Since 1993, the annual Congress of the College of the Italian Dental Professors (CDUO) has been the most important multidisciplinary event involving all Italian dental schools. The aim of this study was to retrospectively evaluate the characteristics and fate of the posters' abstracts presented in the editions from 2015 to 2019 under the category "Endodontics." Abstracts presented in the category Endodontics from 2015 and 2019 were retrieved from the conference proceedings and reviewed. The following data were extracted: year, title, authors, affiliation, topic and study design. PubMed, Scopus, and Google Scholar were searched to determine if each abstract was subsequently published as a full article in an indexed journal. The publication rate was calculated as well as the independent predictors of publication. 118 endodontic posters from 19 Italian dental schools were assessed. The University of Turin submitted the most, followed by Catania and Rome La Sapienza. "Mechanical Instrumentation" was the most common topic, and 82% of the studies were in vitro/ex vivo. Of the 118 abstracts, 42 (35.6%) were published in full in indexed journals. Research collaboration and affiliation with the University of Catania significantly increased likelihood of publication. The published articles (N.=39) received a total of 1093 citations. Most appeared in the Journal of Endodontics and the International Endodontic Journal. Over one-third of the endodontic abstracts presented at CDUO congresses progressed to full publication in indexed journals, generating a notable number of citations. These results highlight the solid quality of Italian endodontic research and its increasing visibility within the international scientific community.
The aim of this study was to assess the overall performance of artificial intelligence (AI) chatbots in taking the American Board of Endodontics simulated Oral Board Examination. Three oral board cases were constructed by 2 academic board-certified endodontists. Each case included a comprehensive patient profile consisting of medical history, dental history, and results of clinical testing, followed by 20 consecutive open-ended oral board-style questions. Two publicly accessible AI chatbots were selected to take the exam: GPT-4o and Gemini-2.5 Pro. Responses were scored based on a comprehensive rubric on a 4-point ordinal scale (0-3) by the same 2 examiners independently: response validity, citation validity, and overall performance score. A Cumulative Link Mixed Model (proportional odds) was used with fixed effects for chatbot and case, and random intercepts for reviewer and question to analyze and compare the performance of models, that is, inter- and intra-chatbot comparisons. Gemini-2.5 Pro and GPT-4o achieved high mean overall performance scores of 2.83 (±0.42) and 2.73 (±0.51), respectively. Cumulative Link Mixed Model showed no significant difference between the 2 chatbots in probability of receiving an excellent score (ie, 3) in response validity (odds ratio = 2.44, 95% confidence interval [0.98-6.06], P = .054) or in overall performance (odds ratio = 2.04, 95% confidence interval 0.97-4.30, P = .061). There was a positive correlation between response validity and citation validity for GPT-4o (ρ = 0.21, P = .019). Both chatbots scored considerably high in the simulated American Board of Endodontics Oral Board Examination. Results of this study support the concept of using AI chatbots as aid in endodontic education.
This scoping review aimed to map the existing literature on OHRQoL in endodontics by identifying the types of treatments investigated, measurement instruments used, and assessment time points, as well as to highlight current knowledge gaps and directions for future research. Three electronic databases (MEDLINE, the Cochrane Central Register of Controlled Trials, and Scopus) were searched until February 22, 2025. A total of 3961 records were identified; 132 were screened and assessed for eligibility, and 67 articles were included. The findings showed that (1) an increasing incorporation of patient-reported outcomes was observed, particularly in non-surgical root canal treatment; (2) the Oral Health Impact Profile-14 (OHIP-14) was the most frequently used OHRQoL instrument; (3) substantial heterogeneity was found in outcome measures and assessment time points; and (4) the lack of methodological consistency limits comparability across studies and underscores a need for standardised assessment frameworks. This scoping review highlights growing use of OHRQoL as a patient-reported outcome in endodontic research. However, substantial methodological heterogeneity limits cross-study comparability, underscoring the need for standardised outcome measures and follow-up protocols to strengthen patient-centred evidence in endodontics. Patient-reported outcomes are increasingly recognized as essential indicators of treatment success in endodontics. This review identifies significant variability in OHRQoL assessment methods, which hinders evidence synthesis and clinical applicability. The development of standardized, consensus-based outcome measures is crucial to strengthen patient-centred evidence and improve the translation of research findings into everyday endodontic care.
Disinfection is critical for regenerative endodontic procedures, yet the antibiofilm activity of root canal irrigants remains poorly characterized. This study investigated the effects of NaOCl (1, 3 and 6%) and CHX (2%) on biofilm viability and extracellular matrix composition. Multispecies biofilms were developed for 7 or 21 days and treated with CHX or NaOCl. Untreated biofilms served as controls. Biofilms were subject to multimodal assessment including (i) quantification of bacterial viability, (ii) characterization of three-dimensional architecture and (iii) quantification of extracellular matrix composition using a selective fluorescence-binding assay and confocal microscopy. Data were statistically analyzed by two-way ANOVA and Tukey multiple comparisons test, with significance set at P < 0.05 RESULTS: Both NaOCl and CHX significantly reduced biofilm bacterial viability compared to the untreated control in 7-day old biofilms (P < 0.05), with no significant difference between any NaOCl concentration and CHX (P > 0.05). However, against 21-day biofilms, all NaOCl concentrations killed significantly more bacteria than CHX (P < 0.05). All NaOCl concentrations significantly reduced biovolume compared to 2% CHX in young biofilms (P < 0.05), whereas only 3% and 6% NaOCl achieved greater reductions than CHX in mature biofilms (P < 0.05). All NaOCl concentrations significantly outperformed CHX in reducing eDNA and exopolysaccharide levels at both timepoints (P < 0.05). CHX exhibited limited antibiofilm activity against mature biofilms, while 3 and 6% NaOCl achieved superior bacterial killing and matrix disruption compared to both 1% NaOCl and CHX in mature biofilms.
Scientific articles have doubled in number during the past few years, and the number of publications has continuously increased over time. The purpose of this bibliometric analysis was to identify and analyse the top 100 most cited articles published on pulp vitality devices between 1965 and 2024. The 100 most-cited scientific papers on pulp vitality devices were searched and analysed using Elsevier's Scopus database. The search used the keywords "Dental Pulp Test," "Pulp Vitality Testing," and "Pulp Vitality Devices," with no restrictions on publication date, language, or status. A total of 1,005 articles were retrieved, and all were organized in descending order based on citation count. The articles were ordered in descending order depending on their citation counts after the screening procedure was completed by two independent reviewers. These papers were then cross matched with citations harvested from Google Scholar. The publications were examined, and data such as citation counts, citation density, publication year, authorship, contributing institutions, countries, article topic, study design and keywords were extracted. Using the Visualization of Similarities programme (VOSviewer, version 1.6.13; Leiden University Centre for Science and Technology Studies, Netherlands) collaboration networks were created between authors, nations, and keywords. The literature search identified 1005 articles. Citation counts of the top 100 articles were selected. The most-cited article received 169 total citations in Scopus and 345 citations in Google Scholar. The years 1996 and 2002 had the highest number of publications among the top 100 articles (n = 6). The articles obtained in the search were published in 28 journals, with the Journal of Endodontics contributing the maximum number of articles (n = 31). 318 were the most frequently published authors. The 100 most cited articles on pulp vitality tests originated from 22 different countries. The most common keywords used were "dental pulp test", "tooth pulp disease", laser doppler flowmetry (LDF). This study illustrates the advancement, communication and research areas in the fields of pulp vitality devices, thereby predicting potential future research directions. The Journal of Endodontics, Oral Surgery, Oral Medicine, Oral Pathology, International Endodontic Journal, and Dental Traumatology were the four main journals in terms of production volume, USA being the most productive country. Among the most-cited articles, randomised clinical trials, systematic reviews, and meta-analyses were rare.
The aim was to identify and analyse publication trends, bibliometric indicators, and research characteristics of artificial intelligence studies published in Endodontic journals. An advanced search was performed in "Web of Science All Databases" and "Scopus" employing the keywords "Endodontics", "Endodontic", "Artificial Intelligence", and "AI". Articles published in journals containing the terms "Endodontic", "Endodontics", or "Endodontology" were included. A total of 214 authors contributed to the 48 analyzed studies. MohammadRahimi, H., and Nosrat, A., were the most productive authors. The United States contributed the highest number of publications. The Journal of Endodontics was the primary outlet. Publications increased sharply between 2024 and 2025. Basic research predominated, with radiology as the dominant study field. Deep learning was the most frequently used AI methodology, particularly convolutional neural networks for radiographic diagnosis and segmentation. AI research in endodontics has expanded markedly in recent years, driven predominantly by advances in deep learning and imaging analysis.
Occurrence of post-treatment apical periodontitis characterizes the failure of endodontic treatment. This study described the histobacteriologic and histopathologic features of biopsy specimens of teeth with post-treatment apical periodontitis. The material comprised sequential biopsy specimens of 71 human root canal-treated teeth with apical periodontitis. Specimens were obtained by apical surgery or extraction and consisted of root apexes with attached lesions, which were processed for histobacteriologic and histopathologic evaluation of the cause of failure, infection distribution, and the type of lesion. Different aspects of infection were evaluated for associations with demographic, clinical, radiographic and histopathologic parameters. Intraradicular bacteria were found in the apical root canal system of 94% of the specimens, often organized in biofilm structures (79% of the cases). Infection extended to dentinal tubules and ramifications in many cases. The occurrence of biofilms in the main apical canal lumen was significantly more frequent in teeth with underfillings and inadequate root canal treatment (P < .05). An extraradicular infection occurred in 37% of the cases; in all but one case, it was associated with an intraradicular infection. Extraradicular bacteria were observed as a biofilm (sometimes with calcification foci) attached to the outer root surface and as planktonic cells or flocs at the lesion body or in the cyst lumen. Extraradicular infection was significantly more present in cases with symptoms and sinus tracts, abscesses, large lesions, and retreatment (P < .05). Nonepithelialized granuloma was the most frequent type of post-treatment apical periodontitis (42%). Intraradicular infection was the major factor associated with post-treatment apical periodontitis. Extraradicular infection was observed in about one-third of the cases, and in the large majority of them associated with concomitant intraradicular infection. Granuloma was the most common histopathologic diagnosis of posttreatment lesions.
The professional relationship between general practitioners (GPs) and endodontists is essential for high-quality patient care. The purpose of this study was to provide a dual-perspective evaluation of the referral patterns and professional perceptions held by both referring dentists (RDs) and endodontists (EDs) to identify modern barriers to effective collaboration. An anonymous 22-item online survey was distributed to EDs and RDs through professional networks and social media. The questionnaire addressed demographics, clinical workflows, and professional perceptions. Data were analyzed using Pearson chi-squared tests and binary logistic regression (p < 0.05). A total of 1,352 responses were analyzed (793 EDs, 559 RDs). Clinical procedural problems were the primary driver for referral for both RDs (47.2%) and EDs (50.7%). However, significant perceptual gaps were identified: 30% of RDs believed restorability assessment was primarily the endodontist's responsibility, compared to 20.6% of EDs (p < 0.05). Although RDs reported high satisfaction with specialist reports, 44.2% of EDs found referral letters inadequate more than 30% of the time. While both groups prioritized phone communication for relationship maintenance (RD: 51.4%; ED: 25.7%), EDs placed a significantly higher value on personal office visits (18.2%) than RDs (7.4%). Relationship termination also differed, with RDs most commonly citing patient dissatisfaction (30.7%) and EDs citing divergent treatment philosophy (40.0%) as the primary reasons for discontinuing referral. The RD-ED referral pathway is characterized by shared clinical goals but significant discrepancies in documentation expectations and responsibility for restorability. Implementing standardized referral templates and improving bidirectional communication of restorative intent are essential for reducing professional friction and enhancing the continuity of patient care.
Regenerative endodontic procedures (REPs) are biologically based approaches aimed at restoring the vitality of immature teeth with pulp necrosis. Over the past decades, these procedures have gained increasing attention. This study mapped and critically appraised the clinical trial evidence on REPs, providing an overview of research trends and methodological characteristics. A comprehensive bibliometric analysis was conducted following Bibliometric Reviews of the Biomedical Literature guidelines using the Web of Science Core Collection database. Randomized and nonrandomized clinical trials available in the database up to 2025 were included, covering the full period of indexed clinical evidence on REPs. Quantitative variables (citations, countries, journals, and keywords) and qualitative aspects (techniques, materials, irrigants, intracanal medications, and barriers) were analyzed. Among the 6,287 retrieved records, 58 clinical studies met the inclusion criteria. The most productive authors were De-Jesus-Soares A, Gomes BPFA, Kang J, Nazzal H, and Elheeny AAH. The most cited author was Xuan K, with 346 citations. Asia was the most productive continent, and the Journal of Endodontics published the highest number of studies. The most frequent keywords were regenerative endodontics, revascularization, and immature teeth. Blood clot induction was the predominant regenerative technique, while sodium hypochlorite, triple antibiotic paste, and mineral trioxide aggregate were the most commonly used irrigant, intracanal medication, and barrier material, respectively. Clinical evidence on REPs suggests a consolidation of biologically based strategies, particularly blood clot induction with mineral trioxide aggregate barriers. However, methodological heterogeneity limits the strength and comparability of findings, highlighting the need for standardized protocols and long-term randomized studies.
Regarding the limited clinical curative efficacy of CD47-targeted immunotherapy in treating oral squamous cell carcinoma (OSCC), the project aims to study the effect and mechanism of imiquimod-enhanced CD47 targeting in treating OSCC. The effect of imiquimod on enhancing the phagocytosis and clearance of OSCC cells of CD47 targeting was studied through phagocytosis experiments and cell clearance experiments. Then, the safety of the local application of imiquimod was confirmed, and the effect of imiquimod was verified in vivo by immunohistochemistry staining and tumor growth analysis. Finally, transcriptome sequencing, macrophage polarization, phagocytosis experiments, and cell clearance experiments were used to study the mechanism of imiquimod-enhanced CD47 targeting for treating OSCC. Imiquimod significantly enhances the phagocytosis and removal of OSCC cells when combined with CD47 targeting. In vivo studies have confirmed its capacity to potentiate CD47 targeting and revealed good biosafety of imiquimod. Mechanistically, imiquimod promotes M1 macrophage polarization by activating the Toll-like receptor (TLR)7-nuclear factor (NF)-κB pathway in macrophages. This activation enhanced the phagocytic capacity of macrophages to effectively remove OSCC cells. Imiquimod enhances CD47 targeting in phagocytosing and removing OSCC cells by activating macrophage TLR7-NF-κB activation and subsequent M1 polarization, providing a promising approach for treating OSCC.
Early childhood caries (ECC) continues to be a public health problem. The application of silver diamine fluoride (SDF) is a simple, non-invasive procedure. This study aims to evaluate SDF's effectiveness, acceptability and oral health-related quality of life (OHRQoL) compared with atraumatic restorative treatment in managing ECC. An open-label parallel superiority randomised clinical trial will be conducted involving children aged 2-5 years. Participants will include children with at least one active cavitated lesion (ICDAS 5+) of their primary teeth, with no signs of pulp involvement. The trial will occur at preschools in the La Araucanía and Metropolitan Regions of Chile from 2025 to 2027. The primary outcome variable will be the caries lesion arrest, acceptability and OHRQoL. We will also determine the presence of any adverse effects. Evaluations will be carried out at 6 and 12 months. A sample of 234 teeth with carious lesions per group is estimated. The primary inferential analysis will be performed on an intention-to-treat basis; a per-protocol analysis will be conducted for adverse effects. For caries lesion arrest, a multilevel logistic regression model adjusted for significant covariates will be used to account for within-child clustering. The acceptability will be assessed through quantitative and qualitative methods. The magnitude of change in OHRQoL between baseline and follow-up will be quantified using effect size estimates derived from the early childhood health impact scale survey data. This study's implementation benefits the study population, and the ethical principles of research have been considered and approved by the Science Committee of the University, Resolution N°049_19. The results and conclusions of the clinical trial will be published in academic conferences and peer-reviewed journals. NCT06786975.
A retrospective analysis of a large group of cases was conducted to examine the clinical traits of teeth subjected to intentional replantation (IR) and the factors influencing the treatment effect, so as to provide guidance for indication selection and surgical operations. A total of 445 patients, each with one affected tooth, underwent IR surgery at West China Hospital of Stomatology, Sichuan University, from 2016 to 2023, were included. Data on basic patient information, preoperative status, intraoperative procedures, and follow-up results for 107 patients with a follow-up duration exceeding 1 year were collected. Statistical analysis was performed using SPSS. The results showed that most IR patients were female (62.25%) and aged between 21 and 50 (80.45%). The predominant teeth for surgery were the mandibular second molars (44. 94%), maxillary second molars (19.33%), and maxillary lateral incisors (11.24%). The main preoperative symptoms were percussion pain (78. 65%), periodontal pockets (50.11%), sinus tract (40.45%), and tooth mobility (30.79%). The rate of completing preoperative root canal treatment was 93.71%. During surgery, 66 teeth (14.83%) had root surface cracks. Sixty-two of these teeth were not reimplanted during the operation; 47 of 62 (75.81%) had vertical root fractures. The overall success rates were 78.50%. Univariate analysis showed that the lack of periodontal pockets and the absence of bony plate defects significantly increased the success rate (P < .05). The success rate for severe coronal defects and root defects on the distal surface of the second molar was 73.68%. IR can be used for complex endodontic and periapical diseases, as well as teeth with periodontitis, serving as a viable solution for salvaging challenging teeth. The periodontal status, initial etiology, and the severity of the bony plate defect are key prognostic factors.
Persistent periapical lesions (PePL) represent a clinical challenge because of their inadequate response to conventional endodontic therapies. Studies indicate differences in immunoinflammatory mechanisms between primary periapical lesions (PrPL) and PePL but the findings remain conflicting. This study aimed to evaluate CD4+ and CD8+ T lymphocytes and the expression of immune checkpoint proteins (PD-1 and PD-L1) in PrPL and PePL, correlating the findings with the intensity of the inflammatory infiltrate and pattern of the cystic epithelial lining. Ten primary radicular cysts (PrRC), 10 persistent radicular cysts (PeRC), 10 primary periapical granulomas (PrPG), and 10 persistent periapical granulomas (PePG) were submitted to immunohistochemical analysis using anti-CD8, anti-CD4, anti-PD-1, and anti-PD-L1 antibodies. Higher median T lymphocyte counts were observed in PeRC when compared to the other groups, with a statistically significant difference in CD8+ T cells compared to PrPG (P < .05). Regarding PD-L1, PeRC exhibited higher median percentages of positivity in connective tissue and epithelial lining, which differed significantly from the other groups (P < .005). There were no statistically significant differences in the numbers of CD4+ or CD8+ T lymphocytes nor in the expression of PD-1 or PD-L1 according to morphological parameters (P > .05). Immunoexpression of PD-L1 and CD4+ T lymphocyte count showed a positive correlation in PrPL (r = .592; P < .005) and PePL (r = .532; P < .05). In the latter, PD-L1 and CD8+ T lymphocyte count were also positively correlated (r = .690; P < .001). The results suggest the involvement of PD-1 and PD-L1 in the regulation of immunoinflammatory responses in PrPL and PePL. These immune checkpoint proteins may be particularly important for the suppression of CD4+ and CD8+ T lymphocyte activities in the periapical lesions studied, contributing to their chronicity.
Hydraulic calcium silicate cement-based sealers (CSC sealers) are now frequently used with warm vertical compaction in root canal treatment. However, the impact of heat on the biological properties of CSC sealers remains unclear. Therefore, this study investigated the effects of thermal pretreatment on the material characteristics, antimicrobial activity, and cytocompatibility of CSC sealers, assessed immediately after setting and after a 28-day post-setting maturation period. An epoxy resin-based sealer (AH Plus) and two CSC sealers (AH Plus Bioceramic and BioRoot Flow) were evaluated. The sealers were heated to 100°C for 30 s and subsequently cooled to 37°C. Materials were characterized by field emission scanning electron microscopy, energy-dispersive spectroscopy, and X-ray diffraction analysis. The leaching profile, pH, surface roughness, and contact angles were also assessed. All tests were performed immediately after setting and after 28 days of post-setting maturation. The antimicrobial activity of freshly mixed and set sealers was assessed against 3-day Enterococcus faecalis biofilms by quantifying colony-forming units. The osteogenic cell line MC3T3-E1 was assessed with regard to cell viability and cell migration/proliferation following exposure to sealer leachates. Statistical analyses included one-way ANOVA with Tukey's post hoc test for group comparisons and paired t-tests for temperature and post-setting maturation period, alongside non-parametric tests where appropriate (P < .05). Microstructural changes in the CSC sealers were observed after thermal pretreatment at 100°C. Calcium ion release significantly decreased in BioRoot Flow after thermal pretreatment (P < .05). Thermal pretreatment significantly increased antimicrobial activity in AH Plus Bioceramic after a 72-hour setting period (P < .05), whereas no significant change was observed in BioRoot Flow (P > .05). Regardless of thermal pretreatment, BioRoot Flow maintained its antimicrobial activity after 28 days of post-setting maturation. Both CSC sealers maintained alkalinity for up to 28 days. No significant differences were observed between the 100°C-pretreated and 37°C control groups in cell viability or proliferation (P > .05). Thermally pretreated AH Plus Bioceramic and BioRoot Flow exhibited changes in microstructure and calcium ion release, which may affect early antimicrobial activity in a material-dependent manner, but did not influence cytocompatibility or alkalinity.
To develop and evaluate a deep learning-based system for automatic detection of the accessory mental foramen (AMF) using cone-beam computed tomography (CBCT) images, and to compare the detection accuracy and clinical reliability performance of two convolutional neural network (CNN) architectures for this model. A total of 3000 CBCT scans were retrospectively screened. After expert evaluation, 700 CBCT scans exhibiting AMFs were identified. For comparative analysis, 700 CBCT scans with normal mental-foramen anatomy were selected as the matched control group. A custom lightweight CNN and a ResNet-50 model were trained for binary classification of AMF presence. Model performance was evaluated by determining accuracy, precision, recall, and the F1-score. Gradient-weighted class activation mapping (Grad-CAM) visualisation was employed to assess the anatomical relevance of the models' attention maps. Statistical analyses were performed to compare the diagnostic performance of the two networks. The ResNet-50 model achieved superior performance (overall accuracy: 85.8% for ResNet-50 vs 71.1% for the custom CNN). With the ResNet-50 model, anomaly recall improved from 0.68 to 0.88, reducing missed detections by 63%. Grad-CAM analysis demonstrated that the models focused primarily on anatomically valid regions around the MF, confirming the interpretability and clinical relevance of the models. Automatic detection of the AMF using CBCT and deep learning represents a reliable, objective, and efficient diagnostic approach that minimises observer bias and enhances clinical decision-making. Deep learning-based detection of AMFs on CBCT can enhance diagnostic accuracy and reduce the risk of surgical complications by providing consistent, observer-independent evaluations.
Oral mucositis is a frequent adverse effect of chemotherapy that significantly affects patients' quality of life and treatment continuity. Despite its clinical relevance, effective preventive strategies remain limited. This study aims to compare the efficacy and safety of betamethasone mouthwash with those of sodium gualenate hydrate mouthwash for preventing chemotherapy-induced oral mucositis. This Phase II, multicenter, open-label, randomized controlled trial aims to enroll 296 adult patients (≥18 years) undergoing chemotherapy for solid tumors (excluding head and neck and hematological cancers). Participants will be randomized 1:1 into two arms: a betamethasone mouthwash (intervention) group and a sodium gualenate hydrate mouthwash (control) group. The primary outcome is the prevention of Grade 1 oral mucositis, assessed using the Common Terminology Criteria for Adverse Events v3.0 and v5.0. Secondary outcomes include prevention of Grade 2-3 oral mucositis, the incidence of oral candidiasis, and chemotherapy completion rates. Data will be analyzed using Kaplan-Meier survival curves, log-rank tests, and Cox regression models. This study aims to establish betamethasone mouthwash as an effective preventive strategy for potentially enhancing the quality of life of patients with cancer. This study was registered with the Japan Registry of Clinical Trials on September 20, 2024 (jRCTs071240060).
This study aimed to investigate a novel quantitative adenosine triphosphate assay, to evaluate organic debris/bacterial reduction after irrigation activation with passive ultrasonic irrigation and the XP-endo Finisher (XPF), and to compare its efficacy with traditional colony-forming unit (CFU) detection in vitro. The root canals of 40 extracted single-canal teeth were shaped to a 30.04 using NiTi files. Following inoculation of the root canals with Enterococcus faecalis for 3 weeks, the teeth were randomly allocated into 2 experimental groups (n = 20): (1) activation of 5.25% NaOCl using passive ultrasonic irrigation, or (2) activation using the XPF. The quantitative adenosine triphosphate assay (Endocator) was used before and after the irrigant activation protocols to determine the amount of bacteria/organic debris present. Data were analyzed using the Student t test and the Mann-Whitney U test (P = .05). The Endocator raw score exhibited a strong correlation with the number of bacteria present, as determined by CFU counts (R2 = 0.99). In contrast, Endoscore values showed a high correlation with the logarithmically transformed CFU counts (R2 = 0.95). The amount of intracanal organic debris/bacteria remaining after the passive ultrasonic irrigation and XPF protocols was approximately 1.7% and 1.2%, respectively. No statistically significant differences were observed between the groups regarding the amount of residual bacteria remaining in the canals after the irrigation protocols (P > .05). Both irrigation activation systems were similarly effective in removing organic debris/bacteria from the root canal system following final irrigation. None of the tooth samples was completely free of bacterial or organic debris residues after treatment with either of the tested systems.
Perforating inflammatory root resorption (PIRR) in permanent teeth can cause extensive dentin loss, periodontal breakdown, and eventual tooth loss. Regenerative endodontic procedures (REPs) have been proposed to treat PIRR. Among them, cellular therapy based on transplantation of mesenchymal stromal cells (MSCs) has been suggested as a potential option for treating PIRR, because of their paracrine and anti-inflammatory effects during tissue repair. A 13-year-old girl presented with a traumatized tooth #9 showing discoloration, a buccal sinus tract, 8-mm probing depth, tenderness to percussion, and nonresponse to thermal and electric tests; after unsuccessful REP. Radiography and cone-beam computed tomography (CBCT) revealed a large PIRR extending from the cervical to apical third of the root, communication with the periodontium, lateral perforation, and complete loss of buccal alveolar bone in the apical third. All of this was consistent with the presence of PIRR, pulp necrosis, and chronic apical abscess. The canal was disinfected with NaOCl, EDTA, and intracanal calcium hydroxide. Allogeneic MSCs were thawed, cultured, expanded, included in platelet-rich plasma clot, and transplanted into the canal, followed by a Biodentine coronal plug and composite restoration. The tooth was followed-up for 48 months. The sinus tract resolved after 1 month, and buccal probing depth normalized and remained stable throughout follow-up. Radiographs and CBCT showed infilling of the resorptive defect with mineralized tissue, re-establishment of the periodontal ligament space, and buccal bone healing over 4 years. The tooth became asymptomatic and consistently responded to electric pulp testing, while responses to cold testing were variable. This single case shows that allogeneic MSC transplantation may promote long-term healing of PIRR with pulp necrosis and chronic apical abscess in young permanent teeth. Controlled clinical studies are required to confirm the capacity of healing PIRR by MSCs.
The present study aimed to compare the use of conventional freehand access cavity preparation with the static-guided (SG) endodontic technique in terms of its ability to locate and negotiate root canals, iatrogenic errors (perforations), and the amount of tooth structure loss while treating single-rooted traumatized teeth with pulp canal calcifications. This randomized clinical trial was registered in the Clinical Trial Registry of India (https://ctri.nic.in, CTRI/2024/01/061580). A total of 30 patients with traumatized teeth exhibiting calcified root canals were included in the study. The patients were randomly divided into 2 groups as follows: SG endodontic technique and conventional freehand technique. Following the completion of the treatments, the cases were evaluated as either successful (canal located) or failed (perforation or canal not located). In addition, the amount of removed tissue was calculated on the postoperative radiographs using ImageJ software (National Institutes of Health, Bethesda, MD). Chi-square and Mann-Whitney U tests were performed to analyze the data (P = .05). In the SG endodontic group, the root canals were located in all teeth, while in the conventional freehand approach, 13% of cases reported failure to locate the root canals. The tooth sturucture loss was significantly lower in the SG approach compared to the conventional freehand approach (P < .05). The conventional freehand technique caused three times more tooth structure loss compared to the SG endodontic approach. There were no failed cases in the SG endodontic technique group, and all root canals were successfully located.
This paper explores the historical evolution of dentistry through the lens of eponyms, focusing particularly on endodontics. From the era of extractions to the introduction of restorations by Pierre Fauchard and the development of prosthodontics and root preservation in the 19th century, dentistry has advanced in parallel with scientific breakthroughs in microbiology and technology. These innovations enabled the understanding and treatment of pulpal disease and the creation of effective root canal techniques. We highlight 31 key eponyms-32 individuals whose contributions to instruments, methods, materials, or classifications shaped modern endodontics and whose legacies remain embedded in practice.