Restorative Dentistry & Endodontics

Review Article

Evaluation of postoperative pain following foraminal enlargement in asymptomatic necrotic teeth undergoing root canal treatment: a systematic review and meta-analysis: Mohammad Sabeti, Seyed Mohammadreza Masoumi, Rachel Li, Mohammad Hosein Amirzade-Iranaq; J Korean Acad Conserv Dent ;Published online October 1, 2026; DOI: https://doi.org/10.5395/rde.2026.51.e40 [Epub ahead of print]

Abstract PDF: Objectives
The apical third is crucial for endodontic success, and while foraminal enlargement (FE) may enhance canal debridement, its effect on postoperative pain remains uncertain. This review aimed to determine whether FE during single-visit nonsurgical root canal treatment (NSRCT) of asymptomatic necrotic permanent teeth leads to increased postoperative pain compared with non-FE.
Methods
This systematic review followed PRISMA 2020 and was registered in PROSPERO (CRD420250652786). MEDLINE, Web of Science, Embase, and Cochrane Central were searched to May 20, 2025, for randomized controlled trials (RCTs) comparing single-visit NSRCT with and without FE. Risk of bias was evaluated with RoB 2, and meta-analysis was conducted using a random-effects model.
Results
Six RCTs involving 426 teeth were included. The overall pooled analysis demonstrated significantly greater postoperative pain in the FE group (standardized mean difference, 1.02; 95% confidence interval, 0.24–1.80; p = 0.01). The certainty of the evidence was low, primarily because of considerable inconsistency. Subgroup analyses showed statistically significant differences at 12 and 72 hours. Overall heterogeneity was substantial (I² = 92.3%) but decreased after exclusion of two influential studies without changing the direction of the pooled effect.
Conclusions
FE is associated with a significant, though transient, increase in postoperative pain during the first week following NSRCT.

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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

Abstract PDF Supplementary Material

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

Effect of Restoration Strategy and Cavity Location on the Fracture Resistance of Teeth with External Cervical Resorption
Saadet Elpe, Öznur Sarıyılmaz
Journal of Endodontics.2026; 52(6): 980. CrossRef
Influence of Different Post-core Restorative Modalities on Fracture Characteristics of Immature Endodontically Treated Premolars
Wafa H Alaajam, Khalid M Abdelaziz, Malaz M Mustafa, Mohammed S Al-Ak'hali, Ashraf A Khalil, Mohammed M Al Moaleem, Hoda L Abouzeid
The Journal of Contemporary Dental Practice.2026; 27(4): 399. CrossRef
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
Efficacy of Mineral Trioxide Aggregate Versus Biodentine as a Direct Pulp Capping Material in Carious Human Mature Permanent Teeth: A Systematic Review
Rashmi Misra, Nikita Toprani, Sumita Bhagwat, Aashaka Vaishnav, Aastha Dureja, Omkar Bhosale
Cureus.2025;[Epub] 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

Vital tooth with periapical lesion: spontaneous healing after conservative treatment: Hyun-Joo Kim, Seung-Jong Lee, Il-Young Jung, Sung-Ho Park; Restor Dent Endod 2012;37(2):123-126. Published online May 18, 2012; DOI: https://doi.org/10.5395/rde.2012.37.2.123

Abstract PDF: It is often presumed that apical periodontitis follows total pulp necrosis, and consequently root canal treatment is commonly performed. Periapical lesion development is usually caused by bacteria and its byproduct which irritate pulp, develop pulpitis, and result in necrosis through an irreversible process. Afterwards, apical periodontitis occurs. This phenomenon is observed as an apical radiolucency in radiographic view. However, this unusual case presents a spontaneous healing of periapical lesion, which has developed without pulp necrosis in a vital tooth, through conservative treatment.

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