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Research Articles
Stress distribution of restorations in external cervical root resorption under occlusal and traumatic loads: a finite element analysis
Padmapriya Ramanujam, Paul Kevin Abishek Karthikeyan, Vignesh Srinivasan, Selvakarthikeyan Ulaganathan, Velmurugan Natanasabapathy, Nandini Suresh
Restor Dent Endod 2025;50(2):e21.   Published online May 21, 2025
DOI: https://doi.org/10.5395/rde.2025.50.e21
AbstractAbstract PDFPubReaderePub
Objectives
This study analyzed the stress distribution in a maxillary central incisor with external cervical resorptive defect restored with different restorative materials under normal masticatory and traumatic loading conditions using finite element analysis.
Methods
Cone-beam computed tomography of an extracted intact incisor and created resorptive models (Patel’s 3D classification-2Bd and 2Bp) in the maxillary central incisor was performed for finite element models. The 2Bd models were restored either with glass ionomer cement (GIC)/Biodentine (Septodont) or a combination of both with composite resin. 2Bp models were restored externally with a combination technique and internally with root canal treatment. The other model was external restoration with GIC and internal with fiber post. Two masticatory loads were applied at 45˚ to the palatal aspect, and two traumatic loads were applied at 90˚ to the buccal aspect. Maximum von Mises stresses were calculated, and stress distribution patterns were studied.
Results
In 2Bd models, all restorative strategies decreased stress considerably, similar to the control model under all loads. In 2Bp models, the dentin component showed maximum stress at the deepest portion of the resorptive defect, which transfers into the adjacent pulp space. In 2Bp defects, a multilayered restoration externally and root canal treatment internally provides better stress distribution compared to the placement of a fiber post.
Conclusions
Increase in load, proportionally increased von Mises stress, despite the direction or angulation of the load. Multilayered restoration is preferred for 2Bd defects, and using an internal approach of root canal treatment is suggested to restore 2Bp defects.
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Cleaning protocols to enhance bond strength of fiberglass posts on root canals filled with bioceramic sealer: an in vitro comparative study
Thiago Bessa Marconato Antunes, Juliana Delatorre Bronzato, Joice Graciani, Ana Cristina Padilha Janini, Rocharles Cavalcante Fontenele, Francisco Haiter Neto, Brenda Paula Figueiredo de Almeida Gomes, Marina Angélica Marciano da Silva
Restor Dent Endod 2025;50(2):e20.   Published online May 21, 2025
DOI: https://doi.org/10.5395/rde.2025.50.e20
AbstractAbstract PDFPubReaderePub
Objectives
This study aimed to evaluate whether the agitation protocols using ultrasonic inserts or the XP-endo Finisher R file improved the removal of two different endodontic sealer remnants and the bond strength of fiberglass posts to dentin.
Methods
Seventy-two human teeth were selected. The canals were prepared with Reciproc 50 and Easy ProDesign 30/.10 and root filled according to the endodontic sealer groups: AH Plus or EndoSequence BC Sealer HiFlow. The samples were kept at 37ºC and 95% humidity for 28 days. During the post space preparation, the obturation was removed with Largo burs, and the groups were divided according to the irrigant agitation protocols (n = 12): no agitation, agitation with R1-Clearsonic associated with E1-Irrisonic ultrasonic inserts, or agitation with XP-endo Finisher R file. The fiberglass posts were cemented with RelyX ARC. The roots were sectioned into slices and submitted to the push-out test. Micro-computed tomography analysis was used to check the effectiveness of irrigating solution agitation in the elimination of remnants.
Results
The cleaning protocols with agitation were more effective in increasing the bond strength of posts to dentin for both sealer groups compared to non-agitation (p < 0.05). There was no difference between the same cleaning protocols for the different sealers. Among the different thirds, there was no statistical difference for the same sealer in the different cleaning protocols (p > 0.05).
Conclusions
Both agitation protocols effectively clean root-filled canals sealed with resin-based and calcium silicate-based sealers during fiberglass post space preparation. These protocols result in improved bond strength compared to non-agitation methods.
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Dentin thickness of C-shaped root canal walls in mandibular premolars based on cone-beam computed tomography: a retrospective cross-sectional study
Elif Aslan, Ali Canberk Ulusoy, Bilge Hakan Sen, B. Guniz Baksi, Erinc Onem, Ali Mert
Restor Dent Endod 2025;50(2):e18.   Published online May 15, 2025
DOI: https://doi.org/10.5395/rde.2025.50.e18
AbstractAbstract PDFPubReaderePub
Objectives
This study aimed to measure the dentin thickness of C-shaped canals in mandibular first and second premolars at coronal, middle, and apical root levels using cone-beam computed tomography (CBCT).
Methods
Dentin thicknesses of buccal, lingual, mesial, and distal root walls of 41 C-shaped premolars were measured at three different root levels on axial CBCT slices. The measurements were made at the midpoint of each third, along with 1 mm below and above the midpoint. C-shape configurations of the premolar root canals were also recorded. Analysis of variance, Kruskal-Wallis, and the independent samples t-tests were used for the comparisons (p = 0.05).
Results
The thickest walls for both premolars were buccal and lingual walls at all three root levels (p < 0.05). The thinnest walls for the first premolar teeth were mesial and distal walls of the lingual canal, while it was the mesial end of the buccal and lingual canals for the second premolars (p < 0.05). Dentin wall thicknesses at the mesial end of buccal and lingual canals of C1-shaped first premolars were thinner than C2-shaped first premolars at the apical level (p < 0.05).
Conclusions
Danger zones for C-shaped mandibular first and second premolars are predominantly mesial walls facing the radicular groove and distal wall of the lingual canal. CBCT imaging during endodontic treatment is recommended to avoid complications.
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Impact of the use of high-power 810-nm diode laser as monotherapy on the clinical and tomographic success of the treatment of teeth with periapical lesions: an observational clinical study
Fabricio Hinojosa Pedraza, Abel Victor Isidro Teves-Cordova, Murilo Priori Alcalde, Marco Antonio Hungaro Duarte
Restor Dent Endod 2025;50(2):e15.   Published online May 15, 2025
DOI: https://doi.org/10.5395/rde.2025.50.e15
AbstractAbstract PDFPubReaderePub
Objectives
The aim of this study was to demonstrate the impact of a high-power 810-nm diode laser as monotherapy on the clinical and tomographic success of treating teeth with periapical lesions, through a series of 31 cases.
Methods
Teeth with apical lesions underwent endodontic treatment in which a high-power 810-nm diode laser with saline solution was used as monotherapy for disinfection. This type of therapy aimed to replace the traditional irrigation protocol with sodium hypochlorite. This research is the first to assess the clinical success of this alternative treatment, along with tomographic evaluations conducted over periods ranging from 2 to 7 years, analyzed using the periapical index based on cone-beam computed tomography (CBCTPAI). All cases were performed by a single clinician following the same laser protocol, which involved using 1 W of continuous power and four cycles of 20 seconds of laser activation.
Results
All teeth showed no clinical symptoms upon follow-up examination. However, the tomographic evaluation revealed that the success rates for teeth receiving primary treatment were 60% and 80% according to strict and loose criteria, respectively. For teeth requiring retreatment, the success rates were 12.5% and 37.5% using strict and loose criteria, respectively.
Conclusions
The teeth with apical lesions that underwent primary treatment did not present clinical symptoms, but they showed a moderate success rate on tomographic evaluation. However, despite lacking clinical symptoms, teeth with apical lesions that required retreatment had a very low success rate on tomographic evaluation.
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Bibliometric analysis of the GentleWave system: trends, collaborations, and research gaps
Raimundo Sales de Oliveira Neto, Thais de Moraes Souza, João Vitor Oliveira de Amorim, Thaine Oliveira Lima, Guilherme Ferreira da Silva, Rodrigo Ricci Vivan, Murilo Priori Alcalde, Marco Antonio Hungaro Duarte
Restor Dent Endod 2025;50(2):e17.   Published online May 12, 2025
DOI: https://doi.org/10.5395/rde.2025.50.e17
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Objectives
The study aimed to conduct a bibliometric analysis of the GentleWave system (Sonendo, Inc.).
Methods
An electronic search was conducted in June 2024 using the Web of Science Collection database. Two reviewers independently screened publications, extracting data on authorship, publication details, study design, and citation metrics. Statistical analyses were performed in R to assess variable correlations, while the VOSviewer (Visualization of Similarities Viewer) software was used to map author and keyword networks.
Results
The search yielded 47 records, with 32 studies included. Publications spanned 2014 to 2024. The Journal of Endodontics published the highest number of studies (n = 15), and the International Endodontic Journal had the highest impact factor (5.4). The University of British Columbia and Sonendo, Inc. were the most frequent affiliations. Among the 32 articles, 28 were in vitro studies, primarily focusing on microbiology (n = 9). A total of 95 authors were identified, with Haapasalo and Shen being the most cited (n = 229). The articles accumulated 495 citations, demonstrating a strong positive correlation between the number of studies and citation counts (r = 0.98).
Conclusions
The analysis highlights a predominance of in vitro studies. Geographic concentration in the United States and Canada limits diversity, while the strong correlation between study numbers and citations suggests that increased publication volume enhances visibility.
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The effect of limonene extract on the adhesion of different endodontic cements to root dentin: an in vitro experimental study
Nayara Lima Ferraz Aguiar, Eduardo José Soares, Guilherme Nilson Alves dos Santos, Anna Luísa Araújo Pimenta, Laryssa Karla Romano, Ricardo Gariba Silva, Fernanda de Carvalho Panzeri
Restor Dent Endod 2025;50(2):e16.   Published online May 12, 2025
DOI: https://doi.org/10.5395/rde.2025.50.e16
AbstractAbstract PDFPubReaderePub
Objectives
The study aimed to evaluate the effect of limonene extract (LE) on push-out bond strength (BS) to root dentin in endodontically treated teeth.
Methods
Single-rooted teeth were selected and instrumented using the reciprocating technique, then divided into three groups based on the final irrigating solution: 2.5% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA), and 5% LE. The roots were further divided (n = 12) and obturated using the single-cone technique with epoxy resin-based (ERB) or bioceramic sealer (Bio-C). After 3 days, the roots were sectioned into 2-mm slices, obtaining two slices from each root third. Push-out BS testing was conducted at 0.5 mm/min, followed by failure pattern and adhesive interface analysis using scanning electron microscopy. Push-out BS data were analyzed by three-way analysis of variance and Tukey post-hoc test (p < 0.05).
Results
ERB showed higher BS when irrigated with EDTA (5.0 ± 2.3 MPa) compared to NaOCl (1.8 ± 1.1 MPa) (p = 0.0005), particularly in the cervical third. LE yielded intermediate values without significant differences from the other irrigants (3.5 ± 1.9 MPa) (p > 0.05). For Bio-C, the highest BS was observed in the apical third, especially with LE (9.4 ± 5.0 MPa), differing from other thirds and final irrigating solutions (p < 0.05). Mixed failure patterns were most prevalent, regardless of the irrigant solutions.
Conclusions
The combination of LE with Bio-C demonstrated superior BS in the apical third, suggesting its potential as a final irrigating solution in endodontic treatments.
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Shaping ability and cyclic fatigue resistance between Genius ProFlex, ZenFlex, and TruNatomy rotary systems: an experimental study
Raimundo Sales de Oliveira Neto, Murilo Priori Alcalde, Pedro Cesar Gomes Titato, Pedro Henrique Souza Calefi, Carlos Alberto Spironelli Ramos, Guilherme Ferreira da Silva, Rodrigo Ricci Vivan, Marco Antonio Hungaro Duarte
Restor Dent Endod 2025;50(1):e9.   Published online February 13, 2025
DOI: https://doi.org/10.5395/rde.2025.50.e9
AbstractAbstract PDFPubReaderePub
Objectives
The aim of this study was to investigate the efficacy of three newly introduced rotary endodontic systems: Genius ProFlex (Medidenta), TruNatomy (Dentsply Maillefer), and ZenFlex (Kerr).
Methods
Forty-five mandibular molars with root canal curvatures <5° were utilized. Micro-computed tomography scans were performed pre- and post-preparation to assess apical transportation, centralization, percentage of dentin wear, and canal volume alterations. Eight instruments of each diameter underwent cyclic fatigue testing.
Results
The percentage of dentin wear on mesial and distal walls showed no significant differences among ZenFlex, TruNatomy, and Genius ProFlex at 1, 2, 3, and 4 mm from the apical foramen and root canal orifice (p > 0.05). Centering ability varied in the mesiolingual canal (p < 0.05). No notable differences were observed in transportation (p > 0.05). Genius ProFlex demonstrated lower volumetric changes (p < 0.05). There were significant differences in cyclic fatigue, with higher values for Genius ProFlex and lower values for TruNatomy (p < 0.05).
Conclusions
The three nickel-titanium rotary instruments are safe and efficient for root canal preparation, with Genius ProFlex exhibiting superior cyclic fatigue resistance.
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Effect of quality of radiographs taken during root canal treatment on technical quality of root canal fillings and endodontic outcome
Jia Min Ng, Yan Yee Lee, Prashanti Chippagiri, Elaheh Ahanin, Abhishek Parolia
Restor Dent Endod 2025;50(1):e3.   Published online January 7, 2025
DOI: https://doi.org/10.5395/rde.2025.50.e3
AbstractAbstract PDFPubReaderePub
Objectives
This study evaluated the number and quality of working length (WL) and master cone (MC) radiographs taken during root canal treatment by dental undergraduates, and their associations with the technical quality of root canal fillings (TQRCF) and endodontic outcomes (EO).
Methods
A retrospective evaluation of radiographs from 303 root canal-treated teeth in 231 patients was conducted, with 72 patients attending recall visits to assess EO. The chi-square and one-way analysis of variance tests were performed.
Results
A total of 505 WL and 557 MC radiographs were reviewed, with 72.9% and 75% deemed satisfactory, respectively. Satisfactory TQRCF was achieved in 60.4% of cases. Significant associations were found between the extension of the file in WL and gutta-percha in MC radiographs and TQRCF (p = 0.000). Misinterpretation of these radiographs resulted in poor TQRCF. Furthermore, 64.2% of teeth had satisfactory EO. A significant relationship was noted between the quality of MC radiographs and both TQRCF (p = 0.043) and EO (p = 0.003).
Conclusions
Unsatisfactory MC radiographs were linked to poor TQRCF and unfavorable EO. Regular radiographic training is recommended to enhance EO.

Citations

Citations to this article as recorded by  
  • Assessment of radiographic errors and repetition rates in undergraduate endodontic education: a retrospective clinical study
    Marwa Ameen, Abdul Rahman Saleh, Dunia Alhadi, Manal Almaslamani
    The Saudi Dental Journal.2025;[Epub]     CrossRef
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Case Report
Guided endodontics, precision and predictability: a case series of mineralized anterior teeth with follow-up cone-beam computed tomography
Rafael Fernández-Grisales, Wilder Javier Rojas-Gutierrez, Pamela Mejía, Carolina Berruecos-Orozco, Néstor Ríos-Osorio
Restor Dent Endod 2025;50(1):e4.   Published online January 6, 2025
DOI: https://doi.org/10.5395/rde.2025.50.e4
AbstractAbstract PDFPubReaderePub
Pulp chamber and root canal obliteration (PCO/RCO) presents a challenge for clinicians when nonsurgical endodontic treatment is indicated. Guided endodontics (GE) aims to precisely locate the root canal (RC) system while preserving as much pericervical dentin as possible. GE involves integrating cone-beam computed tomography (CBCT) of the affected tooth with a digital impression of the maxillary/mandibular arch, allowing for careful planning of the drilling path to the RC system through a three-dimensional (3D) static guide. This article reports four cases of teeth with PCO/RCO, accompanied by additional diagnoses of internal and external root resorption and horizontal tooth fracture, all successfully treated with GE. These cases highlight the clinical and radiographic success of GE treatments using CBCT, establishing this technique as a predictable approach for managing mineralized teeth.
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Review Article
Influence of disinfecting solutions on the surface topography of gutta-percha cones: a systematic review of in vitro studies
Lora Mishra, Gathani Dash, Naomi Ranjan Singh, Manoj Kumar, Saurav Panda, Franck Diemer, Monika Lukomska-Szymanska, Barbara Lapinska, Abdul Samad Khan
Restor Dent Endod 2024;49(4):e42.   Published online November 1, 2024
DOI: https://doi.org/10.5395/rde.2024.49.e42
AbstractAbstract PDFSupplementary MaterialPubReaderePub

The surface integrity of gutta-percha cones is a crucial factor in the success of endodontic procedures. Disinfecting solutions play a pivotal role in sterilizing gutta-percha cones, but their influence on gutta-percha surface topography remains a subject of concern. This systematic review aimed to present a qualitative synthesis of available laboratory studies assessing the influence of disinfecting solutions on the surface topography of gutta-percha and offers insights into the implications for clinical practice. The present review followed PRISMA 2020 guidelines. An advanced database search was performed in PubMed, Google Scholar, Embase, Scopus, LILAC, non-indexed citations and reference lists of eligible studies in May 2024. Laboratory studies, in English language, were considered for inclusion. The quality (risk of bias) of the included studies was assessed using parameters for in vitro studies. A total of 28 studies were included in the qualitative synthesis. Based on the included in vitro studies, surface deposits and alterations in the physical properties of gutta-percha cones were observed after the disinfection protocol. A comprehensive review of the available literature indicates that the choice of disinfecting solution, its concentration, and immersion time significantly affect the surface topography of gutta-percha cones.

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Research Articles
Fracture resistance after root canal filling removal using ProTaper Next, ProTaper Universal Retreatment or hybrid instrumentation: an ex vivo study
Hadeel Hassan Hanafy, Marwa Mahmoud Bedier, Suzan Abdul Wanees Amin
Restor Dent Endod 2024;49(4):e38.   Published online October 11, 2024
DOI: https://doi.org/10.5395/rde.2024.49.e38
AbstractAbstract PDFPubReaderePub
Objectives

This study evaluated the effect of ProTaper Next (PTN), ProTaper Universal Retreatment (PTR) and hybrid instrumentation (HI) for canal filling removal on the fracture resistance (FR), mode of failure (MoF), and filling removal time.

Materials and Methods

Ninety-six, mandibular premolars were decoronated and randomly divided into 6 groups (n = 16), as follows: sound (S), untreated canals; prepared teeth (P), canals only prepared to ProTaper Universal finishing instrument (F4); endodontically-treated (ET), prepared and obturated canals using the single-cone technique; and groups PTN, PTR, and HI where filling was removed using PTN, PTR, or HI respectively. FR under vertical loading; MoF and time were assessed. Data were analyzed (Significance level [α] = 0.05).

Results

There was a significant difference in FR among all groups (p < 0.001) (HI < P < PTN < S < ET < PTR). HI showed lower FR than S, ET and PTR, and P showed lower FR than PTR (p < 0.05). For experimental groups, there was a significant difference between every group pair (p < 0.05) No significant difference was found regarding MoF distribution (p > 0.05). HI required the highest filling removal time, while PTR required the least (p < 0.05 between every group pair).

Conclusions

The effect of filling removal on FR may depend on the filling removal technique/system used. PTR could be faster and protect against fracture followed by PTN; HI could adversely affect FR. FR may be associated with filling removal time.

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Procedural errors detected by cone beam tomography in cases with indication for retreatment: in vivo cross-sectional study
Henry Paul Valverde Haro, Carmen Rosa Garcia Rupaya, Flávio R. F. Alves
Restor Dent Endod 2024;49(3):e26.   Published online June 24, 2024
DOI: https://doi.org/10.5395/rde.2024.49.e26
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to investigate the frequency and type of endodontic procedural errors in cases indicated for retreatment through cone-beam computed tomography (CBCT) analysis.

Materials and Methods

The sample consisted of 96 CBCT scans, encompassing 122 permanent teeth with fully formed roots. Errors included perforation, instrument fracture, canal transportation, missed canals, and inadequate apical limit of filling. Additionally, potential risk factors were analyzed and subjected to statistical modeling.

Results

The most frequent procedural error observed was the inadequate apical limit of filling, followed by canal transportation, perforation, missed canal, and instrument fracture. Statistically significant associations were identified between various procedural errors and specific factors. These include canal transportation and root canal wall, with the buccal wall being the most commonly affected; missed canal and tooth type, particularly the palatine and second mesiobuccal canal canals; inadequate apical limit of filling and root curvature, showing a higher deviation to the mesial direction in severely curved canals; inadequate apical limit of filling and the presence of calcifications, with underfilling being the most frequent; canal transportation and periapical lesion, notably with deviation to the buccal direction; and the direction of perforation and periapical lesion, most frequently occurring to buccal direction.

Conclusions

CBCT emerges as a valuable tool in identifying procedural errors and associated factors, crucial for their prevention and management.

Citations

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  • ANALYSIS OF THE QUALITY OF ROOT CANAL OBTURATION AND PREVALENCE OF APICAL PERIODONTITIS IN ENDODONTICALLY TREATED TEETH
    Cristina Coralia Nistor, Ioana Suciu , Elena Zabrac , Ruxandra Ioana Bartok , Bogdan Dimitriu , Andreea Baluta
    Romanian Journal of Oral Rehabilitation.2024; 16(4): 311.     CrossRef
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Alkasite restorative material for endodontically treated teeth: a randomized controlled pilot study
Davi Ariel Nobuo Bepu, Renata Siqueira Scatolin, Natalia Saud Junqueira Franco, Luiza Pejon Sanchez, Aline Evangelista Souza-Gabriel, Silmara Aparecida Milori Corona
Restor Dent Endod 2024;49(3):e24.   Published online June 11, 2024
DOI: https://doi.org/10.5395/rde.2024.49.e24
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to evaluate the clinical performance of an alkasite restorative material in molars that had undergone root canal treatment.

Materials and Methods

The research was registered in Brazilian Registry of Clinical Trials. The randomized clinical trial involved 33 patients, each with at least 1 mandibular molar requiring restoration after receiving endodontic treatment. Patients were randomly assigned to receive either bulk-fill resin composite (Tetric N Ceram Bulk Fill, Ivoclar Vivadent) or the alkasite restorative material (Cention N, Ivoclar Vivadent). Upon completion of the restorations, 3 calibrated professionals utilized the United States Public Health Service criteria to assess various factors, including retention, secondary caries, marginal adaptation, restoration color, marginal pigmentation, and anatomical form. Evaluations were conducted at intervals of 7 days, 6 months, and 17 months. Additionally, the assessment encompassed the presence of radiolucent lines adjacent to the restoration, material deficiencies or excess, contact points, and caries recurrence. The data underwent analysis using the Friedman and Mann-Whitney tests (α = 0.05).

Results

After 17 months, the results revealed that the alkasite restorative material exhibited greater wear of anatomical shape compared to the bulk-fill resin composite (p = 0.0189). Furthermore, the alkasite restorative material significantly differed from the natural tooth color in most cases (p = 0.0000). However, no other criteria displayed significant differences between the materials or over time (p > 0.05).

Conclusions

The alkasite restorative material (Cention N) emerges as a viable option for restoring endodontically treated teeth, displaying clinically acceptable alterations after a 17-month evaluation period.

Trial Registration

Brazilian Registry of Clinical Trials (ReBEC) Identifier: RBR-97kx5jv

Citations

Citations to this article as recorded by  
  • Alkasites in restorative dentistry: a review of their performance and properties
    Alexander Bonchev, Ralitsa Bogovska-Gigova
    Journal of Dentistry.2025; 160: 105916.     CrossRef
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Effects of a relined fiberglass post with conventional and self-adhesive resin cement
Wilton Lima dos Santos Junior, Marina Rodrigues Santi, Rodrigo Barros Esteves Lins, Luís Roberto Marcondes Martins
Restor Dent Endod 2024;49(2):e18.   Published online March 27, 2024
DOI: https://doi.org/10.5395/rde.2024.49.e18
AbstractAbstract PDFPubReaderePub
Objectives

This study was conducted to evaluate the mechanical properties of relined and non-relined fiberglass posts when cemented to root canal dentin using a conventional dual-cure resin cement or a self-adhesive resin cement.

Materials and Methods

Two types of resin cements were utilized: conventional and self-adhesive. Additionally, 2 cementation protocols were employed, involving relined and non-relined fiberglass posts. In total, 72 bovine incisors were cemented and subjected to push-out bond strength testing (n = 10) followed by failure mode analysis. The cross-sectional microhardness (n = 5) was assessed along the root canal, and interface analyses (n = 3) were conducted using scanning electron microscopy (SEM). Data from the push-out bond strength and cross-sectional microhardness tests were analyzed via 3-way analysis of variance and the Bonferroni post-hoc test (α = 0.05).

Results

For non-relined fiberglass posts, conventional resin cement exhibited higher push-out bond strength than self-adhesive cement. Relined fiberglass posts yielded comparable results between the resin cements. Type II failure was the most common failure mode for both resin cements, regardless of cementation protocol. The use of relined fiberglass posts improved the cross-sectional microhardness values for both cements. SEM images revealed voids and bubbles in the incisors with non-relined fiberglass posts.

Conclusions

Mechanical properties were impacted by the cementation protocol. Relined fiberglass posts presented the highest push-out bond strength and cross-sectional microhardness values, regardless of the resin cement used (conventional dual-cure or self-adhesive). Conversely, for non-relined fiberglass posts, the conventional dual-cure resin cement yielded superior results to the self-adhesive resin cement.

Citations

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  • Push-Out Bond Strength of Different Luting Cements Following Post Space Irrigation with 2% Chitosan: An In Vitro Study
    Shimaa Rifaat, Ahmed Rahoma, Hind Muneer Alharbi, Sawsan Jamal Kazim, Shrouq Ali Aljuaid, Basmah Omar Alakloby, Faraz A. Farooqi, Noha Taymour
    Prosthesis.2025; 7(1): 18.     CrossRef
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Prevalence of apical periodontitis and quality of root canal treatment in an adult Kuwaiti sub-population: a cross-sectional study
Abdulrahman A. Alhailaa, Saad A Al-Nazhan, Mazen A Aldosimani
Restor Dent Endod 2024;49(2):e16.   Published online March 22, 2024
DOI: https://doi.org/10.5395/rde.2024.49.e16
AbstractAbstract PDFPubReaderePub
Objectives

This cross-sectional study evaluated the prevalence of apical periodontitis (AP) and the technical quality of root canal fillings in an adult Kuwaiti subpopulation using cone-beam computed tomography (CBCT) images.

Materials and Methods

Two experienced examiners analyzed 250 CBCT images obtained from Kuwaiti patients aged 15–65 years who attended government dental specialist clinics between January 2019 and September 2020. The assessment followed the radiographic scoring criteria proposed by De Moor for periapical status and the technical quality of root canal filling. Chi-square and Fisher’s exact tests were used for statistical analysis, with significance level set at p < 0.05.

Results

Among the 2,762 examined teeth, 191 (6.91%) exhibited radiographic signs of AP, and 176 (6.37%) had undergone root canal filling. AP prevalence in root canal-treated teeth was 32.38%, with a significant difference between males and females. Most of the endodontically treated teeth exhibited adequate root canal filling (71.5%).

Conclusions

The study demonstrated a comparable prevalence of AP and satisfactory execution of root canal treatment compared to similar studies in different countries.

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The status of clinical trials regarding root canal sealers
Ahmad AL Malak, Yasmina EL Masri, Mira Al Ziab, Nancy Zrara, Tarek Baroud, Pascale Salameh
Restor Dent Endod 2024;49(1):e5.   Published online January 15, 2024
DOI: https://doi.org/10.5395/rde.2024.49.e5
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to present the results and analyses of clinical trials, including updates on the different functions of root canal sealers.

Materials and Methods

In June 2023, we performed a comprehensive search of ClinicalTrials.gov to identify interventional clinical trials pertaining to root canal sealers. In total, 23 clinical trials conducted up to June 2023 were included in this study.

Results

Approximately half of the trials (11 out of 23) were completed, while none were terminated or withdrawn. Each included trial had a minimum of 10 participants, with 11 trials having more than 100 participants. None of the assessed trials provided outcomes, and the majority (17 out of 23) lacked associated publications. In terms of geographic distribution, the USA and Canada did not contribute to any root canal sealer trials.

Conclusions

This study highlights the lack of diversity in trial locations, the absence of reported results, and a scarcity of clinical trials examining the physicochemical properties of different sealers. Most published trials primarily focused on assessing the post-operative pain effect of these sealers, but no significant difference was found regarding post-operative pain control.

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Predictor factors of 1-rooted mandibular second molars on complicated root and canal anatomies of other mandibular teeth
Hakan Aydın, Hatice Harorlı
Restor Dent Endod 2024;49(1):e2.   Published online January 3, 2024
DOI: https://doi.org/10.5395/rde.2024.49.e2
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to determine the effects of 1-rooted mandibular second molar (MnSM) teeth on root canal anatomy complexities of the mandibular central incisor (MnCI), mandibular lateral incisor (MnLI), mandibular canine (MnCn), mandibular first premolar (MnFP), mandibular second premolar (MnSP), and mandibular first molar (MnFM) teeth.

Materials and Methods

Cone-beam computed tomography images of 600 patients with full lower dentition were examined. Individuals with 1-rooted MnSMs were determined, and the complexity of root canal anatomy of other teeth was compared with individuals without 1-rooted MnSMs (Group-1; subjects with at least one 1-rooted MnSM, Group-2; subjects with more than a single root in both MnSMs). A second canal in MnCIs, MnLIs, MnCns, MnFPs, and MnSPs indicated a complicated root canal. The presence of a third root in MnFMs was recorded as complicated.

Results

The prevalence of 1-rooted MnSMs was 12.2%, with the C-shaped root type being the most prevalent (9%). There were fewer complicated root canals in MnCIs (p = 0.02), MnLIs (p < 0.001), and MnFPs (p < 0.001) in Group 1. The other teeth showed no difference between the groups (p > 0.05). According to logistic regression analysis, 1-rooted right MnSMs had a negative effect on having complex canal systems of MnLIs and MnFPs. Left MnSMs were explanatory variables on left MnLIs and both MnFPs.

Conclusions

In individuals with single-rooted MnSMs, a less complicated root canal system was observed in all teeth except the MnFMs.

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Case Report
Ingestion and surgical retrieval of an endodontic file: a case report
Devon Marta Ptak, Elinor Alon, Robert Bruce Amato, Julia Tassinari, Adrian Velasquez
Restor Dent Endod 2023;48(4):e32.   Published online September 2, 2023
DOI: https://doi.org/10.5395/rde.2023.48.e32
AbstractAbstract PDFPubReaderePub

Ingestions and aspirations of foreign bodies are rare, but do occasionally occur during dental treatment. Although reports exist, few include photos demonstrating the extensive surgical intervention that may be necessary to manage such events. Perhaps this lack of visualization, and associated lack of awareness, is one of the reasons some clinicians still provide non-surgical root canal therapy (NSRCT) without a rubber dam. This case report outlines the medical treatment of a 30-year-old male who initially presented to a general dentist’s office (not associated with the authors) for NSRCT of their mandibular right first molar. A rubber dam was not used for this procedure, during which the accidental ingestion of an endodontic K-file occurred. The patient was subsequently hospitalized for evaluation and treatment, consisting of numerous imaging studies, endoscopic evaluation, and surgical removal of the file from his small intestine. The ingestion of foreign bodies, and the associated complications, can be reduced through the routine use of a rubber dam, which is considered the standard of care for NSRCT. This case graphically illustrates the potential consequences associated with deviating from the standard of care and should remind clinicians that a rubber dam is necessary for all cases of NSRCT.

Citations

Citations to this article as recorded by  
  • Dental Dam Isolation for Crown Removal, Atraumatic Tooth Extraction, Immediate Implant Placement, and Restoration Cementation: A Case Study
    G Guzman-Perez, S Rojas-Rueda, F Floriani, A Unnadkat, C-C Fu, CA Jurado
    Operative Dentistry.2025; 50(1): 5.     CrossRef
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Research Article
Effect of irrigation protocols on smear layer removal, bond strength and nanoleakage of fiber posts using a self-adhesive resin cement
Rodrigo Stadler Alessi, Renata Terumi Jitumori, Bruna Fortes Bittencourt, Giovana Mongruel Gomes, João Carlos Gomes
Restor Dent Endod 2023;48(3):e28.   Published online July 27, 2023
DOI: https://doi.org/10.5395/rde.2023.48.e28
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to investigate the effect of the application method of 2% chlorhexidine (CHX) and its influence on the adhesion of fiberglass posts cemented with a self-adhesive resin cement.

Materials and Methods

Sixty human mandibular premolars were endodontically treated and divided into 5 groups (n = 12), according to the canal irrigant and its application method: 2 groups with conventional syringe irrigation (CSI)—2.5% sodium hypochlorite (NaOCl) (control) and 2% CHX— and 3 groups with 2% CHX irrigation/activation—by passive ultrasonic irrigation (PUI), Easy Clean file, and XP-Endo Finisher file. Two roots per group were evaluated for smear layer (SL) removal by scanning electron microscopy. For other roots, fiber posts were luted using a self-adhesive resin cement. The roots were sectioned into 6 slices for push-out bond strength (BS) (7/group) and nanoleakage (NL) (3/group). Data from SL removal were submitted to Kruskal-Wallis and Student-Newman-Keuls tests (α = 0.05). Data from BS and NL were evaluated by 2-way analysis of variance and Tukey’s test (α = 0.05).

Results

For SL removal and BS, the CHX irrigation/activation promoted better values than CSI with CHX (p < 0.05), but it was not significantly different from CSI with NaOCl (p > 0.05). For NL, the lowest values were obtained by the chlorhexidine irrigation/activation groups (p < 0.05).

Conclusions

Active 2% CHX irrigation can be used to improve the post space cleaning and adhesion before fiber post cementation with self-adhesive resin cements.

Citations

Citations to this article as recorded by  
  • Laser‐Activated Irrigation via Photon‐Induced Photoacoustic Streaming and Shock Wave Enhanced Emission on Smear Layer Removal Efficacy, Pushout Bond Strength, and Sealer Adaptation: A SEM Assessment
    Basil Almutairi, Fahad Alkhudhairy
    Microscopy Research and Technique.2025; 88(6): 1806.     CrossRef
  • The impact of passive ultrasonic irrigation on the bond strength of two different self-etch adhesives to human pulp chamber dentine: a laboratory investigation
    Mohammed Turky, Jukka Matinlinna, Monika Lukomska-Szymanska, Venkateshbabu Nagendrababu, Paul M. H. Dummer, Ahmad Abdel Hamid Elheeny, Nermin Alsayed Mahmoud
    BMC Oral Health.2025;[Epub]     CrossRef
  • The effect of nanoparticles incorporation titanium dioxide and zirconium oxide within self-adhesive resin cement on the push-out bond strength of the fiber post to the radicular dentin: An in vitro study
    Sawsan Hameed Al-Jubori, Maha Anwer AL-Murad
    Saudi Endodontic Journal.2025; 15(2): 162.     CrossRef
  • Evaluation of Microleakage Using Different Luting Cements in Kedo Zirconia Crowns: An In Vitro Assessment
    Guru Vishnu, Ganesh Jeevanandan
    Cureus.2024;[Epub]     CrossRef
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Review Article
Does photobiomodulation on the root surface decrease the occurrence of root resorption in reimplanted teeth? A systematic review of animal studies
Theodoro Weissheimer, Karolina Frick Bischoff, Carolina Horn Troian Michel, Bruna Barcelos Só, Manoela Domingues Martins, Matheus Albino Souza, Ricardo Abreu da Rosa, Marcus Vinícius Reis Só
Restor Dent Endod 2023;48(3):e24.   Published online June 12, 2023
DOI: https://doi.org/10.5395/rde.2023.48.e24
AbstractAbstract PDFSupplementary MaterialPubReaderePub

This review aimed to answer the following question “Does photobiomodulation treatment of the root surface decrease the occurrence of root resorption in reimplanted teeth?” Electronic searches were performed in the MEDLINE/PubMed, Cochrane Library, Scopus, Web of Science, Embase, and Grey Literature Report databases. Risk of bias was evaluated using SYRCLE Risk of Bias tool. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) tool was used to assess the certainty of evidence. In total, 6 studies were included. Five studies reported a reduced occurrence of root resorption in teeth that received photobiomodulation treatment of the root surface prior to replantation. Only 1 study reported contradictory results. The photobiomodulation parameters varied widely among studies. GRADE assessment showed a low certainty of evidence. It can be inferred that photobiomodulation treatment of the root surface prior to replantation of teeth can reduce the occurrence of root resorption. Nonetheless, further clinical studies are needed.

Trial Registration

PROSPERO Identifier: CRD42022349891

Citations

Citations to this article as recorded by  
  • Feasibility and Outcomes of Cell-based Regenerative Endodontic Therapy in Postautogenous Transplantation of a Mature Tooth: A Case Report
    Noriaki Yoshihashi
    Journal of Endodontics.2025; 51(1): 85.     CrossRef
  • Evidence Mapping and Quality Assessment of Systematic Reviews in Dental Traumatology: A 54 Months Update
    Nitesh Tewari, Pavithra Devi, Hemlata Nehta, Ekta Wadhwani, Rigzen Tamchos, Georgios Tsilingaridis, Vijay Prakash Mathur, Morankar Rahul
    Dental Traumatology.2025;[Epub]     CrossRef
  • Photobiomodulation Literature Watch September 2023
    James D. Carroll
    Photobiomodulation, Photomedicine, and Laser Surgery.2024; 42(7): 498.     CrossRef
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Research Article
Effects of different calcium-silicate based materials on fracture resistance of immature permanent teeth with replacement root resorption and osteoclastogenesis
Gabriela Leite de Souza, Gabrielle Alves Nunes Freitas, Maria Tereza Hordones Ribeiro, Nelly Xiomara Alvarado Lemus, Carlos José Soares, Camilla Christian Gomes Moura
Restor Dent Endod 2023;48(2):e21.   Published online May 5, 2023
DOI: https://doi.org/10.5395/rde.2023.48.e21
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Objectives

This study evaluated the effects of Biodentine (BD), Bio-C Repair (BCR), and mineral trioxide aggregate (MTA) plug on the fracture resistance of simulated immature teeth with replacement root resorption (RRR) and in vitro-induced osteoclastogenesis.

Materials and Methods

Sixty bovine incisors simulating immature teeth and RRR were divided into 5 groups: BD and BCR groups, with samples completely filled with the respective materials; MTA group, which utilized a 3-mm apical MTA plug; RRR group, which received no root canal filling; and normal periodontal ligament (PL) group, which had no RRR and no root canal filling. All the teeth underwent cycling loading, and compression strength testing was performed using a universal testing machine. RAW 264.7 macrophages were treated with 1:16 extracts of BD, BCR, and MTA containing receptor activator of nuclear factor-kappa B ligand (RANKL) for 5 days. RANKL-induced osteoclast differentiation was assessed by staining with tartrate-resistant acid phosphatase. The fracture load and osteoclast number were analyzed using 1-way ANOVA and Tukey’s test (α = 0.05).

Results

No significant difference in fracture resistance was observed among the groups (p > 0.05). All materials similarly inhibited osteoclastogenesis (p > 0.05), except for BCR, which led to a lower percentage of osteoclasts than did MTA (p < 0.0001).

Conclusions

The treatment options for non-vital immature teeth with RRR did not strengthen the teeth and promoted a similar resistance to fractures in all cases. BD, MTA, and BCR showed inhibitory effects on osteoclast differentiation, with BCR yielding improved results compared to the other materials.

Citations

Citations to this article as recorded by  
  • In vitro comparison of fracture strength of maxillary incisors with the simulated external root resorption cavities repaired with BioMTA or Biodentine
    Tufan Ozasir, Birgul Ozasir, Nagihan Aribal, Derin Bugu Yuzer, Baris Kandemir, Kamran Gulsahi
    Journal of Dental Sciences.2025; 20(3): 1532.     CrossRef
  • Comparative Analysis of Gene Expression in Periodontal Ligament Stem Cells Exposed to Biodentine and Bio-C Repair: Implications for Cementogenesis—An In Vitro Study
    Mahmoud M. Bakr, Mahmoud Al Ankily, Mohammed Meer, Mohamed Shamel
    Oral.2025; 5(1): 19.     CrossRef
  • Evaluation of Different Techniques and Materials for Filling in 3-dimensional Printed Teeth Replicas with Perforating Internal Resorption by Means of Micro–Computed Tomography
    Angelo J.S. Torres-Carrillo, Helena C. Assis, Rodrigo E. Salazar-Gamarra, Leonardo Moreira Teodosio, Alice C. Silva-Sousa, Jardel F. Mazzi-Chaves, Priscila B. Ferreira-Soares, Manoel D. Sousa-Neto, Fabiane C. Lopes-Olhê
    Journal of Endodontics.2024; 50(2): 205.     CrossRef
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Case Report
Successful nonsurgical treatment of type II dens invaginatus with 5 root canals using a self-adjusting file: a case report
George Táccio de Miranda Candeiro, Antônio Sérgio Teixeira de Menezes, Ana Carolina Saldanha de Oliveira, Flávio Rodrigues Ferreira Alves
Restor Dent Endod 2023;48(2):e17.   Published online April 27, 2023
DOI: https://doi.org/10.5395/rde.2023.48.e17
AbstractAbstract PDFPubReaderePub

The present report describes the endodontic treatment of an Oehlers type II dens invaginatus in a maxillary lateral incisor with 5 root canals, an extremely rare condition. Apical periodontitis and related symptoms were noted. Cone-beam computed tomography was used to aid the diagnosis, reveal tooth morphology, and assist in canal location. The pulp chamber was carefully accessed, and the root canals were explored under magnification. All root canals were prepared with an R25 Reciproc Blue system and sodium hypochlorite (NaOCl) irrigation. After initial preparation, a self-adjusting file (SAF) with NaOCl and ethylenediaminetetraacetic acid was used to complement the disinfection. Additionally, calcium hydroxide medication was applied. Vertical compaction was used to fill the canals with a calcium silicate-based endodontic sealer and gutta-percha. After 12 months, the patient exhibited healing of the periapical region, absence of symptoms, and normal dental function. In conclusion, this nonsurgical treatment protocol was successful in promoting the cure of apical periodontitis. Both complementary disinfection with an SAF and use of calcium hydroxide medication should be considered when choosing the best treatment approach for dens invaginatus with very complex anatomy.

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Research Articles
Influence of CBCT parameters on image quality and the diagnosis of vertical root fractures in teeth with metallic posts: an ex vivo study
Larissa Pereira Lagos de Melo, Polyane Mazucatto Queiroz, Larissa Moreira-Souza, Mariana Rocha Nadaes, Gustavo Machado Santaella, Matheus Lima Oliveira, Deborah Queiroz Freitas
Restor Dent Endod 2023;48(2):e16.   Published online April 27, 2023
DOI: https://doi.org/10.5395/rde.2023.48.e16
AbstractAbstract PDFPubReaderePub
Objectives

The aim of this study was to evaluate the influence of peak kilovoltage (kVp) and a metal artifact reduction (MAR) tool on image quality and the diagnosis of vertical root fracture (VRF) in cone-beam computed tomography (CBCT).

Materials and Methods

Twenty single-rooted human teeth filled with an intracanal metal post were divided into 2 groups: control (n = 10) and VRF (n = 10). Each tooth was placed into the socket of a dry mandible, and CBCT scans were acquired using a Picasso Trio varying the kVp (70, 80, 90, or 99), and the use of MAR (with or without). The examinations were assessed by 5 examiners for the diagnosis of VRF using a 5-point scale. A subjective evaluation of the expression of artifacts was done by comparing random axial images of the studied protocols. The results of the diagnoses were analyzed using 2-way analysis of variance and the Tukey post hoc test, the subjective evaluations were compared using the Friedman test, and intra-examiner reproducibility was evaluated using the weighted kappa test (α = 5%).

Results

The kVp and MAR did not influence the diagnosis of VRF (p > 0.05). According to the subjective classification, the 99 kVp protocol with MAR demonstrated the least expression of artifacts, while the 70 kVp protocol without MAR led to the most artifacts.

Conclusions

Protocols with higher kVp combined with MAR improved the image quality of CBCT examinations. However, those factors did not lead to an improvement in the diagnosis of VRF.

Citations

Citations to this article as recorded by  
  • Diagnostic Performance of Iterative Reconstruction of Cone-beam Computed Tomography for Detecting Vertical Root Fractures in the Presence of Metal Artifacts
    Matheus Barros-Costa, Gustavo Santaella, Christiano Oliveira-Santos, Deborah Queiroz Freitas, William C. Scarfe, Francisco Carlos Groppo
    Journal of Endodontics.2025;[Epub]     CrossRef
  • Radiographic and Clinical Outcomes of Laser-Enhanced Disinfection in Endodontic Therapy
    Janos Kantor, Sorana Maria Bucur, Eugen Silviu Bud, Victor Nimigean, Ioana Maria Crișan, Mariana Păcurar
    Journal of Clinical Medicine.2025; 14(12): 4055.     CrossRef
  • Vertical root fracture diagnosis in teeth with metallic posts: Impact of metal artifact reduction and sharpening filters
    Débora Costa Ruiz, Lucas P. Lopes Rosado, Rocharles Cavalcante Fontenele, Amanda Farias-Gomes, Deborah Queiroz Freitas
    Imaging Science in Dentistry.2024; 54(2): 139.     CrossRef
  • Comparing standard- and low-dose CBCT in diagnosis and treatment decisions for impacted mandibular third molars: a non-inferiority randomised clinical study
    Kuo Feng Hung, Andy Wai Kan Yeung, May Chun Mei Wong, Michael M. Bornstein, Yiu Yan Leung
    Clinical Oral Investigations.2024;[Epub]     CrossRef
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Buckling resistance, torque, and force generation during retreatment with D-RaCe, HyFlex Remover, and Mtwo retreatment files
Yoojin Kim, Seok Woo Chang, Soram Oh
Restor Dent Endod 2023;48(1):e10.   Published online February 6, 2023
DOI: https://doi.org/10.5395/rde.2023.48.e10
AbstractAbstract PDFPubReaderePub
Objectives

This study compared the buckling resistance of 3 nickel-titanium (NiTi) retreatment file systems and the torque/force generated during retreatment.

Materials and Methods

The buckling resistance was compared among the D-RaCe (DR2), HyFlex Remover, and Mtwo R25/05 retreatment systems. J-shaped canals within resin blocks were prepared with ProTaper NEXT X3 and obturated by the single-cone technique with AH Plus. After 4 weeks, 4 mm of gutta-percha in the coronal aspect was removed with Gates-Glidden drills. Retreatment was then performed using DR1 (size 30, 10% taper) followed by DR2 (size 25, 4% taper), HyFlex Remover (size 30, 7% taper), or Mtrwo R25/05 (size 25, 5% taper) (15 specimens in each group). Further apical preparation was performed with WaveOne Gold Primary. The clockwise torque and upward force generated during retreatment were recorded. After retreatment, resin blocks were examined using stereomicroscopy, and the percentage of residual filling material in the canal area was calculated. Data were analyzed using 1-way analysis of variance with the Tukey test.

Results

The HyFlex Remover files exhibited the greatest buckling resistance (p < 0.05), followed by the Mtwo R25/05. The HyFlex Remover and Mtwo R25/05 files generated the highest maximum clockwise torque and upward force, respectively (p < 0.05). The DR1 and DR2 files generated the least upward force and torque (p < 0.05). The percentage of residual filling material after retreatment was not significantly different between file systems (p > 0.05).

Conclusions

NiTi retreatment instruments with higher buckling resistance generated greater clockwise torque and upward force.

Citations

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  • Comparative evaluation of the efficacy of three different retreatment files in removing root canal filling material: An In vitro confocal microscopy study
    Meghna Sarah Abraham, Aravind R. Kudva, Prathap M. S. Nair, Shravan Kini, Samreena Kalander, Faseeh Muhammed Bin Farookh
    Endodontology.2025; 37(2): 136.     CrossRef
  • Cone-beam computed tomographic evaluation and fracture resistance of endodontically retreated teeth using hyflex remover, Mtwo, and ProTaper retreatment file systems: An in vitro study
    Isha Singh, Dakshita Joy Sinha, Pallavi Sharma, Kunal Bedi, Priyanka Rani, Swapnil Vats
    Saudi Endodontic Journal.2024; 14(1): 56.     CrossRef
  • Comparison of torsional, bending, and buckling resistances of different nickel-titanium glide path files
    Feyyaz Çeliker, İrem Çetinkaya
    Matéria (Rio de Janeiro).2024;[Epub]     CrossRef
  • Assessing the impact of obturation techniques, kinematics and irrigation protocols on apical debris extrusion and time required in endodontic retreatment
    Eugenio Pedullà, Francesco Iacono, Martina Pitrolo, Giovanni Barbagallo, Giusy Rita Maria La Rosa, Chiara Pirani
    Australian Endodontic Journal.2023; 49(3): 623.     CrossRef
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Review Article
Effect of endodontic sealer on postoperative pain: a network meta-analysis
Cynthia Maria Chaves Monteiro, Ana Cristina Rodrigues Martins, Alessandra Reis, Juliana Larocca de Geus
Restor Dent Endod 2023;48(1):e5.   Published online December 29, 2022
DOI: https://doi.org/10.5395/rde.2023.48.e5
AbstractAbstract PDFPubReaderePub

This systematic review and network meta-analysis aimed to answer the following focused research question: “Does the type of endodontic sealer affect the postoperative pain in patients who received endodontic treatment?” Different databases and grey literature were surveyed. Only one randomized controlled trial were included. The risk of bias in the studies was evaluated by using the Cochrane Collaboration’s tool. A random-effects meta-analysis was conducted to compare the risk and intensity of postoperative pain. The quality of the body of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation approach. Out of 11,601 studies, 15 remained for qualitative analyses and 12 for meta-analysis. Seven studies were classified at high risk of bias, and 8 studies raised some concerns. No significant differences between the endodontic materials were observed in the direct comparisons, both in risk and in intensity of postoperative pain (pairwise comparisons with 2 studies: I2 = 0%; p > 0.05 and 8 studies: I2 = 23%; p > 0.05, respectively). The certainty of the evidence was graded as low or moderate. There was no difference in the risk and intensity of postoperative pain after filling with different endodontic sealers. Further systematic reviews should be conducted.

Trial Registration

PROSPERO Identifier: CRD42020215314

Citations

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  • Effect of occlusal reduction on post-operative pain of symptomatic and asymptomatic molar teeth
    Aysenur Kamacı Esen, Fatma Furuncuoğlu, Fatima Betul Basturk, Muhammet Nuri Taşcıoğlu, Masoud Parirokh
    Acta Odontologica Scandinavica.2025; 84: 371.     CrossRef
  • Comparative evaluation of postoperative pain and periapical healing after root canal treatment using three different endodontic sealers: A randomized controlled clinical trial
    Ruchika Pandey, Nitin Kararia, Deepak Kumar Sharma, Vishal Rathod, Anand Vilas Bansod, Dhaval Desai
    Journal of Conservative Dentistry and Endodontics.2024; 27(9): 962.     CrossRef
  • Effect of bioceramic-based and resin-based sealers on postoperative discomfort following root canal therapy: a systematic review and meta-analysis
    Mansi Supare, Ajinkya M. Pawar, Kashmira Sawant, Dian Agustin Wahjuningrum, Suraj Arora, Firas Elmsmari, Mohmed Isaqali Karobari, Bhagyashree Thakur
    PeerJ.2024; 12: e18198.     CrossRef
  • Comparative Evaluation of Incidences of Post Operative Pain in Patient Treated in Single Visit Root Canal Treatment by Using Different Sealers: - An in-Vivo Study
    Sadashiv Daokar, Aishwarya Ranjalkar, Kalpana Pawar, Komal Potfode, Dhanashri Padwal, Sana Khan
    International Journal of Innovative Science and Research Technology (IJISRT).2024; : 2743.     CrossRef
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Research Article
Comparison of shaping ability of the Reciproc Blue and One Curve with or without glide path in simulated S-shaped root canals
Vincenzo Biasillo, Raffaella Castagnola, Mauro Colangeli, Claudia Panzetta, Irene Minciacchi, Gianluca Plotino, Simone Staffoli, Luca Marigo, Nicola Maria Grande
Restor Dent Endod 2022;47(1):e3.   Published online December 28, 2022
DOI: https://doi.org/10.5395/rde.2022.47.e3
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to assess the impact of a glide-path on the shaping ability of 2 single-file instruments and to compare the centering ability, maintenance of original canal curvatures and area of instrumentation in simulated S-shaped root canals.

Materials and Methods

Forty simulated S-shaped root canals were used and were prepared with One Curve (group OC), One G and OC (group GOC), Reciproc Blue (group RB) and R-Pilot and RB (group PRB) and scanned before and after instrumentation. The images were analyzed using AutoCAD. After superimposing the samples, 4 levels (D1, D2, D3, and D4) and 2 angles (Δ1 and Δ2) were established to evaluate the centering ability and modification of the canal curvatures. Then, the area of instrumentation (ΔA) was measured. The data were analyzed using 2-way analysis of variance and Tukey's test for multiple comparisons (p < 0.05).

Results

Regarding the centering ability in the apical part (D3, D4), the use of the glide-path yielded better results than the single-file groups. Among the groups at D4, OC showed the worst results (p < 0.05). The OC system removed less material (ΔA) than the RB system, and for Δ1, OC yielded a worse result than RB (p < 0.05).

Conclusions

The glide-path improved the centering ability in the apical part of the simulated S-shaped canals. The RB system showed a better centering ability in the apical part and major respect of the canal curvatures compared with OC system.

Citations

Citations to this article as recorded by  
  • Evaluation of Apical Debris Extrusion and the Remaining Canal Material during Retreatment of a Bioceramic Sealer by the XP-endo Finisher File System, Followed by Various Supplementary Methods: An in Vitro Study
    Paras Mull Gehlot, Parvathi Sudeep, Annapoorna B Mariswamy
    World Journal of Dentistry.2025; 15(10): 837.     CrossRef
  • Shaping Ability of Rotary NiTi Systems in S‐Shaped Root Canals of Mandibular Molars
    Renata M. S. Leal, Emmanuel J. N. L. Silva, Maria C. B. P. Campos, Clarissa T. Rodrigues, Marco A. H. Duarte, Bruno C. Cavenago
    Australian Endodontic Journal.2025; 51(1): 133.     CrossRef
  • Comparison of Debris Extrusion and Preparation Time by Traverse, R‐Motion Glider C, and Other Glide Path Systems in Severely Curved Canals
    Taher Al Omari, Layla Hassouneh, Khawlah Albashaireh, Alaa Dkmak, Rami Albanna, Ali Al-Mohammed, Ahmed Jamleh, Lucas da Fonseca Roberti Garcia
    International Journal of Dentistry.2025;[Epub]     CrossRef
  • Glide Path – An Ineluctable Route for Successful Endodontic Mechanics: A Literature Review
    Mahima Bharat Mehta, Anupam Sharma, Aniket Jadhav, Aishwarya Handa, Abhijit Bajirao Jadhav, Ashwini A. Narayanan
    Journal of the International Clinical Dental Research Organization.2024; 16(2): 101.     CrossRef
  • Screw-in force, torque generation, and performance of glide-path files with three rotation kinetics
    Jee-Yeon Woo, Ji-Hyun Jang, Seok Woo Chang, Soram Oh
    Odontology.2024; 112(3): 761.     CrossRef
  • Glide Path in Endodontics: A Literature Review of Current Knowledge
    Vlad Mircea Lup, Giulia Malvicini, Carlo Gaeta, Simone Grandini, Gabriela Ciavoi
    Dentistry Journal.2024; 12(8): 257.     CrossRef
  • In Vitro Research Methods Used to Evaluate Shaping Ability of Rotary Endodontic Files—A Literature Review
    Ranya F. Elemam, Ana Mano Azul, João Dias, Khaled El Sahli, Renato de Toledo Leonardo
    Dentistry Journal.2024; 12(10): 334.     CrossRef
  • Endodontic glide path - importance and performance techniques
    Milica Jovanovic-Medojevic, Мiljan Stosic, Vanja Opacic-Galic, Violeta Petrovic
    Srpski arhiv za celokupno lekarstvo.2023; 151(5-6): 380.     CrossRef
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Review Article
Influence of the root canal filling technique on the success rate of primary endodontic treatments: a systematic review
Daniel Feijolo Marconi, Giovana Siocheta da Silva, Theodoro Weissheimer, Isadora Ames Silva, Gabriel Barcelos Só, Leonardo Thomasi Jahnke, Jovito Adiel Skupien, Marcus Vinicius Reis Só, Ricardo Abreu da Rosa
Restor Dent Endod 2022;47(4):e40.   Published online October 11, 2022
DOI: https://doi.org/10.5395/rde.2022.47.e40
AbstractAbstract PDFSupplementary MaterialPubReaderePub
Objectives

This study aimed to investigate the influence of different obturation techniques compared to cold lateral compaction on the success rate of primary non-surgical endodontic treatments.

Materials and Methods

Systematic searches were performed for studies published up to May 17th, 2022 in MEDLINE/PubMed, Cochrane Library, Web of Science, Scopus, EMBASE, and Grey Literature Reports. Randomized clinical trials and nonrandomized (nonrandomized clinical trials, prospective or retrospective) studies that evaluated the success rate of primary non-surgical endodontic treatments obturated with the cold lateral compaction (control) and other obturation techniques were included. The revised Cochrane risk of bias tools for randomized trials (RoB 2) and nonrandomized studies of interventions (ROBINS-I) were used to evaluate the risk of bias. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to evaluate the certainty of evidence.

Results

Eleven studies (4 randomized clinical trials (RCTs), 4 prospective, and 3 retrospectives) were included. Two RCTs were classified as having some concerns risk of bias and 2 as a low risk of bias. Two nonrandomized studies were classified as having a critical risk of bias and 5 as having a moderate risk of bias. The GRADE analysis demonstrated a very low to moderate certainty of evidence.

Conclusions

This systematic review generally evidenced no differences in the success rate of primary non-surgical endodontic treatments when the cold lateral compaction technique and other obturation techniques are performed. Further well-designed studies are still necessary.

Citations

Citations to this article as recorded by  
  • Comparative Analysis Of Obturation Techniques In Endodontics: Lateral Vs. Thermoplasticized. Thermoplasticized
    Juan Esteban Díaz Pacheco , Rómulo Guillermo López Torres , Verónica Alejandra Salame Ortíz
    Salud, Ciencia y Tecnología.2025; 5: 1626.     CrossRef
  • Effect of ultrasonic activation of endodontic sealers on root canal filling quality during the single-cone obturation procedure: a systematic review and meta-analysis of laboratory-based studies
    Shuting Feng, Weiqing Zhou, Xiaojun Chu, Shuaimei Xu, Xiongqun Zeng
    Odontology.2025;[Epub]     CrossRef
  • Clinical and Radiographic Failure of Nonsurgical Endodontic Treatment and Retreatment Using Single-cone Technique With Calcium Silicate-based Sealers: A Systematic Review and Meta-analysis
    Mohammad A. Sabeti, Negah Karimpourtalebi, Arash Shahravan, Omid Dianat
    Journal of Endodontics.2024; 50(6): 735.     CrossRef
  • Method of microbial decontamination of endodontic absorbent paper points: a randomised experimental study
    O. A. Pavlovskaya, O. A. Kachanova, V. V. Volobuev, M. N. Mitropanova, A. R. Gazarova, V. Y. Zobenko, A. G. Uvarova
    Pediatric dentistry and dental prophylaxis.2024; 24(2): 157.     CrossRef
  • The Push-Out Bond Strength, Surface Roughness, and Antimicrobial Properties of Endodontic Bioceramic Sealers Supplemented with Silver Nanoparticles
    Karla Navarrete-Olvera, Nereyda Niño-Martínez, Idania De Alba-Montero, Nuria Patiño-Marín, Facundo Ruiz, Horacio Bach, Gabriel-Alejandro Martínez-Castañón
    Molecules.2024; 29(18): 4422.     CrossRef
  • Clinical outcome of non-surgical root canal treatment using different sealers and techniques of obturation in 237 patients: A retrospective study
    Mateusz Radwanski, Krystyna Pietrzycka, Tan Fırat Eyüboğlu, Mutlu Özcan, Monika Lukomska-Szymanska
    Clinical Oral Investigations.2024;[Epub]     CrossRef
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Research Articles
The prevalence and characteristics of external cervical resorption based on cone-beam computed tomographic imaging: a cross-sectional study
Matheus Diniz Ferreira, Matheus Barros-Costa, Felipe Ferreira Costa, Deborah Queiroz Freitas
Restor Dent Endod 2022;47(4):e39.   Published online October 11, 2022
DOI: https://doi.org/10.5395/rde.2022.47.e39
AbstractAbstract PDFPubReaderePub
Objectives

This study investigated the prevalence and characteristics of external cervical resorption (ECR) regarding sex, age, tooth, stages of progression, and portal of entry, using cone-beam computed tomography (CBCT) scans.

Materials and Methods

CBCT scans of 1,313 patients from a Brazilian subpopulation comprising 883 female and 430 male patients (mean age, 55.2 years), acquired using a PreXion 3D CBCT unit, were evaluated. All permanent teeth included in the scans were evaluated for the presence of ECR according to the 3-dimensional classification and the portal of entry. The association between the presence of ECR and the factors studied was assessed using the χ2 test. Intra-observer agreement was analyzed with the kappa test (α = 0.05).

Results

In total, 6,240 teeth were analyzed, of which 84 (1.35%) were affected by ECR. A significant association was found between the presence of ECR and sex, with a higher prevalence in male patients (p = 0.002). The most frequently affected teeth were the mandibular and maxillary central incisors. The most common height was the mid-third of the root. For the portal of entry, 44% of cases were on the proximal surfaces, 40.5% on the lingual/palatal surface and 15.5% on the buccal surface. Intra-observer agreement was excellent.

Conclusions

The prevalence of ECR was 1.35%, with a higher prevalence in male patients and a wide age distribution. The mandibular and maxillary central incisors were the most commonly affected teeth, and cases of ECR most frequently showed a height into the mid-third of the root and proximal entry.

Citations

Citations to this article as recorded by  
  • Prise en charge des lésions cervicales
    C. Mocquot, L. Detzen, I. Fontanille, B. Orlik, F. Decup
    EMC - Médecine buccale.2025; 18(3): 1.     CrossRef
  • Prevalence and Characterization of External Cervical Resorption Using Cone Beam Computed Tomography
    Isadora Carneiro Pereira Machado, Marilia Oliveira Morais, Adriana Lustosa Pereira Bicalho, Patricia Helena Pereira Ferrari, Juliano Martins Bueno, José Luiz Cintra Junqueira, Mariana Quirino Silveira Soares
    Journal of Endodontics.2024; 50(2): 164.     CrossRef
  • Influence of tube current and metal artifact reduction on the diagnosis of external cervical resorption in teeth adjacent to a dental implant in CBCT: an ex-vivo study
    Thamiles Gonzalez-Passos, Matheus Barros-Costa, Matheus L Oliveira, Deborah Queiroz Freitas
    Clinical Oral Investigations.2024;[Epub]     CrossRef
  • Maxillary anterior teeth with extensive root resorption treated with multidisciplinary approach: A case report
    Thais Machado de Carvalho Coutinho, Carollyne Souza Campello, Juliana Pires Abdelnur, Vivian Ronquete, Carlos Henrique Sardenberg Pereira, Marilia F Marceliano-Alves
    International Journal of Case Reports and Images.2023; 14(1): 8.     CrossRef
  • Clinical and radiographic features of external cervical resorption – An observational study
    Shanon Patel, Francesc Abella, Kreena Patel, Paul Lambrechts, Nassr Al‐Nuaimi
    International Endodontic Journal.2023; 56(12): 1475.     CrossRef
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Apical periodontitis in mesiobuccal roots of maxillary molars: influence of anatomy and quality of root canal treatment, a CBCT study
Samantha Jannone Carrion, Marcelo Santos Coelho, Adriana de Jesus Soares, Marcos Frozoni
Restor Dent Endod 2022;47(4):e37.   Published online September 19, 2022
DOI: https://doi.org/10.5395/rde.2022.47.e37
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to evaluate the prevalence of apical periodontitis (AP) in the mesiobuccal roots of root canal-treated maxillary molars.

Materials and Methods

One thousand cone-beam computed tomography images of the teeth were examined by 2 dental specialists in oral radiology and endodontics. The internal anatomy of the roots, Vertucci’s classification, quality of root canal treatment, and presence of missed canals were evaluated; additionally, the correlation between these variables and AP was ascertained.

Results

A total of 1,000 roots (692 first molars and 308 second molars) encompassing 1,549 canals were assessed, and the quality of the root canal filling in the majority (56.9%) of the canals was satisfactory. AP was observed in 54.4% of the teeth. A mesiolingual canal in the mesiobuccal root (MB2 canal) was observed in 54.9% of the images, and the majority (83.5%) of these canals were not filled. Significant associations were observed between the presence of an MB2 canal and the quality of the root canal filling and the presence of AP.

Conclusions

AP was detected in more than half of the images. The MB2 canals were frequently missed or poorly filled.

Citations

Citations to this article as recorded by  
  • Anatomical Configuration of the MB2 Canal Using High-Resolution Cone-Beam Computed Tomography
    Luciana Magrin Blank-Gonçalves, Emmanuel João Nogueira Leal da Silva, Monikelly do Carmo Chagas Nascimento, Ana Grasiela Limoeiro, Luiz Roberto Coutinho Manhães-Jr
    Journal of Endodontics.2025; 51(5): 609.     CrossRef
  • The Effect of Age and Gender on the Distance Between the Maxillary Sinus Cortical Bone and Maxillary Molars: A Cone-Beam Tomography Analysis
    Thaysa Menezes Constantino, Marília Fagury Videira Marceliano-Alves, Vivian Ronquete, Ana Grasiela da Silva Limoeiro, Pablo Andres Amoroso-Silva, Mariano Simon Pedano, Tchilalo Boukpessi, Fábio Vidal, Thais Machado de Carvalho Coutinho
    Sinusitis.2025; 9(1): 9.     CrossRef
  • Retrospective study of the morphology of third maxillary molars among the population of Lower Silesia based on analysis of cone beam computed tomography
    Anna Olczyk, Barbara Malicka, Katarzyna Skośkiewicz-Malinowska, Mohmed Isaqali Karobari
    PLOS ONE.2024; 19(2): e0299123.     CrossRef
  • Relationship between apical periodontitis and missed canals in mesio-buccal roots of maxillary molars: CBCT study
    Badi B. Alotaibi, Kiran I. Khan, Muhammad Q. Javed, Smita D. Dutta, Safia S. Shaikh, Nawaf M. Almutairi
    Journal of Taibah University Medical Sciences.2024; 19(1): 18.     CrossRef
  • APICAL PERIODONTITIS IN MAXILLARY MOLARS WITH MISSED SECOND MESIO-BUCCAL ROOT CANAL: A CBCT STUDY
    Cristina Coralia Nistor, Ioana Suciu , Ecaterina Ionescu , Anca Dragomirescu , Elena Coculescu , Andreea Baluta
    Romanian Journal of Oral Rehabilitation.2024; 16(3): 100.     CrossRef
  • Anatomic Comparison of Contralateral Maxillary Second Molars Using High-Resolution Micro-CT
    Ghassan Dandache, Umut Aksoy, Mehmet Birol Ozel, Kaan Orhan
    Symmetry.2023; 15(2): 420.     CrossRef
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Effect of intracanal cryotherapy on postoperative pain after endodontic treatment: systematic review with meta-analysis
Fernanda Garcias Hespanhol, Ludmila Silva Guimarães, Lívia Azeredo Alves Antunes, Leonardo Santos Antunes
Restor Dent Endod 2022;47(3):e30.   Published online July 4, 2022
DOI: https://doi.org/10.5395/rde.2022.47.e30
AbstractAbstract PDFPubReaderePub
Objectives

This study aimed to evaluate the effectiveness of final irrigation with cold saline solution after endodontic treatment compared with saline solution at room temperature against postoperative pain following endodontic treatment.

Materials and Methods

A broad search was performed in the PubMed, Web of Science, Scopus, Cochrane Library, Virtual Health Library (LILACS), and Grey Literature databases. Two independent reviewers performed data extraction, risk of bias using the Cochrane methodology, and certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.

Results

Eight studies were included in qualitative synthesis. Intracanal cryotherapy favored the reduction of postoperative pain in the systematic review. Four studies were included in meta-analyses. The meta-analysis showed that intracanal cryotherapy reduced postoperative pain in teeth with symptomatic apical periodontitis (SAP) at 24 hours. There was no association between intracanal cryotherapy and control (room temperature) groups in teeth with normal periapical tissue with respect to postoperative pain at 24 hours and 48 hours.

Conclusions

Intracanal cryotherapy was effective in reducing postoperative pain after endodontic treatment in teeth with SAP.

Citations

Citations to this article as recorded by  
  • Impact of intracanal cryotherapy on postoperative pain in symptomatic apical periodontitis: A systematic review and meta-analysis of randomized clinical trials
    Nishtha K. Patel, Prerak Doshi, Shaily R. Dalal, Pooja R. Kesharani, Shilpa S. Shah, Mohil H. Kale
    Endodontology.2025; 37(2): 101.     CrossRef
  • Determining Efficacy of Intracanal Cryotherapy on Post Endodontic Pain in Irreversible Pulpitis
    Anam Fayyaz Bashir, Ussamah Waheed Jatala, Moeen ud din Ahmad, Muhammad Talha Khan, Saima Razzaq Khan, Aisha Arshad Butt
    Pakistan Journal of Health Sciences.2024; : 68.     CrossRef
  • The effect of intracanal cryotherapy with and without foraminal enlargement on pain prevention after endodontic treatment: a randomized clinical trial
    Marcos Felipe Iparraguirre Nuñovero, Marco Antonio Hungaro Duarte, André Vinícius Kaled Segato, Ulisses Xavier da Silva Neto, Vania Portela Ditzel Westphalen, Everdan Carneiro
    Scientific Reports.2024;[Epub]     CrossRef
  • Effect of cryotherapy duration on experimentally induced connective tissue inflammationin vivo
    Jorge Vera, Mayra Alejandra Castro-Nuñez, María Fernanda Troncoso-Cibrian, Ana Gabriela Carrillo-Varguez, Edgar Ramiro Méndez Sánchez, Viviana Sarmiento, Lourdes Lanzagorta-Rebollo, Prasanna Neelakantan, Monica Romero, Ana Arias
    Restorative Dentistry & Endodontics.2023;[Epub]     CrossRef
  • Evaluation of knowledge and awareness of pediatric oral health among school teachers of Hazaribag before and after oral health education.
    Vipin Ahuja, Annapurna Ahuja, Nilima Thosar
    F1000Research.2023; 12: 1292.     CrossRef
  • 841 View
  • 31 Download
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