Journal Of Endodontics[JOURNAL]
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200 papers
Viability of Dental Pulp Derived Stem Cells After Long-Term Cryopreservation.
Malik MA, Perkins E, Nedell A … +3 more , Chopra H, Sugai J, Kaigler D
J Endod · 2025 Dec · PMID 41047003 · Full text
INTRODUCTION: Dental pulp-derived stem cells (DPSCs) have promise for use in regenerative therapies due to their regenerative and immunomodulatory potential. Following their isolation from dental pulp tissue, DPSCs can b...
INTRODUCTION: Dental pulp-derived stem cells (DPSCs) have promise for use in regenerative therapies due to their regenerative and immunomodulatory potential. Following their isolation from dental pulp tissue, DPSCs can be cryopreserved and banked for future use, however, it remains unclear to what extent long-term storage affects their properties. This study evaluated the properties of DPSCs cryopreserved for up to 13 years. METHODS: DPSCs from 12 patients cryopreserved for 5 (DPSC-5 YR), 10 (DPSC-10 YR), and 13 (DPSC-13 YR) years were analyzed for viability, immunophenotype (CD34, CD45, CD73, CD90, CD105), proliferation, and stemness. Additionally, senescence was evaluated through gene expression and senescence-associated β-galactosidase activity. RESULTS: All cryopreserved DPSCs showed high expression of stem cell markers CD73, CD90, and CD105 (>90%) with low expression of hematopoietic markers CD34 and CD45 (<4%). Proliferative capacity and proliferation rate demonstrated no significant differences in population doubling time among groups, with values of 1.32 ± 0.41 for DPSC-5 YR, 1.36 ± 0.44 for DPSC-10 YR, and 1.38 ± 0.53 for DPSC-13 YR, all comparable to DPSCs cryopreserved for less than 1 year (1.37 ± 0.57). Osteogenic and adipogenic differentiation of DPSCs confirmed their ability to retain multipotency. Finally, senescence-associated β-galactosidase staining revealed an absence of senescent cells up to passage 6 and while stemness and senescence gene expression profiles varied, no significant differences were found in expression of these genes between DPSCs, regardless of numbers of years of cryopreservation. CONCLUSIONS: DPSCs can maintain viability, proliferative capacity, and stemness following long-term (up to 13 years) cryopreservation. These data support their long-term banking for clinical therapies aimed at tissue regeneration and immunomodulation.
Effects of Different Root Canal Sealers and Irrigation Agitation Methods on Postoperative Pain in the Treatment of Teeth with Chronic Apical Periodontitis: A Randomized Clinical Trial.
Üstün Y, Eraslan Akyüz İ, Manolya Özdemir İ
J Endod · 2026 Feb · PMID 41043607 · Publisher ↗
INTRODUCTION: This study aimed to explore how different combinations of root canal sealers and irrigation activation techniques affect postoperative pain in single-rooted teeth with chronic apical periodontitis. METHODS:...
INTRODUCTION: This study aimed to explore how different combinations of root canal sealers and irrigation activation techniques affect postoperative pain in single-rooted teeth with chronic apical periodontitis. METHODS: Eighty teeth with single root and chronic apical periodontitis were randomly assigned into four groups according to the sealer and irrigation activation used: AH Plus sealer + manuel dynamic irrigation (MDI), AH Plus sealer + passive ultrasonic irrigation (PUI), NeoSealer Flo + MDI, NeoSealer Flo + PUI. The canals were prepared using Reciproc (R25 and R40) files. Root canals were obturated with gutta-percha cones corresponding in size and taper to the final instrument used. Ah Plus was used in the first and second groups, and NeoSealer Flo was used in the third and fourth groups as the root canal sealer. The 17% ethylenediaminetetraacetic acid used in the final irrigation was activated using two different agitation methods (MDI, PUI). Postoperative pain was assessed at multiple time points up to 7 days using the visual analog scale. RESULTS: Pain intensity generally peaked between 6 and 24 hours after treatment. Among the groups, the AH Plus + MDI combination resulted in the lowest pain scores, while the NeoSealer Flo + PUI group showed higher pain levels. A significant difference was noted between early pain levels and the consumption of analgesics (P < .001). There were no statistically significant differences observed in terms of demographic characteristics (P > .05). CONCLUSIONS: The combination of MDI with the AH Plus showed lower levels of pain in the early postoperative period.
Influence of Anatomical Parameters on the Accuracy of Electronic Apex Locators in C-shaped Canals: A Novel Micro-CT Analysis Incorporating Feret Diameter.
Tung KW, Sasaki H, Cavalcanti B … +2 more , Gardner R, McDonald N
J Endod · 2026 Jan · PMID 41043606 · Publisher ↗
INTRODUCTION: This study aimed to evaluate the influence of anatomical parameters on the accuracy of 2 electronic apex locators (Raypex 6 and Root ZX II) in C-shaped canal mandibular molars using a novel micro-computed t...
INTRODUCTION: This study aimed to evaluate the influence of anatomical parameters on the accuracy of 2 electronic apex locators (Raypex 6 and Root ZX II) in C-shaped canal mandibular molars using a novel micro-computed tomography (micro-CT) analysis incorporating Feret diameter. METHODS: The actual root canal length was measured using the visual method. The electronic canal length, which determined the apical foramen (AF), and the electronic working length, which determined the apical constriction (AC), were obtained using Raypex 6 and Root ZX II. The root working length, calculated by subtracting the AC-AF distance from the root canal length, served as a reference to evaluate the accuracy of the electronic working length. Anatomical parameters were derived from micro-CT scans and included Feret diameters of AC and AF, AC-AF distance, presence/absence of accessory canal, C-shaped type, AF position and AC morphology. Statistical analysis involved Fisher's exact test and multinomial logistic regression. RESULTS: The study included 42 C-shaped molar teeth and 119 canals. Raypex 6 and Root ZX II determined AF within ±0.5 mm in 97.5% and 96.4% of canals, respectively. A statistically significant difference was found in accuracy between detecting AF and AC (P < .05). After multinomial logistic regression, multiple AC morphology was the only factor negatively affecting AC accuracy in both electronic apex locators. CONCLUSIONS: Raypex 6 and Root ZX II accurately detected AF but were less reliable for AC in C-shaped canal mandibular molars. Reduced AC accuracy was associated with multiple AC morphology, indicating that electronic apex locators may detect the first narrow part of the canal apically rather than the narrowest part.
Insights into the October 2025 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 · 2025 Oct · PMID 41038653 · Publisher ↗
Abstract loading — click title to view on PubMed.
Intraoral Sensory Alterations in Myofascial Orofacial Pain Patients: Implications for Clinical Management.
Inamoto K, Minusculi Sander BM, Exposto FG … +3 more , Herrero Babiloni A, Svensson P, Costa YM
J Endod · 2025 Dec · PMID 41033394 · Publisher ↗
INTRODUCTION: This study evaluated differences in intraoral sensitivity to thermal and mechanical stimuli, and pulp sensibility between patients with myofascial orofacial pain (MOP) and healthy controls. We hypothesized...
INTRODUCTION: This study evaluated differences in intraoral sensitivity to thermal and mechanical stimuli, and pulp sensibility between patients with myofascial orofacial pain (MOP) and healthy controls. We hypothesized that patients would exhibit increased sensitivity to these stimuli. METHODS: A controlled study was performed, including 50 MOP patients and 104 controls aged 18-65. Intraoral and extraoral sensitivities were assessed at various sites using simple quantitative sensory testing (numerical ratings of thermal/mechanical stimuli) and qualitative somatosensory testing (side-to-side differences in sensitivity to touch, cold and pinprick as hyper-, hypo- or normal). Pulp sensibility was evaluated using cold stimuli. Statistical analyses included repeated-measures analysis of variance and Fisher's exact test (α = 0.05). RESULTS: Patients exhibited significantly higher intraoral hypersensitivity at the buccal gingiva to touch (14%), cold (34%), and pinprick stimuli (36%) compared to controls (0%, 14%, 15%). Similar trends were observed at extraoral sites including the masseter, temporalis, and thenar region. Pulp testing revealed significantly longer pain durations in patients (mean: 5.9 seconds) compared to controls (mean: 3.7 seconds), although pain intensity did not differ significantly. While simple quantitative sensory testing showed no significant group differences, qualitative somatosensory testing effectively identified intraoral and extraoral somatosensory abnormalities. CONCLUSIONS: Patients with MOP exhibited heightened intraoral sensitivity and prolonged pain responses. These findings underscore the diagnostic challenge of distinguishing sensitivity associated with MOP from odontogenic pain, such as pulpitis, which may lead to unnecessary dental procedures. Thorough assessments may help clinicians avoid misdiagnosis and improve outcomes, while longitudinal studies are needed to assess the possibility of clinical consequences.
Inorganic Ion Permeation through Human Dentinal Tubules: Implications for Bioactive Endodontic and Desensitizing Therapies.
Feng TW, Hsieh MF, Liu ST … +1 more , Lin CP
J Endod · 2026 Jan · PMID 41016427 · Publisher ↗
INTRODUCTION: This study aimed to evaluate the effects of pH, molecular weight, and ion charge on the permeation efficiency of selected inorganic ions through dentinal tubules. METHODS: Standardized 0.5 mm-thick human de...
INTRODUCTION: This study aimed to evaluate the effects of pH, molecular weight, and ion charge on the permeation efficiency of selected inorganic ions through dentinal tubules. METHODS: Standardized 0.5 mm-thick human dentin slices were prepared and exposed to various inorganic salt solutions under pH = 4, 7, and 10 conditions. Ion permeation was quantified over a 60-minute period. Morphologic changes were examined via scanning electron microscopy. ANOVA and Spearman's correlation were used to analyze the influence of multiple variables on the diffusion of ions. RESULTS: pH values were found to be the most influential factor: ion permeation is significantly enhanced under acidic environments and is hindered under alkaline conditions. Molecular weight and ion charge also affected diffusion, with lower molecular weight and +1 charge ions showing superior permeation. No significant difference was observed between cations and anions. Scanning electron microscopy analysis revealed no crystal deposition or tubule occlusion under the conditions investigated in this work. CONCLUSIONS: Ion permeation through dentinal tubules is primarily governed by environmental pH, followed by ion charge and molecular weight. These findings inform the rational design of ion-releasing dental materials tailored for acidic environments. Further research should explore long-term effects and multiion interactions to enhance clinical relevance.
Top 100 Most-cited Articles in Root Canal Anatomy: A Scopus-based Bibliometric Study.
Wu YC, Chiang HS, Dai ZJ … +5 more , Chen YJ, Chao YC, Yeh HW, Huang RY, Shieh YS
J Endod · 2026 Feb · PMID 40997992 · Publisher ↗
INTRODUCTION: Understanding root canal anatomy is fundamental for successful endodontic treatment. This bibliometric study aimed to identify and analyze the 100 most-cited articles related to root canal morphology to dis...
INTRODUCTION: Understanding root canal anatomy is fundamental for successful endodontic treatment. This bibliometric study aimed to identify and analyze the 100 most-cited articles related to root canal morphology to discover research trends, influential publications, and methodological progress in the field. METHODS: Data were extracted from the Scopus database using the search terms "root canal anatomy" OR "root canal morphology" AND NOT "Preparation," with selection finalized on July 28, 2025. Articles were manually screened, and only English-language original research related to human teeth was included. Citation counts, publication years, journal names, countries of origin, study designs, and methodologies were analyzed. RESULTS: Most of the top-cited studies were published in the Journal of Endodontics and International Endodontic Journal, which together contributed 80% of the articles. Cone-beam computed tomography was the most used method, followed by dye-injected decalcified teeth and micro-computed tomography. The most frequently studied teeth were mandibular and maxillary first molars. Geographically, the United States, Brazil, and China led in publication output. Notably, there were no articles from Africa, highlighting a potential area for collaborative development. Over time, research has shifted from invasive in vitro techniques to advanced non-invasive imaging. The most-cited article was Vertucci's 1984 classification study, which remains widely used today. CONCLUSIONS: This bibliometric analysis delivers a comprehensive overview of influential studies in root canal anatomy, offering insights into global research patterns and technological advancement.
Individual Risk Factors Associated with Post-traumatic Trigeminal Neuropathy Following Endodontic Procedures: A Systematic Review.
Candido do Prado LG, Godoi-Lopes J, Lopes-Olhê FC … +2 more , Magri LV, Mazzi-Chaves JF
J Endod · 2025 Dec · PMID 40975481 · Publisher ↗
INTRODUCTION: To identify patient-specific phenotypic, anatomical, psychological, and clinical risk factors associated with the development of post-traumatic trigeminal neuropathy (PTTN) following endodontic procedures....
INTRODUCTION: To identify patient-specific phenotypic, anatomical, psychological, and clinical risk factors associated with the development of post-traumatic trigeminal neuropathy (PTTN) following endodontic procedures. METHODS: This systematic review was conducted following PRISMA 2020 guidelines, with the protocol prospectively registered in PROSPERO (CRD420251071354). Searches were performed in PubMed/MEDLINE and LILACS (via BVS) up to June 2025. Studies were eligible if they reported patient-level phenotypic, anatomical, psychological, or clinical features linked to PTTN following endodontic therapy. Three reviewers independently conducted data extraction and quality assessment. An exploratory meta-analysis was performed to estimate the pooled prevalence of PTTN by sex. RESULTS: Nine studies were included. A predominance of female patients among those with PTTN was observed, with a pooled proportion of 67% (95% CI: 63.3%-70.5%). Psychological comorbidities such as anxiety and depression, previous chronic pain conditions, and endodontic procedures in anatomically high-risk areas particularly mandibular molars were also identified as potential risk factors. Some studies proposed predictive frameworks integrating sensory testing and patient history. However, heterogeneity in study designs and limited quantitative data prevented subgroup analyses. CONCLUSIONS: This review suggests that female sex, psychological vulnerability, and altered sensory modulation may be individual level-risk factors for PTTN following endodontic treatment. These findings reinforce the importance of risk-based clinical decision-making and underscore the need for prospective studies with standardized diagnostic criteria to develop validated predictive models in endodontics.
The Influence of Apical Radiolucency Size on Dentists' Decision-making Regarding Adequately Treated Teeth with Asymptomatic Apical Periodontitis using Digitally Simulated Images.
Wigler R, Itzhakov R, Tsesis I … +1 more , Rosen E
J Endod · 2025 Dec · PMID 40946909 · Publisher ↗
INTRODUCTION: Epidemiologic studies have reported a relatively high prevalence of asymptomatic apical periodontitis in endodontically treated teeth. Such teeth, when adequately restored and endodontically treated, presen...
INTRODUCTION: Epidemiologic studies have reported a relatively high prevalence of asymptomatic apical periodontitis in endodontically treated teeth. Such teeth, when adequately restored and endodontically treated, present a clinical dilemma regarding whether to intervene or follow-up. The aim of this study was to examine dentists' clinical decision-making for well-treated endodontically and adequately restored teeth with asymptomatic apical periodontitis, presenting various sizes of simulated apical radiolucencies. MATERIALS AND METHODS: Twenty dentists (10 endodontic specialists and 10 prosthodontic specialists) completed a questionnaire containing cases of well-treated asymptomatic teeth, that is, adequately restored and endodontically treated, where some teeth showed normal apical tissues and others presented various sizes of simulated periapical radiolucencies (3 mm, 6 mm, 9 mm, or 12 mm). For each case, participants selected one of 4 treatment options: follow-up, root canal retreatment, endodontic surgery, or extraction. RESULTS: Both specialty groups unanimously recommended follow-up for teeth without apical radiolucency. When apical radiolucency was present, its size was significantly associated with an active treatment decision, in both univariate and multivariate analyses. Among those who opted for treatment, endodontic surgery was the most frequently selected option, followed by retreatment, while extraction was the least chosen. CONCLUSIONS: This study suggests that dentists' decision-making regarding asymptomatic, adequately treated teeth with apical periodontitis is influenced by the size of the apical radiolucency. Moreover, there was a general tendency to preserve such teeth and to prefer endodontic surgery over orthograde root canal retreatment.
Three-dimensional Assessment of Healing Variability after Endodontic Microsurgery Using the Bone Lid Technique: A Case Series.
Lee SM, Kwak JD, Ruch A … +3 more , Kratchman SI, Karabucak B, Kohli MR
J Endod · 2026 Jan · PMID 40946908 · Publisher ↗
Cortical bone healing after endodontic microsurgery on molars with apical lesions can be delayed or unpredictable. The bone lid technique offers enhanced surgical access while minimizing bone loss. This case series repor...
Cortical bone healing after endodontic microsurgery on molars with apical lesions can be delayed or unpredictable. The bone lid technique offers enhanced surgical access while minimizing bone loss. This case series reports on patients with intact buccal cortical bone thicker than 1 mm, treated surgically using the bone lid technique. Bone lids were created with a piezotome, preserved in Hank's Balanced Salt Solution, and repositioned after root-end surgery using a collagen matrix for stabilization. Healing was assessed using three-dimensional cone beam computed tomography criteria and evaluation of the bone lid integration perimeter. Out of 6 cases, 2 showed complete healing without complications. One case demonstrated limited cortical plate healing, and in two cases, the bone lids became dislodged, necessitating further intervention. These findings indicate that the bone lid technique in endodontic microsurgery may support favorable cortical healing when postoperative stability is maintained. Bone lid integrity appears to be a critical factor in successful outcomes.
Insights Into the September 2025 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 · 2025 Sep · PMID 40945930 · Publisher ↗
Abstract loading — click title to view on PubMed.
Diabetes Increases Residual Stress and Microcrack Length in Dentin: An XRD-SEM Study with AI-assisted Quantification.
Saghiri MA, Momeni K, Chien CH … +3 more , Conte M, Pinnaka P, Morgano SM
J Endod · 2025 Dec · PMID 40935322 · Publisher ↗
INTRODUCTION: This study evaluated the association between residual stress and microcracks length in root dentin using an AI-assisted quantification workflow run in parallel with Fiji/ImageJ. METHODS: Twenty mandibular p...
INTRODUCTION: This study evaluated the association between residual stress and microcracks length in root dentin using an AI-assisted quantification workflow run in parallel with Fiji/ImageJ. METHODS: Twenty mandibular premolars were collected, including ten (n = 10) from diabetic patients and ten (n = 10) from healthy controls. Following standardized rotary instrumentation and irrigation protocols, the roots were longitudinally sectioned. Residual stress was assessed using the sinψ X-ray diffraction method. Microcracks were visualized under scanning electron microscopy and quantitatively analyzed using a Fiji-based workflow with an AI-assisted comparator. Statistical analyses included independent t tests, Pearson correlation, and linear regression, using two-sided tests with α = 0.05. RESULTS: Significant differences were observed between diabetic and nondiabetic dentin in terms of residual stress (1.40 ± 0.47 MPa vs -1.10 ± 0.44 MPa, P < .001). Microcracks length was greater in diabetic dentin (54.6 ± 9.4 μm) than in nondiabetic controls (20.0 ± 4.6 μm, P < .001), indicating that higher stress levels were associated with longer microcracks. CONCLUSION: This study found that residual stress contributes to increased microcracks length in instrumented roots, with diabetic dentin showing longer cracks. These findings may explain the higher failure risk in diabetic patients.
Integrated Micro-Computed Tomography and Computational Fluid Dynamics Analysis of Stepwise Enlargement in Mesial Root Canals of Mandibular Molars.
Furtado SM, Martins JNR, Silva EJNL … +3 more , Rito Pereira M, Versiani MA, Ginjeira A
J Endod · 2026 Jan · PMID 40930490 · Publisher ↗
INTRODUCTION: To evaluate how stepwise enlargement in the mesial root canals of mandibular first molars affect shaping outcomes and irrigant dynamics. METHODS: The shaping ability and irrigant flow patterns in mesial can...
INTRODUCTION: To evaluate how stepwise enlargement in the mesial root canals of mandibular first molars affect shaping outcomes and irrigant dynamics. METHODS: The shaping ability and irrigant flow patterns in mesial canals of mandibular first molars enlarged with ProTaper Next instruments (25/.06v, 30/.07v, 40/.06v) were evaluated using micro-computed tomography (micro-CT) and computational fluid dynamics (CFD). Instrument design and metallurgical properties were assessed by 3D scanning, scanning electron microscopy, energy-dispersive X-ray spectroscopy, and differential scanning calorimetry to ensure manufacturing consistency. An extracted mandibular molar with two curved mesial root canals was selected and scanned by micro-CT to generate 3D models for CFD simulation. Root canals were prepared stepwise with the ProTaper Next. Digital canal and needle geometries were reconstructed from micro-CT and scanning electron microscopy data. CFD simulations were conducted in ANSYS Fluent to calculate irrigant velocity, wall shear stress, and apical pressure. For shaping analysis, ten mesial canals from 5 mandibular molars were scanned before and after each preparation step. Canal volume, surface area, unprepared surfaces, and pericervical dentine thickness were quantified. Data were analyzed using repeated measures ANOVA with Bonferroni correction (P < .05). RESULTS: Excluding for dimensions, all instruments shared similar metallurgical features and design characteristics, with minor surface imperfections. The open-ended needle consistently delivered irrigant to the working length, unlike the side-vented needle. Enlargement slightly increased apical velocity and irrigant density, particularly with the open-ended needle, which also generated higher wall shear stress and apical pressure. Canal volume and surface area increased significantly with larger files (P < .05), while unprepared areas decreased. Progressive canal enlargement significantly reduced minimal dentine thickness at the distal aspect of the mesial canals (most at 1-2 mm below the furcation), dropping from preoperative means of ∼1 mm to 0.60 mm after the 40/.06v instrument (P < .05), with the proportion of sections with dentine <0.5 mm increasing from 0% to 26%, while those >1 mm decreased markedly. CONCLUSIONS: Progressive apical enlargement improved shaping and irrigant dynamics, but additional increases offered limited benefits. Irrigant effectiveness was more influenced by needle design than by size alone, suggesting that optimizing delivery systems may enhance cleaning efficiency while minimizing unnecessary dentine removal.
Investigation of Static versus Dynamic Cyclic Fatigue Resistance in NiTi Endodontic Instruments with Different Alloy Treatments at Body Temperature.
Abdulkareem T, Jamal M, Atmeh A … +4 more , Elbishari H, Khamis AH, Kim HC, El Abed R
J Endod · 2026 Jan · PMID 40930489 · Publisher ↗
INTRODUCTION: This study evaluated the fatigue resistance of 2 nickel-titanium engine-driven file systems with identical geometries and different heat treatments tested under static and dynamic conditions in simulated ro...
INTRODUCTION: This study evaluated the fatigue resistance of 2 nickel-titanium engine-driven file systems with identical geometries and different heat treatments tested under static and dynamic conditions in simulated root canals. METHODS: Cyclic fatigue tests were conducted using ProTaper Universal (PTU) and ProTaper Gold (PTG) instruments with a curvature of 35° and a radius of 6 mm in both static and dynamic modes at body temperature using a customized cyclic fatigue testing device. The number of cycles to fracture was recorded. A scanning electron microscope was used to examine the fracture surfaces of fractured fragments. RESULTS: The cyclic fatigue resistances of PTU and PTG varied depending on the testing methods (static or dynamic). Statistically significant differences were observed between the 2 file systems, with PTG demonstrating superior fatigue resistance in both testing modes. Notably, dynamic testing resulted in a higher number of cycles to fracture for both PTU and PTG compared to static testing. However, the relative improvement in the cyclic fatigue resistance of PTG over PTU remained consistent under both conditions. The scanning electron microscope analysis of the cross-sectional and longitudinal aspects of the fractured specimens revealed microcrack initiation regions, overloaded quick fracture areas, and microcracks. PTG demonstrated a lower concentration of microcracks compared to PTU. CONCLUSIONS: This study confirmed that heat treatment significantly enhances the cyclic fatigue resistance of NiTi instruments and static mode reduces the fatigue resistance of the file. Heat-treated files showed better property due to their martensitic phase, which improves flexibility and reduces crack initiation.
Clinical Validation of Smartphone-Enabled Pulse Oximetry for Objective Pulp Vitality Assessment: A Diagnostic Accuracy Study.
Caldeira CL, Diaz Zamalloa SI, Guimaro Sakitani CR … +2 more , Barletta FB, Holzhausen M
J Endod · 2025 Dec · PMID 40921351 · Publisher ↗
INTRODUCTION: Pulse oximetry exhibits great potential for use in endodontic diagnosis as an effective method to assess pulp vitality. Cell phone-integrated oximeters represent an emerging alternative that may offer great...
INTRODUCTION: Pulse oximetry exhibits great potential for use in endodontic diagnosis as an effective method to assess pulp vitality. Cell phone-integrated oximeters represent an emerging alternative that may offer greater accessibility. This study aimed to investigate the relation between pulp oxygenation rates (%SpO) and clinical diagnosis of healthy pulp (HP), reversible pulpitis (RP), symptomatic irreversible pulpitis (IP), or pulp necrosis (PN), comparing 2 pulse oximeters (conventional [PO1] and mobile-connected). METHODS: Thirty affected premolars were grouped according to the clinical diagnosis of RP, IP, or PN and compared to vitality diagnosis by %SpO obtained by both pulse oximeters: PO1 and by smartphone-based (PO2). For each affected tooth, 2 additional teeth (adjacent and contralateral) with HP were tested. Statistical analysis was performed using one-way ANOVA with Tukey's post-hoc test. RESULTS: The mean %SpO values measured by PO1 were 87.7% for RP, 80.5% for IP, 73.2% for PN, and 91.89% for HP. Corresponding values obtained with PO2 were 85.6% (RP), 79.3% (IP), 72.1% (PN), and 90.1% (HP). Significant differences in %SpO were observed among RP, IP, and PN groups (P < .05), but not between healthy control subgroups (adjacent and contralateral). PO1 consistently recorded higher oxygen saturation than PO2 across all clinical conditions (P < .05), demonstrating superior discriminatory capability. CONCLUSIONS: Both pulse oximeters demonstrated significant clinical value for pulp vitality assessment and differentiation of pulpal inflammation stages and necrosis. The smartphone-adapted oximeter has proven to be comparable to PO1 in diagnostic performance, while offering data collection efficiency and clinical workflow integration.
Autogenous Transplantation of an Immature Undersized Third Molar to Rehabilitate a Cyst-associated Lateral Incisor Defect: A 3-Year Case Report.
Bi C, Bian Z, Peng B … +4 more , Wang H, Jiang J, Chen Y, Tan J
J Endod · 2026 Feb · PMID 40907606 · Publisher ↗
Severe periapical cysts frequently result in tooth loss with concomitant severe alveolar bone destruction, precluding immediate implant placement. Autogenous tooth transplantation, which involves transplanting the patien...
Severe periapical cysts frequently result in tooth loss with concomitant severe alveolar bone destruction, precluding immediate implant placement. Autogenous tooth transplantation, which involves transplanting the patient's own tooth to the recipient site, offers a biological approach to reconstruct both the dentition and supporting bone structures. This report presents a 25-year-old female with a mobile, discolored maxillary right lateral incisor (#12) exhibiting grade 3 mobility due to a large periapical cyst (extending to #14 on cone-beam computed tomography) with root developmental arrest, secondary to Oehlers type II dens invaginatus. Autogenous transplantation was performed using an immature impacted third molar (#28) with compatible root morphology. Despite pulp necrosis requiring root canal treatment at 1 month, functional stability was achieved by 3 months. Three-year follow-up demonstrated complete bone healing, intact periodontal ligament space, and absence of resorption or ankylosis on cone-beam computed tomography. This case underscores the promising role of autogenous tooth transplantation as a viable treatment option for complex dental scenarios.
Sexual Dimorphism in Apical Periodontitis Severity Detected by CBCT.
Estrela LRA, Estrela C, Bueno MR … +1 more , Diogenes A
J Endod · 2025 Dec · PMID 40907605 · Publisher ↗
INTRODUCTION: Although several elegant studies have reported apical periodontitis prevalence in different populations, far less is known about its associated bone loss and its correlation to sex and age. Thus, this study...
INTRODUCTION: Although several elegant studies have reported apical periodontitis prevalence in different populations, far less is known about its associated bone loss and its correlation to sex and age. Thus, this study investigated the impact of sex and age differences on the severity of apical periodontitis (AP) using cone-beam computed tomography (CBCT) and a volumetric periapical index (CBCT-PAI). METHODS: CBCT scans of 401 patients (1,027 teeth) were analyzed by calibrated examiners in CBCT-PAI. Chi-square tests were used to assess associations between AP, sex, and age with other variables such as the presence and quality of endodontic treatment and coronal restorations. Robust Poisson regression models were used to evaluate the relationships between dependent and independent variables, with significance set at P < .05. RESULTS: The prevalence of AP was greater in female patients compared to males (66.9% vs 33.1%). Notably, men showed a significantly higher prevalence of larger lesions (CBCT-PAI 4 and 5) than women. Apical periodontitis was more common in root-filled teeth than primary infections, particularly posterior teeth. Lastly, AP was more commonly found in teeth with inadequate root canal fill or coronal restoration, while an intracanal post did not affect its prevalence. CONCLUSIONS: AP was more common in women. However, the osteolytic lesions in females were smaller than those seen in males, who demonstrated a greater prevalence of severe lesions. These findings emphasize the importance of early diagnosis and treatment and highlight the significant sexual dimorphism in the pathophysiology of AP.
Investigation of Endodontic Disinfection by Combination of Laser and Nanobubble Technology.
Ci H, Xin B, Hubbard AW … +9 more , Hamilton E, Ainsworth C, Dagen BM, Bursian ER, Zhang Y, Zhang YH, Morrow BR, Nakashima M, Huang GJ
J Endod · 2025 Dec · PMID 40889701 · Publisher ↗
INTRODUCTION: To investigate the combined use of laser, nanobubble water (NB-HO), and calcium hydroxide (Ca(OH)) for endodontic disinfection, particularly in regenerative endodontic cases where maximum effectiveness is n...
INTRODUCTION: To investigate the combined use of laser, nanobubble water (NB-HO), and calcium hydroxide (Ca(OH)) for endodontic disinfection, particularly in regenerative endodontic cases where maximum effectiveness is needed. METHODS: The canal of human teeth were prepared, sterilized, and inoculated with Enterococcus faecalis (E. faecalis). Teeth were assigned to 4 groups for 2 rounds of disinfection with Er,Cr: YSGG laser (Biolase). Group I - control, no disinfection, Group II - 6.25% NaOCl, Group III - 1.25% NaOCl, and Group IV - 1.25% NaOCl/NB-HO. Ca(OH) was placed in the canal for ∼10 days between the 2 disinfection rounds. Teeth were evaluated by scanning electron microscopy for biofilm removal and confocal laser scanning microscopy to detect live/dead bacteria in the dentinal tubules. RESULTS: Scanning electron microscopy analysis of the canal disinfection indicated that the NB-HO group (1.25% NaOCl/NB-HO) appeared to enhance the removal of biofilm/smear layer. However, it was not consistently more effective than other groups in killing the bacteria in the dentinal tubules. The combined use of low-concentration NaOCl, laser, NB-HO and Ca(OH) largely reduced E. faecalis but did not achieve complete eradication from the canal or in the dentinal tubules. CONCLUSIONS: Our comprehensive disinfection protocol reduced the bacteria in the dentinal tubules to a level potentially suited for regenerative endodontic therapy.
Managing Perforating Internal Root Resorption in Mature Incisor with Laser-assisted Regenerative Endodontic Procedures.
Lu G, Wang X, Chen R … +2 more , Zeng Y, Huang X
J Endod · 2026 Feb · PMID 40889700 · Publisher ↗
INTRODUCTION: This report presented the successful application of laser-assisted regenerative endodontic procedures (REPs) in managing perforating internal root resorption (PIRR) in a mature incisor. METHODS: A 24-year-o...
INTRODUCTION: This report presented the successful application of laser-assisted regenerative endodontic procedures (REPs) in managing perforating internal root resorption (PIRR) in a mature incisor. METHODS: A 24-year-old female with a history of trauma was referred for treatment of her maxillary anterior tooth. Clinical examination and cone-beam computed tomography imaging revealed that tooth #9 had PIRR with a lateral inflammatory lesion and thin canal walls. Consequently, a novel laser-assisted REPs was performed to treat PIRR. RESULTS: Three-year follow-up showed apical healing, cessation of resorption, and hard tissue formation within the resorptive defect. CONCLUSIONS: This outcome demonstrated the efficacy of laser-assisted REPs for managing infection in mature teeth with PIRR, where bleeding from the apical foramen could be supplemented by blood flow through the lateral wall perforations, thereby enhancing the outcome of REPs.
Biocompatibility of a Novel Light-Curable Hydrogel-Based Root Canal Obturation Material: In Vivo and In Vitro Analyses.
Kyaw MS, Yahata Y, Nakano M … +7 more , Toyama F, Ke C, Shuai W, Kamano Y, Harada F, Noguchi T, Saito M
J Endod · 2025 Dec · PMID 40885490 · Publisher ↗
INTRODUCTION: This study aims to evaluate the biocompatibility of a new light-curable hydrogel-based root canal obturation material, OdneFill, through in vivo and in vitro analyses. METHODS: Intentional overinstrumentati...
INTRODUCTION: This study aims to evaluate the biocompatibility of a new light-curable hydrogel-based root canal obturation material, OdneFill, through in vivo and in vitro analyses. METHODS: Intentional overinstrumentation and overobturation were performed on the mandibular first molars of 10-week-old male rats, divided into 4 groups: group 1 (instrumentation only), group 2 (OdneFill), group 3 (gutta-percha + AH Plus), and group 4 (sound teeth). Mandibles were dissected after 3, 28, and 90 days for micro-computed tomography, histological analysis, and immunohistochemical staining and analyzed by two-way analysis of variance and post hoc Tukey test. Cytotoxicity and proinflammatory cytokine expression were assessed using RAW 264.7 cells and analyzed by 1-way analysis of variance and Tukey test (α = 0.05). RESULTS: Micro-computed tomographic analysis showed no significant difference in bone resorption (P > .05). However, AH Plus exhibited a higher inflammatory score (score: 1%-90%, score: 2%-10%) with increased neutrophil and macrophage infiltration in immunostaining (P < .05) compared to the instrumentation only group at day 90. In contrast, Odnefill showed comparable results (score: 0%-50%, score: 1%-30%, score: 2%-20%) to the instrumentation-only group (P > .05). Moreover, Odnefill did not affect the viability of RAW 264.7 cells, whereas the AH Plus extract decreased cell viability and upregulated inflammatory cytokines such as interleukin-1 beta and interleukin-6. CONCLUSIONS: OdneFill demonstrated superior biocompatibility, and a minimal inflammatory response compared to AH Plus.
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