http://feed.informer.com/digests/RP4HYZUCRE/feeder WP Front Range Dental Respective post owners and feed distributors Tue, 17 May 2016 00:58:54 -0700 Feed Informer http://feed.informer.com/ https://onlinelibrary.wiley.com/doi/10.1111/iej.14228?af=R International Endodontic Journal urn:uuid:223510f0-2ece-1705-7fbf-6f8eb5933326 Thu, 20 Mar 2025 04:49:01 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Aim</h2> <p>The COVID-19 pandemic affected practice in endodontic offices. Same-day endodontic emergencies are cases with moderate or severe self-reported pain who request an unscheduled visit on the day they contact the office. The aims of this observational study were to: (A) analyse the rate of same-day endodontic emergencies in two endodontists' private offices, with respect to their demographic, aetiologic, diagnostic and procedural data; and (B) investigate the changes in characteristics of same-day emergencies between March 16 and May 31 annually over five years: 2019–2023.</p> <h2>Methodology</h2> <p>Records of 5795 patients were reviewed and 892 same-day emergencies were identified. Overall and year-to-year comparisons of proportions of same-day emergencies, as well as demographic, aetiologic, diagnostic and procedural data were performed using chi-square test of independence followed by adjustments for multiple testing using the Benjamini-Hochberg method.</p> <h2>Results</h2> <p>The rate of same-day endodontic emergencies significantly increased during the initial outbreak of COVID-19 in 2020 and remained high in 2021 (<i>p</i> &lt; .05; <i>Q</i> &lt; .05). The rate of same-day emergencies in 2022 subsided to levels comparable to 2019 (<i>p</i> &gt; .05). Year-to-year comparisons of aetiologic factors (caries, restorative, persistent infection and cracks) showed a significant increase only in the rate of cracks in 2020, 2021and 2022 compared with 2019 (<i>p</i> &lt; .05), but this increase did not reach the significance level after adjusting for multiple comparisons throughout the 5 years (<i>Q</i> &gt; .05).</p> <h2>Conclusions</h2> <p>The COVID-19 pandemic was associated with a significant increase in the rate of same-day endodontic emergencies for 2 years. The spike in endodontic emergencies associated with the COVID-19 pandemic lasted well beyond the initial period of the outbreak. Further national and international studies are recommended to better understand the long-term impacts of pandemics of respiratory diseases on the public's oral health.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14226?af=R International Endodontic Journal urn:uuid:eb36c28e-bfed-c86a-c47b-b2d9ac5f8fc8 Wed, 19 Mar 2025 09:33:06 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Aim</h2> <p>Establishing functional circulation on time is crucial to dental pulp tissue regeneration. Mesenchymal stem cells (MSCs) could act as mural cells to stabilize newly formed blood vessels, accelerating anastomosis. Our preliminary study found that direct coculture of dental pulp stem cells (DPSCs) and human umbilical vein endothelial cells (HUVECs) significantly enhanced Activin A secretion. This study aimed to disclose the dynamic patterns of Activin A expression and its regulation on vascular formation and stabilization.</p> <h2>Methodology</h2> <p>DPSCs and HUVECs were cocultured directly at a ratio of 1:1 for 3 and 6 days. Activin A and Follistatin expression were evaluated by qRT-PCR and ELISA. HUVECs were exposed to 100 ng/mL Activin A or the conditioned medium (CM) generated from DPSC monoculture and DPSC-HUVEC coculture, respectively. HUVEC proliferation, migration, tube formation and angiogenic sprouting were assessed. In parallel, membrane-bound vascular endothelial growth factor receptors (mVEGFR1 and mVEGFR2) and soluble VEGFR1 (sVEGFR1) were analysed at days 3 and 6.</p> <h2>Results</h2> <p>Activin A expression and secretion were elevated time-dependently during DPSC-HUVEC coculture. Follistatin expression decreased in DPSC-HUVEC coculture while the ratio of Activin A/Follinstain increased significantly. Activin A treatment did not promote DPSC towards smooth muscle cell (SMC)-specific differentiation, while Activin A and DPSC+HUVEC-CM suppressed HUVEC proliferation, migration, tube formation and sprouting. Activin A and DPSC+HUVEC-CM treatment markedly increased mVEGFR1 expression and sVEGFR1 secretion, suppressing HUVEC vascular formation. Activin A IgG partially reversed the effects of DPSC+HUVEC-CM on HUVECs by decreasing VEGFR1 expression and increasing vessel formation. Activin A pretreatment downregulated VEGF-triggered VEGFR2 phosphorylation of HUVECs. INHBA knockdown DPSCs disrupted the stabilization of the preformed HUVEC vascular tube network.</p> <h2>Conclusion</h2> <p>DPSC-HUVEC direct coculture upregulates Activin A secretion, interrupting VEGF receptors' balance in HUVECs to suppress HUVEC angiogenic sprouting and enhance vascular stabilization. These findings provide novel insights into the paracrine interactions on vascular stabilization of DPSC-HUVEC direct coculture.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14222?af=R International Endodontic Journal urn:uuid:81bc5825-c80f-edbe-42d1-4ad30308b21e Wed, 19 Mar 2025 08:59:04 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Aim</h2> <p>To evaluate the prevalence of apical periodontitis (AP) and caries in subjects with psoriasis vulgaris.</p> <h2>Methodology</h2> <p>In total, 152 patients with psoriasis vulgaris were included in the study. The severity and extent of psoriasis were assessed according to the Psoriasis Area Severity Index (PASI), the Body Surface Area (BSA) and the Physician's Global Assessment Scale (PGA). Periapical status was assessed through dental examination and periapical radiographs. Data regarding the Periapical Index (PAI), caries experience expressed as the Decayed, Missing, Filled Teeth Index (DMFT) and psoriasis medications were recorded. A predictive logistic regression model for the presence of AP and a linear regression model were then built to relate the severity and extent of AP to the type of drug therapy taken for psoriasis and to the severity and extent of the skin disease.</p> <h2>Results</h2> <p>Subjects with severe/moderate psoriasis showed a significantly higher prevalence of AP (<i>p</i> = .002) and a higher PAI score (<i>p</i> = .0035) than subjects with mild psoriasis. No significant correlation was found between AP and caries experience (<i>p</i> = .76). The logistic regression model showed that moderate/severe psoriasis increased the odds of having AP [odds ratio (OR) = 1.30 ± 1.088, 1.55]. A negative linear relationship between biological drug intake and PAI score value was observed (coefficient = −.54; <i>p</i> = .04).</p> <h2>Conclusions</h2> <p>The degree of severity of psoriasis is significantly associated with AP, suggesting that psoriasis may play a role in the pathogenesis of AP. However, no significant correlation was observed for caries experience. Furthermore, the immune-modulating drugs taken by these patients did not seem to have different effects on the prevalence of AP.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14224?af=R International Endodontic Journal urn:uuid:97296989-bde4-6442-61fb-e939485bcc98 Fri, 14 Mar 2025 08:58:04 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Aim</h2> <p>This study aimed to compare the release of inflammatory mediators and post-operative pain after conservative and conventional root canal preparations of mandibular molars with asymptomatic irreversible pulpitis.</p> <h2>Methodology</h2> <p>Forty-five healthy patients diagnosed with asymptomatic irreversible pulpitis were randomly assigned to three groups based on the system used for root canal preparation (<i>n</i> = 15): ProTaper Gold, OneShape and TruNatomy. Gingival crevicular fluid samples were collected for baseline measurements, 24 and 72 h after root canal treatment. Inflammatory mediators (Substance P, IL-6, IL-10 and PGE-2) were quantified using enzyme-linked immunosorbent assays, and post-operative pain was assessed using the visual analogue scale (VAS) and compared among groups with linear regression analysis.</p> <h2>Results</h2> <p>All mediators exhibited an increase at 24 h and a decrease at 72 h. The release of Substance P in the OneShape group was significantly higher than in the TruNatomy and ProTaper Gold groups (Odds Ratio (OR) = 17.4 and 21.7, respectively, at 24 h and 21.5 and 15.6 at 72 h; <i>p</i> &lt; .05). IL-6 and IL-10 were significantly higher in the OneShape and ProTaper Gold groups compared to TruNatomy at 24 h (<i>p</i> &lt; .05). PGE2 levels were not affected by the type of instruments (<i>p</i> &gt; .05). VAS scores were significantly higher at 24 h compared to baseline, with root canal preparation using OneShape significantly associated with higher post-operative pain than preparation with ProTaper Gold (<i>p</i> &lt; .05). Analgesic intake was not related to the instrumentation group or any other patient- or tooth-related factors.</p> <h2>Conclusion</h2> <p>Conservative root canal preparation of mandibular molars with asymptomatic irreversible pulpitis decreased the release of inflammatory mediators but did not influence post-operative pain.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14225?af=R International Endodontic Journal urn:uuid:062ca426-a3b4-91f6-64fe-4da9bf7cbed7 Fri, 14 Mar 2025 07:53:59 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <p>The influence of gender is underexplored in endodontic educational research. This review examines the effect of gender on learning within the domains of skill acquisition, performance and difficulties encountered. It also analyses the stress and confidence experienced by male and female students during clinical endodontics, as well as their preparedness at the end of their undergraduate studies. Finally, this review analyses the influence of gender on student career choices in dentistry with a focus on endodontics. The review highlights that gender is invariably studied as a secondary outcome in endodontic education. Based on current evidence, it appears that female students tend to underestimate their skills and knowledge more than male counterparts in endodontics. They are also often more stressed than males, feeling less confident and not as prepared. A recognition of gender differences in learning and stress management is important. Student aspirations regarding their choice of endodontic postgraduate speciality appear to be relatively well balanced in terms of gender. Finally, there is a need for further research to elucidate more clearly the impact of gender in endodontic education and endodontic career choice.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14221?af=R International Endodontic Journal urn:uuid:8ac83cf7-711f-d0ca-b466-20500eec9871 Fri, 14 Mar 2025 07:34:27 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Aim</h2> <p>To characterize the deep dentinal caries microbiota in teeth diagnosed with normal pulp with deep caries (NP), reversible pulpitis (RP), symptomatic irreversible pulpitis (SIP), and asymptomatic irreversible pulpitis (AIP), and to identify potential key pathogens associated with pulpitis progression, exploring their roles in disease advancement.</p> <h2>Methodology</h2> <p>In this cross-sectional study, we collected 108 dentinal caries samples, categorized into NP (<i>n</i> = 27), RP (<i>n</i> = 27), SIP (<i>n</i> = 27), and AIP (<i>n</i> = 27), according to the American Association of Endodontists' diagnostic criteria. 2 NP samples and 2 RP samples were excluded due to contamination. Samples were processed using Illumina MiSeq high-throughput sequencing. Alpha and beta diversity, taxa abundance differences, co-occurrence network analysis, and functional prediction were evaluated. Correlation analysis between the abundance of bacteria associated with clinical diagnosis, clinical signs, and pulp exposure status was performed with Spearman analysis and the Mantel test.</p> <h2>Results</h2> <p>The bacteriome of deep dentinal caries exhibited statistically significant differences among NP, RP, SIP, and AIP groups. NP and RP showed similar microbial community structures, with comparable alpha diversity, beta diversity, bacterial phenotypes, functions, and network structures. In contrast, AIP and SIP displayed distinct microbial community profiles. AIP was characterized by higher alpha diversity and a greater abundance of gram-negative bacteria, with <i>Propionibacterium</i> and <i>Prevotella_7</i> identified as bacteria associated with AIP pathogenesis. On the other hand, SIP showed lower alpha diversity and a higher abundance of facultative anaerobes, with <i>Lactobacillus</i> and <i>Limosilactobacillus</i> identified as bacteria associated with SIP pathogenesis. <i>Fusobacterium</i>, <i>Prevotella</i>, <i>Treponema</i>, and <i>Selenomonas</i> were identified as bacteria associated with both AIP and SIP. Compared to NP and RP, the microbial networks in AIP and SIP are more complex and contain more gram-negative endodontic pathogens. These pathogens form complex positive correlations with each other and numerous negative correlations with lactic acid bacteria.</p> <h2>Conclusions</h2> <p>The bacteriome of deep dentinal caries differs significantly across teeth diagnosed with NP, RP, AIP, and SIP. NP and RP exhibit similar microbial communities, whereas SIP and AIP display distinct microbial profiles.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14219?af=R International Endodontic Journal urn:uuid:6748267e-8fba-41d6-55e8-59cf80fcff36 Wed, 12 Mar 2025 07:28:37 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Background</h2> <p>Smartphone applications are increasingly used in medical and dental education, offering flexible and interactive learning opportunities. In medicine, these tools enhance knowledge retention, clinical decision-making, and patient care.</p> <h2>Objective</h2> <p>This review aims to evaluate the role of smartphone applications in endodontic education, assessing their quality, functionality, perceived impact, usability, and impact on learning outcomes.</p> <h2>Methods</h2> <p>A systematic search of the App Store, Google Play, PubMed, and Scopus was conducted to identify relevant applications. The quality assessment of the apps was performed through heuristic evaluation and the uMARS tool. The Inclusion criteria focused on apps designed for endodontic education and clinical practice.</p> <h2>Results</h2> <p>From 350 records, 9 applications met the criteria. The heuristic rating for all apps was low to medium, except for Endolit, which demonstrated severe usability issues. Dental Endo Master received the best mean score in the uMARS rating. The selected applications offer diverse functionalities, including educational tools (EndoPrep, Endo Lit, Dental Endo Master, Adat Endodontic Cram Cards, Tooth SOS, Injured Tooth, AcciDent), diagnostic aids (Endo10), and case difficulty assessments (AAE Endo Case). Most apps were available on Android and iOS, with ratings ranging from 4.2/5 to 5/5.</p> <h2>Discussion</h2> <p>This study highlights the growing role of smartphone applications in endodontics, particularly in education, clinical support, and patient guidance. While these apps offer interactive learning and diagnostic assistance, their quality varies due to differences in developer expertise, usability, and regulatory oversight. Some excel in engagement and functionality, while others require improvements in customization and accessibility. Ensuring evidence-based development, standardized evaluations, and user-centered design is essential for maximizing their impact on dental education and clinical practice.</p> <h2>Conclusion</h2> <p>Smartphone applications have transformative potential in endodontic education, enabling flexible learning and improved clinical skills. However, challenges such as inconsistent quality and limited validation require attention.</p> <h2>Registration</h2> <p>No formal registration was required for this narrative review.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14218?af=R International Endodontic Journal urn:uuid:ad9110cf-d8e9-9c4f-20cd-67641392aa42 Tue, 11 Mar 2025 09:35:41 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Aim</h2> <p>This study investigated the correlation between microbiota of caries-free enamel and caries-affected dentine biofilms and that of root canals with primary apical periodontitis, by using an Illumina MiSeq platform.</p> <h2>Methodology</h2> <p>Biofilm from caries-free enamel surface (Biofilm-C) or caries-affected dentine (Biofilm-E) and root canal paper point samples (Canal) were collected from 31 teeth with primary apical periodontitis. Microbial composition was analysed by amplicon sequencing that targeted the V3–V4 region of 16S rRNA gene. Alpha and beta diversities of bacterial communities between sampling sites were compared using the Kruskal–Wallis test and pairwise permutational multivariate analysis of variance, respectively. Differentially abundant taxa identified using MaAsLin2 were adjusted for multiple comparisons using the Benjamini–Hochberg method.</p> <h2>Results</h2> <p>Totals of 16 phyla, 130 genera and 314 species were identified. Distinct and shared bacterial communities were observed between biofilm and canal samples. No significant differences in alpha diversity were observed across all sampling sites. A total of 32 genera including <i>Acinetobacter, [Eubacterium], Dialister, Erysipelotrichaceae</i> UCG-006, <i>Lawsonella</i>, W5053, <i>Phocaeicola, Mogibacterium, Pyramidobacter</i> and <i>Parvimonas</i> were more abundant in Canal samples compared to both Biofilm-C and Biofilm-E. The genera <i>Hallella, Lactobacillus, Shuttleworthella, Olsenella, Cryptobacterium, Alloprevotella, Phocaeicola, Limosilactobacillus,</i> <i>Selenomonadaceae</i> and <i>Anaeroglobus</i> were increased significantly in Biofilm-E compared to Biofilm-C. <i>Hallela multisaccharivorax, Olsenella uli, Lactobacilllus gasseri, Selenomonadaceae</i> species and <i>Scardovia inopinata</i> exhibited higher abundance in both Biofilm-E and Canal, than Biofilm-C. These differences in bacterial composition among sampling sites, including the increased presence of specific taxa in caries-affected dentine and root canals, suggest that these microorganisms may contribute to the development of primary apical periodontitis.</p> <h2>Conclusion</h2> <p>Bacterial community structure differed significantly between biofilm and root canal samples, but showed no significant differences among biofilm samples based on dental caries status. However, some taxa were shared among caries-affected lesions, including dentine and root canals. <i>H. multisaccharivorax, O. uli, L. gasseri, Selenomonadaceae</i> species and <i>S. inopinata</i> exhibited higher abundance in caries-affected dentine and root canals with primary apical periodontitis, suggesting that specific bacteria in caries-affected dentine play a crucial role in the development of root canal infections and the pathogenesis of primary apical periodontitis.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14202?af=R International Endodontic Journal urn:uuid:7fc3d699-682d-6e8b-bb9f-268f71d76a3f Mon, 10 Mar 2025 04:00:27 -0700 International Endodontic Journal, Volume 58, Issue 4, Page 548-549, April 2025. https://onlinelibrary.wiley.com/doi/10.1111/iej.14088?af=R International Endodontic Journal urn:uuid:753b7f94-be1c-3e3c-4a63-fb3d7cb1d1cf Mon, 10 Mar 2025 04:00:27 -0700 International Endodontic Journal, Volume 58, Issue 4, Page 547-547, April 2025. https://onlinelibrary.wiley.com/doi/10.1111/iej.14193?af=R International Endodontic Journal urn:uuid:4c4ed493-4abb-0497-4ee5-f56a597cdaac Mon, 10 Mar 2025 04:00:27 -0700 International Endodontic Journal, Volume 58, Issue 4, Page 550-565, April 2025. <h2>Abstract</h2> <h2>Aim</h2> <p>Autotransplantation of teeth (ATT) is a viable biological method for addressing dental defects. The objective was to achieve occlusal reconstruction-orientated ATT to enhance functionality and obtain optimal location and adjacency. This study proposes a new concept of a guide (a fully guided system) to achieve position-predictable ATT.</p> <h2>Methodology</h2> <p>This study included 30 transplants in 29 patients who were randomly divided into two groups during the initial examination using a single-blind method. The experimental group comprised 15 transplants in 14 patients who underwent surgery using a fully guided system. Fifteen transplants were performed on 15 patients in the control group using only a replica.</p> <h2>Results</h2> <p>The mean number of repeated teeth autotransplantation attempts and mean preparation time exhibited no significant differences. The mean follow-up period was 1 year. Twenty-six transplants were followed up clinically, while four were only followed up by phone calls. The experimental group demonstrated a 100% success rate, whereas the control group exhibited a 70% success rate, with an overall 100% survival rate. 3D analysis: Deviation of both angle and distance was calculated for evaluation of accuracy. The mean centre deviation of teeth in experiment group was 0.79 mm (95% confidence interval [CI], 0.51–1.08) compared to 1.79 mm (95% CI, 1.10–2.47) in control group (<i>p</i> &lt; .05). The mean of average index points distance deviation showed a significant difference. The mean angle deviation of long axis in experiment group was 3.87° (95% CI, 2.25–5.49) compared to 12.98° (95% CI, 8.64–17.31) in control group (<i>p</i> &lt; .05). The angle deviation of long axis in mesio-distal direction, buccal-lingual direction and rotation showed a significant difference also.</p> <h2>Conclusions</h2> <p>The results of the analysis indicated that the fully guided system increased the predictability of achieving an ideal transplant position with intuitive data, establishing a solid foundation for optimal dental functional recovery and restoration. However, this study had limitations regarding the generalisability of the design of the optimal location for transplantation and the equipment requirements for clinical procedures. Therefore, further research on the screening of indications for guided systems and location planning is necessary.</p> <h2>Clinical Trial Registration</h2> <p>This study was registered on the Chinese Clinical Trial Registry (Registration Number: ChiCTR 2300074646).</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14194?af=R International Endodontic Journal urn:uuid:366fc697-62b0-c8b5-8218-b7e9d7905877 Mon, 10 Mar 2025 04:00:27 -0700 International Endodontic Journal, Volume 58, Issue 4, Page 627-642, April 2025. <h2>Abstract</h2> <h2>Aim</h2> <p>3D-printed scaffolds loaded with healing directed agents could be employed for better treatment outcome in regenerative dentistry. The aim of this study was to fabricate and characterize simple 3D-printed poly lactic acid (PLA) scaffolds coated with nanoHydroxyapatite (nHA), Naringin (NAR), or their combination, and testing their morphological, chemical, mechanical, antibacterial, biocompatible and bioactive properties.</p> <h2>Methodology</h2> <p>Two variants pore sizes, 300 and 700 μm, of 3D-printed PLA disc scaffolds measuring (10 × 1 mm) were fabricated. These scaffolds were dip-coated with nHA, NAR, or both (nHA/NAR). Field emission scanning electron microscopy (FeSEM), energy-dispersive X-ray spectroscopy (EDX), Fourier transforms infrared (FTIR), compressive and flexural strength testing was employed for optimizing pore size. Then, antibacterial activity against isolated <i>Streptococcus mutans</i> and <i>Enterococcus faecalis</i>, and cytotoxicity against normal human fibroblast were assessed. Additionally, appetite formation on scaffold surfaces was assessed after storage in simulated body fluid (SBF) for 14 days by further using FeSEM, EDX and XRD.</p> <h2>Results</h2> <p>FeSEM showed uniform structure for 3D-printed scaffolds in both pore size designs, and a consistent surface coating with nHA and NAR, which were further confirmed by EDX and FTIR. However, mechanical testing revealed statistical significant higher compressive and flexural strengths (<i>p</i> &lt; .000) for 300 μm pore size scaffolds. Statistical significant antibacterial activities (<i>p</i> &lt; .05) were also found with PLA/NAR, and PLA/nHA /NAR scaffolds in comparison with neat. The MTT assay revealed biocompatibility of PLA, nHA and NAR, with the combinations of the latter two working synergistically. Lastly, the formation of a calcium-phosphate appetite layer was recognized on the surface of PLA/nHA, PLA/nHA/NAR scaffold after being stored in SBF.</p> <h2>Conclusions</h2> <p>3D-printed, 300 μm pore size, PLA scaffold coated with a combination of nHA and NAR showed the best surface characteristics and improved mechanical, antibacterial and biocompatible properties for further investigation in regenerative studies.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14200?af=R International Endodontic Journal urn:uuid:e95e920c-31e1-66df-ba12-e45ab351817f Mon, 10 Mar 2025 04:00:27 -0700 International Endodontic Journal, Volume 58, Issue 4, Page 658-671, April 2025. <h2>Abstract</h2> <h2>Aim</h2> <p>To develop and validate an artificial intelligence (AI)-powered tool based on convolutional neural network (CNN) for automatic segmentation of root canals in single-rooted teeth using cone-beam computed tomography (CBCT).</p> <h2>Methodology</h2> <p>A total of 69 CBCT scans were retrospectively recruited from a hospital database and acquired from two devices with varying protocols. These scans were randomly assigned to the training (<i>n</i> = 31, 88 teeth), validation (<i>n</i> = 8, 15 teeth) and testing (<i>n</i> = 30, 120 teeth) sets. For the training and validation data sets, each CBCT scan was imported to the Virtual Patient Creator platform, where manual segmentation of root canals was performed by two operators, establishing the ground truth. Subsequently, the AI model was tested on 30 CBCT scans (120 teeth), and the AI-generated three-dimensional (3D) virtual models were exported in standard triangle language (STL) format. Importantly, the testing data set encompassed different types of single-rooted teeth. An experienced operator evaluated the automated segmentation, and manual refinements were made to create refined 3D models (R-AI). The AI and R-AI models were compared for performance evaluation. Additionally, 30% of the testing sample was manually segmented at two different times to compare AI-based and human segmentation methods. The time taken by each segmentation method to obtain 3D models was recorded in seconds(s) for further comparison.</p> <h2>Results</h2> <p>The AI-driven tool demonstrated highly accurate segmentation of single-rooted teeth (Dice similarity coefficient [DSC] ranging from 89% to 93%; 95% Hausdorff distance [HD] ranging from 0.10 to 0.13 mm), with no significant impact of tooth type on accuracy metrics (<i>p</i> &gt; .05). The AI approach outperformed the manual method (<i>p</i> &lt; .05), showing higher DSC and lower 95% HD values. In terms of time efficiency, manual segmentation required significantly more time (2262.4 ± 679.1 s) compared to R-AI (94 ± 64.7 s) and AI (41.8 ± 12.2 s) methods (<i>p</i> &lt; .05), representing a 54-fold decrease.</p> <h2>Conclusions</h2> <p>The novel AI-based tool exhibited highly accurate and time-efficient performance in the automatic root canal segmentation on CBCT, surpassing the human performance.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14192?af=R International Endodontic Journal urn:uuid:d023dc1c-d22d-9808-3bf1-0f5249c7a34d Mon, 10 Mar 2025 04:00:27 -0700 International Endodontic Journal, Volume 58, Issue 4, Page 579-586, April 2025. <h2>Abstract</h2> <h2>Aim</h2> <p>This study aimed to evaluate the effects of chronic consumption of two sugar-sweetened carbonated soft drinks – one containing caffeine (Coca-Cola®) and one without (Sprite®) – on the progression of periapical lesions and the levels of pro-inflammatory cytokines in rats.</p> <h2>Methodology</h2> <p>Twelve Wistar rats were divided into three groups (<i>n</i> = 4): Control group, Coca-Cola group and Sprite group. The rats in Coca-Cola and Sprite groups were given <i>ad libitum</i> access to their respective soft drinks for 3 months, while the Control group received filtered water. After 2 months of consumption, the pulps of the lower left first molars were exposed for 28 days to induce periapical lesions. Following euthanasia, the jaws were removed, and the periapical lesions were assessed using micro-computed tomography imaging. Blood samples were collected to analyse the pro-inflammatory cytokines IL-1β, IL-6, IL-2, IL-17 and TNF-α via Luminex assay. Non-parametric data were analysed using the Kruskal-Wallis test followed by Dunn's test, while parametric data were analysed using one-way ANOVA followed by Tukey's test (<i>p</i> &lt; 0.05).</p> <h2>Results</h2> <p>Both the Coca-Cola and Sprite groups exhibited periapical lesions with significantly greater volume and diameter compared to the Control group (<i>p</i> &lt; 0.05). Additionally, both soft drink groups had significantly higher levels of IL-1β, IL-6 and IL-2 compared to the Control group (<i>p</i> &lt; 0.05). The Sprite group displayed significantly higher levels of IL-1β than the Coca-Cola group (<i>p</i> &lt; 0.05), while the Coca-Cola group showed significantly elevated TNF-α levels compared to both the Control and Sprite groups (<i>p</i> &lt; 0.05). No significant differences in IL-17 levels were observed among the groups (<i>p</i> &gt; 0.05).</p> <h2>Conclusions</h2> <p>The chronic consumption of sugar-sweetened carbonated soft drinks, regardless of caffeine content, has detrimental effects on the inflammatory response and progression of apical periodontitis in rats.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14195?af=R International Endodontic Journal urn:uuid:3aab4ef5-fb76-9f05-cdb3-1678fef05edb Mon, 10 Mar 2025 04:00:27 -0700 International Endodontic Journal, Volume 58, Issue 4, Page 566-578, April 2025. <h2>Abstract</h2> <h2>Aim</h2> <p>Although many pain assessment tools exist, none are specific to the relatively unique presentation of pulpal pain. The aim of this study was to develop and validate a novel pain assessment tool based on pulp symptoms.</p> <h2>Methodology</h2> <p>A preliminary list of items best-describing pulpitis was developed based on deductive and inductive approaches and the preliminary tool was piloted (<i>n</i> = 80). A final 11-item pain assessment tool was developed comprising 5 closed-ended items evaluating pain intensity to diverse stimuli (thermal and sweet) and 6 closed-ended items assessing various aspects of pulp pain (such as spontaneity, duration, referral, postural pain, pain upon biting and requirement for analgesics). The tool was tested on 300 adult patients (age range = 18–54 years) who presented with symptoms indicating some form of pulpitis. The 11 items were each scored from 1 to 4, yielding a total score between 11 and 44. These scores were subsequently compared to a set of diagnoses made utilizing established clinical reference standards, these include patient history, clinical examination, periapical radiographs, and pulp testing.</p> <h2>Results</h2> <p>All items in the tool reached an excellent content validity index score (≥0.83) for relevance. Following the pilot, six items were rephrased and five were removed. After final testing the constructed tool had a reliability coefficient of .8641, indicating a high level of internal consistency. Factor analysis extracted two factors that accounted for 59.61% of variance. The sensitivity and specificity was 95.36% and 86.58%, respectively. Likelihood ratio was 7.104 (LR+) and 0.05 (LR−) at cut-off point. The area under the ROC curve was 0.9714 with a SE of 0.0076. The cut off score by Youden index was 25 between reversible and irreversible pulpitis.</p> <h2>Conclusions</h2> <p>The developed tool proved to be both valid and reliable. It is the first comprehensive multidimensional tool designed to standardize the pulp pain assessment protocol, covering various attributes of pulp pain and effectively distinguishing between reversible and irreversible pulpitis with a defined cut-off score. Furthermore, its use is anticipated to provide support in diagnosing ambiguous cases of inflamed pulp, which is especially helpful for less experienced dentists.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14196?af=R International Endodontic Journal urn:uuid:509fc5e9-4a4f-7c0b-4029-a70092991821 Mon, 10 Mar 2025 04:00:27 -0700 International Endodontic Journal, Volume 58, Issue 4, Page 604-612, April 2025. <h2>Abstract</h2> <h2>Introduction</h2> <p>Biofilms may show varying adherence strengths to dentine. This study quantified the shear force required for the detachment of multispecies biofilm from the dentine using fluid dynamic gauging (FDG) and computation fluid dynamics (CFD). To date this force has not been quantified.</p> <h2>Methods</h2> <p>Multispecies biofilms were grown over 3, 7 and 14 days on 2 mm thick dentine sections of human molars (<i>n</i> = 8 per group). The FDG technique with different suction flow rates (100%, 80% and 40%) was used to assess biofilm removal. At maximum suction (100%), the flow rate was 500 mL/min. Digital images of each stained dentine sample were captured (10× magnification) before and after subjecting the samples to the various suction flow rates. The change in colour saturation versus control (△E) value was determined to assess removal of biofilm using digital softwares (Image J© and Colormine©). The imposed shear forces were then estimated using CFD and correlated with the △E values.</p> <h2>Results</h2> <p>FDG and CFD analysis showed that complete removal of biofilm by using water as the gauging liquid was not possible across any of the experimental groups. Three-day biofilms required significantly lower shear forces for removal than 7-day or 14-day biofilms.</p> <p>The maximum shear forces were seen in the 14-day biofilm group at all flow rates tested.</p> <p>When assessing for residual biofilm on the dentine, the △E value showed residual biofilms of approximately 40% at all time periods at a 100% flowrate. Complete removal of multispecies biofilm was not possible in any experimental group.</p> <h2>Conclusions</h2> <p>This study for the first-time records forces needed to remove polymicrobial biofilms form the surface of a dentine sample. Within the limits of this study, mature biofilms require greater shear forces for removal. This is important when planning protocols for biofilm removal.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14197?af=R International Endodontic Journal urn:uuid:9901eff2-58cb-a198-6559-a4f6ec0e6a22 Mon, 10 Mar 2025 04:00:27 -0700 International Endodontic Journal, Volume 58, Issue 4, Page 643-657, April 2025. <h2>Abstract</h2> <h2>Aim</h2> <p>This study aimed to evaluate the compliance of dentists in Croatia and the Czech Republic with endodontic recommendations and identify the subjective and objective factors influencing their adherence to them.</p> <h2>Methodology</h2> <p>A total of 1386 dentists from Croatia and the Czech Republic participated in an online survey through a self-administered, author-designed questionnaire. After excluding those who did not perform root canal treatments (RCT), 1376 responses (394 from Croatia and 982 from the Czech Republic) were statistically analysed.</p> <h2>Results</h2> <p>The median age of respondents was 40 years, with a higher proportion of females in both countries. Croatian dentists treated fewer patients weekly but performed more RCTs and placed more composite fillings than their Czech counterparts. Czech dentists more frequently employed magnification devices, rubber dam (RD), pre-endodontic build-ups, nickel-titanium (NiTi) instruments, irrigant activation, bioceramic sealers, indirect post-endodontic restoration of lateral teeth, and single-visit treatments. These practices were also more common among endodontists than general dental practitioners and other specialists in both countries. Croatian dentists adhered more consistently to the recommended irrigation protocol. In the Czech group, adherence to recommended procedures, such as magnification, RD usage, and irrigation protocol correlated with younger age, smaller weekly number of patients, and preference for treating patients in the supine position. No such correlations were observed among the Croatian dentists.</p> <h2>Conclusions</h2> <p>Despite notable improvements in recent years, dentists still do not fully comply with the recommended RCT working procedures in Croatia and the Czech Republic.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14198?af=R International Endodontic Journal urn:uuid:6cc4dfb2-327a-3f99-3ef0-0a662a95c2f9 Mon, 10 Mar 2025 04:00:27 -0700 International Endodontic Journal, Volume 58, Issue 4, Page 587-603, April 2025. <h2>Abstract</h2> <h2>Aim</h2> <p>Effective control of mesenchymal stem cell (MSC) differentiation towards osteogenic lineages is fundamental for bone regeneration. This study elucidates the regulatory role of methyltransferase like 7A (METTL7A) in the osteogenic differentiation of MSCs.</p> <h2>Methodology</h2> <p>Alkaline phosphatase staining, Alizarin Red S staining, western blotting, and <i>in vivo</i> studies were conducted to determine the effects of METTL7A depletion or overexpression on the osteogenic differentiation of various types of MSCs. Then the downstream signalling pathways regulated by METTL7A in MSCs were further investigated.</p> <h2>Results</h2> <p>Our findings indicate that METTL7A expression significantly increases during the osteogenic differentiation of MSCs. Furthermore, depletion of METTL7A hindered, whereas its overexpression enhanced, the osteogenic differentiation of MSCs. Mechanistically, METTL7A influences MSC osteogenic differentiation by activating the YAP1-TEAD1 signalling pathway. It enhances YAP1 expression not only by stabilising <i>YAP1</i> mRNA but also, crucially, by recruiting the eIF4F complex, thereby boosting the translation efficiency of <i>YAP1</i> mRNA. Additionally, the YAP1/TEAD1 complex transcriptionally regulates METTL7A expression, creating a positive feedback loop that amplifies osteogenic differentiation.</p> <h2>Conclusions</h2> <p>Overall, our study uncovers a previously unknown molecular mechanism of MSC osteogenic differentiation and suggests that activating METTL7A could offer new avenues for enhancing bone regeneration.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14199?af=R International Endodontic Journal urn:uuid:b6751414-4f88-0d80-6c93-032f533004c2 Mon, 10 Mar 2025 04:00:27 -0700 International Endodontic Journal, Volume 58, Issue 4, Page 613-626, April 2025. <h2>Abstract</h2> <h2>Aim</h2> <p>Previous studies have shown the important relationships between <i>Enterococcus faecalis</i> and <i>Candida albicans</i> in post-treatment endodontic disease (PTED). However, the fungal–bacterial interactions and their possible functional routes are less understood. In this study, we investigated the effect of extracellular vesicles (EVs) derived from <i>C. albicans</i> on <i>E. faecalis</i> growth and pathogenicity.</p> <h2>Methodology</h2> <p><i>Candida albicans</i> EVs were isolated from a yeast nitrogen base (YNB) medium, and their morphology, size distribution, and protein concentration were observed and identified. The effects of EVs on planktonic <i>E. faecalis</i> were evaluated using growth curves and colony-forming unit counts, whereas the effects on <i>E. faecalis</i> biofilms were determined using scanning electron and confocal laser scanning microscopes. The ability of <i>E. faecalis</i> to resist a detrimental environment, infect dentinal tubules, and biofilm formation on gutta percha was examined. Additionally, the effect of EVs on cell invasion and cytotoxicity of <i>E. faecalis</i> were assessed. Statistical analysis was performed using one-way analysis of variance, and <i>p</i>-values of &lt;.05 were considered significantly different.</p> <h2>Results</h2> <p><i>Candida albicans</i> EVs were nanoparticles with bilayer membranes and with peak sizes of 111.9 and 230 nm. EVs exhibited a complex effect on <i>E. faecalis</i> and its biofilms; 5 μg/mL of EVs showed inhibitory effects whereas 0.156 μg/mL of EVs facilitated their growth. The EVs showed consistent effects on <i>E. faecalis</i> virulence. Notably, 5 μg/mL of EVs reduced the damage to RAW264.7 cells caused by <i>E. faecalis</i>, as well as the invasion ability of <i>E. faecalis</i> to macrophages and the intracellular survival ability of <i>E. faecalis</i> after macrophage phagocytosis, whereas 0.156 μg/mL of EVs had completely opposite effects.</p> <h2>Conclusion</h2> <p><i>Candida albicans</i> EVs showed dual effects on <i>E. faecalis</i> growth and virulence <i>in vitro</i>, suggesting <i>C. albicans</i> EVs are involved in fungal–bacterial communication. Moreover, the inhibitory effects exhibited by 5 μg/mL of EVs <i>in vitro</i> may suggest a new agent for the control of <i>E. faecalis</i>.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14220?af=R International Endodontic Journal urn:uuid:17cee415-e92d-3158-ac68-30dced2bd56c Sun, 09 Mar 2025 11:24:38 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Aim</h2> <p>This study aimed to evaluate bacteriome profiles (diversity, composition and relative abundances of bacterial genera) of the fluids from apical periodontitis (AP)-related radicular cysts (RCs).</p> <h2>Methodology</h2> <p>This observational study included 29 patients with AP and RC with complete sample triplets (supragingival plaque, cryopulverized tooth and cystic fluid). The bacteriome profiles of each matrix as well as of negative controls (NCs) were examined using 16S rRNA amplicon sequencing.</p> <h2>Results</h2> <p>Bacteriome profiles of cystic fluids differed from NCs in 79% of cases. The number of distinct amplicon sequence variants and Shannon index detected in cystic fluids and cryopulverized teeth were significantly lower than in paired supragingival plaque samples. Gram-negative genera and anaerobic genera were more abundant in cystic fluids than in paired cryopulverized teeth or their supragingival plaques. The relative abundances of the genera <i>Prevotella_7/Prevotella</i>, <i>Fusobacterium</i> and <i>Porphyromonas</i> were higher in cystic fluids than in paired cryopulverized teeth and NCs; their relative abundances dominated (&gt;20%) in individual cystic fluids. Also, DNA from the genus <i>Fretibacterium</i> was significantly more commonly found in cryopulverized teeth and cystic fluids than in supragingival plaque samples. The relative abundances of this gram-negative bacterial genera in cryopulverized teeth differed from NCs; the difference from cystic fluids was borderline insignificant.</p> <h2>Conclusions</h2> <p>Although the alpha-diversity in the cystic fluids is much lower compared to supragingival plaques, most cystic fluids are not sterile. DNA from specific anaerobic gram-negative bacterial genera dominated the fluids from AP-related RCs.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14216?af=R International Endodontic Journal urn:uuid:ec644caf-8f40-e00a-1b9f-b2ea4523399a Wed, 05 Mar 2025 05:10:24 -0700 International Endodontic Journal, EarlyView. https://onlinelibrary.wiley.com/doi/10.1111/iej.14217?af=R International Endodontic Journal urn:uuid:f9f69513-7c9c-bec3-f6d2-d4756cd03cce Sun, 02 Mar 2025 12:39:18 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Aims</h2> <p>The aim of this study was to evaluate the accuracy and consistency of responses given by two different versions of Chat Generative Pre-trained Transformer (ChatGPT), ChatGPT-4, and ChatGPT-4o, to multiple-choice questions prepared from undergraduate endodontic education topics at different times of the day and on different days.</p> <h2>Methodology</h2> <p>In total, 60 multiple-choice, text-based questions from 6 topics of undergraduate endodontic education were prepared. Each question was asked to ChatGPT-4 and ChatGPT-4o 3 times a day (morning, noon, and evening) and for 3 consecutive days. The accuracy and consistency of AIs were compared using SPSS and R programs (<i>p</i> &lt; .05, 95% confidence interval).</p> <h2>Results</h2> <p>The accuracy rate of ChatGPT-4o (92.8%) was significantly higher than that of ChatGPT-4 (81.7%; <i>p</i> &lt; .001). The question groups affected the accuracy rates of both AIs (<i>p</i> &lt; .001). The times at which the questions were asked did not affect the accuracy of either AI (<i>p</i> &gt; .05). There was no statistically significant difference in the consistency rate between ChatGPT-4 and ChatGPT-4o (<i>p</i> = .123). The question groups did not affect the consistency of either AI, too (<i>p</i> &gt; .05).</p> <h2>Conclusions</h2> <p>According to the results of this study, the accuracy of ChatGPT-4o was better than that of ChatGPT-4. These findings demonstrate that AI chatbots can be used in dental education. However, it is also necessary to consider the limitations and potential risks associated with AI.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14214?af=R International Endodontic Journal urn:uuid:5aa0a3df-f81a-20df-6ac1-fdcc3fe5d3cd Sun, 02 Mar 2025 12:35:15 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <p>Apical periodontitis (AP) is a common and clinically significant oral health condition, associated with an inflammatory response to infections within the root canal system. As patients retain natural teeth for longer, managing AP becomes more complex. Whilst generally effective, endodontic treatment outcomes can vary considerably in individuals with systemic health conditions, such as autoimmune diseases. The intersection of systemic inflammation, immune dysfunction and pharmacological treatments of the different diseases raises important questions about how autoimmune diseases influence AP prevalence and healing. This article examines current evidence on this interplay, its clinical implications and the need for tailored endodontic approaches in patients with autoimmune diseases.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14211?af=R International Endodontic Journal urn:uuid:b7bb5214-0737-1b81-580c-c94f336d4f5a Thu, 27 Feb 2025 09:58:42 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Background</h2> <p>Pulpitis, an inflammatory condition of the dental pulp, typically arises due to caries. It can remain asymptomatic for extended periods, complicating its diagnosis. The inflammatory response induced by bacterial invasion encompasses both cell-mediated and humoural immunity, accompanied by neural and vascular changes. The primary aim of inflammation is to eradicate invading pathogens from the pulp. However, failure to eliminate pathogens may result in necrosis of the pulp. Before direct bacterial contact with cells occurs, the pulp initiates protective responses like the formation of tertiary dentine. The interaction between bacterial surface proteins and specific receptors on pulp cells, primarily odontoblasts and dendritic cells, activates intracellular signalling pathways. These cascades, mediated by transcription factors, regulate gene expression and subsequent protein synthesis, thereby modulating the inflammatory response. In addition to proinflammatory and anti-inflammatory mediators, microRNAs and epigenetic modifications play a key role in gene expression in dental pulp. Epigenetic changes including DNA methylation and histone modifications can occur within the pulp.</p> <h2>Objectives</h2> <p>Dental pulp inflammation represents a highly intricate network of signalling pathways, messenger molecules and cellular interactions. The ongoing research continuously expands our understanding of these processes. The objective of this review is to investigate mechanisms of dental pulp inflammation, concentrating on the regulation of gene expression. This consists of transcription factors, microRNAs, epigenetic modifications and mitochondrial DNA, among others. This review aims to highlight recent findings about biomolecular and epigenetical mechanisms of pulpitis as well as their role in gene expression.</p> <h2>Conclusions</h2> <p>Pulp inflammation is a complex series of events happening on a molecular and cellular level. Even though the pulp tissue is hardly examined in vivo, laboratory studies offer great new insights and potential for our understanding of its inflammatory mechanisms. Recognition of bacterial components by pulp cells is the initiator of overlapping signalling pathways that will eventually lead to gene activation or repression. Specific genes might be activated, resulting in the production of messenger molecules like cytokines and chemokines. Trending topics of medicine like microRNA and epigenetics are also discussed in the context of dentistry. This knowledge could be used to develop new therapeutics in endodontics.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14212?af=R International Endodontic Journal urn:uuid:217cceba-793e-10f0-51c1-69749c7f98a6 Thu, 27 Feb 2025 09:54:20 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Aim</h2> <p>Leadership opportunities within professional fields often include invitations to speak at major organizational meetings. However, the representation of speakers from underrepresented groups at annual scientific meetings of endodontic organizations has yet to be documented. This observational study aimed to evaluate the percentage of women invited to speak at selected endodontic organization meetings.</p> <h2>Methodology</h2> <p>The number of male and female keynote or invited speakers at the European Society of Endodontology (ESE), Asian Pacific Endodontic Confederation (APEC), and International Federation of Endodontic Associations (IFEA) conferences from 2013 to 2023 were recorded. A chi-square test was conducted to assess differences in the percentage of women speakers over time and among the three organizations.</p> <h2>Results</h2> <p>A total of 714 keynote and invited speakers from the scientific meetings of the three endodontic organizations between 2013 and 2023 met the inclusion criteria. Of these, 601 (84.17%) were men, and 113 (15.83%) were women, reflecting a significant gender disparity (<i>p</i> &lt; 0.001). No significant differences were observed between the organizations, nor was there a significant change in the number of women speakers over time.</p> <h2>Conclusions</h2> <p>Regardless of the organization or the timeframe, the number of women speakers at scientific meetings remains consistently lower than that of men, with no significant change observed over the past decade.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14210?af=R International Endodontic Journal urn:uuid:bae8de8e-7a60-4325-c43c-c2051293f5c6 Sun, 23 Feb 2025 12:19:13 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Background</h2> <p>The formation of a reparative hard tissue bridge is a key indicator of defensive pulp response and successful vital pulp treatment (VPT); however, there is a lack of comprehensive information regarding the impact of bioactive materials on hard tissue formation.</p> <h2>Objectives</h2> <p>This systematic review with meta-analyses aimed to evaluate the hard tissue bridge formation in direct pulp capping and pulpotomies in humans, comparing the use of ProRoot MTA with other calcium silicate-based cements (CSCs) and calcium hydroxide.</p> <h2>Methods</h2> <p>The search was conducted in six electronic databases, until May 2024. The selection process followed the PICOS criteria. Clinical trials that evaluated the hard tissue bridge formation in VPTs using ProRoot MTA compared with other CSCs or calcium hydroxide, were included. The quality of the studies was assessed using the RoB-2 tool for randomized clinical trials, and ROBINS-I for nonrandomized trials. Meta-analyses were performed to compare the frequency of complete bridge formation using RevMan software 5.3. The GRADE tool was used to determine the overall certainty of evidence.</p> <h2>Results</h2> <p>Twenty-six studies were included, and the majority showed high risk of bias. Meta-analyses revealed that using ProRoot MTA resulted in significantly higher frequency of complete hard tissue bridge formation compared with using other CSCs and calcium hydroxide. Subgroup analyses indicated that using ProRoot MTA led to higher complete bridge formation compared with Biodentine. The certainty of evidence was low.</p> <h2>Conclusions</h2> <p>The use of ProRoot MTA resulted in significantly higher frequency of complete hard tissue bridge formation, greater hard tissue thickness and better morphology compared with various other CSCs and calcium hydroxide. Almost all studies were performed in premolars extracted due to orthodontic reasons or third molars. This scenario does not represent the clinical setting and therefore results should be interpreted with caution.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14203?af=R International Endodontic Journal urn:uuid:309fe250-0929-9fa6-eb5f-8930c66fd18d Tue, 18 Feb 2025 08:47:57 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Introduction</h2> <p>The aim of this study was to investigate the applications of cone beam computed tomography (CBCT) amongst endodontic specialists in the United Kingdom (UK) via an online survey.</p> <h2>Methods</h2> <p>An online invitation to take part in the survey was sent out to 306 specialist endodontists registered on the UK specialist register. The survey consisted of a series of questions associated with demographics, access and use of CBCT, utilization of dose optimization parameters, and frequency of use in different clinical scenarios.</p> <h2>Results</h2> <p>In total, 202 respondents completed the survey (a response rate of 66.3%), 128 were male (63.4%), and 74 were female (36.6%). Of the 202 respondents, 174 (85.7%) used CBCT for diagnosis and/or management of endodontic problems. A CBCT scanner was on-site in 71.3% (<i>n</i> = 124) and 28.7% (<i>n</i> = 50) being off-site. A small field of view (FOV) was the prescribed scan in most cases (88.5%, <i>n</i> = 154/174). The cost of the CBCT scan was included in the assessment/treatment fee in 21.8% (38/174) of cases, with 78.2% (136/174) charged a separate fee for the scan. In total, 89.1% (155/174) respondents used CBCT ‘often or always’ for management of complex root canal anatomy, 87.4% (152/174) for root resorption, 84.5% (147/174) for periapical microsurgery, only 20.7% (36/174) of respondents would use CBCT to assess the outcome of treatment. Only 35.1% (61/174) of respondents would prescribe a CBCT scan for a pregnant patient and 78.2% (136/174) would take a CBCT scan for a paediatric patient. In total, 22.4% (39/174) of respondents did not report or request reports of their CBCT scans. Respondents chose to alter the exposure parameters depending on the patient's age or if the dentition was deemed extensively restored. Of the clinicians who incorporate CBCT into their practice, 93.7% (164/174) believe it improves the quality of the care they provide, and 93.6% (163/174) felt that the use of CBCT improves confidence in their diagnosis.</p> <h2>Conclusions</h2> <p>The use of CBCT amongst specialist endodontists in the UK is commonplace. However, usage does not appear to completely follow best practice guidance for certain clinical scenarios and highlights the need for further training in CBCT.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14209?af=R International Endodontic Journal urn:uuid:733c23f6-49ce-d237-5ca2-a23511c589ce Fri, 14 Feb 2025 11:44:31 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Aim</h2> <p>The aim of this study was to investigate the characteristics of vertical root fractures (VRFs) at early stages and compare them with previously reported dentinal microcracks.</p> <h2>Methodology</h2> <p>Endodontically treated teeth with vertical root fractures at early stages were collected. The characteristics of these VRFs were evaluated by in vitro observation and micro-CT scanning: (1) the number of fractures (buccal, lingual, mesial and distal were counted separately); (2) vertical extension on the roots (classified into four categories according to cemento-enamel junction and root apex involved or not); (3) the direction of fractures (bucco-lingual or mesial-distal); (4) horizontal extension of fractures (involved the root canal wall or the root surface or both); (5) the width of fractures (measured at the widest site on the axial micro-CT image); and (6) the location of the widest fractured site on the root (coronal third portion, middle third portion and apical third portion).</p> <h2>Results</h2> <p>A total of 28 vertical root fractures at early stages were collected in this study, involving 30 roots with a total of 51 fractures. All fractures involved the middle portion of root; all fractures were bucco-palatal/lingual and extended from the root canal wall to the root surface. The maximum width of these fractures were &lt;150 μm, and widest fractures may be at the coronal, middle or apical third portion of the tooth root.</p> <h2>Conclusions</h2> <p>All vertical root fractures involved the middle portion of root, initiated from the root canal wall and directed buccal-lingually. The fractures were irregular and tortuous, with fracture widths exhibiting considerable variability. These characteristics help us to have a better understanding of the initiation and development of VRFs, and also supply evidence dentinal microcracks are an experimental phenomenon.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14208?af=R International Endodontic Journal urn:uuid:696d1872-8091-f25d-ef16-61d4f9d6669e Thu, 06 Feb 2025 10:08:27 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <p>Stimuli-responsive hydrogels are smart and functional materials that respond to various environmental stimuli, including temperature, light, magnetic field, pH, redox, enzymes and glucose. This responsiveness allows for the controlled release of therapeutic agents encapsulated within the hydrogels, enhancing treatment precision, improving therapeutic outcomes and minimizing side effects. Such hydrogels show great potential in root canal disinfection, management of dental pulp inflammation and pulp regeneration, making them promising candidates for more personalized and effective endodontic treatments. This article provides an overview of the latest advancements in the design and application of stimuli-responsive hydrogels in endodontics, emphasizing their potential to revolutionize endodontic treatments. It also addresses current challenges and explores future directions in the field, aiming to inspire and motivate researchers to further engage in or intensify their efforts within this promising area of research.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14206?af=R International Endodontic Journal urn:uuid:d9c06d37-1a00-84c3-0cfa-9f6dcc96a8b7 Tue, 04 Feb 2025 09:16:34 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Aim</h2> <p>Clinical and in vitro evidence indicates that chronic inflammatory responses initiated by dental caries can persist in the dental pulp even after treatment, necessitating the formation of reparative dentin to restore tissue homeostasis and health. Human dental pulp stem cells (hDPSCs) serve as crucial precursors in this reparative process. This study explores the role of B cells and their secreted factor, Angiopoietin Like 1 (ANGPTL1), in promoting hDPSCs differentiation into odontoblasts under carious conditions, with a particular focus on the activation of Forkhead box O1 (FoxO1).</p> <h2>Methodology</h2> <p>Single-cell RNA sequencing (scRNA-Seq) data from the GEO database were analysed to explore cellular interactions and molecular mechanisms in dental pulp. Immunofluorescence staining was used to investigate the expression patterns of B cells or hDPSCs in dental pulp and hydroxyapatite/tricalcium phosphate (HA/TCP) scaffolds. The expression levels of ANGPTL1 were quantified using enzyme-linked immunosorbent assay (ELISA). Odontoblast differentiation capacity was assessed by alkaline phosphatase activity, alizarin red S staining, and western blotting analysis. hDPSCs were overexpressed or knocked down FoxO1 with lentiviruses. The regulatory interaction between FoxO1 and the DSPP promoter was evaluated through dual-luciferase reporter assay and chromatin immunoprecipitation assay. Statistical analyses were conducted using Student's <i>t</i>-test or one-way analysis of variance (<span class="smallCaps">anova</span>) with a <i>p</i>-value of &lt;.05 considered statistically significant.</p> <h2>Results</h2> <p>scRNA-Seq data indicated a significant increase in B cells and ANGPTL1 expression in carious dental pulp. Functional analyses confirmed that ANGPTL1 secreted by B cells activated FoxO1 expression in hDPSCs, enhancing their differentiation into odontoblast-like cells. Blocking ANGPTL1 signalling with a specific antibody reduced FoxO1 expression, indicating a regulatory link between ANGPTL1 and FoxO1. Overexpression of FoxO1 in hDPSCs promoted their differentiation into odontoblasts and facilitated mineralized matrix formation. Mechanistic studies revealed that FoxO1 directly binds to the DSPP promoter, thereby inducing its expression.</p> <h2>Conclusions</h2> <p>Our study reveals a novel mechanism in which ANGPTL1 secreted by B cells in a carious environment promotes the odontoblast differentiation of hDPSCs by upregulating FoxO1. This finding highlights a potential therapeutic target for enhancing dental pulp repair and regeneration.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14207?af=R International Endodontic Journal urn:uuid:2132a873-5c96-7283-549f-d13c84aa8ef9 Tue, 04 Feb 2025 09:09:25 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Aim</h2> <p>To evaluate whether performing apical patency (AP) poses a risk for the development of osteonecrosis in rats treated with the antiresorptive drugs Zoledronic Acid (ZA) or Denosumab (DMAB).</p> <h2>Methodology</h2> <p>Forty-two male Wistar rats were divided into six groups according to the medication administered and whether apical patency was performed (<i>n</i> = 7): ZA, ZA-AP, DMAB, DMAB-AP, and the control groups CON and CON-AP. The ZA and ZA-AP groups received 0.125 mg/kg of ZA, while the DMAB and DMAB-AP groups received 0.25 mg/kg of DMAB, both administered via intraperitoneal injection twice a week for 4 weeks. One week after completing drug administration, endodontic access was performed on the distal occlusal fossa of the lower left first molars in all animals. AP was carried out in the distal canal of the ZA-AP, DMAB-AP, and CON-AP groups using a size 10 K-file with the aid of an electronic apex locator, extending beyond the apical foramen. In the other groups, the file was inserted up short of apex as determined by electronic apex locator measurement. Coronal sealing was performed and after 21 days, the animals were euthanized, and visual analysis, micro-CT, and histopathological assessments were conducted to evaluate the presence or absence of osteonecrosis. Statistical analysis was performed using frequency statistics and a GLM multivariate ANOVA model followed by Tukey's test with significance at <i>p</i> &lt; .05.</p> <h2>Results</h2> <p>None of the animals exhibited bone exposure or other clinical signs associated with medication-related osteonecrosis of the jaw. No cortical bone destruction, periosteal reaction, or bone sequestration was observed in the micro-CT or histopathological assessments. Medication significantly influenced some micro-CT parameters (<i>p</i> &lt; .05), while the apical patency alone did not (<i>p</i> &gt; .05). When interacting with medication*apical patency, the ZA-AP group showed a significantly lower percentage of bone volume and bone mineral density compared to the ZA group, a tendency not observed in DMAB groups (<i>p</i> &lt; .05).</p> <h2>Conclusions</h2> <p>Apical patency in rats treated with zoledronic acid or denosumab did not cause osteonecrosis of the jaw, only micro-CT changes in bone microarchitecture that cannot be linked to osteonecrosis in zoledronic acid treated animals.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14205?af=R International Endodontic Journal urn:uuid:da0f4f25-c8b7-0017-5aa5-178b5261c75b Fri, 31 Jan 2025 06:04:50 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Aim</h2> <p>To compare the outcome of full and deep pulpotomy performed in mature permanent teeth with extremely deep carious lesion and symptomatic irreversible pulpitis.</p> <h2>Methodology</h2> <p>This parallel-group, double-blind, non-inferiority randomized controlled trial was conducted after ethical clearance. Patients with mature permanent teeth with extremely deep carious lesion and diagnosis of symptomatic irreversible pulpitis were recruited. Teeth were randomly allocated to two study groups, i.e. Group I: full pulpotomy (excision of pulp tissue up to the level of root canal orifices) and Group II: deep pulpotomy (excision of radicular pulp tissue 2–3 mm apical to root canal orifices). Haemostasis was achieved using cotton pellet moistened with 2.5% NaOCl for up to 10 min. Mineral trioxide aggregate was used as a pulp capping agent and teeth were restored in the same visit with resin composite. Outcome assessment was performed at 12-month follow-up based on clinical and radiographic evaluation. The success rate was determined by intention-to-treat (ITT) and per-protocol (PP) analysis. Two sample t-tests were used to compare the time taken to achieve haemostasis and determine its association with treatment outcome.</p> <h2>Results</h2> <p>A total of sixty teeth received treatment in both study groups. The bleeding time was significantly more in Group I (6.13 ± 1.59 min) compared to group II (5.23 ± 1.22 min) (<i>p</i> &lt; .0171). The recall rate was 86.6% at study end point when fifty-two teeth were analysed at 12-month follow up. The success rate was 88.46% and 92.30% for per protocol analysis and 76.67 and 80% for ITT analysis for Group I and Group II, respectively, without any statistically significant difference (<i>p</i> = .610). The absolute risk difference between each treatment was within the 10% non-inferiority limit. There was no statistically significant association between time taken to achieve haemostasis and treatment outcome in both study groups.</p> <h2>Conclusions</h2> <p>There was no significant difference between full and deep pulpotomy techniques, with respect to achievement of haemostasis and treatment outcome for management of teeth with extremely deep caries and irreversible pulpitis.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14204?af=R International Endodontic Journal urn:uuid:8511fe9d-9efe-0ba2-4bec-bd793ed84613 Fri, 31 Jan 2025 05:49:05 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Aim</h2> <p>Endodontic conditions are associated with severe odontogenic infections. However, no studies have explicitly explored their role in the infectious process. This study aimed to assess associations between tooth-related and patient-related factors resulting in severe odontogenic infections and clinical care needs.</p> <h2>Methodology</h2> <p>A retrospective audit was conducted of all records of patients who presented with severe odontogenic infections requiring admission between 2018 and 2023, at the largest public hospital in South Australia. Pericoronitis, postoperative, and non-odontogenic infections were excluded. Associations between tooth-related factors (type, location, presence/absence of caries, restorations, root canal filling, apical periodontitis, and space of infection), patients-related factors (diabetes and smoking statuses), clinical management (length of admission, intensive care unit admission number of days, and need for general anaesthesia) were explored. <i>χ</i> ², Mann–Whitney's test and Fisher's exact test were used for statistical analysis, and the level of statistical significance was set at 5%.</p> <h2>Results</h2> <p>Of 382 records identified, 189 met the inclusion criteria. Mandibular (95.8%) molars (92.1%) were the most commonly offending teeth. Eight (4.2%) were root canal filled, 27 (14.3%) restored, 166 carious (87.8%), and 181 (95.8%) were associated with an apical radiolucency. Over half the sample were smokers (56.9%) and 16.4% were diabetics. The most common infection involved the submandibular space (56.1%). Intensive care unit admission was required for 157 patients (83.1%), and stay depended on the space of infection, with buccal space having the shortest duration (median 1 day) compared with submandibular (median 4 days) (<i>p</i> &lt; .001). Need for general anaesthesia was associated with Ludwig's angina (<i>n</i> = 3, 100%) (<i>p</i> = .04) and submandibular space infection (<i>n</i> = 104, 98.1%) (<i>p</i> &lt; .001), plus intensive care unit admission (<i>p</i> &lt; .001). Conversely, for buccal space infection, the need for general anaesthesia was lower (<i>n</i> = 5, 23.8%). No further significant differences were found.</p> <h2>Conclusion</h2> <p>Untreated mandibular molars with apical periodontitis were the most frequent tooth-related findings. Results from the present study suggest associations between the most severe clinical presentations (Ludwig's angina and submandibular infection) and complexity in clinical care. Buccal space infections required the least complex management.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14201?af=R International Endodontic Journal urn:uuid:dba0f1cf-0193-c39d-4d76-9f84e7c5539d Mon, 27 Jan 2025 11:14:52 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Background</h2> <p>Circadian rhythm disruption (CRD) affects the expression levels of a range of biological clock genes, such as brain and muscle ARNT-Like-1 (BMAL1), which is considered to be an important factor in triggering or exacerbating inflammatory response. However, the underlying effect of CRD on the pathogenesis of apical periodontitis, a common oral inflammatory disease, currently remains unknown. Exploring the effects and pathogenic mechanisms of CRD on apical periodontitis will be beneficial in providing new ideas for the prevention and treatment of apical periodontitis.</p> <h2>Methodology</h2> <p>The cross-sectional study was conducted among patients with apical periodontitis visiting to hospital. Rat models combining CRD and apical periodontitis were constructed, and the destruction of periapical alveolar bone was assessed by Micro-CT, H&amp;E, and TRAP staining assay. Rat periapical alveolar bone tissues were collected for RT-qPCR and immunohistochemistry to further detect the expression of periapical biological clock genes. A model of apical periodontitis was constructed using <i>Bmal1</i> ^{<i>−/−</i>} and WT rats to further verify the key role played by <i>Bmal1</i>. Finally, rats raised in CRD environment were intraperitoneally injected with melatonin to restore the circadian rhythm, and the periapical alveolar bone repair was observed by Masson's staining and staining of osteogenic markers (ALP, RUNX2).</p> <h2>Results</h2> <p>A close association between CRD and acute exacerbation of chronic apical periodontitis (CAP) in patients was first found in an epidemiological survey. By constructing animal models of CRD and apical periodontitis, it was found that CRD could aggravate the inflammatory stress of apical periodontitis and even drive the acute exacerbation of CAP. Further investigations suggested that the expression of crucial clock genes, especially <i>Bmal1</i>, were significantly disrupted in the periapical tissue of apical periodontitis. In addition, the periapical tissue from <i>Bmal1</i> knockout rat displayed stronger inflammatory response and more severe alveolar bone destruction in apical periodontitis. Restoring circadian rhythm by melatonin supplementation could effectively alleviate both the inflammatory response and alveolar bone loss in apical periodontitis.</p> <h2>Conclusion</h2> <p>CRD is a novel trigger in aggravating the inflammatory response and alveolar bone loss of apical periodontitis. Melatonin is expected to be used in the dental clinic as an important adjunctive therapy strategy for the healing of periapical tissue in apical periodontitis.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14187?af=R International Endodontic Journal urn:uuid:e86a3915-032c-4a67-232c-6c8b2ffdc671 Sun, 12 Jan 2025 10:38:54 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Aim</h2> <p>To evaluate the presence of women on editorial boards and as authors in leading global endodontics journals from 2018 to 2023.</p> <h2>Methodology</h2> <p>The selection of journals was based on the impact factor from Journal Citation Reports (JCR) and CiteScore 2022, with criteria of JCR above 1 and CiteScore above 1.5. Editorial board members were categorized as editor-in-chief and associate editor. Authorship was categorized into first, last, and corresponding author roles. The names of editorial board members and authors were extracted into an Excel spreadsheet, and gender analysis was conducted using the platforms Genderize, PubMed, Scopus, ResearchGate, and author's affiliated institutions' websites, categorized in a binary way. Descriptive statistics were used to analyse the data on the editorial board. A Poisson regression analysis was performed to investigate the prevalence ratio (PR) of female authorship compared with male authorship in the roles of first, last, and corresponding author. The Chi-square test was performed to evaluate the associations between female authors in prominent positions and the presence of other female authors.</p> <h2>Results</h2> <p>A total of four journals were analysed, identifying 24 editors-in-chief and 233 associate editors. None of the editor-in-chief were women, and 23 (9.8%) of the associate editors were female. Amongst the 8965 authors identified, 2983 (33.2%) were female: 1288 (41.1%) were first authors, 827 (27.7%) were last authors and 928 (31.1%) were correspondence authors. The PR for female corresponding authors was higher in AEJ than in JOE (1.07 [CI 1.03–1.11]), whilst the PR for female first authors was lower in IEJ than in JOE (0.96 [CI 0.93–0.99]). There was a lower PR for women as first authors in 2018 (0.94 [CI 0.90–0.99]) and as first (0.94 [CI 0.90–0.98]) and last (0.94 [CI 0.90–0.98)] authors in 2019 compared with 2023. The presence of women in prominent authorship positions was associated with increased female authorship in other positions (<i>p</i> &lt; .01).</p> <h2>Conclusion</h2> <p>Female participation on editorial boards and as prominent authors in leading journals is low, indicating significant challenges. Increasing female presence in prominent authorship roles may lead to greater female participation in other authorship positions.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14171?af=R International Endodontic Journal urn:uuid:71395ce8-fd91-ed6f-a761-0ba9e99e55a3 Mon, 18 Nov 2024 07:04:06 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Introduction</h2> <p>Competency in endodontic access cavity preparation requires key motor skills, good conceptual understanding, along with an appreciation of 3-dimensional pulp chamber anatomy. These are traditionally learned using natural or artificial teeth (AT) mounted within a phantom head (PH). Simodont® (Nissin Dental Products INC, JPN) is a haptic virtual reality simulator (HVRS) and offers an alternative to AT for training.</p> <h2>Aims</h2> <p>This study aimed to (1) evaluate the evolution in the performance of learners trained to prepare access cavities incorporating Simodont (test group) against learners trained on AT mounted within PH (control group), (2) determine learner acceptability of HVRS.</p> <h2>Methodology</h2> <p>Forty dental students, with no prior endodontic training, were given instruction and video demonstration of access cavity preparation using a mandibular left 1st molar AT (LL6). Thereafter, they prepared an access cavity on PH mounted AT LL6. This provided a baseline record of performance. Participants were randomly assigned to the test or control groups. The test group (<i>n</i> = 22) trained using Simodont: preparing a virtual tooth LL6 for a period of 60 minutes with instructor feedback. The control group (<i>n</i> = 18) trained using AT LL6 on a PH for 60 minutes with instructor feedback. Subsequently, learners from both groups prepared an access cavity on an AT LL6 in a PH. This provided a re-evaluation record. Two calibrated examiners graded the teeth from the baseline and re-evaluation using rubric criteria; assigning scores with a grading range from 0 to 17. The examiners were blinded to which group the teeth belonged. Change in performance was determined by calculating the difference in assessment grade from baseline to re-evaluation. Scores which improved by 3 or more units were labelled improvers, all other scores were described as non-improvers.</p> <h2>Results</h2> <p>Within the test group, the numbers of improvers were 5 (23%) versus 7 (39%) in the control group The difference failed to indicate statistical significance (<i>p</i> = .315). The Cohen kappa values for intra and inter-examiner agreement were 1.00 and 0.73 respectively.</p> <h2>Conclusion</h2> <p>The evolution of skills in learners trained using Simodont is comparable to those trained using AT. It is, therefore, reasonable to use Simodont, which was acceptable to learners, as an adjunct to AT for endodontic access cavity training.</p> https://onlinelibrary.wiley.com/doi/10.1111/iej.14160?af=R International Endodontic Journal urn:uuid:2528a146-b32d-f0a8-77bb-ba962e058ee5 Mon, 28 Oct 2024 11:16:17 -0700 International Endodontic Journal, EarlyView. <h2>Abstract</h2> <h2>Aim</h2> <p>To evaluate the current status of endodontic education and assessment at an undergraduate/predoctoral level in dental schools worldwide.</p> <h2>Methodology</h2> <p>The current survey comprised a 50-item online questionnaire related to undergraduate endodontic education. The project leaders emailed the survey's details to faculty members responsible for endodontic teaching at one dental school in every country to seek their willingness to participate in the survey. After the faculty members accepted, the survey details were sent to participants along with the survey link. Simple descriptive statistics were used to represent the data.</p> <h2>Results</h2> <p>Amongst the 44 faculty members from different countries who agreed to participate, 36 completed the survey. Endodontic training starts in 50% of dental schools from the third year of the curriculum. Each dental school employs a diverse range of educational methods. During pre-clinical training, 19.4% of the participating dental schools used only natural teeth. Stainless-steel hand instruments, syringe irrigation with a needle, resin-based sealer and the cold lateral compaction technique are the most frequently used in pre-clinical and clinical training. A significant percentage of dental institutions necessitate that students treat a predetermined quantity of canals or teeth throughout their pre-clinical and clinical education. Dental institutions conduct formative, summative or a combination of the formative and summative throughout the clinical and pre-clinical phases of endodontic training.</p> <h2>Conclusions</h2> <p>According to the data collected from this survey, there are considerable variations in the curriculum for undergraduate/predoctoral endodontic programmes amongst the surveyed dental schools. Pre-clinical and clinical education should integrate a larger array of modern tools and procedures.</p> https://www.123dentist.com/lendcare-partners-with-123dentist/ 123Dentist urn:uuid:479e4cc3-3a93-8099-a72d-efaa118a24c6 Mon, 12 Jun 2023 11:29:36 -0700 <p>Easy financing will help the millions of Canadians who cannot afford basic dental care.</p> <p>The post <a rel="nofollow" href="https://www.123dentist.com/lendcare-partners-with-123dentist/">LendCare Partners With 123Dentist</a> appeared first on <a rel="nofollow" href="https://www.123dentist.com">123Dentist</a>.</p> https://www.123dentist.com/123dentist-and-altima-dental-announce-a-strategic-merger-with-support-from-peloton-capital-kkr-and-heartland-dental/ 123Dentist urn:uuid:cdbbd46f-e88a-722c-8aa0-3bef9151b0d1 Tue, 12 Jul 2022 03:00:00 -0700 <p>123Dentist combines with Altima Dental and Lapointe Group, solidifying its position as one of the largest dental support organizations in Canada</p> <p>The post <a rel="nofollow" href="https://www.123dentist.com/123dentist-and-altima-dental-announce-a-strategic-merger-with-support-from-peloton-capital-kkr-and-heartland-dental/">123Dentist and Altima Dental Announce a Strategic Merger with Support from Peloton Capital, KKR, and Heartland Dental</a> appeared first on <a rel="nofollow" href="https://www.123dentist.com">123Dentist</a>.</p> https://www.123dentist.com/123dentist-named-one-of-canadas-best-managed-companies/ 123Dentist urn:uuid:fcdf2ca8-e613-56e0-5653-e78102f45969 Tue, 10 May 2022 10:40:10 -0700 <p>Now in its 29th year, Canada’s Best Managed Companies remains one of the country’s leading business awards programs recognizing Canadian-owned and managed companies for innovative, world-class business practices. </p> <p>The post <a rel="nofollow" href="https://www.123dentist.com/123dentist-named-one-of-canadas-best-managed-companies/">123Dentist Named One of Canada’s Best Managed Companies</a> appeared first on <a rel="nofollow" href="https://www.123dentist.com">123Dentist</a>.</p> https://www.123dentist.com/our-mission-vision-values-and-culture/ 123Dentist urn:uuid:84f9419d-5f14-3404-fd3b-9192c26ba26e Thu, 13 Jan 2022 10:52:59 -0700 <p>A word about our mission, vision, values and culture at 123Dentist from our CEO, Dr. Amin Shivji and Vice President of Human Resources, Sandra Morrison 123Dentist is based and founded on customer service and patient care. What began in 1993 with a single clinic in Vancouver has become Canada’s largest majority Dentist-owned network of dental [&#8230;]</p> <p>The post <a rel="nofollow" href="https://www.123dentist.com/our-mission-vision-values-and-culture/">A word about our mission, vision, values and culture from our CEO and VP of Human Resources</a> appeared first on <a rel="nofollow" href="https://www.123dentist.com">123Dentist</a>.</p> https://www.123dentist.com/working-at-123dentist-a-word-from-our-employees/ 123Dentist urn:uuid:51e87d25-138a-1e45-21ec-09b5f2f91dcd Thu, 13 Jan 2022 10:46:07 -0700 <p>123Dentist is a great place to work. But don&#8217;t take our word for it. Listen to some kind words from our team members and what it&#8217;s like working at 123Dentist. “If you want a great, fun environment to work in, a place to learn, grow and feel supported, then 123Dentist could be a great opportunity [&#8230;]</p> <p>The post <a rel="nofollow" href="https://www.123dentist.com/working-at-123dentist-a-word-from-our-employees/">Working at 123Dentist &#8211; A word from our Employees</a> appeared first on <a rel="nofollow" href="https://www.123dentist.com">123Dentist</a>.</p> https://www.123dentist.com/a-better-patient-experience-with-the-epic-hygiene-dental-laser/ 123Dentist urn:uuid:21213c5a-216c-17db-fca4-45cd35fe194a Mon, 20 Dec 2021 18:11:16 -0700 <p>Stony Plain Dental Centre, a member of 123Dentist, one of Canada’s largest majority dentist-owned network of dental practices, has been serving the Stony Plain community in Alberta, Canada, since 1999.  Over the years, Stony Plain Dental has encouraged its team to grow with continuing education, training, advances in dental technology, and communication skills to better serve [&#8230;]</p> <p>The post <a rel="nofollow" href="https://www.123dentist.com/a-better-patient-experience-with-the-epic-hygiene-dental-laser/">A Better Patient Experience With The Epic Hygiene Dental Laser</a> appeared first on <a rel="nofollow" href="https://www.123dentist.com">123Dentist</a>.</p> https://www.123dentist.com/123-dentist-presents-history-braces/ 123Dentist urn:uuid:7052a99b-b078-175a-c206-549a8017baa4 Fri, 01 Oct 2021 06:00:46 -0700 <p>It&#8217;s almost hard to remember a time when braces weren&#8217;t metal wires fastened to your teeth, but Invisalign is helping to make the past feel more distant. Now dentists and patients have a better option, one that achieves the same result without the downside. Invisalign costs about the same as regular braces, treatment takes around [&#8230;]</p> <p>The post <a rel="nofollow" href="https://www.123dentist.com/123-dentist-presents-history-braces/">123Dentist Presents: The History of Braces</a> appeared first on <a rel="nofollow" href="https://www.123dentist.com">123Dentist</a>.</p> https://www.123dentist.com/123dentist-gives-cdi-college-15000-reasons-to-smile/ 123Dentist urn:uuid:1a81b059-d13b-63df-d707-a160f2392b14 Fri, 27 Aug 2021 17:21:56 -0700 <p>123Dentist presented a number of completion scholarships to CDI College graduates from the Dental Assisting and Dental Receptionist programs during an awards luncheon on August 9, 2021. $15,000 worth of scholarships were awarded to twelve CDI College graduates from Burnaby and Surrey campuses. “We are tremendously proud to partner with and support the growth of [&#8230;]</p> <p>The post <a rel="nofollow" href="https://www.123dentist.com/123dentist-gives-cdi-college-15000-reasons-to-smile/">123Dentist Gives CDI College $15,000 Reasons to Smile</a> appeared first on <a rel="nofollow" href="https://www.123dentist.com">123Dentist</a>.</p> https://www.123dentist.com/colleges-modern-dental-clinic-gets-a-boost-from-123dentist/ 123Dentist urn:uuid:a2b39b7b-5a44-705f-00ae-d86967495351 Tue, 22 Jun 2021 17:21:44 -0700 <p>123Dentist, Canada’s largest majority dentist-owned network of dental practices, is giving $30,000 to support Okanagan College’s state-of-the-art dental space located in the new $18.9-million Health Sciences Centre. The new clinic is a major upgrade for Certified Dental Assistant (CDA) students, who can now learn in private operatories comparable to today’s dental practices along with smart [&#8230;]</p> <p>The post <a rel="nofollow" href="https://www.123dentist.com/colleges-modern-dental-clinic-gets-a-boost-from-123dentist/">College’s modern dental clinic gets a boost from 123Dentist</a> appeared first on <a rel="nofollow" href="https://www.123dentist.com">123Dentist</a>.</p> https://mobile.twitter.com/DentistryIQ/status/1270468211151179777?p=v Twitter Search / dentistryiq urn:uuid:fa5d33dc-8bd4-77f1-53bb-2a12d7ae6071 Tue, 09 Jun 2020 14:23:52 -0700 <div class="dir-ltr" dir="ltr"> Prescreening is now an important part of <a class="twitter-hashtag dir-ltr" dir="ltr" href="https://twitter.com/hashtag/dental?src=hash">#dental</a> practice procedures. In this <a class="twitter-hashtag dir-ltr" dir="ltr" href="https://twitter.com/hashtag/video?src=hash">#video</a>, <a class="twitter-atreply dir-ltr" dir="ltr" href="https://twitter.com/amber">@Amber</a> AugerRDH stresses that it's imperative to talk to every patient. Here's what her office is doing. <a href="https://www.dentistryiq.com/covid-19/video/14177410/coronavirus-impact-on-dental-practices-tips-for-effectively-prescreening-your-patients-video">dentistryiq.com/covid-19/video&hellip;</a> <a class="twitter_external_link dir-ltr tco-link has-expanded-path" dir="ltr" href="https://t.co/pt1lE8WtBL" rel="nofollow" target="_top">pic.twitter.com/pt1lE8WtBL</a> </div> https://mobile.twitter.com/DentistryIQ/status/1270407814008246281?p=v Twitter Search / dentistryiq urn:uuid:3dc11f46-a763-5dbe-59bb-64e05eb7c16a Tue, 09 Jun 2020 10:23:52 -0700 <div class="dir-ltr" dir="ltr"> From our partners at <a class="twitter-atreply dir-ltr" dir="ltr" href="https://twitter.com/RDHmag">@RDHmag</a>: <a class="twitter-hashtag dir-ltr" dir="ltr" href="https://twitter.com/hashtag/Dental?src=hash">#Dental</a> professionals should take special care to ensure they do not take <a class="twitter-hashtag dir-ltr" dir="ltr" href="https://twitter.com/hashtag/COVID?src=hash">#COVID</a>-19 aerosols home with them on the soles of their shoes. <a class="twitter-hashtag dir-ltr" dir="ltr" href="https://twitter.com/hashtag/dentistry?src=hash">#dentistry</a> <a href="https://www.rdhmag.com/covid-19/article/14177220/could-sarscov2-be-on-the-soles-of-your-shoes">rdhmag.com/covid-19/artic&hellip;</a> <a class="twitter_external_link dir-ltr tco-link has-expanded-path" dir="ltr" href="https://t.co/wT5a4SMfMh" rel="nofollow" target="_top">pic.twitter.com/wT5a4SMfMh</a> </div> https://mobile.twitter.com/DentistryIQ/status/1270358487751553027?p=v Twitter Search / dentistryiq urn:uuid:a24aca6e-b645-85e9-64e0-68694144c185 Tue, 09 Jun 2020 07:23:52 -0700 <div class="dir-ltr" dir="ltr"> <a class="twitter-hashtag dir-ltr" dir="ltr" href="https://twitter.com/hashtag/Dentists?src=hash">#Dentists</a>: Are you searching for information to help you reopen your practices? Dr. Chris Salierno has compiled a great list of resources from <a class="twitter-atreply dir-ltr" dir="ltr" href="https://twitter.com/dentalmagazine">@dentalmagazine</a> right here. <a class="twitter-hashtag dir-ltr" dir="ltr" href="https://twitter.com/hashtag/dental?src=hash">#dental</a> <a class="twitter-hashtag dir-ltr" dir="ltr" href="https://twitter.com/hashtag/dentistry?src=hash">#dentistry</a> <a href="https://www.dentistryiq.com/covid-19/article/14177376/getting-back-to-work-postcovid">dentistryiq.com/covid-19/artic&hellip;</a> <a class="twitter_external_link dir-ltr tco-link has-expanded-path" dir="ltr" href="https://t.co/c8uGFM62q4" rel="nofollow" target="_top">pic.twitter.com/c8uGFM62q4</a> </div> https://mobile.twitter.com/DentistryIQ/status/1270098274272206850?p=v Twitter Search / dentistryiq urn:uuid:0ade1abe-f4ce-3ee4-8334-28a378478bde Sun, 07 Jun 2020 17:00:00 -0700 <div class="dir-ltr" dir="ltr"> In this <a class="twitter-hashtag dir-ltr" dir="ltr" href="https://twitter.com/hashtag/video?src=hash">#video</a>, <a class="twitter-atreply dir-ltr" dir="ltr" href="https://twitter.com/HenrySchein">@HenrySchein</a> CEO Stan Bergman talks about how the company has been available to help <a class="twitter-hashtag dir-ltr" dir="ltr" href="https://twitter.com/hashtag/dentists?src=hash">#dentists</a> through every step of this trying time. <a class="twitter-hashtag dir-ltr" dir="ltr" href="https://twitter.com/hashtag/dental?src=hash">#dental</a> <a class="twitter-hashtag dir-ltr" dir="ltr" href="https://twitter.com/hashtag/dentistry?src=hash">#dentistry</a> <a class="twitter-hashtag dir-ltr" dir="ltr" href="https://twitter.com/hashtag/COVID?src=hash">#COVID</a>-19 <a href="https://www.dentistryiq.com/covid-19/video/14177309/coronavirus-impact-on-dental-practices-the-many-ways-henry-schein-supports-dentistry-video">dentistryiq.com/covid-19/video&hellip;</a> <a class="twitter_external_link dir-ltr tco-link has-expanded-path" dir="ltr" href="https://t.co/s8eOYwwEND" rel="nofollow" target="_top">pic.twitter.com/s8eOYwwEND</a> </div>