The State of the Art in Endodontics

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: closed (15 April 2022) | Viewed by 52701

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Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84126 Salerno, Italy
Interests: endodontics; restorative dentistry; oral health
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Department of Medicine, Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, 84126 Salerno, Italy
Interests: endodontics; restorative dentistry; oral health
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Nowadays, we use the term “modern endodontics” thanks to new technologies, novel materials, and revolutionary techniques. Various equipment is available to facilitate and improve our endodontic treatments, such as operating microscopes, ultrasounds, lasers, modern alloys for rotary files, powerful irrigation systems, new materials for filling root canals, 3D radiology, and several more. With the aid of the previously mentioned advances, complex endodontic treatments can be carried out safely, hence guaranteeing patients a high level of care and, above all, saving teeth that would otherwise be doomed for extraction. General practitioners and, even more importantly, specialists in endodontics should implement these modern technologies in their practice.

This Special Issue will focus on modern endodontics regarding all the recent updates. Full papers of original articles, short communications, and review articles are all invited.

Prof. Dr. Massimo Amato
Prof. Dr. Giuseppe Pantaleo
Prof. Dr. Alfredo Iandolo
Guest Editors

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Keywords

  • modern endodontics
  • endodontic treatment
  • endodontic surgery
  • cleaning
  • shaping
  • obturation
  • endodontic retreatment

Published Papers (15 papers)

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Editorial

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4 pages, 197 KiB  
Editorial
Special Issue “The State of the Art in Endodontics”
by Alfredo Iandolo, Alessandra Amato, Dina Abdellatif, Giuseppe Pantaleo and Massimo Amato
J. Clin. Med. 2022, 11(9), 2329; https://doi.org/10.3390/jcm11092329 - 22 Apr 2022
Viewed by 2226
Abstract
Currently, the term “modern endodontics” is used more often due to contemporary applied science and original materials that have been developed in recent years [...] Full article
(This article belongs to the Special Issue The State of the Art in Endodontics)

Research

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11 pages, 2081 KiB  
Article
Effect of Rotational Speed on the Resistance of NiTi Alloy Endodontic Rotary Files to Cyclic Fatigue—An In Vitro Study
by Vicente Faus-Matoses, Vicente Faus-Llácer, Celia Ruiz-Sánchez, Sharon Jaramillo-Vásconez, Ignacio Faus-Matoses, Benjamín Martín-Biedma and Álvaro Zubizarreta-Macho
J. Clin. Med. 2022, 11(11), 3143; https://doi.org/10.3390/jcm11113143 - 31 May 2022
Cited by 7 | Viewed by 1631
Abstract
The present study aims to evaluate and contrast the function of the rotational speed of NiTi alloy endodontic rotary files on how resistant they are to dynamic cyclic fatigue. Methods: A total of 150 NiTi alloy endodontic rotary files with similar geometrical design [...] Read more.
The present study aims to evaluate and contrast the function of the rotational speed of NiTi alloy endodontic rotary files on how resistant they are to dynamic cyclic fatigue. Methods: A total of 150 NiTi alloy endodontic rotary files with similar geometrical design and metallurgical properties were randomly divided into study groups: Group A: 200 rpm (n = 30); Group B: 350 rpm (n = 30); Group C: 500 rpm (n = 30); Group D: reciprocating movement at 350 rpm with 120° counterclockwise and 30° clockwise motion (350 rpm+) (n = 30); and Group E: reciprocating movement at 400 rpm with 120° counterclockwise and 30° clockwise motion (400 rpm+) (n = 30). A dynamic device was designed to carry out dynamic cyclic fatigue tests using artificial root canal systems made from stainless steel with an apical diameter of 250 µm, 5 mm radius of curvature, 60° curvature angle, and 6% taper, and 20 mm in length. A Weibull statistical analysis and ANOVA test were used to analyze the results. Results: The ANOVA analysis showed differences in time to failure among all the study groups that were of statistical significance (p < 0.001). Conclusions: NiTi alloy endodontic rotary files using reciprocating movement at 350 rpm with 120° counterclockwise and 30° clockwise motion exhibit greater resistance to dynamic cyclic fatigue than files used with a reciprocating movement at 400 rpm with 120° counterclockwise and 30° clockwise motion, continuous rotational speed at 200 rpm, continuous rotational speed at 350 rpm, or continuous rotational speed at 500 rpm; it is therefore advisable to use reciprocating movements at a low speed. Full article
(This article belongs to the Special Issue The State of the Art in Endodontics)
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20 pages, 839 KiB  
Article
Influence of Cross-Section and Pitch on the Mechanical Response of NiTi Endodontic Files under Bending and Torsional Conditions—A Finite Element Analysis
by Victor Roda-Casanova, Antonio Pérez-González, Alvaro Zubizarreta-Macho and Vicente Faus-Matoses
J. Clin. Med. 2022, 11(9), 2642; https://doi.org/10.3390/jcm11092642 - 8 May 2022
Cited by 7 | Viewed by 4786
Abstract
In this article, the effects of cross-section and pitch on the mechanical response of NiTi endodontic files is studied by means of finite element analyses. The study was conducted over a set of eight endodontic rotary files, whose geometry was obtained from combinations [...] Read more.
In this article, the effects of cross-section and pitch on the mechanical response of NiTi endodontic files is studied by means of finite element analyses. The study was conducted over a set of eight endodontic rotary files, whose geometry was obtained from combinations of two cross-sections (square and triangular) and four pitches. Each file was subjected to bending and torsional analyses, simulating the testing conditions indicated in the ISO 3630 Standard, in order to assess their stiffness and mechanical strength. The results indicate that endodontic files with a square cross-section have double the stiffness of those with triangular cross-sections, both in terms of bending and torsion. For both loading modes, endodontic files with a triangular cross-section can undergo larger deformations before overload failure than those with a square cross-section: up to 20% more in bending and 40% in torsion. Moreover, under equivalent boundary conditions, endodontic files with triangular cross-sections present a higher fatigue life than those with square cross-sections: up to more than 300% higher for small pitches. The effect of pitch on the stiffness and strength of the file is smaller than that of the cross-section shape, but smaller pitches could be beneficial when using a triangular cross-section, as they increase the bending flexibility, fatigue life, and torsion stiffness. These results suggest a clinical recommendation for the use of files with a triangular-shaped cross-section and a small pitch in order to minimize ledging and maximize fatigue life. Finally, in this study, we reveal the sensitivity of the orientation of files with respect to the bending direction, which must be taken into account when designing, reporting, and interpreting test results under such loading conditions. Full article
(This article belongs to the Special Issue The State of the Art in Endodontics)
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34 pages, 1585 KiB  
Article
Root and Root Canal Configuration Characterization Using Microcomputed Tomography: A Systematic Review
by Mohmed Isaqali Karobari, Sohaib Arshad, Tahir Yusuf Noorani, Naveed Ahmed, Syed Nahid Basheer, Syed Wali Peeran, Anand Marya, Charu Mohan Marya, Pietro Messina and Giuseppe Alessandro Scardina
J. Clin. Med. 2022, 11(9), 2287; https://doi.org/10.3390/jcm11092287 - 20 Apr 2022
Cited by 16 | Viewed by 4622
Abstract
This systematic review’s objective was to conduct a complete analysis of the literature on the root canal morphology using advanced micro-computed tomography. The electronic web databases PubMed, Scopus, and Cochrane were examined for research papers concerning the chosen keywords, evaluating the root canal [...] Read more.
This systematic review’s objective was to conduct a complete analysis of the literature on the root canal morphology using advanced micro-computed tomography. The electronic web databases PubMed, Scopus, and Cochrane were examined for research papers concerning the chosen keywords, evaluating the root canal morphology using Micro-CT, published up to 2021. The articles were searched using MeSH keywords and searched digitally on four specialty journal websites. DARE2 extended (Database of Attributes of Reviews of Effects) was used to assess bias risk. The information was gathered from 18 published studies that strictly met the criteria for inclusion. In the included studies, a total of 6696 samples were studied. The studies were conducted on either maxillary (n-2222) or mandibular teeth (n-3760), permanent anteriors (n-625), and Third molars (n-89). To scan samples, a Scanco Medical machine in was used in 10 studies, Bruker Micro-CT in 34, and seven other machines were utilized in the rest. Bruker Micro-CT software from Kontich, Belgium, VG-Studio Max 2.2 software from Volume Graphics, Heidelberg, Germany, was the most commonly used software. The minimum Voxel size (resolution) adopted in the included studies was 11.6 µm. However, 60 µm was the maximum. Most studies classified the root canal morphology using Vertucci’s classification system (n-16) and the four-digit system (n-6). Full article
(This article belongs to the Special Issue The State of the Art in Endodontics)
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8 pages, 621 KiB  
Article
Confocal Laser Scanner Evaluation of Bactericidal Effect of Chitosan Nanodroplets Loaded with Benzalkonium Chloride
by Mario Alovisi, Damiano Pasqualini, Narcisa Mandras, Janira Roana, Pietro Costamagna, Allegra Comba, Roberta Cavalli, Anna Luganini, Alfredo Iandolo, Lorenza Cavallo, Nicola Scotti and Elio Berutti
J. Clin. Med. 2022, 11(6), 1650; https://doi.org/10.3390/jcm11061650 - 16 Mar 2022
Cited by 3 | Viewed by 2004
Abstract
The aim was to evaluate the antibacterial efficacy and penetration depth into dentinal tubules of a solution of chitosan nanodroplets (NDs) loaded with Benzalkonium Chloride (BAK). Seventy-two human single-root teeth with fully formed apex were used. Cylindrical root dentin blocks were longitudinally sectioned [...] Read more.
The aim was to evaluate the antibacterial efficacy and penetration depth into dentinal tubules of a solution of chitosan nanodroplets (NDs) loaded with Benzalkonium Chloride (BAK). Seventy-two human single-root teeth with fully formed apex were used. Cylindrical root dentin blocks were longitudinally sectioned and enlarged to a size of a Gates Glidden drill #4. After sterilization, root canals were infected with Enterococcus faecalis ATCC 29212 and further incubated for three weeks. Specimens were assigned to three experimental groups (n = 20), plus positive (n = 6) and negative (n = 6) controls. In the first group, irrigation was achieved with 2 mL of NDs solution loaded with BAK (NDs-BAK), in the second with 2 mL of 5% sodium hypochlorite (NaOCl) and in the last with 2 mL of 2% chlorhexidine (CHX). Specimens were rinsed and vertically fractured. Confocal laser scanning microscopy (CLSM) and viability staining were used to analyze the proportions of dead and live bacteria quantitatively. The volume ratio of red fluorescence (dead) was calculated in 3D reconstructions. Data were analyzed by one-way ANOVA and post hoc Bonferroni tests (p < 0.05). The ratio of red fluorescence over the whole green/red fluorescence resulted in a significant comparison of NDs-BAK with NaOCl (p < 0.01) and NaOCl with CHX (p < 0.01). No differences were found between NDs-BAK and CHX (p > 0.05). The mean depth of efficacy was, respectively: NDs-BAK 325.25 μm, NaOCl 273.36 μm and CHX 246.78 μm with no statistical differences between groups. The NaOCl solution showed the highest antimicrobial efficacy, but nanodroplets with BAK seemed to have the same effect as CHX with a high depth of efficacy. Full article
(This article belongs to the Special Issue The State of the Art in Endodontics)
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12 pages, 6572 KiB  
Article
Influence of Static Navigation Technique on the Accuracy of Autotransplanted Teeth in Surgically Created Sockets
by Elena Riad Deglow, Nayra Zurima Lazo Torres, David Gutiérrez Muñoz, María Bufalá Pérez, Agustín Galparsoro Catalán, Álvaro Zubizarreta-Macho, Francesc Abella Sans and Sofía Hernández Montero
J. Clin. Med. 2022, 11(4), 1012; https://doi.org/10.3390/jcm11041012 - 15 Feb 2022
Cited by 2 | Viewed by 1611
Abstract
The aim of this study was to analyse and compare the position of single-rooted autotransplanted teeth using computer-aided SNT drilling and conventional freehand (FT) drilling, by comparing the planned and performed position at the coronal, apical and angular level. Materials and methods: Forty [...] Read more.
The aim of this study was to analyse and compare the position of single-rooted autotransplanted teeth using computer-aided SNT drilling and conventional freehand (FT) drilling, by comparing the planned and performed position at the coronal, apical and angular level. Materials and methods: Forty single-root upper teeth were selected and distributed into the following study groups: A. Autotransplanted tooth using the computer-aided static navigation technique (SNT) (n = 20) and B. Autotransplanted tooth using the conventional free-hand technique (FT) (n = 20). Afterwards, the teeth were embedded into two experimental models and 10 single-root upper teeth were randomly autotransplanted in each experimental model. The experimental models were submitted to a preoperative cone-beam computed tomography (CBCT) scan and a digital impression by a 3D intraoral scan, in addition to a postoperative CBCT scan, after the autotransplantation. Datasets from postoperative CBCT scans of the two study groups were uploaded to the 3D implant planning software, aligned with the autotransplantation planning, and the coronal, apical and angular deviations were measured. The results were analysed using Student’s t-test and Mann–Whitney non-parametric statistical analysis. Results: Coronal (p = 0.079) and angular (p = 0.208) statistical comparisons did not present statistically significant differences; however, statistically significant differences between the apical deviation of the SNT and FT study groups (p = 0.038) were also observed. Conclusions: The computer-aided static navigation technique does not provide higher accuracy in the positioning of single-root autotransplanted teeth compared to the conventional free-hand technique. Full article
(This article belongs to the Special Issue The State of the Art in Endodontics)
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14 pages, 2092 KiB  
Article
Short-Term Pain Evolution and Treatment Success of Pulpotomy as Irreversible Pulpitis Permanent Treatment: A Non-Randomized Clinical Study
by Julien Beauquis, Hugo M. Setbon, Charles Dassargues, Pierre Carsin, Sam Aryanpour, Jean-Pierre Van Nieuwenhuysen and Julian G. Leprince
J. Clin. Med. 2022, 11(3), 787; https://doi.org/10.3390/jcm11030787 - 31 Jan 2022
Cited by 5 | Viewed by 7780
Abstract
The objective of this work was to evaluate (1) the short-term evolution of pain and (2) the treatment success of full pulpotomy as permanent treatment of irreversible pulpitis in mature molars. The study consisted of a non-randomized comparison between a test group ( [...] Read more.
The objective of this work was to evaluate (1) the short-term evolution of pain and (2) the treatment success of full pulpotomy as permanent treatment of irreversible pulpitis in mature molars. The study consisted of a non-randomized comparison between a test group (n = 44)—full pulpotomy performed by non-specialist junior practitioners, and a control group (n = 40)—root canal treatments performed by specialized endodontists. Short-term pain score (Heft–Parker scale) was recorded pre-operatively, then at 24 h and 7 days post-operatively. Three outcomes were considered for treatment success: radiographic, clinical and global success. For short-term evolution of pain, a non-parametric Wilcoxon test was performed (significance level = 0.05). For treatment success, a Pearson Chi square or Fisher test were performed (significance level = 0.017–Bonferroni correction). There was no significant difference between test and control groups neither regarding short term evolution of pain at each time point, nor regarding clinical (80% and 90%, respectively) or global success (77% and 67%, respectively). However, a significant difference in radiographic success was observed (94% and 69%, respectively). The present work adds to the existing literature to support that pulpotomy as permanent treatment could be considered as an acceptable and conservative treatment option, potentially applied by a larger population of dentists. Full article
(This article belongs to the Special Issue The State of the Art in Endodontics)
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10 pages, 1503 KiB  
Article
Comparative Analysis of Root Canal Dentin Removal Capacity of Two NiTi Endodontic Reciprocating Systems for the Root Canal Treatment of Primary Molar Teeth. An In Vitro Study
by Vicente Faus-Llácer, Dalia Pulido Ouardi, Ignacio Faus-Matoses, Celia Ruiz-Sánchez, Álvaro Zubizarreta-Macho, Anabella María Reyes Ortiz and Vicente Faus-Matoses
J. Clin. Med. 2022, 11(2), 338; https://doi.org/10.3390/jcm11020338 - 11 Jan 2022
Cited by 6 | Viewed by 2049
Abstract
The objective of the present study was to evaluate and compare the dentin removal capacity of Endogal Kids and Reciproc Blue NiTi alloy endodontic reciprocating systems for root canal treatments in primary second molar teeth via a micro-computed tomography (micro-CT) scan. Materials and [...] Read more.
The objective of the present study was to evaluate and compare the dentin removal capacity of Endogal Kids and Reciproc Blue NiTi alloy endodontic reciprocating systems for root canal treatments in primary second molar teeth via a micro-computed tomography (micro-CT) scan. Materials and Methods: Sixty root canal systems in fifteen primary second molar teeth were chosen and classified into one of the following study groups: A: EK3 Endogal Kids (n = 30) (EDG) and B. R25 Reciproc Blue (n = 30) (RB). Preoperative and postoperative micro-CT scans were uploaded into image processing software to analyze the changes in the volume of root canal dentin using a mathematical algorithm that enabled progressive differentiation between neighboring pixels after defining and segmenting the root canal systems in both micro-CT scans. Volumetric variations in the root canal system and the root canal third were calculated using a t-test for independent samples or a nonparametric Mann–Whitney–Wilcoxon test. Results: Statistically significant differences (p = 0.0066) in dentin removal capacity were found between the EDG (2.89 ± 1.26 mm3) and RB (1.22 ± 0.58 mm3) study groups for the coronal root canal third; however, no statistically significant differences were found for the middle (p = 0.4864) and apical (p = 0.6276) root canal thirds. Conclusions: Endogal and Reciproc Blue NiTi endodontic reciprocating systems showed similar capacity for the removal of root canal dentin, except for the coronal root canal third, in which the Reciproc Blue NiTi endodontic reciprocating system preserved more root canal dentin tissue. Full article
(This article belongs to the Special Issue The State of the Art in Endodontics)
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15 pages, 5322 KiB  
Article
Fatigue Analysis of NiTi Rotary Endodontic Files through Finite Element Simulation: Effect of Root Canal Geometry on Fatigue Life
by Victor Roda-Casanova, Antonio Pérez-González, Álvaro Zubizarreta-Macho and Vicente Faus-Matoses
J. Clin. Med. 2021, 10(23), 5692; https://doi.org/10.3390/jcm10235692 - 3 Dec 2021
Cited by 7 | Viewed by 2838
Abstract
This article describes a numerical procedure for estimating the fatigue life of NiTi endodontic rotary files. An enhanced finite element model reproducing the interaction of the endodontic file rotating inside the root canal was developed, which includes important phenomena that allowed increasing the [...] Read more.
This article describes a numerical procedure for estimating the fatigue life of NiTi endodontic rotary files. An enhanced finite element model reproducing the interaction of the endodontic file rotating inside the root canal was developed, which includes important phenomena that allowed increasing the degree of realism of the simulation. A method based on the critical plane approach was proposed for extracting significant strain results from finite element analysis, which were used in combination with the Coffin–Manson relation to predict the fatigue life of the NiTi rotary files. The proposed procedure is illustrated with several numerical examples in which different combinations of endodontic rotary files and root canal geometries were investigated. By using these analyses, the effect of the radius of curvature and the angle of curvature of the root canal on the fatigue life of the rotary files was analysed. The results confirm the significant influence of the root canal geometry on the fatigue life of the NiTi rotary files and reveal the higher importance of the radius of curvature with respect to the angle of curvature of the root canal. Full article
(This article belongs to the Special Issue The State of the Art in Endodontics)
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11 pages, 1567 KiB  
Article
The Effect of Ultrasonic Agitation on the Porosity Distribution in Apically Perforated Root Canals Filled with Different Bioceramic Materials and Techniques: A Micro-CT Assessment
by Saulius Drukteinis, Goda Bilvinaite, Hagay Shemesh, Paulius Tusas and Vytaute Peciuliene
J. Clin. Med. 2021, 10(21), 4977; https://doi.org/10.3390/jcm10214977 - 27 Oct 2021
Cited by 2 | Viewed by 1750
Abstract
The present study evaluated the effect of ultrasonic agitation on the porosity distribution of BioRoot RCS/single gutta-percha cone (BR/SC) and MTA Flow (MF) root canals fillings used as apical plugs in moderately curved and apically perforated roots. Eighty mesial root canals of mandibular [...] Read more.
The present study evaluated the effect of ultrasonic agitation on the porosity distribution of BioRoot RCS/single gutta-percha cone (BR/SC) and MTA Flow (MF) root canals fillings used as apical plugs in moderately curved and apically perforated roots. Eighty mesial root canals of mandibular first molars were enlarged up to ProTaper NEXT X5 rotary instrument 2 mm beyond the apical foramen, simulating apical perforations. Specimens were randomly divided into four experimental groups (20 canals per group) according to the material and technique used for root canal obturation: BR/SC, BR/SC with ultrasonic agitation (BR/SC-UA), MF and MF with ultrasonic agitation (MF-UA). The ultrasonic tip was passively inserted into the root canal after the injection of flowable cement and activated for 10 s. The specimens were scanned before and after obturation with a high-resolution micro-computed tomography scanner, and the porosity of the apical plugs was assessed. The differences between groups were analyzed using the Kruskal-Wallis and Mann-Whitney tests, with the significance level set at 5%. None of the obturation materials and techniques used in this study was able to provide a pore-free root canal filling in the apical 5 mm. Considerably higher percentages of open and closed pores were observed in the MF and MF-UA groups, with the highest porosity being in the MF-UA group (p < 0.05). No significant differences were observed between the BR/SC and BR/SC-UA groups, where the quantity of open and closed pores remained similar (p > 0.05). Full article
(This article belongs to the Special Issue The State of the Art in Endodontics)
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11 pages, 3019 KiB  
Article
Influence of the Geometrical Cross-Section Design on the Dynamic Cyclic Fatigue Resistance of NiTi Endodontic Rotary Files—An In Vitro Study
by Vicente Faus-Llácer, Nirmine Hamoud-Kharrat, María Teresa Marhuenda Ramos, Ignacio Faus-Matoses, Álvaro Zubizarreta-Macho, Celia Ruiz Sánchez and Vicente Faus-Matoses
J. Clin. Med. 2021, 10(20), 4713; https://doi.org/10.3390/jcm10204713 - 14 Oct 2021
Cited by 10 | Viewed by 2313
Abstract
The aim of this study was to analyze and compare the influence of the geometrical cross-section design on the dynamic cyclic fatigue resistance of NiTi endodontic rotary files. Materials and Methods: Forty sterile endodontic rotary files were selected and distributed into the following [...] Read more.
The aim of this study was to analyze and compare the influence of the geometrical cross-section design on the dynamic cyclic fatigue resistance of NiTi endodontic rotary files. Materials and Methods: Forty sterile endodontic rotary files were selected and distributed into the following study groups: A: 25.06 double S-shaped cross-section NiTi alloy endodontic rotary files (Mtwo) (n = 10); B: 20.04 rectangular cross-section NiTi alloy endodontic rotary files (T Pro E1) (n = 10); C: 25.04 convex triangular cross-section NiTi alloy endodontic rotary files (T Pro E2) (n = 10); and D: 25.06 triangular cross-section NiTi alloy endodontic rotary files (T Pro E4) (n = 10). A cyclic fatigue device was used to conduct the static cyclic fatigue tests with stainless steel artificial root canal systems with 200 µm and 250 µm apical diameter, 60° curvature angle, 3 mm radius of curvature, 20 mm length, and 4% and 8% taper. The results were analyzed using the ANOVA test and Weibull statistical analysis. Results: All the pairwise comparisons presented statistically significant differences between the time to failure and number of cycles to failure for the cross-section design study groups (p < 0.001). Conclusions: the double S-shaped cross-section of Mtwo NiTi endodontic files shows higher cyclic fatigue resistance than the rectangular cross-section of T Pro E1 NiTi endodontic files, the convex triangular cross-section of T Pro E2 NiTi endodontic files, and the triangular cross-section of T Pro E4 NiTi endodontic files. Full article
(This article belongs to the Special Issue The State of the Art in Endodontics)
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Review

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15 pages, 3016 KiB  
Review
Influence of Guided Tissue Regeneration Techniques on the Success Rate of Healing of Surgical Endodontic Treatment: A Systematic Review and Network Meta-Analysis
by Álvaro Zubizarreta-Macho, Roberta Tosin, Fabio Tosin, Pilar Velasco Bohórquez, Lara San Hipólito Marín, José María Montiel-Company, Jesús Mena-Álvarez and Sofía Hernández Montero
J. Clin. Med. 2022, 11(4), 1062; https://doi.org/10.3390/jcm11041062 - 18 Feb 2022
Cited by 10 | Viewed by 2762
Abstract
Several regeneration techniques and materials have been proposed for the healing of bone defects after surgical endodontic treatment; however, the existing literature does not provide evidence on the most recommended techniques or materials. The aim of the present systematic review and network meta-analysis [...] Read more.
Several regeneration techniques and materials have been proposed for the healing of bone defects after surgical endodontic treatment; however, the existing literature does not provide evidence on the most recommended techniques or materials. The aim of the present systematic review and network meta-analysis (NMA) is to summarize the clinical evidence on the efficacy of guided tissue regeneration techniques (GRTs). The PRISMA recommendations were followed. Four databases were searched up to December 2021. Randomized clinical trials (RCTs) with a minimum follow-up of 6 months were included. The risk of bias was assessed using the Cochrane Collaboration tool. A fixed effects model and frequentist approach were used in the NMA. Direct GRT technique comparisons were combined to estimate indirect comparisons, and the estimated effect size of the comparisons was analyzed using the odds ratio (OR). Inconsistency was assessed with the Q test, with a significance level of p < 0.01, and a net heat plot. A total of 274 articles was identified, and 11 RCTs (6 direct comparisons of 15 techniques) were included in the NMA, which examined 6 GRT techniques: control, Os, PL, MB, MB + Os, and MB + PL. The MB + Os group compared to the control (OR = 3.67, 95% CI: 1.36–9.90) and to the MB group (OR = 3.47, 95% CI: 1.07–11.3) showed statistically significant ORs (p ˂ 0.05). The MB + Os group presented the highest degree of certainly (P-score = 0.93). Full article
(This article belongs to the Special Issue The State of the Art in Endodontics)
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11 pages, 812 KiB  
Review
Vital and Nonvital Pulp Therapy in Primary Dentition: An Umbrella Review
by Luísa Bandeira Lopes, Catarina Calvão, Filipa Salema Vieira, João Albernaz Neves, José João Mendes, Vanessa Machado and João Botelho
J. Clin. Med. 2022, 11(1), 85; https://doi.org/10.3390/jcm11010085 - 24 Dec 2021
Cited by 3 | Viewed by 5101
Abstract
Dental caries is the most common non-communicable disease in children with significant aesthetic, functional, and quality of life deterioration. Depending on the depth, two approaches may be considered in primary dentition: vital pulp therapy (VPT) or non-vital therapy (NPT). This umbrella review aimed [...] Read more.
Dental caries is the most common non-communicable disease in children with significant aesthetic, functional, and quality of life deterioration. Depending on the depth, two approaches may be considered in primary dentition: vital pulp therapy (VPT) or non-vital therapy (NPT). This umbrella review aimed to critically assess the available systematic reviews (SRs) on VPT and NPT. An electronic database search was conducted (PubMed, Embase, Scopus, Cochrane, Web of Science, and LILACS) until June 2021. The Risk of Bias (RoB) of SRs was analyzed using the Measurement Tool to Assess SRs criteria 2 (AMSTAR2). From 272 entries, 33 SRs were included. Regarding the methodological quality, three studies were critically low, nine low, seventeen moderate, and six were rated as high quality. The quality of evidence produced by the available SRs was moderate. Future high standard SRs and well-designed clinical trials are warranted to better elucidate the clinical protocols and outcomes of VPT and NPT. Full article
(This article belongs to the Special Issue The State of the Art in Endodontics)
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10 pages, 1050 KiB  
Review
Postoperative Pain following Root Canal Filling with Bioceramic vs. Traditional Filling Techniques: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
by Elina Mekhdieva, Massimo Del Fabbro, Mario Alovisi, Allegra Comba, Nicola Scotti, Margherita Tumedei, Massimo Carossa, Elio Berutti and Damiano Pasqualini
J. Clin. Med. 2021, 10(19), 4509; https://doi.org/10.3390/jcm10194509 - 29 Sep 2021
Cited by 15 | Viewed by 3593
Abstract
This meta-analysis aimed to evaluate postoperative pain (POP) following root canal filling (RCF) with gutta-percha/bioceramic sealer (BCS) vs. gutta-percha/traditional sealer (TS) techniques. Electronic databases were searched for randomized trials. Subgroup analyses were performed for analgesic intake, flare-ups, postoperative time (24/48 h), pulp status, [...] Read more.
This meta-analysis aimed to evaluate postoperative pain (POP) following root canal filling (RCF) with gutta-percha/bioceramic sealer (BCS) vs. gutta-percha/traditional sealer (TS) techniques. Electronic databases were searched for randomized trials. Subgroup analyses were performed for analgesic intake, flare-ups, postoperative time (24/48 h), pulp status, and retreatment. The search yielded 682 records, and nine studies were selected. BCS was associated with significantly lower POP vs. TS at 24 h (P = 0.04) and 48 h (P = 0.0005). In addition, non-significant trends favoring BCS for analgesic intake at 24 h (P = 0.14), flare-ups (P = 0.24) and obturation techniques at 24 h (P = 0.41) and 48 h (P = 0.33), non-significant trends for lower POP with TS vs. BCS 24 h and 48 h in vital teeth (P = 0.50, P = 0.18, respectively), and for lower POP with BCS vs. TS in non-vital teeth at 24 h and 48 h (P = 0.16, P = 0.84, respectively). POP was numerically lower with TS vs. BCS at 24 h (P = 0.65) and 48 h after retreatment (P = 0.59). Moreover, POP did not vary between fillers when the treatment was over single (P = 0.28) or multiple visits (P = 0.50). BCS was associated with significantly lower short-term POP, and with a trend for lower analgesic intake and flare-up incidence, as compared to TS. Full article
(This article belongs to the Special Issue The State of the Art in Endodontics)
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35 pages, 4659 KiB  
Systematic Review
Clinical Outcome and Comparison of Regenerative and Apexification Intervention in Young Immature Necrotic Teeth—A Systematic Review and Meta-Analysis
by Pratima Panda, Lora Mishra, Shashirekha Govind, Saurav Panda and Barbara Lapinska
J. Clin. Med. 2022, 11(13), 3909; https://doi.org/10.3390/jcm11133909 - 5 Jul 2022
Cited by 9 | Viewed by 4796
Abstract
This systematic review aimed to evaluate interventions individually and compare the clinical outcome of young, immature teeth treated with regenerative endodontic therapy (RET) and apexification procedure. The protocol was registered with PROSPERO (International Prospective Register of Systematic Reviews), bearing the registration number CRD42021230284. [...] Read more.
This systematic review aimed to evaluate interventions individually and compare the clinical outcome of young, immature teeth treated with regenerative endodontic therapy (RET) and apexification procedure. The protocol was registered with PROSPERO (International Prospective Register of Systematic Reviews), bearing the registration number CRD42021230284. A bibliographic search in the biomedical databases was conducted in four databases—PubMed, CENTRAL, EMBASE and ProQuest—using searching keywords and was limited to studies published between January 2000 and April 2022 in English. The search was supplemented by manual searching, citation screening and scanning of all reference lists of selected paper. The study selection criteria were randomized clinical trial, prospective clinical studies and observational studies. The search found 32 eligible articles, which were included in the study. The quality assessment of the studies was performed using the Cochrane risk of bias tool for randomized control trials and non-randomized clinical studies. The meta-analysis was performed using Review Manager software (REVMAN, version 5). The results indicated that a clinicians’ MTA apexification procedure was more successful compared to calcium hydroxide. In RET, apical closure and overall success rate is statistically same for both apical platelet concentrates (APCs) and blood clots (BC). Both interventions have similar survival rates; however, RET should be preferred in cases where the root development is severely deficient, there is insufficient dentine and the tooth’s prognosis is hopeless even with an apexification procedure. Full article
(This article belongs to the Special Issue The State of the Art in Endodontics)
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