Sodium hypochlorite (NaOCl), ethylenediaminetetraacetic acid (EDTA), and calcium hydroxide (Ca(OH)) are used in root canal treatment. However, further research is needed to assess their effectiveness at time points not considered in previous guidelines. This review complements the systematic review by Rossi-Fedele and Rödig (2023) by considering time points excluded by the latter. A search was conducted in PubMed-MEDLINE, Scopus, EMBASE, Google Scholar, and repositories between March and May 2024. Four studies met the inclusion criteria, providing data from 212 teeth for irrigation and 108 for dressings. No significant differences in pain reduction within 7 days or radiographic reduction of apical lesion size were found between 2% chlorhexidine, 5.25% NaOCl, EDTA, and various NaOCl concentrations. Single and multiple visit protocols also showed no significant differences in postoperative pain. Two studies had a 'low risk' of bias and two 'some concerns'. Evidence suggests that Ca(OH) dressings may not offer additional benefits.

This study reports two cases of traumatised non-vital immature teeth (IT). Both underwent surgical and nonsurgical treatments after healing failure. In the first case, both maxillary central incisors underwent revascularization as the first treatment option. Failure was detected in tooth #8 after 15 months, while tooth #9 showed periapical healing and further root development. Apical microsurgery was performed because of persistent cystic fluid during nonsurgical retreatment. In the second case, there was recurrent endodontic treatment failure in tooth #9 after nonsurgical mineral trioxide aggregate (MTA) apical plug placement and apical surgery (AS). Endodontic resurgery comprised debridement, apical and lateral root surface planning and removal of remaining MTA from the bone lesion. For both cases, histopathological examination revealed the presence of inflammatory cysts. Periapical healing was observed 1 year after treatment. Apical surgery, and even resurgery, should be considered as alternatives to tooth extraction in growing patients with IT and recurrent healing failure.

This study tested the impact of troughing on the detection rates of MB2 canals with and without calcifications. Traditional access cavities were prepared and the detection of MB2 canals was recorded in 200 maxillary molars selected based on micro-CT scans. In specimens, the MB2 orifice was not detected; troughing was performed. The number of negotiated MB2 with and without troughing was compared with micro-CT using McNemar's test. After traditional access cavity preparation without troughing, the operator detected MB2 in 142 specimens (82%). Troughing of the remaining specimens led to the further identification of 16 MB2 canals, increasing detection rate to 91%. Troughing significantly improved the detection rate of non-calcified MB2s (p < 0.05) but did not significantly impact the detection of calcified MB2 canals (p > 0.05). While troughing is highly effective in enhancing MB2 canal detection in non-calcified canals, it may be limited in cases where calcification is present.

The influence of ultrasonic activation (UA) on the physicochemical properties of setting time (n = 5), volumetric stability (n = 10), alkalizing activity/calcium ions release (pH/Ca) (n = 10) and calcium/phosphate-rich substance formation in simulated body fluid (Hank's balanced salt solution; HBSS) of three cements was evaluated: white MTA-Angelus (MTA), MTA Repair HP (MTAHP) and Biodentine (BIO). It was observed that UA influenced the setting times (min) distinctly, delaying the initial setting time of MTA (40.8/64.6) and accelerating that of BIO (35.6/22.4). The final setting time of MTAHP (154.4/114.6) and BIO (64.4/42.4) were also accelerated (p < 0.05). Volumetric reduction was observed in all groups, with MTA/UA being the most volumetrically stable (0.98%); UA did not influence volumetric stability (p > 0.05). All groups exhibited an alkaline pH, with a disadvantage for MTAHP and MTAHP/UA at 24 h, 72 h and 168 h (p < 0.05). All groups showed Ca release. The tested cements exhibited a favourable Ca/P ratio on their surface after 28 days.

This clinical study assessed the effectiveness of diode laser-980 nm as adjuvant in retreatment of failed endodontic cases with chronic periapical lesions on basis of IL-8 expression and postoperative pain when compared to placebo. For 28 patients, the pre-instrumentation periapical samples (S1) were gathered, following retreatment. After chemo-mechanical preparation, post-instrumentation samples (S2) were collected. Patients were allocated to diode laser (DL) or placebo (PL) groups. After which post-irradiation samples (S3) were gathered. Patients recorded their pain on NRS scale at 6, 12, 24 and 7 days. After 1 week, samples (S4) were collected. An ELISA kit was used to measure an amount of IL-8. DL group showed significantly lower IL-8 levels at S4 (p < 0.001) and postoperative pain at 6 h (p = 0.003) compared to PL. Intracanal diode laser irradiation is a beneficial adjunct to endodontics, in retreatment cases regarding reducing postoperative pain and lowering the level of IL-8 expression.

This in vitro study evaluated three dentine replacement materials: Biodentine, Ketac Molar and TheraBaseCa. Specimens of each material (n = 19) were prepared for investigations of hardness, calcium release, pH and water sorption-solubility. SEM and EDX analysis were also used for these investigations. One-way ANOVA and robust ANOVA tests were used for normally and non-normally distributed data for statistical analysis, respectively. TheraBaseCa showed the lowest hardness (p < 0.001), while Biodentine had the highest pH and calcium release (p < 0.001). Significant differences in water sorption-solubility were observed as Biodentine>Ketac Molar>TheraBaseCa (p < 0.001). SEM and EDX revealed that Biodentine had a crystalline structure with O, Ca, C, Si and Bi; Ketac Molar had a particulate matrix with O, C, F, Ca, Si and Al; and TheraBaseCa had a matrix with C, O, Si, Yb, Al and Ca. In conclusion, Biodentine was more alkaline and released more calcium, while TheraBaseCa had the lowest water sorption-solubility over 28 days.

This study aims to evaluate the effect of antimicrobial photodynamic therapy(aPDT) with polydopamine nanoparticle functionalised with Curcuma longa(nPD-Cur) against root canal biofilm. nPD-Cur was prepared and characterised using Scanning Electron Microscopy(SEM), dynamic light scattering(DLS), Fourier-transform infrared spectroscopy(FTIR) and Ultraviolet visual(UV/Vis) spectrophotometry. Root sections (10 mm length) were obtained from 53 single-rooted human premolars and chemo-mechanically prepared followed by inoculation with E. faecalis. All the specimens were randomly divided into five groups(n = 10) and irrigated (Group 1-Saline; Group 2-2.5% Sodium hypochlorite(NaOCl); Group 3-Cur; Group 4-nPD; and Group 5-nPD-Cur) followed by diode irradiation and analysed for reduction in colony-forming units(CFU)/mL, bacterial viability using Confocal Laser Scanning Microscopy(CLSM) and SEM for biofilm disruption. Results were analysed using one-way ANOVA followed by post hoc Tukey's test for pairwise comparison (p < 0.05). nPD-Cur revealed the characteristic absorption patterns. The antimicrobial potency was highest for NaOCl followed by nPD > Cur-nPD > Cur.

This in-vitro study aimed to explore the potential of Diode Laser by quantifying the release of transforming growth factor-beta 1 (TGF-β1), platelet-derived growth factor (PDGF)-BB, and vascular endothelial growth factor (VEGF) from root dentin after ethylenediaminetetraacetic acid (EDTA) and diode laser. In 30 hemi-roots distributed into five groups: G1: Tris-buffered solution (TBS); G2: 17%EDTA; G3: 17% EDTA +650 nm Diode Laser; G4:17% EDTA +810 nm Diode Laser; and G5: 810 nm Diode Laser. The concentration of the three factors was quantified using a cytokine bead array. Statistical tests were performed to estimate intergroup differences (p ≤ 0.05). TGF-β1 and VEGF were solubilised in all test protocols. The ability of low-level power diode lasers to release proteins from the matrix is limited. Its effect on the release of VEGF and PDGF-BB does not make a difference. A synergy between EDTA and Diode Laser led to a greater proportion of TGF-β1 release.

The study aims to conduct a bibliometric analysis on root canal irrigation to elucidate the development of this domain and pose the future research trends. Of 6722 articles retrieved from Clarivate Analytics' Web of Science Core Collection and PubMed, 6650 publications were included for bibliometric analysis. Irrigation field had received emerging attention for the last half century, peaking at 399 in 2022. The United States was revealed as the most influential contributor, with Journal of Endodontics representing the most voluminous resource. Franklin R Tay was regarded as the most productive author, while Siqueira, Jose. F. was the most prominent. Both keywords cluster analysis and burst analysis revealed the main research branch fields were irrigation protocols. Within this branch, the discussion of irrigants (with a frequency of 1135) ranked first. This bibliometric study revealed the research hotspot of irrigants, while suggesting the future directions of irrigants' creations and micro-level mechanism elucidation.

This study evaluated the cytotoxicity and biocompatibility of a new strontium silicate-based root canal sealer (C-Root SP), in comparison with those of iRoot SP and AH plus. The sealer extract was diluted to the concentrations of 100%, 75%, 50%, and 25%. L929 cells were cultured for 24 h, and the absorbance value was determined. Two-way analysis of variance (two-way ANOVA) and sealers were implanted in the tibia of Sprague-Dawley (SD) rats, At 2, 6, and 12 weeks, rats were euthanised. The tissue reaction was evaluated by HE staining. The least significant difference (LSD) t-test and Kruskal-Wallis test were used. The cytotoxicity of C-Root SP and iRoot SP was found to be less than that of AH plus. At 12 weeks, new bone formation was induced around C-Root SP and iRoot SP sealer, but minimal evidence of bone formation was found in AH plus. C-Root SP has low cytotoxicity and superior biocompatibility.

This case report describes a successful autotransplantation procedure for an impacted mandibular left second premolar with incomplete root formation. Despite caries and root resorption, the patient's mandibular left second primary molar was retained. Furthermore, the severe impaction of the mandibular left second premolar ruled out orthodontic realignment. Due to the young age of the patient, dental implantation was not feasible, leading to the selection of autotransplantation as the preferred method for replacing the retained primary molar. To address the insufficient buccolingual width of the recipient site, a combination of piezosurgery-assisted alveolar ridge splitting and guided bone regeneration techniques was employed in this autotransplantation procedure.

To establish an acid-etching protocol for Biodentine and Cimmo DTA, evaluating compressive strength, bond strength, surface morphology in scanning electron microscope and failure modes after different etching times. Two test specimens were prepared for each cement and divided into four groups (n = 12) according to the acid-etching time (0, 5, 10 and 15 s). Compressive strength was tested using a universal testing machine, while bond strength was evaluated after bonding with Filtek Bulk Flow resin using Universal ESPE Single Bond adhesive. Failures were classified as surface-adhesive, cement-cohesive, resin-cohesive and mixed. Biodentine showed significantly higher compressive strength than Cimmo DTA (p < 0.001), regardless of acid etch time (p < 0.001). Different acid-etching strategies are required for Biodentine and Cimmo DTA, with Biodentine requiring selective etching and Cimmo DTA requiring a full 15-s etch to optimise bond strength properties.

This study assessed the usability of ultrasonography in detecting root canal perforations. The buccal side of incisor root were perforated. The actual lengths up to the perforation site were measured by visualisation of the tip of a file. Specimens were embedded in gypsum, and it was scraped to simulate bone resorption. Resorption cavities were filled with ultrasound gel. Measurements were taken by advancing a file through the canal until the tip became visible in the ultrasound image. 3D scans were obtained using cone-beam computed tomography (CBCT) and the distance between the coronal point of the resorption cavity and the reference point was measured. The actual distance of the resorption cavity from the reference point varied 6-10.6 mm. The same distances were measured via ultrasound as 5.7-10.9 mm, while measured using CBCT 6-10.5 mm. No significant differences were found. Ultrasonography shows promise for detecting root perforations, however further research is needed.

The use of rotary file in permanent teeth is well-documented, but there is limited scientific evidence for its effectiveness in primary teeth. A meta-analysis was conducted to compare rotary and manual tools in primary tooth pulpectomy procedures. Ten databases were searched from 2000 to 2024 to find relevant literature. The Cochrane Risk of Bias (ROB) tool assessed bias in randomised control trials. STATA software version 18 conducted the meta-analysis. A random-effects model was used for instrumentation time and obturation quality evaluation while sensitivity analysis followed high heterogeneity detection. Twenty RCTs were included after screening 723 studies. Publication bias and heterogeneity were found for instrumentation time, leading to removal of nine studies. Significant difference in mean instrumentation time (1.42) was noted. Obturation quality assessment showed an odds ratio of 1.82. Use of rotary instrumentation yielded superior outcomes compared with manual instrumentation for pulpectomy for primary teeth.

This study aimed to assess the antibiotic prescribing pattern for endodontic infections among general dental practitioners (GDPs) and endodontic specialists in Malaysia. A 22-questions survey on demographic and general information on antibiotic prescribing patterns for endodontic infection was delivered to the email addresses of general dentists and specialists via the Dental Practitifoner Information Management System database. Collected data were analysed using multivariate logistic regression tests at the significance level of 0.05. A total of 372 responses were collected. 94% of respondents were GDPs, and 6% endodontists. Clinical experience and frequency of endodontic treatment performance were the significant factors in prescribing antibiotics (p < 0.05). The common reasons for antibiotic prescription were to control the spread of infection and fever (88%). Endodontists have better knowledge of antibiotic prescription than GDPs. The majority of GDPs had inappropriately prescribed antibiotics. Improving the knowledge of GDPs in Malaysia regarding antibiotics-indications in endodontics is mandatory.

The aim was to evaluate the chemical, morphological aspects and microhardness of root dentin after treatment with Triton™ solution. Twenty blocks of root dentin were distributed in two groups (n = 10): Control (C) (2.5% NaOCl+17% EDTA+2.5% NaOCl) and Triton™ solution (T). Morphological analysis was performed before and after treatments with confocal laser microscopy. Chemical composition and microhardness were analysed after the treatments using Raman spectroscopy and Knoop microhardness. Results were submitted to Student's t-test and Mann-Whitney test (p < 0.05). The C group had greater tubule number, area and perimeter (p < 0.001), besides a regular surface, while T showed an irregular surface with cracks and erosions, lower organic content intensity (p < 0.001) and higher inorganic/organic ratio (p = 0.003) than C, which had higher microhardness than T (p = 0.003). Triton™ exposed a lower number, area and perimeter of dentinal tubules, with cracks and erosions in root dentin. It also showed significant chemical alterations in the organic content, reducing it, resulting in lower microhardness.

This study assessed the influence of root canal treatment quality on the architecture of periapical lesions. A total of 121 lesions were involved in this research. Two researchers analysed the surface of the lesions, diameters in three planes, volume and sphericity. The quality of root canal treatment was assessed with PESS index. Non-parametric statistical tests: Mann-Whitney and Spearman rank correlation coefficient were used in this research. Connected lesions of multirooted teeth spread in the coronal plane revealed a positive correlation with coronal seal and root canal filling homogenicity, however their spread in the sagittal plane showed a positive correlation only with root canal filling homogenicity. The quality of root canal treatment has an influence on the periapical lesions' architecture.

This study aimed to evaluate the relationship of incidence between radix entomolaris (RE) in permanent mandibular first molars (FM) with C-shaped canal (CSC) in permanent mandibular second molars (SM). A total of 1015 cone-beam computed tomography (CBCT) images of permanent mandibular molars from Malaysian patients were collected retrospectively and analysed by researchers from seven dental schools in Malaysia trained in CBCT technology. The presence and absence of RE and CSC were scored as 'yes' or 'no'. The prevalence of FM with RE was 21.2% and SM with CSC was 37.9%. The co-occurrence of RE and CSC in the same quadrant was 6.5% (OR = 1.497, p = 0.014). Female, Chinese and samples from Eastern Peninsular Malaysia were associated with CSC in SM (p < 0.05). The increased appearance of CSC in SM when RE is present in FM makes it imperative for clinicians to be vigilant during examination and diagnosis to prevent potential endodontic mishaps.

This study evaluated the glass fibre post (GFP) removal using three different protocols with ultrasonic tips. Thirty-six extracted single-rooted teeth were endodontically treated and cemented with a 10-mm GFP. Three protocols were used for GFP removal: 20 s activated with cooling, 20 s activated without cooling and 40 s activated without cooling. The removal time and temperature increase on the external root surface were recorded. The amount of residual material and the volume of dentin loss were assessed using micro-computed tomography. Data were analysed using ANOVA with a 5% significance level. The removal time and the amount of residual material were not affected by the protocol. There was no difference in temperature increase between the 20-s groups. The 40s activated without cooling produced the highest temperatures, especially in the apical region, and greater dentin loss. It is not advisable to use the ultrasonic insert continuously for more than 20 s.