Search

The assessment of root canal curvature is essential for clinical and research purposes. This systematic review presents an overview of the published techniques for the measurement of root canal curvature features using imaging and to provide a critique of their clinical application. A database search in PubMed, PubMed Central, Embase, Scopus, EBSCO Dentistry & Oral Sciences Source and Virtual Health Library was conducted, using appropriate key words to identify measurement methods for root canal curvatures. The search strategy retrieved 10594 records in total, and 31 records fulfilled the inclusion criteria. From 2D image acquisitions, eleven studies measured exclusively the angle of curvature, an additional thirteen measured other curvature features (level, height, radius, length and shape). Seven reports described methods from 3D imaging (CBCT, μCT). Root canal curvatures should be measured, for clinical proposes, to facilitate endodontic treatment planning, and in research, to reduce the risk of selection bias. This review has revealed that there are many methods described in the literature; however, no consensus exists on which method should be used. Some of the methodologies have potential clinical translation, whereas others are suitable for research purpose only, as they require a specific software or radiographic exposure in the mesiodistal direction. [ABSTRACT FROM AUTHOR]

Introduction: Tetracycline resistance is commonly found in endodontic bacteria. One of the most common tetracycline-resistance genes is tet(M), which is often encoded on the broad-host-range conjugative transposon Tn 916. This study aimed to determine whether tet(M) was present in bacteria isolated from endodontic patients at the Eastman Dental Institute and whether this gene was carried on the transferable conjugative transposon Tn 916. Methods: The cultivable microflora isolated from 15 endodontic patients was screened for resistance to tetracycline. Polymerase chain reactions for tet(M) and for unique regions of Tn 916 were carried out on the DNA of all tetracycline-resistant bacteria. Filter-mating experiments were used to see if transfer of any Tn 916-like elements could occur. Results: Eight out of 15 tetracycline-resistant bacteria isolated were shown to possess tet(M). Furthermore, four of these eight were shown to possess the Tn 916-unique regions linked to the tet(M) gene. Transfer experiments demonstrated that a Neisseria sp. donor could transfer an extremely unstable Tn 916-like element to Enterococcus faecalis. Conclusions: The tet(M) gene is present in the majority of tetracycline-resistant bacteria isolated in this study and the conjugative transposon Tn 916 has been shown to be responsible for the support and transfer of this gene in some of the bacteria isolated. [ABSTRACT FROM AUTHOR]

Super-oxidised waters, particularly Sterilox®, have been suggested for the disinfection of dental unit water lines and dental impression materials owing to their antimicrobial efficacy. One of the previously suggested characteristics is their short shelf life. The purpose of this investigation was to understand the effect of storage conditions on Sterilox®'s stability. Eight bottles (four completely full, four half-full) of freshly prepared solution were divided into four groups and subsequently stored by being either exposed to or protected from sunlight. The chlorine concentration was monitored using chlorine test strips until the concentration reached zero, or until the thirteenth week. Statistically significant differences between the groups exposed to sunlight and the non-exposed groups (p <0.001) were found. The mean loss of chlorine per day for the non-exposed samples was 1.01 mg/L, whilst the mean for the exposed samples was 2.42 mg/L. The presence of air did not affect the chlorine decomposition in the bottles. The results of this investigation indicate that when the solution is exposed to sunlight, the decrease of chlorine starts at day 4, whilst for the groups sheltered from sunlight, the process started after day 14. Therefore, Sterilox® solutions appear to be more stable than previously surmised. [ABSTRACT FROM AUTHOR]

Aim: To evaluate the agreement between six currently available periapical radiography-based methods for measuring the root canal curvatures in mesial roots of mandibular first molars, assessed by two examiners with different proficiency levels., Methodology: Non-endodontically treated mesial roots of 41 human mandibular first molars were radiographed using the parallelling technique. Two independent observers (a specialist in endodontics and radiology and a final-year dental student) assessed their root canal curvature using the methodologies described by Schneider (1971, Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 32, 271), Weine (1982, Endodontic therapy), Berbert and Nishiyama (1994, Revista Gaúcha de Odontología, 356), Luiten et al. (1995, Journal of Endodontics, 21, 26), Hankins and ElDeeb (1996, Journal of Endodontics, 22, 123) and Pettiette et al. (1999, Journal of Endodontics, 25, 230). Intra- and inter-examiner reliability was assessed using the intraclass correlation coefficient. The differences in curvature angle measured by the different methods were compared using the one-way anova for repeated measures test, followed by Tukey's post hoc analysis. The effect was calculated using the Cohen's d method. To determine the agreement between methods, the Bland-Altman analysis was used. The significance level was set at 5%., Results: Agreement for the observers was excellent (>0.81) for the six methods considered. For the angle comparisons between methods, the maximum differences were for Schneider versus Weine (35.77°) and Luiten versus Hankins (35.14°), whilst the highest percentage of angles with a difference >10° were Weine versus Luiten and Berbert versus Pettiette (90%) and the comparison Weine versus Hankins presented with the lowest frequency (15%). Excellent agreement was found for five comparisons: Weine versus Luiten (0.940), Berbert versus Pettiette (0.917), Weine versus Pettiette (0.907), Luiten versus Pettiette (0.904) and Berbert versus Luiten (0.812). Compared to Schneider's method, the other methods showed a tendency of increasing difference as the angles became more acute. The other methods exhibited linear differences, remaining constant for smaller and larger angles., Conclusions: Reliability was excellent for all methods assessed separately. Maximum differences in curvature angles were found when comparing Schneider versus Weine and Luiten versus Hankins. Excellent agreement was found for Weine versus Luiten, Berbert versus Pettiette, Weine versus Pettiette, Luiten versus Pettiette and Berbert versus Luiten. In the presence of dilacerations, the method by Schneider was less sensitive., (© 2024 The Author(s). International Endodontic Journal published by John Wiley & Sons Ltd on behalf of British Endodontic Society.)

Introduction: The aim of this study was to evaluate changes in geometry following root canal preparation using R-Motion instruments with different apical sizes and tapers., Methods: Fifty-four mesial canals of mandibular molars with single curvature of angles ranging between 20° and 30° were stratified into 3 groups according to their internal anatomy (R-Motion 25/.06, 30/.04, Reciproc Blue) (n = 18 per group). Micro-computed tomography was used to standardize the samples before instrumentation and, after instrumentation, to assess canal transportation, changes in canal volume and centering ability. Canals were irrigated with 17% EDTA and sodium hypochlorite, and the final rinse included subsonic agitation of these solutions. Measurements were analyzed automatically using the Dragonfly software (Come, Montreal, Canada) and were confirmed by a technician and an endodontist, based on a previously validated methodology. The results were analyzed using the Kruskal-Wallis's and Mann-Whitney's tests. The level of statistical significance was set at 5%., Results: Significant differences were found in the coronal third for canal transportation, with Reciproc Blue R25 having greater values compared with both R-Motion instruments (P < .05) and greater changes in volume when compared with R-Motion 30/.04 (P < .05)., Conclusions: R-Motion of apical size and taper 25/.06 and 30/.04 were associated with similar changes in geometry following root canal preparation in curved mesial canals of mandibular molars, whereas Reciproc Blue was associated with greater canal transportation in the coronal root third., (Copyright © 2024 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

Numerous systematic reviews (SRs) have produced conflicting findings on engine-driven nickel-titanium reciprocating instruments (reciprocating instruments) since Yared's seminal study 15 years ago. This umbrella review analysed SRs examining the clinical and laboratory evidence regarding reciprocating instruments for root canal treatment. SRs that evaluated qualitatively and/or quantitatively the outcomes postoperative pain, oral health-related quality of life (OHRQoL), shaping ability, debris extrusion, microbial load, endotoxins reduction, cyclic fatigue, file fracture, dentinal cracks and root canal filling removal were included. The AMSTAR 2 tool was used to evaluate SRs quality, while the ROBIS tool to assess risk of bias (RoB). Forty SRs were included. The SRs revealed predominantly 'high' RoB and 'critically low' quality. Most focused on technical outcomes, exhibiting significant methodological and statistical heterogeneity. Findings suggest comparable efficacy between reciprocating and rotary instruments. However, due to the scarcity of high-quality evidence, future well-designed studies and reviews considering core outcome measures are needed., (© 2024 The Author(s). Australian Endodontic Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Endodontology Inc.)

Studies investigating the accuracy of diagnostic tests should provide data on how effectively they identify or exclude disease in order to inform clinicians responsible for managing patients. This consensus-based project was undertaken to develop reporting guidelines for authors submitting manuscripts, which describe studies that have evaluated the accuracy of diagnostic tests in endodontics. These guidelines are known as the Preferred Reporting Items for Diagnostic Accuracy Studies in Endodontics (PRIDASE) 2024 guidelines. A nine-member steering committee created an initial checklist by integrating and modifying items from the Standards for Reporting of Diagnostic Accuracy (STARD) 2015 checklist and the Clinical and Laboratory Images in Publications (CLIP) principles, as well as adding a number of new items specific to the specialty of endodontics. Thereafter, the steering committee formed the PRIDASE Delphi Group (PDG) and the PRIDASE Online Meeting Group (POMG) in order to collect expert feedback on the preliminary draft checklist. Members of the Delphi group engaged in an online Delphi process to reach consensus on the clarity and suitability of the items in the checklist. The online meeting group then held an in-depth discussion on the online Delphi-generated items via the Zoom platform on 20 October 2023. According to the feedback obtained, the steering committee revised the PRIDASE checklist, which was then piloted by several authors when preparing manuscripts describing diagnostic accuracy studies in endodontics. Feedback from this process resulted in the final version of the PRIDASE 2024 checklist, which has 11 sections and 66 items. Authors are encouraged to use the PRIDASE 2024 guidelines when developing manuscripts on diagnostic accuracy in endodontics in order to improve the quality of reporting in this area. Editors of relevant journals will be invited to include these guidelines in their instructions to authors., (© 2024 British Endodontic Society. Published by John Wiley & Sons Ltd.)

Background: The European Society of Endodontology published in 2023, the S3-level clinical practice guidelines, which supersede the Quality Guidelines for Endodontic Treatment published in 2006., Objectives: This review aims to summarize and compare the above guidelines to support their dissemination., Method: A narrative synthesis of the main differences alongside tabulation according to the main themes., Results: Three tables were prepared according to the following themes: diagnosis of pulpal and apical condition; treatment of pulpitis; and treatment of nonvital pulp and apical periodontitis., Conclusions: A compared and simplified message regarding the most recent clinical practice guidelines has been prepared., Registration: Not applicable as a narrative review., (© 2024 The Authors. International Endodontic Journal published by John Wiley & Sons Ltd on behalf of British Endodontic Society.)

Guidelines were developed by the Australian Society of Endodontology Inc. with the intent to describe relevant aspects of contemporary evidence-based root canal treatment. The document aims to support clinicians by describing a Standard of Practice in the Australian context. The presented guidelines refer to Competence criteria and Quality standards for the main steps in root canal treatment. While the intent is not to replace individual clinical decision-making, it is envisaged that these periodically reviewable guidelines may help to improve clinical outcomes., (© 2024 The Author(s). Australian Endodontic Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Endodontology Inc.)

This retrospective cohort study compared the effect of primary root canal treatment (RCT) with root canal retreatment (Re-RCT) on patient-reported outcomes in Kuala Lumpur, Malaysia. Forty randomly selected adults participated (RCT n = 20; Re-RCT n = 20). The impact their dentition had on the Oral Health Impact Profile-14 (OHIP-14) was assessed by calculating the prevalence of oral health impact, and the severity score. Focus group discussions using a semi-structured guide were arranged through an online meeting platform. Qualitative content analysis identified common themes, and relevant quotes gathered. The impact on OHIP-14 was limited for both RCT and Re-RCT groups with no significant differences in the prevalence of oral health impact. Significant differences were found for functional limitation (RCT higher) and psychological discomfort (Re-RCT higher). Common themes from the discussions include the importance of retaining teeth, the significance of effective communication between clinicians and patients and that the respondents were satisfied with the treatment., (© 2024 The Author(s). Australian Endodontic Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Endodontology Inc.)

Objective: This study evaluated the root and canal morphology in permanent mandibular incisors teeth using cone-beam computer tomography imaging in a Spanish subpopulation, and compared these findings with ipsilateral (similarity) and contralateral (symmetry) incisors. In addition, the position of canal splitting was measured., Methods: A total of 229 datasets comprising four mandibular teeth each (n=916 incisors) were analysed using Vertucci and Ahmed et al. classifications, and, the similarity and symmetry were calculated. The distance from the cemento-enamel junction (CEJ), and the most coronal canal divergence was measured (if present). The role of sex was also assessed. The Cochran Q Test, LOGIS PROC in SUDAAN, Chi-square, and Kappa were used for the different comparisons. A p-value of less than 0.05 was considered significant., Results: All incisors were single-rooted and no significant differences regarding root canal morphology were found according to the sex of the subjects included in the database. The most common morphology was Vertucci type I/Ahmed et al. 1MI1(65.3% for central and 66.8% for lateral incisors respectively), followed by type III/1MI1-2-1 (31% for central and 30.6% for lateral incisors). 1.8% of the samples were considered as non-classifiable with Vertucci but were classified with codes using the Ahmed et al. system. Similarity values were 74.7% for the left side, and 74.2% for the right side, whereas symmetry values were 90% for central and 84.3% for lateral incisors. In the presence of divergences, the main (SD) distances from the CEJ were for type II/1MI1-2-1 3.8+-0.8 (centrals) 4.0+-0.7 mm (laterals); for type V/1MI1-2 this value ranged between 6.0+-1.8 and 5.5+-1.5 mm, whereas values for 1MI1-2-3-2-1 were 1.8 and 2.1 mm. No significant differences were found when the position of the most coronal divergence was compared between lateral and central incisors for the different morphologies., Conclusion: A high prevalence of Vertucci I/Ahmed et al. 1MI1 configuration was present in mandibular incisors from Spanish individuals. Similarity and symmetry were common, particularly for central incisors. The position of the coronal splitting of the canals varied according to the root canal morphology.

With the ever-increasing understanding of tooth anatomy, there is a renewed focus on the pulp chamber as an important component of the root canal system. For example, the pulp chamber is of critical relevance during diagnostic procedures such as pulp sensibility tests, deep caries removal, vital pulp treatments, access cavity preparation, tooth whitening, tooth restoration as well as methods for examining the floor of the pulp chamber to aid the detection of root canal orifices or the presence of perforations and cracks. The more recent concept of minimal invasive endodontics has also created a need to understand better the anatomy of the pulp chamber. The purpose of this article is to discuss the research methods used to study pulp chamber anatomy and the significance of the pulp chamber in endodontic research and clinical practice. In addition, directions for future research are emphasised.

This study assessed the antimicrobial effect of sodium hypochlorite (NaOCl) mixtures combined with Keratobacter (KB) using an engineered biofilm root canal model. Clinical and reagent grade NaOCl were mixed with KB (9:1-vol/vol) to assess pH values over 1 min to select the ideal solution with a pH just below the pKa of hypochlorous acid. The samples were randomly divided into five groups: 1% and 4% NaOCl reagents, a mixture of NaOCl:KB using 1% and 4% NaOCl reagents and distilled water. Outcome measures were colony-forming units (CFUs/mL) and positive/negative cultures. No significant differences were observed in the pairwise comparisons between 1%, 4% NaOCl and 4% NaOCl+KB for the outcome CFUs/mL. Only 4% NaOCl presented with negative cultures in all samples, whereas 1% NaOCl and 4% NaOCl+KB had similar results (54% vs. 40%). The addition of KB has a limited effect on the antimicrobial efficacy of 4% NaOCl in this laboratory model., (© 2023 The Authors. Australian Endodontic Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Endodontology Inc.)

Introduction: This study aimed to compare the curvature severity of mesio-buccal (MB) canals between sagittal and coronal planes using cone-beam computed tomography., Methods: In a Brazilian subpopulation, untreated MB1 (n = 141) and MB2 (n = 72) with single curvatures in sagittal and coronal planes were measured to determine their angle and radius (r), plus the prevalence of S-shaped canals was recorded. Curvature severity was defined according to the American Association of Endodontists Case Difficulty Assessment form (AAE) and EndoApp (EA), as well as their modified versions that consider angle and radii (AAE-r, EA-r). Data were converted into mean angle and r, percentage of canals >30°, AAE, EA, AAE-r and EA-r categories. The influence of r on case severity was assessed. Statistical analysis was performed using t-tests and chi-squared tests. The level of significance was set as P ≤ .05., Results: For single curvatures, significantly higher mean degrees (SD) angles were found in the sagittal views in both canals (MB1 sagittal: 35 [11]; MB1 coronal: 13 [13]; MB2 sagittal: 29 [14]; MB2 coronal: 22 [15] [P < .05]). A greater percentage of angles >30° (MB1: 56.7% vs 6.4%; MB2: 44.4% vs 22.2%) in sagittal planes compared to coronal planes was also found. Conversely, a higher prevalence of S-shaped canals (MB1: 33.3% vs 7.1% MB2: 31.9% vs 15.3%) was observed in coronal planes. Significant differences between AAE and AAE-r were present with greater case severity when radii were considered (P < .05)., Conclusions: Sagittal planes were associated with more severe single curvatures, while coronal planes had a greater prevalence of S-shaped canals., (Copyright © 2023 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.)

A novel system to classify root and canal morphology was recently introduced (Ahmed et al. 2017). This systematic review aimed to answer the following research question: Does the Ahmed et al. system provide a more accurate and practical classification of root and canal anatomy compared to other classifications? A literature search was conducted in Google Scholar, Scopus and Wiley Online Library to identify the citation counts for the article entitled 'A new system for classifying root and root canal morphology; doi.org/10.1111/iej.12685'. After removal of duplicates and unrelated articles, 15 studies were included and analysed. All studies compared the Ahmed et al. system with the Vertucci classification. Results revealed that both systems were able to classify simple canal configurations in single-rooted anterior and premolar teeth, disto-buccal and palatal roots of maxillary molars. However, the Ahmed et al. system provided more accurate and comprehensive categorisations of single-rooted teeth with complex canal anatomy, multi-rooted maxillary and mandibular premolars and the mesio-buccal root of maxillary molars. Further evidence on the utility of the Ahmed et al. system is required using other diagnostic devices especially in molars., (© 2023 The Authors. Australian Endodontic Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Endodontology Inc.)

This study evaluated a method to determine the spatial geometry of root canal preparation (RCP) using navigation dynamics and a specific algorithm from a new CBCT software (e-Vol DX). CBCT scans of 168 root canals of mandibular molars were acquired before and after RCP, using nickel-titanium (NiTi) instruments (ProTaper Next, BioRace, Reciproc Blue, and WaveOne Gold). The spatial geometry of the root canals and the operative risk of disproportional wear of dentinal walls after RCP were evaluated using a new CBCT software. A 3-point scoring system was used after the measuring of cementum/dentin thickness before and after RCP in all root thirds. The root thirds were distributed into three parts of similar sizes, and the scores were categorized at three levels: 1. mild risk (1/3), 2. moderate risk (2/3), 3. severe risk (3/3). These levels were proposed according to the risk of creating disproportionate shapes, thin walls, or perforations. The data were analyzed statistically by Fischer's exact test (α = 5%). There were no significant differences in operative risk among the NiTi engine-driven systems, for the distal or mesial walls of all the root canal thirds (p>0.05). The spatial geometry method to assess operative risk allows clinical planning for a predictable enlargement of the root canal in all root thirds. Based on using a map-reading strategy on root canals in CBCT scans, NiTi engine-driven instruments did not present an increased operative risk during RCPs.

Background: Sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) and/or calcium hydroxide (Ca(OH) 2 ) are commonly used during root canal treatment. Evaluation of their effectiveness regarding clinical and patient-related outcomes requires further understanding., Objectives: To assess the effectiveness of root canal irrigation and dressing for the treatment of teeth with apical periodontitis (AP)., Methods: A search was conducted in the PubMed-MEDLINE, Scopus, EMBASE, Google scholar databases and available repositories, followed by hand searches, until July 2021. Eligibility criteria followed the a priori formulated Population, Intervention, Comparator, Outcomes, Timing, and Study design (PICOTS) framework. Clinical studies restricted to English language were included. The revised Cochrane risk-of-bias tool for randomised trials (RoB 2) was used to assess the quality of included studies. Meta-analyses were performed using the fixed-effect model to obtain Risk Ratio (RR) and 95% Confidence Interval (CI), with sensitivity analysis. Overall quality of evidence of meta-analyses was assessed through the Grading of Recommendations Assessment, Development, and Evaluation tool., Results: The search identified 1357 records of which six fulfilled the inclusion criteria, providing data for 'irrigation' from 212 teeth and for 'dressings' from 438 teeth. Two studies reported no significant difference regarding the outcome 'pain at 7 days' using 2% chlorhexidine vs. 5.25% NaOCl and EDTA or after using different concentrations of NaOCl (1% vs. 5%). No significant difference was detected between different NaOCl concentrations regarding the reduction of AP. A meta-analysis was possible for the comparison of single-visit (SV) versus multiple-visits including the use of Ca(OH) 2 demonstrating a significant effect in favour of SV (RR: 1.10; 95% CI: 1.03-1.19; p = .007; I 2  = 0). RoB of included studies was moderate to low., Discussion: The use of Ca(OH) 2 for the treatment of AP may not be beneficial. There is scarce or no evidence fulfilling the proposed PICOTS regarding irrigants and dressings., Conclusions: There is moderate certainty that SV treatment is associated with better radiographic evidence of normal periodontal ligament space (strict criteria) compared with the use of Ca(OH) 2. Reduction of AP is comparable after irrigation with 1% and 5% NaOCl, whereas postoperative pain at 7 days for the irrigants assessed is similar., Registration: PROSPERO database CRD42021260271., (© 2022 The Authors. International Endodontic Journal published by John Wiley & Sons Ltd on behalf of British Endodontic Society.)

Background: Preoperative pulpal status may influence the outcomes of root canal treatment (RCTx) according to various measures used., Objectives: To compare the effectiveness of RCTx of teeth with a vital pulp versus a necrotic pulp, using a range of clinical and patient-related outcomes proposed for the development of S3-level clinical practice guidelines., Methods: A search was conducted in the PubMed-MEDLINE, Scopus, EMBASE, Google scholar databases and available repositories, followed by hand searches, until 29 March 2022. Clinical studies published in the English language comparing the stipulated outcomes of RCTx of teeth with vital versus necrotic pulp were included. The Newcastle-Ottawa Scale was adapted to assess study quality. Effects of pulpal status were estimated and expressed as risk ratio (RR) using fixed- and random-effect meta-analyses. The quality of evidence was assessed through the Grading of Recommendations Assessment, Development and Evaluation tool., Results: Twenty-eight studies published between 1961 and 2021 were included. Five studies have investigated the "tooth survival" outcome, four reported pulpal status was not a significant predictor, consistent with meta-analysis findings (RR: 1.00; 95% CI: 1.00, 1.00; n = 3). Seven studies reported pulpal status had no significant influence on postoperative pain, regardless of duration after treatment. Sixteen studies have analysed "periapical health," and 11 revealed pulpal status had no significant influence. Meta-analyses revealed the influence was not significant if preoperative periapical radiolucency was absent (RR: 0.95; 95% CI: 0.90, 1.00; n = 9) but significant if it was present (RR: 1.12; 95% CI: 1.05, 1.19; n = 11). Most studies were classified as "some concerns" (n = 17) to "low" (n = 9) risk of bias RoB., Discussion: Evidence is limited and only available for three outcomes when comparing the effectiveness of RCTx in permanent teeth with vital pulp versus pulp necrosis. Nevertheless, the quality of available evidence was moderate to high. The "periapical health" data heterogeneity could be explained by preoperative radiolucency, thus RCTx was found more effective for prevention than the resolution of apical periodontitis., Conclusions: There was no significant difference in the "tooth survival," "postoperative pain" and "evidence of apical radiolucency" outcomes of RCTx in teeth with vital or necrotic pulps., Registration: PROSPERO database (CRD42021260280)., (© 2022 The Authors. International Endodontic Journal published by John Wiley & Sons Ltd on behalf of British Endodontic Society.)

This study compared the performance of Reciproc and Reciproc Blue endodontic files in retreatment time and re-establishment of apical patency, plus removal of a bioceramic sealer from the canal surface with the supplementary use of the XP-endo Finisher R. Following preparation, slightly curved oval root canals in mandibular incisors were filled using a corresponding gutta-percha point and a bioceramic sealer. Apical patency achievement was assessed and the time required to reach the original working length was recorded. The samples were split longitudinally and were photographed to assess the material remaining on the canal walls. No significant differences were observed regarding patency achievement or retreatment times when comparing Reciproc and Reciproc Blue. Significant less material remained on the canal walls when Reciproc was followed by XP-endo compared with Reciproc alone, and when the data for Reciproc and Reciproc Blue were pooled., (© 2022 The Authors. Australian Endodontic Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Endodontology Inc.)

This systematic review assessed the clinical influence of centric and eccentric engine-driven instrument design for reduction in microbial load in infected root canal system. The literature search was conducted in electronic databases (PubMed, Cochrane Library, Scopus, Lilacs and Google Scholar) and grey literature till June 2022. The search strategy followed the PRISMA 2020 guidelines. Qualitative and quantitative synthesis was conducted based on the guidelines of the Cochrane Handbook. The risk of bias was assessed using the revised Cochrane criteria and quality of evidence was conducted using the Grading of Recommendation Assessment, Development and Evaluation tool. Out of 28 papers, only five papers met the inclusion criteria of this review. Studies showed reduction in microbial load after instrumentation using centric or eccentric instruments with no statistically significant difference in the meta-analysis. In conclusion, there is low-grade evidence suggesting that microbial reduction is similar using centric and eccentric instruments., (© 2022 The Authors. Australian Endodontic Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Endodontology Inc.)

Cone-beam computed tomography (CBCT) is an increasingly used imaging modality. This study aimed to identify the factors that predict its usage amongst endodontists in Australia and New Zealand and describe usage characteristics. Data were collected via an online questionnaire, with analysis including descriptive statistics, cross-tabulation and multifactorial modelling. Ninety-four endodontists completed the questionnaire who were using CBCT for 7 years (median), over half had a CBCT unit in practice, with most prescribing up to 10 scans/month and 55 using a small field of view. Sixty-eight participated in >5 h of CBCT education/year and a third received a specialist-prepared report. The number of prescriptions/month was significantly associated with on-site CBCT units (Exp B: 8.53; 95% CI: 1.46-49.86, p < 0.05) and the number of years of CBCT usage by participants (Exp B: 1.46; 95% CI: 1.17-1.84, p = 0.001). CBCT imaging in endodontics is a useful diagnostic aid to decision making and treatment planning, with widespread acceptance and usage., (© 2022 The Authors. Australian Endodontic Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Endodontology Inc.)

Dental patient-reported outcomes (dPROs) are self-reported descriptions of a patient's oral health status that are not modified or interpreted by a healthcare professional. Dental patient-reported outcome measures (dPROMs) are objective or subjective measurements used to assess dPROs. In oral healthcare settings, the emphasis on assessing treatment outcomes from the patient's perspective has increased and this is particularly important after traumatic dental injuries (TDIs), as this group of injuries represent the fifth most prevalent disease or condition worldwide. The purpose of this review is to summarize the current use of dPROs and dPROMs in the field of dental traumatology. Oral Health-Related Quality of Life, pain, swelling, aesthetics, function, adverse effects, patient satisfaction, number of clinical visits and trauma-related dental anxiety are the key dPROs following TDIs. Clinicians and researchers should consider the well-being of patients as their top priority and conduct routine evaluations of dPROs using measures that are appropriate, accurate and reflect what is important to the patient. After a TDI, dPROs can assist clinicians and patients to choose the best management option(s) for each individual patient and potentially improve the methodology, design and relevance of clinical studies., (© 2023 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

The main purpose of this study was to answer the question: "Can radiotherapy cause changes in the dental pulp condition of patients treated with irradiation in the head and neck region?" Clinical observational studies in adults with head and neck cancer undergoing treatment with ionizing radiation, longitudinal or cross-sectional follow-up to measure oxygen saturation (SpO2), and/or pulp sensitivity test to cold stimulation, were considered eligible. A systematic literature search was performed in six different databases, including the gray literature, and in article references. Two independent evaluators selected the studies, extracted the data, recorded the data on electronic spreadsheets, and then evaluated the methodological quality using the Checklist for Quasi-Experimental Studies tool devised by JBI. The data were assessed qualitatively using the Synthesis Without Metanalysis (SWiM) guidelines. After removing the duplicate articles, carefully analyzing the titles and abstracts, and reading the papers in full, seven studies were included. Four of the studies evaluated applied the cold sensitivity test, two associated pulse oximetry and cold sensitivity, and only one used just pulse oximetry. Evaluation using the cold sensitivity test and pulse oximetry in the initial periods before radiotherapy showed a decrease in the sensitive response and in SpO2 levels during a maximum period of 1 year. However, analyses thereafter indicated a normal response in both tests from 5 to 6 years after the end of radiotherapy treatment. Radiotherapy causes changes in pulp behavior patterns in the short term; however, recovery and return to average values occurs after long periods.