Journal Of Endodontics[JOURNAL]
Sun
200 papers
Histologic Study of a Human Immature Permanent Premolar with Chronic Apical Periodontitis after Regenerative Endodontic Procedures.
Yang F, Zhu X, Tan X … +2 more , Wang J, Xie F
J Endod · 2026 Apr · PMID 41967634 · Publisher ↗
The histologic outcomes of regenerative endodontic procedures (REPs) in humans remain debated, with evidence varying between cementum-/bone-like tissue and true pulp-dentin complex regeneration. Here, we present a case o...
The histologic outcomes of regenerative endodontic procedures (REPs) in humans remain debated, with evidence varying between cementum-/bone-like tissue and true pulp-dentin complex regeneration. Here, we present a case of a 10-year-old girl who underwent REPs for a maxillary premolar (tooth #4) diagnosed as symptomatic irreversible pulpitis with symptomatic apical periodontitis. At the 8-month follow-up, the patient was asymptomatic with radiographic evidence of apical closure and dentinal wall thickening; the tooth was subsequently extracted due to orthodontic indications, along with the sound contralateral premolar (tooth #12) as control. Micro-computed tomography confirmed apical closure and dentinal wall thickening with heterogeneous intracanal mineralization in tooth #4. Histologic examination revealed dentin-like tissue with tubular structures, surfaced by flattened, dentin sialophosphoprotein-positive cells. Neurovascular regeneration assessed by CD31/PGP9.5 co-localization was sparse and disorganized compared to the normal control. Osteoid tissue ingrowth was present in the apical region. This case demonstrates that REPs can yield structurally disorganized pulp-dentin-like tissue, highlighting the key challenge of achieving true histologic regeneration.
Interpreting Research Findings in Endodontics: A Biostatistical Primer.
Farajollahi M, Azarpazhooh A, Nosrat A … +2 more , Saber Tahan S, Peters OA
J Endod · 2026 Apr · PMID 41966447 · Publisher ↗
Statistical significance testing has long been the dominant method for making inferences in dental and endodontic research. Null hypothesis significance testing assesses how compatible the data are with a null hypothesis...
Statistical significance testing has long been the dominant method for making inferences in dental and endodontic research. Null hypothesis significance testing assesses how compatible the data are with a null hypothesis. It does not prove a hypothesis to be true or false. This method has been criticized because it relies on the P-value, which is commonly misused, misinterpreted and provides limited information about the data. Therefore, it is recommended to complement null hypothesis significance testing with effect sizes and their confidence intervals to support a more informative interpretation of the results. This biostatistical primer focuses on endodontics and presents practical guidance on interpreting study findings from a clinical perspective. The paper addresses the common pitfalls of interpreting results based solely on the P-value and explains the importance of incorporating effect size and the associated confidence interval to determine the magnitude, direction, precision, and clinical relevance of the observed effect. This biostatistical guide provides a critical approach to interpreting research findings by using endodontic literature to translate statistical concepts into clinically meaningful interpretations. Overall, a shift away from binary significance testing based solely on P-values toward comprehensive measures is suggested to improve the translation of research into practice and ultimately support more informed, patient-centered clinical decision-making in endodontics.
Recommended Guidelines of the American Association of Endodontists for the Treatment of Traumatic Dental Injuries.
Sigurdsson A, Blicher B, Miller AJ … +4 more , Singh V, Teixeira FB, Williamson AE, Bourguignon C
J Endod · 2026 Apr · PMID 41941956 · Publisher ↗
Abstract loading — click title to view on PubMed.
Insights into the April 2026 Issue of the JOE.
Aminoshariae A, Azarpazhooh A, Glickman GN … +9 more , He J, Kim SG, Kishen A, Letra AM, Levin L, Ordinola-Zapata R, Setzer FC, Tay FR, Hargreaves KM
J Endod · 2026 Apr · PMID 41932789 · Publisher ↗
Abstract loading — click title to view on PubMed.
Hydrophilic Polymer-Modified Poly(ε-caprolactone)/Hydroxyapatite Three-dimensional-Printed Scaffolds with Enhanced Hydrophilicity and Biodegradability for Regenerative Endodontic Applications.
Kim YR, Kim YS, Kang JH … +2 more , Park C, Lee BN
J Endod · 2026 Jul · PMID 41905722 · Publisher ↗
INTRODUCTION: Poly(ε-caprolactone) (PCL) is widely used as a scaffold material for tissue regeneration; however, its intrinsic hydrophobicity and slow biodegradation limit cell adhesion and tissue remodeling. This study...
INTRODUCTION: Poly(ε-caprolactone) (PCL) is widely used as a scaffold material for tissue regeneration; however, its intrinsic hydrophobicity and slow biodegradation limit cell adhesion and tissue remodeling. This study aimed to improve the hydrophilicity and biodegradability of PCL-based scaffolds by incorporating the hydrophilic polymer poloxamer 407 (P407) while maintaining mechanical stability through hydroxyapatite (HA) reinforcement. The composite system was designed as a bioactive platform for dentin-pulp complex regeneration and other regenerative endodontic applications. METHODS: Disc-shaped scaffolds with approximately 65% porosity were fabricated via fused deposition modeling-based 3D printing at varying PCL/HA/P407 ratios (P, PH, PHP1, PHP2, and PHP3). Physicochemical and biological properties-including printability, hydrophilicity, degradation, and mechanical strength-were analyzed using rheology, contact angle measurement, degradation testing, field-emission scanning electron microscopy, thermogravimetric/differential thermal analysis, compressive testing, and Fourier transform infrared spectroscopy. Human dental pulp stem cells (hDPSCs) were cultured to assess cell adhesion, proliferation, and osteo/odontogenic differentiation through alkaline phosphatase activity and alizarin red S staining. RESULTS: P407 incorporation significantly enhanced scaffold hydrophilicity and degradation while maintaining mechanical strength. The optimal P407 concentration (PHP2) showed improved hDPSCs adhesion, proliferation, and mineralized matrix formation without cytotoxicity. Increased alkaline phosphatase activity and calcium deposition indicated a favorable microenvironment for early osteo/odontogenic differentiation. CONCLUSION: The P407-incorporated PCL/HA composite scaffold exhibited balanced mechanical stability, enhanced hydrophilicity, and tunable biodegradability, supporting favorable hDPSCs responses. These results suggest its potential as a promising scaffold for dentin-pulp complex regeneration and broader tissue engineering applications in regenerative endodontics.
Automated Detection of Middle Mesial Canals in Mandibular Molars on CBCT using nnU-Net: A Retrospective Diagnostic Accuracy Study.
Turp ŞS, Er K, Çakmak YE … +2 more , Varol N, Yilmaz SG
J Endod · 2026 Mar · PMID 41903680 · Publisher ↗
BACKGROUND: This study aimed to develop and validate a fully three-dimensional (3D) convolutional neural network for automated detection of the mid-mesial canal (MMC) in mandibular molars on cone-beam computed tomography...
BACKGROUND: This study aimed to develop and validate a fully three-dimensional (3D) convolutional neural network for automated detection of the mid-mesial canal (MMC) in mandibular molars on cone-beam computed tomography (CBCT). METHODS: In this retrospective diagnostic accuracy study, 248 CBCT volumes were used for model development, with an independent test set of 28 cases (1.611 axial slices). Ground-truth MMC status was defined by endodontist-radiologist consensus; multiclass manual masks (dentin, mesiobuccal-, mesiolingual-, and mid-mesial-canal) were created in 3D Slicer. A 3D nnU-Net-based model was trained using canal-focused patch sampling and a combined Dice plus weighted cross-entropy loss. MMC detection was evaluated at slice and case levels using sensitivity, specificity, accuracy, positive predictive value/negative predictive value, and Cohen's κ; paired comparisons used McNemar's test. RESULTS: Interobserver agreement for slice-level MMC labeling was excellent (κ = 0.892). For case-level MMC detection using a prespecified threshold (≥5 AI-positive slices), performance was sensitivity 94.7%, specificity 100%, accuracy 96.4%, and κ = 0.920. At slice level, agreement remained high versus individual observers (κ ≈ 0.80) and consensus references (κ = 0.812 for OR; κ = 0.792 for AND). No significant difference was observed between AI and the OR-consensus reference at slice level, nor between AI and the case-level ground truth. CONCLUSIONS: A fully 3D nnU-Net framework achieved clinician-level MMC detection on CBCT and may support standardized, efficient identification of this frequently overlooked anatomical variation.
Differential Healing Patterns of Odontogenic Maxillary Sinusitis Following Nonsurgical Endodontic Therapy: A Cone-Beam Computed Tomography-Based Case Series.
Yang G
J Endod · 2026 Jul · PMID 41903679 · Publisher ↗
This case series evaluated the differential healing patterns of maxillary sinus mucosa and periapical bone following nonsurgical root canal treatment for odontogenic maxillary sinusitis to propose a prognostic perspectiv...
This case series evaluated the differential healing patterns of maxillary sinus mucosa and periapical bone following nonsurgical root canal treatment for odontogenic maxillary sinusitis to propose a prognostic perspective based on distinct radiographic features. Ten cases of odontogenic maxillary sinusitis managed by primary nonsurgical root canal treatment or retreatment were categorized into 4 radiographic patterns based on periapical and sinus lesions. Clinical symptoms were recorded, and radiographic healing was assessed using cone-beam computed tomography (CBCT) at baseline and during follow-up periods ranging from approximately 3-17 months. All cases showed clinical symptoms recovery and sinus opacities radiographic resolution. Maxillary sinus mucosal lesions, including extensive opacification and sinus floor perforations, resolved to a normal physiological thickness (<2 mm) within approximately 3 months. Conversely, periapical alveolar bone regeneration required a longer progress (approximately 3-17 months) to demonstrate radiographic healing. Cases with extensive bone destruction or periosteal displacement (periapical osteoperiostitis/halo sign) showed delayed bone healing. Within the limits of this case series, maxillary sinus mucosa appears to heal faster than periapical tissues, typically resolving within 3 months. Although periapical radiographs remain useful for evaluating sinus floor perforation and extensive bone destruction, CBCT offers superior three-dimensional assessment in anatomically complex cases or when radiographs are inconclusive. We suggest that, in selected cases, early postoperative CBCT evidence of mucosal resolution (approximately 3 months) may be considered as an adjunctive early indicator of treatment response, while acknowledging that periapical bone regeneration often lags and requires longer follow up.
Micro-CT Study of Shaping Behavior of ProTaper Ultimate, TruNatomy and Reciprocating WaveOne Gold in Severely Curved Root Canals.
Bago I, Katić M, Milanović-Litre M … +2 more , Gambarini G, Zdrilić IV
J Endod · 2026 Mar · PMID 41887503 · Publisher ↗
INTRODUCTION: To analyze the canal transportation and centering ability of rotary, ProTaper Ultimate (PTU) and TruNatomy (TRN), and reciprocating WaveOne Gold (WOG) instrumentation systems in curved root canals. METHODS:...
INTRODUCTION: To analyze the canal transportation and centering ability of rotary, ProTaper Ultimate (PTU) and TruNatomy (TRN), and reciprocating WaveOne Gold (WOG) instrumentation systems in curved root canals. METHODS: Forty-two upper human molars with curved mesiobuccal canals (30°-40°) were selected. The samples were assigned into 3 groups based on the instruments used: Group 1. PTU up to F2, 25/08; Group 2. TRN Primary file 26/04; Group 3. WOG Primary file 25/07. For irrigation, 3% sodium hypochlorite (NaOCl) was used throughout the instrumentation. Final irrigation protocol included 3% NaOCl, followed by 15% ethylenediaminetetraacetic acid and NaOCl. Each sample was scanned by micro-computed tomography (μCT) before and after the chemomechanical instrumentation. On μCT scans, the canal transportation and centring ability of the instrumentation systems were calculated at the levels of 3, 5, and 7 mm from the apex. Analysis of variance with Bonferroni test were used for the statistical analysis with the P value set at 0.05. RESULTS: There were no significant differences between the instrumentation systems regarding their centering ability and transportation (P > .05). PTU showed significantly better centering in the coronal third (mean 0.595 mm) compared with WOG (mean 0.329 mm; P = .035). Regarding canal transportation at different canal levels, no significant difference between the groups was found (P > .05). CONCLUSIONS: All tested instrumentation systems showed similar canal transportation, with one exception; PTU showed better centring ability in the coronal third. The study confirmed that different manufacturing and design features, if properly combined, may all result in valid operative sequence and proper shaping.
Morphometric Mapping of Mandibular Incisor Root Canals and Its Implications for Instrument Size-taper Selection.
Lima CO, Silva EJNL, Maciel LV … +3 more , Montan JB, Barbosa AFA, Versiani MA
J Endod · 2026 Jul · PMID 41887502 · Publisher ↗
INTRODUCTION: This study aimed to characterize the morphology of mandibular incisor root canals and to evaluate their correspondence with commonly used nickel-titanium (NiTi) instruments. METHODS: One hundred extracted h...
INTRODUCTION: This study aimed to characterize the morphology of mandibular incisor root canals and to evaluate their correspondence with commonly used nickel-titanium (NiTi) instruments. METHODS: One hundred extracted human mandibular incisors were scanned using high-resolution micro-computed tomography. Minor and major canal diameters and aspect ratios were measured at 1-mm intervals from the apical foramen to 10 mm coronally. Canal cross-sections were classified as round, long-oval, or flat based on aspect ratio. A supplementary analysis determined the percentage frequency of canals with diameters equal to or smaller than a wide range of size-taper combinations of constant-taper NiTi instruments. An 80% frequency threshold was applied to identify meaningful correspondence between canal dimensions and instrument sizes. Descriptive statistics were calculated, and the association between major and minor diameters was assessed using Pearson's correlation coefficient. RESULTS: Both minor and major canal diameters increased progressively in the coronal direction, although enlargement of the major diameter was more pronounced from the middle third coronally. Round canals predominated in the apical region, whereas long-oval canals were most prevalent in the middle and coronal thirds; flat canals occurred mainly between 6 and 7 mm from the apex. Correspondence between NiTi instruments and the minor canal diameter depended strongly on instrument taper, with larger tapers required for smaller tip sizes to reach the 80% threshold. In contrast, correspondence with the major canal diameter was markedly limited across all instrument sizes and tapers, with no instrument achieving ≥80% correspondence along the entire root length. The correlation between minor and major canal diameters was weak, indicating disproportionate enlargement of canal dimensions. CONCLUSIONS: Mandibular incisors present pronounced anatomical asymmetry, particularly in the middle and coronal thirds, resulting in limited correspondence between conventional NiTi instruments and the major canal diameter.
Filling Capability of Different Obturation Techniques for the Sealing of Internal Root Resorption Located in the Middle Root Canal Third - An In Vitro Study.
García-Gavilá TB, Ruiz-Sánchez C, Gutiérrez Ortega C … +6 more , Muñoz-Santoro T, Urteaga XM, Cortés-Domínguez I, Abella Sans F, Zubizarreta-Macho Á, Faus-Matoses V
J Endod · 2026 Mar · PMID 41887501 · Publisher ↗
INTRODUCTION: The aim of this study was to compare the filling ability of different root canal obturation techniques for the sealing of internal root resorption (IRR) located in the middle root canal third. METHODS: Thir...
INTRODUCTION: The aim of this study was to compare the filling ability of different root canal obturation techniques for the sealing of internal root resorption (IRR) located in the middle root canal third. METHODS: Thirty maxillary central incisors were printed based on the standard tessellation language digital file obtained from a preoperative cone beam micro-computed tomography, which was edited to design IRRs in the middle root canal third (n = 30). Subsequently, the group was randomly subdivided according to the following obturation techniques: Group A: rigid carrier-based technique (n = 10) (GuttaCore); Group B: warm vertical condensation technique (n = 10) (Calamus); and Group C: single-cone technique with bioceramic cement (n = 10) (Bioceramic). Subsequently, postoperative micro-computed tomography scans were performed and extracted files were quantified using Fiji/ImageJ software The following volumetric parameters were quantified: channel resin volume (mm3), IRR "sphere" resin volume (mm3), "root" volume (without sphere) (mm3), residual resin volume (mm3) and total resin volume (mm3). Differences among the root canal filling techniques were evaluated using analysis of variance (ANOVA). RESULTS: ANOVA revealed statistically significant differences in the resin penetration volumes between the different obturation techniques evaluated for the "channel," resorptive cavity "sphere," "root," and "residual" resin volumes (mm³) (P = .0001, P = .0001, P = .0065, and P < .0001, respectively). CONCLUSIONS: The warm vertical condensation technique demonstrated a sealing ability comparable to that of the single-cone bioceramic technique in cases of IRR located in the middle third of the root canal system, as well as the overall root canal system, when compared to the GuttaCore carrier-based obturation technique.
Post-treatment Apical Periodontitis: Histobacteriologic and Histopathologic Findings.
Ricucci D, Campello AF, Milovidova I … +2 more , Rôças IN, Siqueira JF
J Endod · 2026 Jun · PMID 41865833 · Publisher ↗
INTRODUCTION: 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 wit...
INTRODUCTION: 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. METHODS: 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. RESULTS: 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%). CONCLUSIONS: 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.
Herpes Zoster of the Maxillary Division of the Trigeminal Nerve Presenting as Endodontic Post-treatment Pain: Case Report and Review of the Literature.
Lin J, Jalali P, Teixeira FB … +4 more , Lin Y, Allen SP, Hanson J, Wang FM
J Endod · 2026 Mar · PMID 41862013 · Publisher ↗
Herpes zoster (HZ), caused by the reactivation of varicella zoster virus, presents a major diagnostic challenge in dentistry, particularly when involving the trigeminal nerve. The prodromal symptoms of HZ can closely res...
Herpes zoster (HZ), caused by the reactivation of varicella zoster virus, presents a major diagnostic challenge in dentistry, particularly when involving the trigeminal nerve. The prodromal symptoms of HZ can closely resemble endodontic pain, leading to misdiagnosis and delayed appropriate treatment. This case report described a 54-year-old male who presented to the emergency dental clinic with severe unilateral, radiating maxillary pain originating from posterior to anterior teeth. Initially diagnosed with symptomatic apical periodontitis on a previously endodontically treated tooth #3, the patient's condition underwent a shift in diagnosis 2 days later when a unilateral vesicular rash appeared along the maxillary division of the trigeminal nerve. The patient's acute nonodontogenic pain attributed to HZ was successfully managed through systemic antiviral and adjunctive therapies without endodontic intervention on tooth #3. While the acute symptoms of HZ were resolved, the patient subsequently developed postherpetic neuralgia and enduring sensory disturbances. A comprehensive review of the literature revealed that beyond postherpetic neuralgia, patients may experience other complications manifesting years after the HZ episode, including pulp necrosis, root resorptions, and osteonecrosis. It is evident that early recognition and diagnosis are paramount in the treatment of HZ. Understanding orofacial manifestations and effective management of HZ are crucial to prevent diagnostic mistakes, ensure optimal patient care and mitigate potential complications.
Biological Matrices Promote Odontoblastic Markers Expression in Stem Cells from Apical Papilla: An In Vitro Study.
Caro JC, Bucchi C, Ponce N … +3 more , Villena J, Palacios-Muñoz A, García IE
J Endod · 2026 Jun · PMID 41862012 · Publisher ↗
INTRODUCTION: Odontoblastic differentiation is a cellular process that requires signaling molecules and extracellular matrix components provided by the dentin-pulp microenvironment. Several scaffolds have been proposed t...
INTRODUCTION: Odontoblastic differentiation is a cellular process that requires signaling molecules and extracellular matrix components provided by the dentin-pulp microenvironment. Several scaffolds have been proposed to induce odontoblast differentiation for pulp regeneration. This study evaluated the ability of collagen sponge and decellularized dental pulp, along with dentin, to promote the expression of odontoblastic markers in stem cells from the apical papilla (SCAPs). METHODS: Experimental groups consisted of 2 different biological matrices: (1) human decellularized dental pulp seeded with SCAP cells in the presence or absence of dentin discs (n = 3), and (2) commercial collagen sponge seeded with SCAP cells in the presence or absence of dentin discs (n = 3), and their respective controls (no seeded matrices). Cultures were placed on a dentin disc model and maintained in a 3-dimensional cell culture for 4 weeks. Thereafter, the samples were processed for histological analysis. Cell expression of odontoblastic markers was assessed on hematoxylin-eosin staining and immunohistochemistry using anti-dentin sialophosphoprotein (DSPP), anti-dentin matrix protein 1 (DMP1), and anti-alkaline phosphatase (ALPL) antibodies. Both qualitative and exploratory quantitative analysis were performed. RESULTS: SCAPs cultured in the decellularized human dental pulp matrix and in the collagen sponge expressed DSPP, DMP1, and ALPL markers. Based on qualitative analysis and exploratory numerical data, the presence of dentin disc appeared to enhance DMP1 expression in the decellularized matrix and collagen sponge groups, while reducing ALPL levels in the decellularized matrix group. CONCLUSIONS: Within the limitations of this study, both decellularized pulp scaffolds and collagen scaffolds supported odontoblastic marker expression in SCAPs. Considering its cost-effectiveness and widespread availability, commercial collagen may be considered a suitable scaffold for regenerative applications. However, further studies are required to confirm these findings.
Six-month Evaluation of Tooth Discoloration Induced by Bioceramic Sealers using Spectrophotometer and Digital Image Analysis: An In Vitro Study.
Karadayi A, Uzun HB, Kutlu Basmaci G … +2 more , Tüter Bayraktar E, Sazak Ovecoglu H
J Endod · 2026 Jun · PMID 41856469 · Publisher ↗
INTRODUCTION: This study aimed to evaluate the discoloration potential of 3 calcium silicate-based endodontic sealers using spectrophotometer and cross-polarized digital image analysis. MATERIALS AND METHODS: Twenty-eigh...
INTRODUCTION: This study aimed to evaluate the discoloration potential of 3 calcium silicate-based endodontic sealers using spectrophotometer and cross-polarized digital image analysis. MATERIALS AND METHODS: Twenty-eight extracted maxillary anterior teeth were randomly allocated to 3 sealer groups (VDW.1Seal, Bio-C Sealer, and CeraSeal) and a control group (n = 7). Color measurements were performed before treatment, immediately after treatment, and at 1 day, 1 week, 1 month, 2 months, 3 months, and 6 months post-treatment using spectrophotometer and standardized digital image analysis with cross-polarization. Measurements were obtained from the cervical, middle, and incisal regions. Color differences were calculated using the CIEDE2000 (ΔE00) formula. Repeated-measures data were analyzed using Aligned Rank Transform analysis of variance (ANOVA) followed by Bonferroni-adjusted post hoc tests (α = 0.05). RESULTS: Both measurement methods demonstrated a significant increase in ΔE values over time in all groups (P < .05). The control group consistently showed significantly lower ΔE values than all material-treated groups at all time points. Spectrophotometric analysis revealed no significant differences among the experimental sealers. In contrast, digital image analysis detected significant inter-material differences at selected time points, with the Bio-C Sealer group exhibiting the highest overall discoloration. Measurements also revealed greater discoloration in the cervical region compared with the middle and incisal regions. CONCLUSION: Within the limitations of this in vitro study, all evaluated calcium silicate-based sealers were associated with tooth discoloration. Color changes became more evident after the third month and remained within clinically perceptible limits at 6 months. While both spectrophotometric analysis and cross-polarized digital imaging demonstrated similar trends, digital imaging showed greater sensitivity in detecting color changes.
Blood Metallomic and Histologic Organs Analysis in Induced Periapical Lesion Model: In Vivo Animal Study.
Leutz ACN, da Costa MCV, Prodocimo MM … +7 more , Pereira JS, Janini ACP, Soares AJ, Gomes BPFA, Tartari T, Pelepenko LE, Marciano MA
J Endod · 2026 Jun · PMID 41825772 · Publisher ↗
INTRODUCTION: Ten essential metallic elements play key roles in metabolic and biological processes, and their levels may vary in pathologic conditions. Apical periodontitis is a common endodontic disease with systemic re...
INTRODUCTION: Ten essential metallic elements play key roles in metabolic and biological processes, and their levels may vary in pathologic conditions. Apical periodontitis is a common endodontic disease with systemic repercussions; however, no studies have assessed its influence on systemic metallic element concentrations compared with healthy conditions. This study aimed to investigate such variations in whole blood and evaluate liver and kidney histopathologic alterations. METHODS: Thirty-eight animals were allocated into periapical lesion (n = 19) and sham (n = 19) groups. Lesions were induced for 40 days, while the sham group underwent same procedures without induction. Whole blood was collected via intracardiac puncture for biochemical and metallomic analysis by inductively coupled plasma optical emission spectrometry, calibrated for sodium, potassium, magnesium, calcium, iron, manganese, cobalt, copper, zinc, and molybdenum. Liver and kidney samples were processed for histology with different staining protocols. Statistical analyses were performed at a 5% significance level. RESULTS: Radiographic analysis confirmed lesion formation. Inductively coupled plasma optical emission spectrometry revealed significantly higher calcium concentrations in the lesion group (P < .05). Biochemical tests showed reduced total bilirubin (P < .05) and direct bilirubin (P < .05), along with elevated alanine aminotransferase (P < .05) and creatinine (P < .05). Histology demonstrated mild hepatic inflammation and pronounced renal injury, including tubular necrosis, indicating systemic repercussions. CONCLUSIONS: Periapical lesions systemically alter metallomic and haematologic homeostasis, with calcium dysregulation in whole blood and histopathologic organ damage confirming their systemic inflammatory impact. Within animal model limitations, findings indicate potential association between apical periodontitis and systemic alterations.
Healing of Perforating Inflammatory Root Resorption by Allogeneic Bone Marrow Mesenchymal Stromal Cells Transplantation: A Case Report.
Gomez-Sosa JF, Wittig O, Diaz-Solano D … +1 more , Cardier JE
J Endod · 2026 Jun · PMID 41812761 · Publisher ↗
INTRODUCTION: 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 propos...
INTRODUCTION: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.
Accuracy and Efficiency of 4 Guided Techniques for Calcified Canal Access: An In Vitro Study with a Novel 3D-printed Model.
Shi Y, Yan M, Sun Q … +8 more , Suo X, Miao L, Zhang C, Zhang Y, Zhang J, Yan M, Yu J, Wu J
J Endod · 2026 Mar · PMID 41812760 · Publisher ↗
INTRODUCTION: Pulp canal calcification (PCC) remains a significant clinical challenge in root canal treatment. This in vitro study used a self-designed reusable 3D-printed calcified root canal model to evaluate the accur...
INTRODUCTION: Pulp canal calcification (PCC) remains a significant clinical challenge in root canal treatment. This in vitro study used a self-designed reusable 3D-printed calcified root canal model to evaluate the accuracy and efficiency of four PCC access preparation methods: freehand, static navigation, dynamic navigation, and robot-assisted (RA) navigation. METHODS: The study utilized a self-designed 3D-printed model that simulates the clinical characteristics of PCC and achieves precise positioning. A total of 192 resin models were used, and 4 cavity preparation methods were performed by specialists and inexperienced operators on maxillary and mandibular models, respectively. Using 3D reconstruction technology, the differences in offset angle, operation time, and tooth tissue loss among the groups were compared. RESULTS: A reusable, standardized PCC model was successfully fabricated. Significant differences were observed among the four methods (P < .05). RA demonstrated the best overall performance, with an angular deviation of 1.31 ± 0.32°, an operation time of 12 ± 2 s, and a tooth substance loss of 9.03 ± 0.57 mm, followed by the static navigation group, while freehand was the poorest performer. RA significantly narrowed the experience gap among operators, enabling novice operators to reach the expert level (P < .05) and compensated for mandibular anatomical difficulties, ensuring consistent accuracy between maxillary and mandibular models (P < .05). CONCLUSIONS: The self-designed PCC model has excellent wear resistance and reusability, and the RA-centered digital system advances endodontic treatment toward precision, minimal invasiveness, and standardization. It provides a promising clinical option for PCC management.
Influence of Sodium Hypochlorite Heating Method, Activation Technique, and Concentration on Organic Tissue Removal in Simulated Internal Resorption Cavities.
Bayındır E, Sarıyılmaz Ö, Sessiz R
J Endod · 2026 Jun · PMID 41796794 · Publisher ↗
INTRODUCTION: This in vitro study aimed to evaluate the effects of sodium hypochlorite (NaOCl) heating method, activation technique, and concentration on organic tissue removal from simulated internal resorption cavities...
INTRODUCTION: This in vitro study aimed to evaluate the effects of sodium hypochlorite (NaOCl) heating method, activation technique, and concentration on organic tissue removal from simulated internal resorption cavities. METHODS: A total of 198 single-rooted resin teeth with simulated internal resorption cavities were included. To simulate organic tissue, the cavities were filled with bovine muscle tissue. Specimens were allocated into 18 groups (n = 11) according to heating method (room temperature, intracanal heating, or extracanal heating), NaOCl concentration (5.25% or 2%), and activation technique (standard needle irrigation, passive ultrasonic irrigation, or XP-endo Finisher). Baseline cone-beam computed tomography scans were obtained before irrigation. Following irrigation and activation procedures, residual organic tissue was assessed using cone-beam computed tomography and the percentage of residual organic tissue was calculated. Statistical analysis was performed with the significance level set at P < .05. RESULTS: XP-endo Finisher resulted in significantly less residual organic tissue than standard needle irrigation under all temperature and concentration conditions. Passive ultrasonic irrigation showed superior tissue removal compared with standard needle irrigation only when 5.25% NaOCl was used with intracanal heating; no significant differences were observed under the other temperature and concentration conditions. Within the XP-endo Finisher groups, heating methods did not significantly influence tissue removal efficacy. In the passive ultrasonic and standard needle irrigation groups, extracanal heating generally yielded greater tissue removal than room temperature. Across all temperature conditions in the passive ultrasonic groups, and in the extracanal heating subgroup of standard needle irrigation, 5.25% NaOCl showed significantly greater tissue dissolution than 2% NaOCl. CONCLUSIONS: XP-endo Finisher demonstrated superior organic tissue removal regardless of irrigation temperature or NaOCl concentration. When standard needle irrigation or passive ultrasonic irrigation was used, extracanal heating of NaOCl enhanced its tissue-dissolving capacity, whereas increasing NaOCl concentration improved dissolution efficiency primarily in passive ultrasonic irrigation.
Insights into the March 2026 Issue of the JOE.
Aminoshariae A, Azarpazhooh A, Glickman GN … +9 more , He J, Kim SG, Kishen A, Letra AM, Levin L, Ordinola-Zapata R, Setzer FC, Tay FR, Hargreaves KM
J Endod · 2026 Mar · PMID 41796531 · Publisher ↗
Abstract loading — click title to view on PubMed.
Taxonomy and Virulence Factors in the Root Canal Microbiome: Metagenomic Insights by Lesion Size and Clinical Factors in Primary Endodontic Infections.
Clarke BC, Ordinola-Zapata R, Noblett WC … +2 more , Gould M, Staley C
J Endod · 2026 Jun · PMID 41765175 · Publisher ↗
INTRODUCTION: This study aimed to investigate the taxonomic and functional profiles of the root canal microbiome in teeth with large versus small periapical lesions, examining the influence of clinical variables on micro...
INTRODUCTION: This study aimed to investigate the taxonomic and functional profiles of the root canal microbiome in teeth with large versus small periapical lesions, examining the influence of clinical variables on microbial composition and functional pathways. METHODS: Samples from 25 teeth with large (>8 mm) and 20 with small periapical lesions (<2 mm) were analyzed. Quantitative polymerase chain reaction, 16S next-generation and whole genome sequencing were used to assess microbial load, diversity, and composition. Functional predictions were performed using the Kyoto Encyclopedia of Genes and Genomes and MetaCyc databases. Alpha diversity was calculated using Shannon and Chao1 indices. Beta diversity was assessed using ANOSIM and PERMANOVA. Significant variables were explored using MaAsLin3. Kruskal-Wallis tests were used for univariate comparisons. RESULTS: Teeth with large lesions exhibited significantly higher bacterial load (P = .011), but comparable alpha diversity and number of species per group in 16S and whole genome analysis (P > .05). Lesion size showed significance by ANOSIM (P = .04) but not in PERMANOVA (P = .36). Age was significant in both beta diversity tests, but the effect size only explained 3.6% of the variance. All clinical variables were not significant in 16S analysis for beta diversity. MetaCyc pathway analysis identified percussion sensitivity as the most influential clinical variable in both tests (ANOSIM R = 0.182, P = .012; PERMANOVA R = 0.063, P = .046). MaAsLin3 modeling revealed enrichment of enzymatic pathways involved in methionine and cysteine-related metabolism. CONCLUSIONS: Large periapical lesions contain significantly higher bacterial load, but similar diversity compared to small lesions. Functional predictions suggest bacterial metabolic activity may contribute to mechanical allodynia in endodontic infections.
About
- Frequency
- Sun
- Papers found
- 200
- RSS feed
- Subscribe