State University of Londrina, (UEL), Londrina, Paraná, Brazil; retrospectively registered on August 21, 2018.</p>","PeriodicalId":19390,"journal":{"name":"Odontology","volume":" ","pages":"1634-1642"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical efficacy of tunnel flap combined with de-epithelialized connective tissue graft in treating gingival recession: a case-series study.","authors":"Jie Ni, Hang Yang, Xiaojun Li, Fei Chen, Wei Lu, Xinjian Ye, Xia Cai, Fuming He","doi":"10.1007/s10266-025-01100-w","DOIUrl":"10.1007/s10266-025-01100-w","url":null,"abstract":"<p><p>To evaluate the clinical efficacy and influencing factors of the tunnel flap (TUN) combined with de-epithelialized connective tissue graft (DCTG) in the treatment of gingival recession (GR) from patient- and site-specific perspectives. Patients treated with the TUN + DCTG technique for GR between August 2020 and December 2023 were included. Baseline and follow-up periodontal measurements were recorded, including gingival recession depth (GRD), keratinized gingival width (KGW), and clinical attachment loss (CAL). Paired sample t-test was performed to assess the clinical efficacy. Moreover, primary outcome metrics, such as complete root coverage rate (CRC), mean root coverage rate (MRC), root coverage esthetic score (RES), and patient satisfaction, were calculated. Patient- and site-specific influencing factors were analyzed using a generalized linear mixed model regression (GLMM). A total of 34 patients with 201 affected teeth were included, comprising 78 cases of Cairo RT1, 86 of RT2, and 37 of RT3. Significant clinical improvements were observed over an average follow-up of 11.97 ± 4.11 months, including reductions in GRD (from 2.13 ± 1.14 mm to 0.48 ± 0.73 mm, P < 0.001) and CAL (from 3.22 ± 1.16 mm to 1.64 ± 0.90 mm, P < 0.001) and increases in KGW (from 2.58 ± 1.28 mm to 3.72 ± 1.66 mm, P < 0.001), with a CRC of 59.2% and MRC of 77.26% ± 33.48%. The mean RES was 8.21 ± 1.74, with 83.3% of patients reporting an improved quality of life. GLMM identified recession type, age, and tooth arch as predictable factors for clinical outcomes (P < 0.001). Within its limitations, this study suggests that the TUN + DCTG technique is a promising approach for managing GR, yielding favorable clinical and aesthetic outcomes. Clinical decision-making for GR treatment should consider a range of influencing factors to optimize individualized patient care.Clinical relevance: The TUN + DCTG technique is a reliable and effective option for GR treatment, providing consistent clinical and aesthetic benefits. Understanding predictive factors enables clinicians to tailor treatment strategies, improving success rates and patient satisfaction.</p>","PeriodicalId":19390,"journal":{"name":"Odontology","volume":" ","pages":"1722-1732"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevention of bisphosphonate-related osteonecrosis of the jaw with basic fibroblast growth factor: an experimental study in rats.","authors":"Satoshi Kurokawa, Takahiro Yagyuu, Naoki Funayama, Mitsuhiko Imada, Tadaaki Kirita","doi":"10.1007/s10266-025-01073-w","DOIUrl":"10.1007/s10266-025-01073-w","url":null,"abstract":"<p><p>Bisphosphonate-related osteonecrosis of the jaw (BRONJ), characterized by persistent jaw bone exposure, is believed to result from the inhibition of bone remodeling and wound healing, often associated with potent intravenous bisphosphonates such as zoledronic acid (ZA). These bisphosphonates are known to significantly impact the healing of soft and bone tissues due to their anti-angiogenic properties. Our study aimed to explore whether applying the basic fibroblast growth factor (bFGF), known for its ability to promote angiogenesis and bone remodeling, over extraction sockets could prevent the onset of BRONJ in rats administered with ZA. The experimental protocol involved administering each rat with two intravenous injections of 60 μg/kg of ZA, followed by tooth extraction. Rats were then divided into two groups: the test group (n = 12), which had a mixture of 3% hydroxypropyl cellulose (HPC) and 0.3% bFGF applied over their extraction sockets, and the control group (n = 12), which received only a 3% HPC application. Wound healing was monitored for 8 weeks post-extraction and assessed using micro-computed tomography, histological evaluations, and immunohistochemical analysis of CD31- and CD105-positive vessels. Results showed a BRONJ incidence rate of 100% (12/12) in the control group, whereas the rate was significantly lower in the test group at 8.3% (1/12). Furthermore, the test group demonstrated marked increases in both angiogenesis and new bone formation. Our findings suggest that the local application of bFGF might serve as an effective therapeutic approach to prevent the onset of BRONJ following tooth extraction in patients receiving bisphosphonate therapy.</p>","PeriodicalId":19390,"journal":{"name":"Odontology","volume":" ","pages":"1427-1435"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468627","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic regulation and oxidative stress attenuation in LPS-stimulated macrophages by flavonoids.","authors":"Cristiane Duque, Natália Leal Vizoto, Gabriel Pereira Nunes, Geórgia Rondó Peres, Simone Nataly Busato Feiria, José Francisco Hofling, Luis Octavio Regasini","doi":"10.1007/s10266-025-01085-6","DOIUrl":"10.1007/s10266-025-01085-6","url":null,"abstract":"<p><p>Periodontal disease, prevalent in 20% to 50% of the population, is a chronic multifactorial inflammation caused by a dysbiotic oral biofilm, with gingivitis and periodontitis being the most common forms. Flavonoids, such as myricetin and catechin, have antioxidant and anti-inflammatory potential, reducing nitric oxide (NO) and reactive oxygen species (ROS) in lipopolysaccharide (LPS)-stimulated macrophages. This study compared the effects of different flavonoids on viability and oxidative response of LPS-stimulated macrophages. RAW 264.7 macrophages were cultured at a density of 1-5 × 10⁵ cells for 24 h. Cells were treated with flavonoids epigallocatechin gallate (EGCG), taxifolin, myricetin, pinocembrin, and kaempferol (200 to 6.25 µM) for 2 h, and evaluated for cytotoxicity, using resazurin assays. Additionally, cells were treated with flavonoids (50, 25, and 12.5 µM) for 2 h, followed by exposure to LPS (100 ng/mL or 1 µg/mL) for 72 h, and cytotoxicity determined. NO and ROS levels were quantified after 2 h of flavonoid treatment, followed by LPS exposure (1 µg/mL), compared to control dexamethasone (DEX). LPS at 1 μg/mL significantly reduced cell viability (75.26%) and in its presence, taxifolin, myricetin, and kaempferol stimulated cell metabolic activity. All flavonoids, regardless of concentration, reduced NO levels when cells were treated with LPS. The flavonoids also reduced ROS levels, with EGCG and myricetin at 50 and 12.5 μM and kaempferol at 50 μM reducing levels to below those of the untreated control, as observed for DEX. The flavonoids, particularly EGCG, taxifolin, myricetin, and kaempferol, at the concentrations tested, stimulated macrophage metabolism, and reduced NO and ROS concentrations in the presence of LPS.</p>","PeriodicalId":19390,"journal":{"name":"Odontology","volume":" ","pages":"1594-1602"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634234","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"METTL14-mediated m6A RNA methylation promotes the osteogenic differentiation of pPDLSCs by regulating WNT3A.","authors":"Lan Ma, Min Li, Guihong Xuan, Ying Dai","doi":"10.1007/s10266-025-01097-2","DOIUrl":"10.1007/s10266-025-01097-2","url":null,"abstract":"<p><p>Periodontitis is a chronic inflammatory disease that leads to the loss of periodontal supporting tissue. Furthermore, human periodontal ligament stem cells (hPDLSCs) are identified as candidate cells for the regeneration of periodontal and alveolar bone tissues. N6-Methyladenosine (m6A) performs a vital role in osteoporosis and bone metabolism. However, the role and mechanism of Methyltransferase-like 14 (METTL14) in the osteogenic differentiation of PDLSCs from periodontitis sufferers (pPDLSCs) is unclear. In this research, GSE223924 database analyzed the expression of METTL14 and Wnt Family Member 3A (WNT3A) in gingival tissue samples of 10 healthy subjects, 10 patients with periodontitis and peri-implantitis. RT-qPCR and western blot detected METTL14, COL1A1, Runx2, ALP, and WNT3A mRNA level and protein level. Osteogenic differentiation was evaluated by Alizarin Red S staining and ALP activity. MeRIP and dual-luciferase reporter assays verified interaction between METTL14 and WNT3A. GSE223924 database showed METTL14 was differentially expressed in patients with periodontitis and peri-implantitis. Furthermore, our data verified that METTL14 and WNT3A expression were decreased in pPDLSCs and were upregulated by osteogenic induction. METTL14 promoted osteogenic differentiation of pPDLSCs. METTL14 regulated WNT3A mRNA expression via m6A methylation. METTL14 facilitates osteogenic differentiation of pPDLSCs via modulating WNT3A, providing a possible target for improving alveolar bone regeneration outcomes.Highlights 1. METTL14 expression was decreased in pPDLSCs 2. METTL14 knockdown negatively regulated the osteogenic differentiation of pPDLSCs 3. WNT3A mRNA was a m6A-methylated target by METTL14.</p>","PeriodicalId":19390,"journal":{"name":"Odontology","volume":" ","pages":"1701-1711"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of craniofacial landmark plotting on magnetic resonance images.","authors":"Shailendra Singh Rana, Arti Sharma, Abhishek Gupta, Sharvari Vichare, Anjana Rajagopalan","doi":"10.1007/s10266-025-01077-6","DOIUrl":"10.1007/s10266-025-01077-6","url":null,"abstract":"<p><p>Several drawbacks of 2D radiography have been addressed by the use of 3D modalities such as CT/CBCT. However, these are associated with significantly increased radiation exposure. Hence, the role of MRI in routine orthodontic planning needs to be further investigated. The objective of the work is to evaluate feasibility of plotting cephalometric landmarks on MRI scans. 40 MRI images were collected randomly and retrospectively irrespective of age, sex, and ethnicity. For plotting purposes, 41 landmarks were found for every anonymized image separately. Two experienced orthodontists completed landmark plotting at two different time intervals. The mean error of landmark plotting, standard deviation, correlation coefficients and t-test were computed to assess the feasibility of landmark plotting on the three axes. The correlation coefficient of 0.9 indicated strong inter-observer reliability for each of the 41 landmarks on the x, y, and z axes. The paired t-test for each landmark revealed negligible differences in the orientation of the volume-rendered images. Out of all the landmarks, Porion and Orbitale had the most localization errors. MRI is a reliable tool for plotting cephalometric landmarks and thus for conducting cephalometric analyses. The landmarks' anatomical placements on the midline, bilateral, and curved structures affect how consistently they are identified. The radiation exposure to the patient for the acquisition of CT/CBCT images can be eliminated for performing 3D cephalometric analysis.</p>","PeriodicalId":19390,"journal":{"name":"Odontology","volume":" ","pages":"1502-1519"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Masticatory performance of unilateral chewing and free chewing.","authors":"Kunihisa Nakajima, Hiroshi Shiga, Hanako Uesugi, Marie Komino, Atsuko Kuramochi, Masaoki Yokoyama, Yuka Sumita","doi":"10.1007/s10266-025-01102-8","DOIUrl":"10.1007/s10266-025-01102-8","url":null,"abstract":"<p><p>This study aims to clarify whether there is a difference in masticatory performance between unilateral chewing and free chewing. The amount of glucose eluted was measured three times when 36 healthy dentate adults chewed gummy jelly for 20 s using two different chewing methods: unilateral chewing on the preferred chewing side and free chewing. The unilateral chewing cases were classified as group U (U1, U2, U3), and the free chewing cases were classified as group F (F1, F2, F3). In each group, the difference between the three measurements was investigated and inter-measurement reliability was assessed. The average of the three measured values and the difference between the largest and smallest values of the three measurements were calculated, and these were compared between group U and group F. The three measurements were similar in both groups U and F, and no significant differences were found between the measurements. Inter-measurement reliability (intraclass correlation coefficient, ICC) for group U was 0.956 for U1-U2-U3, 0.960 for U1-U2, 0.957 for U1-U3, and 0.952 for U2-U3. ICC for group F was 0.822 for F1-F2-F3, 0.832 for F1-F2, 0.871 for F1-F3, and 0.762 for F2-F3. The average of the three measured values was significantly greater in group U than in group F. The difference between the largest and smallest values of the three measurements was significantly greater in group F. These results suggested that there is a clear difference in masticatory performance between unilateral chewing and free chewing.</p>","PeriodicalId":19390,"journal":{"name":"Odontology","volume":" ","pages":"1733-1737"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In vitro comparison of marginal fit between CAD/CAM hybrid ceramic crowns and prefabricated zirconia crowns for primary molars.","authors":"Nehal Raid Salman, Nagwa Mohammad Ali Khattab, Yasser Gomaa, Ahmad Abdel Hamid Elheeny","doi":"10.1007/s10266-025-01089-2","DOIUrl":"10.1007/s10266-025-01089-2","url":null,"abstract":"<p><p>This study aimed to compare the marginal fit of the hybrid ceramic Vita Enamic (VE) crown fabricated with CAD/CAM versus prefabricated zirconia crown (PZC). An in vitro study was conducted on fifty epoxy resin replicas of 25 standardly prepared mandibular second primary molars (2 replicas for each tooth) were obtained. One tooth was restored with CAD/CAM VE (Zahnfabrik, H. Rauter GmbH & Co. KG) after an optical impression acquired using CEREC Omnicam and the other tooth restored with PZC (NuSmile, Houston, TX, USA). Specimens were sectioned buccolingually and mesiodistally. The marginal fit average was measured using a scanning electron microscope (SEM). The difference was tested for statistical significance using an independent t test at a 5% significance level and 95% CI. CAD/CAM VE crowns showed superior marginal adaptation over the PZCs with a significant difference. The mean difference at the buccolingual section was -10.52 µm with a 95% CI of -20.99; -0.05 (P = 0.049). At the mesiodistal section, the mean difference was -10.56 µm with a 95% CI of -20.82; -0.30 (P = 0.044).VE provides a superior marginal fit over the PZC in the restoration of primary molars.</p>","PeriodicalId":19390,"journal":{"name":"Odontology","volume":" ","pages":"1624-1633"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450809/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143972130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A review on innovations in hydroxyapatite: advancing sustainable and multifunctional dental implants.","authors":"Komal Gupta, Niranjan Kaushik, Vikram Sharma, Amit Singh","doi":"10.1007/s10266-025-01096-3","DOIUrl":"10.1007/s10266-025-01096-3","url":null,"abstract":"<p><p>The increasing relevance of biomaterials in medical curements and the care of aging populations has led to significant advancements in the development and modification of these materials. Hydroxyapatite (HAp), a biocompatible ceramic that mimics the composition of bone mineral, stands out for its remarkable abilities. Its stability in body fluids and ability to integrate with bone without causing toxicity or inflammation made it a prime candidate for biomedical utilization, particularly in odontology and orthopedics. Dental implants, which necessitate a strong interface with the jawbone to effectively support prosthetic devices, are enhanced by coatings of calcium phosphate-based materials like HAp. This enhances osseointegration, ensuring a strong bond and longevity of the implant. HAp may be synthesized both synthetically and from natural sources like mammalian bones, marine shells, and plants, each offering unique trace elements that improve its bioactivity. The synthesis of HAp involves differential technique, including chemical precipitation, and hydrothermal techniques, each impacting the final abilities of the material. The use of natural sources is especially promising, providing a sustainable, cost-effective alternative that retains essential biocompatibility. Hence, this article aims to explore the synthesis, properties, and biomedical applications of hydroxyapatite (HAp), with a special emphasis on its role in improving the performance and durability of dental implants. It also addresses the challenges in manufacturing and biocompatibility, offering insights into future advancements in this field. By addressing current challenges in manufacturing and biocompatibility, HAp paves the way for more effective and long-lasting dental treatments.</p>","PeriodicalId":19390,"journal":{"name":"Odontology","volume":" ","pages":"1330-1342"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"N-acetylcysteine antimicrobial action against endodontic pathogens-systematic review and meta-analysis.","authors":"Amjad Abu Hasna, Rayana Duarte Khoury, Gabriela Vieira Mendes, Cláudio Antonio Talge Carvalho, Eduardo Bresciani, Marcia Carneiro Valera","doi":"10.1007/s10266-025-01063-y","DOIUrl":"10.1007/s10266-025-01063-y","url":null,"abstract":"<p><p>Effective root canal disinfection is crucial for the success of endodontic treatment. N-acetylcysteine (NAC), known for its antimicrobial properties, has recently been investigated as a potential endodontic irrigant or intracanal medication. This systematic review aims to assess the antimicrobial efficacy of NAC in comparison to sodium hypochlorite, chlorhexidine, and calcium hydroxide against endodontic pathogens. A comprehensive search was conducted in PubMed, Scopus, Web of Science, Cochrane Library, and LILACS databases up to April 2024, without language or date restrictions. The PICO strategy for this review were as follows: population-teeth requiring endodontic treatment; intervention-NAC used as an endodontic irrigant or intracanal medication; comparison-sodium hypochlorite, chlorhexidine, and calcium hydroxide; Outcomes: reduction in microbial load, encompassing clinical and in vitro studies. Risks of bias assessment and data extraction were conducted with two reviewers independently selecting studies, extracting data, and assessing risk of bias. A general meta-analysis was performed across all included studies, with additional meta-analyses evaluating different exposure times, NAC concentrations, control groups and evaluation methods. After removing duplicates, 9170 studies were initially identified, and seven in vitro studies were included in the systematic review, of which five were included in the meta-analysis. Data were compared using standardized mean differences within a random-effects model. No clinical studies using NAC as an antimicrobial agent were identified. The overall meta-analysis demonstrated that NAC effectively reduced Enterococcus faecalis. Further meta-analyses revealed that exposure time, NAC concentration and choice of control group significantly influenced NAC's effectiveness. NAC effectively reduced Enterococcus faecalis, showing comparable antimicrobial activity to CHX and NaOCl, especially at concentrations of 25-50 mg/mL over a 7-day exposure. Despite significant heterogeneity across studies, NAC demonstrated satisfactory antimicrobial effects in vitro. This suggests that NAC merits reconsideration as an effective intracanal medication for clinical use.</p>","PeriodicalId":19390,"journal":{"name":"Odontology","volume":" ","pages":"1354-1364"},"PeriodicalIF":2.4,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143075048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}