As the most critical part of post-graduate education,the Chinese government launched Standard Resident Training in 2013 to solve the regional inequality of medical quality and meet the increasing social requirement fo...As the most critical part of post-graduate education,the Chinese government launched Standard Resident Training in 2013 to solve the regional inequality of medical quality and meet the increasing social requirement for better medical service.We integrated problem-based learning(PBL)and case-based learning(CBL)in the Endodontics Standard Resident Training.By evaluating with objective parameters including theoretical knowledge and clinical practice skill,and subjective parameters including questionnaire,it was found that PBL+CBL played a positive role in endodontic resident training with a significant difference(P<0.05).This combined training model is instructive for China’s resident training,and this result can provide a rudimentary reference to current postgraduate teaching reform.展开更多
Background: Calcium hydroxide has been used in dentistry since several decades. It has been used in a number of applications in the field of endodontics such as root resorption, intracanal medicament, and root canal s...Background: Calcium hydroxide has been used in dentistry since several decades. It has been used in a number of applications in the field of endodontics such as root resorption, intracanal medicament, and root canal sealers. Although this material exhibits several advantages, it also has some limitations. Objectives: To review the role of calcium hydroxide in the field of endodontics, focusing on its mechanism of action, antimicrobial effects, different applications, cytotoxicity or biocompatibility, and its removal from the root canals. Materials and Methods: An electronic search was done using different databases. Out of 2,664 articles, only 33 articles have been selected to be included in this review because they are directly related to the topic and matched the inclusion criteria of this review: “Language: English” and “Year: 2000-2016”. Results: The antimicrobial effect of calcium hydroxide is controversial. Although some studies supported the effectiveness of calcium hydroxide against some bacteria others reported its limitation against fungal infection. Calcium hydroxide can be used effectively as intracanal medicament, root canal sealer, in weeping canals, for perforation management and root resorption. Conclusions: Despite the limitation of antimicrobial activity of calcium hydroxide, it is used effectively in a number of treatment modalities in endodontics. Due to its biological and therapeutical properties, calcium hydroxide is the material of choice for all pulp therapy. However, when using calcium hydroxide as a dressing material in root canal treatment caution should be taken to prevent the overextension of the paste beyond the tooth apex and avoid the harmful side effects.展开更多
目的 Journal of Endodontics,JOE是牙髓病学科中重要的研究载体之一。在当今口腔医学研究中的影响力日渐增加。本文分析了JOE近10年来发表的相关文献的年际分布、作者空间分布、作者文献数量分布、关键词、文献引用、期刊影响因子等方...目的 Journal of Endodontics,JOE是牙髓病学科中重要的研究载体之一。在当今口腔医学研究中的影响力日渐增加。本文分析了JOE近10年来发表的相关文献的年际分布、作者空间分布、作者文献数量分布、关键词、文献引用、期刊影响因子等方面,并探讨中国作者对该杂志文献构成的贡献,以及国内该领域内研究的组织机构构成等。方法利用ISI Web of Science(ISI WOS)数据库收集文献,将检索到的文献导入书目共现分析系统(BICOMB2.0)、Endnote X6及Excel 2007中进行分析。结果结果表明,近10年来,我国研究者在该杂志上发表的文献,数量逐年增加。作者空间分布表明相关机构具有明显的学科相关性。结论引文分析表明,中国作者发表的文献被引用次数逐年增加,说明中国研究者在牙髓病学领域的专业水平和影响力不断提高。期刊影响因子分析表明JOE是牙髓病学领域内顶尖的期刊之一,同时影响因子的变化已趋于稳定。展开更多
Regenerative endodontics(RE)therapy means physiologically replacing damaged pulp tissue and regaining functional dentin–pulp complex.Current clinical RE procedures recruit endogenous stem cells from the apical papill...Regenerative endodontics(RE)therapy means physiologically replacing damaged pulp tissue and regaining functional dentin–pulp complex.Current clinical RE procedures recruit endogenous stem cells from the apical papilla,periodontal tissue,bone marrow and peripheral blood,with or without application of scaffolds and growth factors in the root canal space,resulting in cementum-like and bone-like tissue formation.Without the involvement of dental pulp stem cells(DPSCs),it is unlikely that functional pulp regeneration can be achieved,even though acceptable repair can be acquired.DPSCs,due to their specific odontogenic potential,high proliferation,neurovascular property,and easy accessibility,are considered as the most eligible cell source for dentin–pulp regeneration.The regenerative potential of DPSCs has been demonstrated by recent clinical progress.DPSC transplantation following pulpectomy has successfully reconstructed neurovascularized pulp that simulates the physiological structure of natural pulp.The self-renewal,proliferation,and odontogenic differentiation of DPSCs are under the control of a cascade of transcription factors.Over recent decades,epigenetic modulations implicating histone modifications,DNA methylation,and noncoding(nc)RNAs have manifested as a new layer of gene regulation.These modulations exhibit a profound effect on the cellular activities of DPSCs.In this review,we offer an overview about epigenetic regulation of the fate of DPSCs;in particular,on the proliferation,odontogenic differentiation,angiogenesis,and neurogenesis.We emphasize recent discoveries of epigenetic molecules that can alter DPSC status and promote pulp regeneration through manipulation over epigenetic profiles.展开更多
BACKGROUND Root canal retreatment is common after root canal therapy in clinical situations.Especially,completing the retreatment of variant root canals can be challenging.This is particularly true for the molars loca...BACKGROUND Root canal retreatment is common after root canal therapy in clinical situations.Especially,completing the retreatment of variant root canals can be challenging.This is particularly true for the molars located at the end of the dental arch.However,advancements in digital dental diagnosis and treatment techniques can solve these problems.Here,we describe a case of a maxillary second molar with a variant distobuccal root canal treated via a novel“inlay-guided endodontics”technique based on improved computer-generated programs.CASE SUMMARY A 63-year-old man complained of a defect in the maxillary left second molar.The tooth,diagnosed with post-treatment endodontic disease,was initially treated by conventional methods,which were ineffective.Our“inlay-guided endodontics”technique was subsequently adopted,with the establishment of a precise integrated three-dimensional(3D)plate model of cone-beam computed tomography data and a digital impression of the dentition.An optimal root canal approach was generated for the“virtual file”in the 3D model.The plate data were imported into a 3D printer and printed.With the help of the guide plate,the file was accurately placed into the cervical third of the distal root canal.The root canal and prosthodontic treatments successfully proceeded subsequently.CONCLUSION Our newly developed inlay guide plates may facilitate individualized and minimally invasive root canal treatment.展开更多
As an important part of postgraduate education,Standard Resident Training(STR)plays a crucial role in the process of culturing a competent dental care provider who can independently treat the common oral infectious di...As an important part of postgraduate education,Standard Resident Training(STR)plays a crucial role in the process of culturing a competent dental care provider who can independently treat the common oral infectious diseases.A systematic and comprehensive evaluation system is desiderating for realization of high-quality Endodontics resident training due to its discipline characteristics of highly specialized and strict operation.This paper analyzes the current status of resident training in our Endodontic Department and discusses how to improve the clinical skills and reasoning ability of residents,in order to construct a comprehensive resident training formative evaluation system in China.展开更多
The objective of this study was to systematically review the literature about the use of the operating microscope in endodontics. It used sources of bibliographic cataloging electronically identified by MEDLINE via Pu...The objective of this study was to systematically review the literature about the use of the operating microscope in endodontics. It used sources of bibliographic cataloging electronically identified by MEDLINE via PubMed, LILACS, BBO and Scopus, using as descriptors: Endodontics, anatomy and microscopy. The selected articles were identified from the titles and abstracts, taking into consideration the following criteria: publications ranging from January 2001 to November 2012, case reports, published in an indexed journal, and publications in English language. The search showed 167 articles related to this topic, and these 21 articles met the inclusion criteria. These indicated that a higher magnification helps coronary access and the location of channels to identify and interpret the complexities of the anatomy of root canals, the removal of nuclei and intracoronary fractured instruments, to minimize trauma of surgeries in soft and hard tissues, and detect fractures and microfractures. It was found that its use has provided Endodontics with a significant improvement in vision of the operative field, offering better quality jobs and a higher success rate.展开更多
Objective:To observe the effectiveness and safety of one-time endodontics in the treatment of chronic apical periodontitis with sinus tract in pediatric deciduous teeth.Methods:109 cases of children with chronic apica...Objective:To observe the effectiveness and safety of one-time endodontics in the treatment of chronic apical periodontitis with sinus tract in pediatric deciduous teeth.Methods:109 cases of children with chronic apical periodontitis with sinus tract in the deciduous teeth treated in our hospital from January 2022 to December 2023 were selected and grouped by the randomized numerical table method,with 54 cases in the experimental group and 55 cases in the control group.The experimental group was treated with one-time endodontics and the control group was treated with conventional endodontics.Results:After the treatment,the total effective rate of treatment was higher in the experimental group than in the control group(P<0.05);the incidence of adverse events was lower in the experimental group than in the control group(P<0.05);the satisfaction of the children's family members was higher in the experimental group than in the control group(P<0.05);the pain duration was lower in the experimental group than in the control group(P<0.05).Conclusion:In the experimental group,children with chronic apical periodontitis with sinus tract of the deciduous teeth were given one-time endodontic treatment,and the results of its implementation were relatively good.展开更多
Objective: to explore the application effect of personalized nursing in childrens outpatient department of dental endodontics. Methods: the selected outpatient children were randomly divided into the control group and...Objective: to explore the application effect of personalized nursing in childrens outpatient department of dental endodontics. Methods: the selected outpatient children were randomly divided into the control group and the experimental group, and routine nursing and humanized nursing were adopted. The influence results of two groups of modes were compared. Results: the resilience, comfort, nursing satisfaction and living ability of the experimental group were better than those of the control group (P < 0.05). Conclusion: humanized nursing of dental pulp in childrens outpatient clinic is effective and worth popularizing.展开更多
Injectable biomaterials,such as thermosensitive chitosan(CH)-based hydrogels,present a highly translational potential in dentistry due to their minimally invasive application,adaptability to irregular defects/shapes,a...Injectable biomaterials,such as thermosensitive chitosan(CH)-based hydrogels,present a highly translational potential in dentistry due to their minimally invasive application,adaptability to irregular defects/shapes,and ability to carry therapeutic drugs.This work explores the incorporation of azithromycin(AZI)into thermosensitive CH hydrogels for use as an intracanal medication in regenerative endodontic procedures(REPs).The morphological and chemical characteristics of the hydrogel were assessed by scanning electron microscopy(SEM),energy dispersive spectroscopy(EDS),and Fourier transform infrared spectroscopy(FTIR).The thermosensitivity,gelation kinetics,compressive strength,cytocompatibility,and antibacterial efficacy were evaluated according to well-established protocols.An in vivo model of periapical disease and evoked bleeding in rats’immature permanent teeth was performed to determine disinfection,tissue repair,and root formation.AZI was successfully incorporated into interconnected porous CH hydrogels,which retained their thermosensitivity.The mechanical and rheological findings indicated that adding AZI did not adversely affect the hydrogels’strength and injectability.Incorporating 3%and 5%AZI into the hydrogels led to minimal cytotoxic effects compared to higher concentrations while enhancing the antibacterial response against endodontic bacteria.AZI-laden hydrogel significantly decreased E.faecalis biofilm compared to the controls.Regarding tissue response,the 3%AZI-laden hydrogel improved mineralized tissue formation and vascularization compared to untreated teeth and those treated with double antibiotic paste.Our findings demonstrate that adding 3%AZI into CH hydrogels ablates infection and supports neotissue formation in vivo when applied to a clinically relevant model of regenerative endodontics.展开更多
Nickel-titanium(NiTi)alloy has been extensively researched in endodontics,particularly in cleaning and shaping the root canal system.Research advances have primarily focused on the design,shape,and geometry of the NiT...Nickel-titanium(NiTi)alloy has been extensively researched in endodontics,particularly in cleaning and shaping the root canal system.Research advances have primarily focused on the design,shape,and geometry of the NiTi files as well as metallurgy and mechanical properties.So far,extensive investigations have been made surrounding surface and thermomechanical treatments,however,limited work has been done in the realm of surface functionalization to augment its performance in endodontics.This review summarizes the unique characteristics,current use,and latest developments in thermomechanically treated NiTi endodontic files.It discusses recent improvements in nano-engineering and the possibility of customizing the NiTi file surface for added functionalization.Whilst clinical translation of this technology has yet to be fully realized,future research direction will lie in the use of nanotechnology.展开更多
<p class="Abstract"style="margin:0 cm;line-height:32px;font-size:12 pt;font-family:"Times New Roman",serif;color:rgb(0,0,0);"><span lang="EN-US">The carious process ...<p class="Abstract"style="margin:0 cm;line-height:32px;font-size:12 pt;font-family:"Times New Roman",serif;color:rgb(0,0,0);"><span lang="EN-US">The carious process leads to inflammation of pulp tissue.Current care options include root canal treatment or apexification.These procedures,however,result in the loss of tooth vitality,sensitivity,and healing.Pulp capping and dental pulp regeneration are continually evolving techniques to regenerate pulp tissue,avoiding necrosis and loss of vitality.Many studies have successfully employed stem/progenitor cell populations,revascularization approaches,scaffolds or material-based strategies for pulp regeneration.Here we outline advantages and disadvantages of different methods and techniques which are currently being used in the field of regenerative endodontics.We also summarize recent findings on efficacious peptide-based materials which target the dental niche.<o:p></o:p>.展开更多
During dental examinations and treatments,many dentists are using magni-fication to improve their vision.The dental operating microscope serves as the most effective tool for this purpose,enhancing the quality,longevi...During dental examinations and treatments,many dentists are using magni-fication to improve their vision.The dental operating microscope serves as the most effective tool for this purpose,enhancing the quality,longevity,and outcome of clinical work.This review will explore the latest research and data on the importance of magnification devices in dentistry,including diagnostic methods,treatment options and ergonomics in specialities such as restorative dentistry,endodontics,pedodontics,periodontics,and prosthodontics.This review aims to provide insights into the optimal magnification for different clinical situations,the specific benefits of dental operating microscopes for each dental branch,and their limitations.展开更多
Instrument separation is a critical complication during root canal therapy,impacting treatment success and long-term tooth preservation.The etiology of instrument separation is multifactorial,involving the intricate a...Instrument separation is a critical complication during root canal therapy,impacting treatment success and long-term tooth preservation.The etiology of instrument separation is multifactorial,involving the intricate anatomy of the root canal system,instrument-related factors,and instrumentation techniques.Instrument separation can hinder thorough cleaning,shaping,and obturation of the root canal,posing challenges to successful treatment outcomes.Although retrieval of separated instrument is often feasible,it carries risks including perforation,excessive removal of tooth structure and root fractures.Effective management of separated instruments requires a comprehensive understanding of the contributing factors,meticulous preoperative assessment,and precise evaluation of the retrieval difficulty.The application of appropriate retrieval techniques is essential to minimize complications and optimize clinical outcomes.The current manuscript provides a framework for understanding the causes,risk factors,and clinical management principles of instrument separation.By integrating effective strategies,endodontists can enhance decision-making,improve endodontic treatment success and ensure the preservation of natural dentition.展开更多
Vertical root fracture(VRF)in molars is a complex and frequently encountered dental condition.Successful management relies on accurate diagnosis,sequential treatment strategies,and systematic care.This paper provides ...Vertical root fracture(VRF)in molars is a complex and frequently encountered dental condition.Successful management relies on accurate diagnosis,sequential treatment strategies,and systematic care.This paper provides a comprehensive review of the sequential therapeutic approaches and systematic management models for molar VRF over the past five years.Particular attention is given to the diagnostic value of cone-beam computed tomography(CBCT),recent advances in tooth-preserving techniques,and the establishment of full-course management frameworks.By constructing an integrated pathway encompassing diagnostic assessment,treatment decision-making,clinical intervention,and long-term maintenance,a“dentist–nurse–patient community”model is proposed to promote standardized clinical guidance.This collaborative model aims to extend the lifespan of affected teeth and restore optimal masticatory function.展开更多
Intentional tooth replantation(ITR)is an advanced treatment modality and the procedure of last resort for preserving teeth with inaccessible endodontic or resorptive lesions.ITR is defined as the deliberate extraction...Intentional tooth replantation(ITR)is an advanced treatment modality and the procedure of last resort for preserving teeth with inaccessible endodontic or resorptive lesions.ITR is defined as the deliberate extraction of a tooth;evaluation of the root surface,endodontic manipulation,and repair;and placement of the tooth back into its original socket.Case reports,case series,cohort studies,and randomized controlled trials have demonstrated the efficacy of ITR in the retention of natural teeth that are untreatable or difficult to manage with root canal treatment or endodontic microsurgery.However,variations in clinical protocols for ITR exist due to the empirical nature of the original protocols and rapid advancements in the field of oral biology and dental materials.This heterogeneity in protocols may cause confusion among dental practitioners;therefore,guidelines and considerations for ITR should be explicated.This expert consensus discusses the biological foundation of ITR,the available clinical protocols and current status of ITR in treating teeth with refractory apical periodontitis or anatomical aberration,and the main complications of this treatment,aiming to refine the clinical management of ITR in accordance with the progress of basic research and clinical studies;the findings suggest that ITR may become a more consistent evidence-based option in dental treatment.展开更多
Mineral trioxide aggregate（MTA） is considered at the present time as the gold standard for root-end filling in endodontic surgery.However, this biocompatible material presents several drawbacks such as a long settin...Mineral trioxide aggregate（MTA） is considered at the present time as the gold standard for root-end filling in endodontic surgery.However, this biocompatible material presents several drawbacks such as a long setting time and handling difficulties. The aim of this article is to present a new commercialized calcium silicate-based material named Biodentine with physical improved properties compared to MTA in a clinical application. Two endodontic microsurgeries were performed by using specific armamentarium（microsurgical instrumentation, ultrasonic tips） under high-power magnification with an operatory microscope. Biodentine was used as a root-end filling in order to seal the root canal system. The two cases were considered completely healed at 1 year and were followed for one more year. The 2-year follow-up consolidated the previous observation with absence of clinical symptoms and radiographic evidence of regeneration of the periapical tissues.展开更多
BACKGROUND Root canal variations frequently occur in maxillary first molars,which greatly affects the success of its treatment.The second mesiobuccal(MB)root canal is the most common root canal variation.However,only ...BACKGROUND Root canal variations frequently occur in maxillary first molars,which greatly affects the success of its treatment.The second mesiobuccal(MB)root canal is the most common root canal variation.However,only a few studies have been conducted on palatal root canal variations.Herein,we report the presence of two separate root canals in a palatal root of the maxillary first molar.CASE SUMMARY A 39-year-old woman complained of pain in the maxillary right region for 1 year,which recently worsened.Clinical examination revealed a poorly restored right maxillary first molar and caries detected at the filling marginal.Cold and heat test results indicated severe pain in the right maxillary first molar.The patient was diagnosed with irreversible pulpitis,and subsequently,root canal treatment(RCT)was performed.In total,five root canals were found in the maxillary first molar,including two separate root canals in the palatal root.RCT was successfully performed using an endodontic microscope and cone-beam computed tomography(CBCT).The CBCT image revealed a vertucci type I canal morphology in the distobuccal root,while the MB and palatal root canals were typeⅣ.At the 1-mo follow-up,the maxillary first molar was completely asy-mptomatic,and the X-ray results indicated a successful RCT.Finally,the ceramic crown restoration was performed.CONCLUSION An endodontic microscope and CBCT are useful in effectively identifying and treating root canal variations.展开更多
Nearly two decades since Cone Beam-Computed Tomography (CBCT) was introduced in dentistry, this technology has been proven to be a useful asset in modern dental practice. The information gleaned from a CBCT scan influ...Nearly two decades since Cone Beam-Computed Tomography (CBCT) was introduced in dentistry, this technology has been proven to be a useful asset in modern dental practice. The information gleaned from a CBCT scan influences treatment decisions and prognostication of challenging endodontic cases. The authors present six cases that utilized CBCT to diagnose vertical root fracture, to assess resorption, to guide the clinician in overcoming anatomical complexities, to hurdle diagnostic dilemmas and to perform pre-surgical evaluation. Initially, a thorough clinical assessment was performed;however, conventional periapical radiographs were not able to provide sufficient information to arrive at a definite diagnosis or a thorough treatment plan. CBCT was therefore deemed helpful for these cases. Clearly, there are advantages to using CBCT. With a better understanding of each case, the clinician can plan a definitive treatment plan and offer a clearer case prognosis to their patient.展开更多
Intracanal instrument fracture is an unpredictable and problematic occurrence that can prevent adequatecleaning and shaping procedures and influence the prognosis of endodontic treatment. The prevalence of instrument ...Intracanal instrument fracture is an unpredictable and problematic occurrence that can prevent adequatecleaning and shaping procedures and influence the prognosis of endodontic treatment. The prevalence of instrument fracture is reported to range between 0.28% and 16.2%. This article presents an overview of the prevention and management of instruments fractured during endodontic therapy on the basis of literature retrieved from Pub Med and selected journal searches. Instrument fracture occurs because of reduced metal fatigue and/or torsional resistance. The reasons include canal morphology and curvature, manufacturing processes and instrument design, instrument use times and technique, rotational speeds and operator experience. With the development of various equipment and techniques, most of the retained instrument separations can be removed safely. However, in canals without associated periapical disease not every fractured separation should be removed from difficult locations because of the increased risk for root perforation and fracture. In difficult cases, either retain or bypass the fragment in the root canal and ensure regular follow-up reviews. Fractured instruments retained in the presence of periapical disease reduce significantly the prognosis of endodontically treated teeth, indicating a greater need to attempt the removal or bypass of the file separations. Apical surgery might be required in some instances, emphasizing the importance of preventing instrument fracture.展开更多
基金supported by the Teaching Reform Project of Stomatology College of Chongqing Medical University(KQJ202215,KQJ202204)the Teaching Reform Project of Chongqing Medical University(JY20220317).
文摘As the most critical part of post-graduate education,the Chinese government launched Standard Resident Training in 2013 to solve the regional inequality of medical quality and meet the increasing social requirement for better medical service.We integrated problem-based learning(PBL)and case-based learning(CBL)in the Endodontics Standard Resident Training.By evaluating with objective parameters including theoretical knowledge and clinical practice skill,and subjective parameters including questionnaire,it was found that PBL+CBL played a positive role in endodontic resident training with a significant difference(P<0.05).This combined training model is instructive for China’s resident training,and this result can provide a rudimentary reference to current postgraduate teaching reform.
文摘Background: Calcium hydroxide has been used in dentistry since several decades. It has been used in a number of applications in the field of endodontics such as root resorption, intracanal medicament, and root canal sealers. Although this material exhibits several advantages, it also has some limitations. Objectives: To review the role of calcium hydroxide in the field of endodontics, focusing on its mechanism of action, antimicrobial effects, different applications, cytotoxicity or biocompatibility, and its removal from the root canals. Materials and Methods: An electronic search was done using different databases. Out of 2,664 articles, only 33 articles have been selected to be included in this review because they are directly related to the topic and matched the inclusion criteria of this review: “Language: English” and “Year: 2000-2016”. Results: The antimicrobial effect of calcium hydroxide is controversial. Although some studies supported the effectiveness of calcium hydroxide against some bacteria others reported its limitation against fungal infection. Calcium hydroxide can be used effectively as intracanal medicament, root canal sealer, in weeping canals, for perforation management and root resorption. Conclusions: Despite the limitation of antimicrobial activity of calcium hydroxide, it is used effectively in a number of treatment modalities in endodontics. Due to its biological and therapeutical properties, calcium hydroxide is the material of choice for all pulp therapy. However, when using calcium hydroxide as a dressing material in root canal treatment caution should be taken to prevent the overextension of the paste beyond the tooth apex and avoid the harmful side effects.
文摘目的 Journal of Endodontics,JOE是牙髓病学科中重要的研究载体之一。在当今口腔医学研究中的影响力日渐增加。本文分析了JOE近10年来发表的相关文献的年际分布、作者空间分布、作者文献数量分布、关键词、文献引用、期刊影响因子等方面,并探讨中国作者对该杂志文献构成的贡献,以及国内该领域内研究的组织机构构成等。方法利用ISI Web of Science(ISI WOS)数据库收集文献,将检索到的文献导入书目共现分析系统(BICOMB2.0)、Endnote X6及Excel 2007中进行分析。结果结果表明,近10年来,我国研究者在该杂志上发表的文献,数量逐年增加。作者空间分布表明相关机构具有明显的学科相关性。结论引文分析表明,中国作者发表的文献被引用次数逐年增加,说明中国研究者在牙髓病学领域的专业水平和影响力不断提高。期刊影响因子分析表明JOE是牙髓病学领域内顶尖的期刊之一,同时影响因子的变化已趋于稳定。
基金Supported by National Natural Science Foundation of China,No.81800929 and No.81771033Sichuan Science and Technology Program,No.2019JDRC0096and Research and Develop Program,West China Hospital of Stomatology Sichuan University,No.LCYJ2019-24.
文摘Regenerative endodontics(RE)therapy means physiologically replacing damaged pulp tissue and regaining functional dentin–pulp complex.Current clinical RE procedures recruit endogenous stem cells from the apical papilla,periodontal tissue,bone marrow and peripheral blood,with or without application of scaffolds and growth factors in the root canal space,resulting in cementum-like and bone-like tissue formation.Without the involvement of dental pulp stem cells(DPSCs),it is unlikely that functional pulp regeneration can be achieved,even though acceptable repair can be acquired.DPSCs,due to their specific odontogenic potential,high proliferation,neurovascular property,and easy accessibility,are considered as the most eligible cell source for dentin–pulp regeneration.The regenerative potential of DPSCs has been demonstrated by recent clinical progress.DPSC transplantation following pulpectomy has successfully reconstructed neurovascularized pulp that simulates the physiological structure of natural pulp.The self-renewal,proliferation,and odontogenic differentiation of DPSCs are under the control of a cascade of transcription factors.Over recent decades,epigenetic modulations implicating histone modifications,DNA methylation,and noncoding(nc)RNAs have manifested as a new layer of gene regulation.These modulations exhibit a profound effect on the cellular activities of DPSCs.In this review,we offer an overview about epigenetic regulation of the fate of DPSCs;in particular,on the proliferation,odontogenic differentiation,angiogenesis,and neurogenesis.We emphasize recent discoveries of epigenetic molecules that can alter DPSC status and promote pulp regeneration through manipulation over epigenetic profiles.
基金the Youth Development Project of Army Military Medical University,No.2018XQN014the Clinical Innovation Project of Army Military Medical University,No.2019XLC2014the Science and Technology Foundation of Chongqing,China,No.cstc2014jcyjA10092.
文摘BACKGROUND Root canal retreatment is common after root canal therapy in clinical situations.Especially,completing the retreatment of variant root canals can be challenging.This is particularly true for the molars located at the end of the dental arch.However,advancements in digital dental diagnosis and treatment techniques can solve these problems.Here,we describe a case of a maxillary second molar with a variant distobuccal root canal treated via a novel“inlay-guided endodontics”technique based on improved computer-generated programs.CASE SUMMARY A 63-year-old man complained of a defect in the maxillary left second molar.The tooth,diagnosed with post-treatment endodontic disease,was initially treated by conventional methods,which were ineffective.Our“inlay-guided endodontics”technique was subsequently adopted,with the establishment of a precise integrated three-dimensional(3D)plate model of cone-beam computed tomography data and a digital impression of the dentition.An optimal root canal approach was generated for the“virtual file”in the 3D model.The plate data were imported into a 3D printer and printed.With the help of the guide plate,the file was accurately placed into the cervical third of the distal root canal.The root canal and prosthodontic treatments successfully proceeded subsequently.CONCLUSION Our newly developed inlay guide plates may facilitate individualized and minimally invasive root canal treatment.
基金supported by Teaching Reform Project of Stomatology College of Chongqing Medical University(No.KQJ201813).
文摘As an important part of postgraduate education,Standard Resident Training(STR)plays a crucial role in the process of culturing a competent dental care provider who can independently treat the common oral infectious diseases.A systematic and comprehensive evaluation system is desiderating for realization of high-quality Endodontics resident training due to its discipline characteristics of highly specialized and strict operation.This paper analyzes the current status of resident training in our Endodontic Department and discusses how to improve the clinical skills and reasoning ability of residents,in order to construct a comprehensive resident training formative evaluation system in China.
文摘The objective of this study was to systematically review the literature about the use of the operating microscope in endodontics. It used sources of bibliographic cataloging electronically identified by MEDLINE via PubMed, LILACS, BBO and Scopus, using as descriptors: Endodontics, anatomy and microscopy. The selected articles were identified from the titles and abstracts, taking into consideration the following criteria: publications ranging from January 2001 to November 2012, case reports, published in an indexed journal, and publications in English language. The search showed 167 articles related to this topic, and these 21 articles met the inclusion criteria. These indicated that a higher magnification helps coronary access and the location of channels to identify and interpret the complexities of the anatomy of root canals, the removal of nuclei and intracoronary fractured instruments, to minimize trauma of surgeries in soft and hard tissues, and detect fractures and microfractures. It was found that its use has provided Endodontics with a significant improvement in vision of the operative field, offering better quality jobs and a higher success rate.
文摘Objective:To observe the effectiveness and safety of one-time endodontics in the treatment of chronic apical periodontitis with sinus tract in pediatric deciduous teeth.Methods:109 cases of children with chronic apical periodontitis with sinus tract in the deciduous teeth treated in our hospital from January 2022 to December 2023 were selected and grouped by the randomized numerical table method,with 54 cases in the experimental group and 55 cases in the control group.The experimental group was treated with one-time endodontics and the control group was treated with conventional endodontics.Results:After the treatment,the total effective rate of treatment was higher in the experimental group than in the control group(P<0.05);the incidence of adverse events was lower in the experimental group than in the control group(P<0.05);the satisfaction of the children's family members was higher in the experimental group than in the control group(P<0.05);the pain duration was lower in the experimental group than in the control group(P<0.05).Conclusion:In the experimental group,children with chronic apical periodontitis with sinus tract of the deciduous teeth were given one-time endodontic treatment,and the results of its implementation were relatively good.
文摘Objective: to explore the application effect of personalized nursing in childrens outpatient department of dental endodontics. Methods: the selected outpatient children were randomly divided into the control group and the experimental group, and routine nursing and humanized nursing were adopted. The influence results of two groups of modes were compared. Results: the resilience, comfort, nursing satisfaction and living ability of the experimental group were better than those of the control group (P < 0.05). Conclusion: humanized nursing of dental pulp in childrens outpatient clinic is effective and worth popularizing.
基金Coordenaçao de Aperfeiçoamento de Pessoal de Nível Superior-Brazil-CAPES(n.88887.489995/2020–00,n.88887.803283/2023–00,n.001),Conselho Nacional de Desenvolvimento Científico e Tecnol´ogico–CNPq(n.310683/2022-0),National Institutes of Health(NIH–National Institute of Dental and Craniofacial Research/NIDCR,Grants R01DE026578 and R01DE031476).
文摘Injectable biomaterials,such as thermosensitive chitosan(CH)-based hydrogels,present a highly translational potential in dentistry due to their minimally invasive application,adaptability to irregular defects/shapes,and ability to carry therapeutic drugs.This work explores the incorporation of azithromycin(AZI)into thermosensitive CH hydrogels for use as an intracanal medication in regenerative endodontic procedures(REPs).The morphological and chemical characteristics of the hydrogel were assessed by scanning electron microscopy(SEM),energy dispersive spectroscopy(EDS),and Fourier transform infrared spectroscopy(FTIR).The thermosensitivity,gelation kinetics,compressive strength,cytocompatibility,and antibacterial efficacy were evaluated according to well-established protocols.An in vivo model of periapical disease and evoked bleeding in rats’immature permanent teeth was performed to determine disinfection,tissue repair,and root formation.AZI was successfully incorporated into interconnected porous CH hydrogels,which retained their thermosensitivity.The mechanical and rheological findings indicated that adding AZI did not adversely affect the hydrogels’strength and injectability.Incorporating 3%and 5%AZI into the hydrogels led to minimal cytotoxic effects compared to higher concentrations while enhancing the antibacterial response against endodontic bacteria.AZI-laden hydrogel significantly decreased E.faecalis biofilm compared to the controls.Regarding tissue response,the 3%AZI-laden hydrogel improved mineralized tissue formation and vascularization compared to untreated teeth and those treated with double antibiotic paste.Our findings demonstrate that adding 3%AZI into CH hydrogels ablates infection and supports neotissue formation in vivo when applied to a clinically relevant model of regenerative endodontics.
文摘Nickel-titanium(NiTi)alloy has been extensively researched in endodontics,particularly in cleaning and shaping the root canal system.Research advances have primarily focused on the design,shape,and geometry of the NiTi files as well as metallurgy and mechanical properties.So far,extensive investigations have been made surrounding surface and thermomechanical treatments,however,limited work has been done in the realm of surface functionalization to augment its performance in endodontics.This review summarizes the unique characteristics,current use,and latest developments in thermomechanically treated NiTi endodontic files.It discusses recent improvements in nano-engineering and the possibility of customizing the NiTi file surface for added functionalization.Whilst clinical translation of this technology has yet to be fully realized,future research direction will lie in the use of nanotechnology.
基金supported by grants NIH R15 EY02950401A1S1 for AAJNIH R15 EY029504+2 种基金NSF IIP 1903617the NJIT Undergraduate Research and Innovation(URI)Program for VAKNIH grant R01DE025885 to E.S.
文摘<p class="Abstract"style="margin:0 cm;line-height:32px;font-size:12 pt;font-family:"Times New Roman",serif;color:rgb(0,0,0);"><span lang="EN-US">The carious process leads to inflammation of pulp tissue.Current care options include root canal treatment or apexification.These procedures,however,result in the loss of tooth vitality,sensitivity,and healing.Pulp capping and dental pulp regeneration are continually evolving techniques to regenerate pulp tissue,avoiding necrosis and loss of vitality.Many studies have successfully employed stem/progenitor cell populations,revascularization approaches,scaffolds or material-based strategies for pulp regeneration.Here we outline advantages and disadvantages of different methods and techniques which are currently being used in the field of regenerative endodontics.We also summarize recent findings on efficacious peptide-based materials which target the dental niche.<o:p></o:p>.
文摘During dental examinations and treatments,many dentists are using magni-fication to improve their vision.The dental operating microscope serves as the most effective tool for this purpose,enhancing the quality,longevity,and outcome of clinical work.This review will explore the latest research and data on the importance of magnification devices in dentistry,including diagnostic methods,treatment options and ergonomics in specialities such as restorative dentistry,endodontics,pedodontics,periodontics,and prosthodontics.This review aims to provide insights into the optimal magnification for different clinical situations,the specific benefits of dental operating microscopes for each dental branch,and their limitations.
文摘Instrument separation is a critical complication during root canal therapy,impacting treatment success and long-term tooth preservation.The etiology of instrument separation is multifactorial,involving the intricate anatomy of the root canal system,instrument-related factors,and instrumentation techniques.Instrument separation can hinder thorough cleaning,shaping,and obturation of the root canal,posing challenges to successful treatment outcomes.Although retrieval of separated instrument is often feasible,it carries risks including perforation,excessive removal of tooth structure and root fractures.Effective management of separated instruments requires a comprehensive understanding of the contributing factors,meticulous preoperative assessment,and precise evaluation of the retrieval difficulty.The application of appropriate retrieval techniques is essential to minimize complications and optimize clinical outcomes.The current manuscript provides a framework for understanding the causes,risk factors,and clinical management principles of instrument separation.By integrating effective strategies,endodontists can enhance decision-making,improve endodontic treatment success and ensure the preservation of natural dentition.
文摘Vertical root fracture(VRF)in molars is a complex and frequently encountered dental condition.Successful management relies on accurate diagnosis,sequential treatment strategies,and systematic care.This paper provides a comprehensive review of the sequential therapeutic approaches and systematic management models for molar VRF over the past five years.Particular attention is given to the diagnostic value of cone-beam computed tomography(CBCT),recent advances in tooth-preserving techniques,and the establishment of full-course management frameworks.By constructing an integrated pathway encompassing diagnostic assessment,treatment decision-making,clinical intervention,and long-term maintenance,a“dentist–nurse–patient community”model is proposed to promote standardized clinical guidance.This collaborative model aims to extend the lifespan of affected teeth and restore optimal masticatory function.
文摘Intentional tooth replantation(ITR)is an advanced treatment modality and the procedure of last resort for preserving teeth with inaccessible endodontic or resorptive lesions.ITR is defined as the deliberate extraction of a tooth;evaluation of the root surface,endodontic manipulation,and repair;and placement of the tooth back into its original socket.Case reports,case series,cohort studies,and randomized controlled trials have demonstrated the efficacy of ITR in the retention of natural teeth that are untreatable or difficult to manage with root canal treatment or endodontic microsurgery.However,variations in clinical protocols for ITR exist due to the empirical nature of the original protocols and rapid advancements in the field of oral biology and dental materials.This heterogeneity in protocols may cause confusion among dental practitioners;therefore,guidelines and considerations for ITR should be explicated.This expert consensus discusses the biological foundation of ITR,the available clinical protocols and current status of ITR in treating teeth with refractory apical periodontitis or anatomical aberration,and the main complications of this treatment,aiming to refine the clinical management of ITR in accordance with the progress of basic research and clinical studies;the findings suggest that ITR may become a more consistent evidence-based option in dental treatment.
文摘Mineral trioxide aggregate（MTA） is considered at the present time as the gold standard for root-end filling in endodontic surgery.However, this biocompatible material presents several drawbacks such as a long setting time and handling difficulties. The aim of this article is to present a new commercialized calcium silicate-based material named Biodentine with physical improved properties compared to MTA in a clinical application. Two endodontic microsurgeries were performed by using specific armamentarium（microsurgical instrumentation, ultrasonic tips） under high-power magnification with an operatory microscope. Biodentine was used as a root-end filling in order to seal the root canal system. The two cases were considered completely healed at 1 year and were followed for one more year. The 2-year follow-up consolidated the previous observation with absence of clinical symptoms and radiographic evidence of regeneration of the periapical tissues.
基金Supported by The Health Discipline Construction Project in Pudong New Area,No.PWYts2021-20.
文摘BACKGROUND Root canal variations frequently occur in maxillary first molars,which greatly affects the success of its treatment.The second mesiobuccal(MB)root canal is the most common root canal variation.However,only a few studies have been conducted on palatal root canal variations.Herein,we report the presence of two separate root canals in a palatal root of the maxillary first molar.CASE SUMMARY A 39-year-old woman complained of pain in the maxillary right region for 1 year,which recently worsened.Clinical examination revealed a poorly restored right maxillary first molar and caries detected at the filling marginal.Cold and heat test results indicated severe pain in the right maxillary first molar.The patient was diagnosed with irreversible pulpitis,and subsequently,root canal treatment(RCT)was performed.In total,five root canals were found in the maxillary first molar,including two separate root canals in the palatal root.RCT was successfully performed using an endodontic microscope and cone-beam computed tomography(CBCT).The CBCT image revealed a vertucci type I canal morphology in the distobuccal root,while the MB and palatal root canals were typeⅣ.At the 1-mo follow-up,the maxillary first molar was completely asy-mptomatic,and the X-ray results indicated a successful RCT.Finally,the ceramic crown restoration was performed.CONCLUSION An endodontic microscope and CBCT are useful in effectively identifying and treating root canal variations.
文摘Nearly two decades since Cone Beam-Computed Tomography (CBCT) was introduced in dentistry, this technology has been proven to be a useful asset in modern dental practice. The information gleaned from a CBCT scan influences treatment decisions and prognostication of challenging endodontic cases. The authors present six cases that utilized CBCT to diagnose vertical root fracture, to assess resorption, to guide the clinician in overcoming anatomical complexities, to hurdle diagnostic dilemmas and to perform pre-surgical evaluation. Initially, a thorough clinical assessment was performed;however, conventional periapical radiographs were not able to provide sufficient information to arrive at a definite diagnosis or a thorough treatment plan. CBCT was therefore deemed helpful for these cases. Clearly, there are advantages to using CBCT. With a better understanding of each case, the clinician can plan a definitive treatment plan and offer a clearer case prognosis to their patient.
文摘Intracanal instrument fracture is an unpredictable and problematic occurrence that can prevent adequatecleaning and shaping procedures and influence the prognosis of endodontic treatment. The prevalence of instrument fracture is reported to range between 0.28% and 16.2%. This article presents an overview of the prevention and management of instruments fractured during endodontic therapy on the basis of literature retrieved from Pub Med and selected journal searches. Instrument fracture occurs because of reduced metal fatigue and/or torsional resistance. The reasons include canal morphology and curvature, manufacturing processes and instrument design, instrument use times and technique, rotational speeds and operator experience. With the development of various equipment and techniques, most of the retained instrument separations can be removed safely. However, in canals without associated periapical disease not every fractured separation should be removed from difficult locations because of the increased risk for root perforation and fracture. In difficult cases, either retain or bypass the fragment in the root canal and ensure regular follow-up reviews. Fractured instruments retained in the presence of periapical disease reduce significantly the prognosis of endodontically treated teeth, indicating a greater need to attempt the removal or bypass of the file separations. Apical surgery might be required in some instances, emphasizing the importance of preventing instrument fracture.
