Endodontics and Endodontology Commons^™

Hypo-Responsiveness Of The Dental Pulp In Patients With Type 2 Diabetes And Hypertension: A Cross-Sectional Study, Kavitha M, Mallolu Anthony Sanjana Vijay, Niveditha B, Fathima A.I, Pavithra D, Vigneshwaran J

International Arab Journal of Dentistry

Introduction: Diabetes mellitus and hypertension, two of the most prevalent metabolic disorders worldwide, exert profound and progressive effects on multiple physiological systems. While their systemic complications are well documented, their subtle yet clinically significant impact on oral structures, particularly the dental pulp, remains underexplored.

Objectives: This study aims to assess the functional responsiveness of dental pulp nerves in individuals with type 2 diabetes mellitus and systemic hypertension, and to compare the findings with responses from healthy individuals, using an Electric pulp tester (EPT) as a diagnostic tool.

Methods: A total of 600 teeth from 75 adult patients (25 diabetic, 25 …

Can Gingival Crevicular Fluid Help In Diagnosing Pulp Inflammation? A Systematic Review, Wael Kassamany, Roula Abiad

BAU Journal - Science and Technology

This review aims to find if there’s a positive correlation between biological markers detected in human gingival crevicular fluid and pulp inflammation.

An electronic search of three databases; PubMed, EBSCOhost and Google Scholar was conducted using the keywords “tooth or teeth or pulp” AND “gingival crevice fluid or gingival crevicular fluid” for English articles published between the year 1990 and 2026. Information regarding study design, patients age range and gender distribution, sampling method used, types of biomarkers studied, assay test used, and key findings of each article were extracted and analyzed.

Biomarkers studied were substance P “SP”, neurokinin A “NKA”, …

Time And Dose Dependent Effects Of Adipose-Derived Stromal Vascular Fraction Exosomes On Human Dental Pulp Stem Cell Proliferation, Sylva Dinie Alinda, Anggraini Margono, Indah Julianto, Dini Asrianti Bagio

Journal of Dentistry Indonesia

Background: Cell proliferation is essential for tissue repair and immunomodulation in regenerative dentistry. Adipose-derived stromal vascular fraction (AD-SVF) is a promising autologous source for tissue engineering. Its exosomes (AD-SVF Exo), as cell-free products stable under ischemic conditions, represent an ethical and attractive modality for dental tissue regeneration and broader regenerative applications. Prior study indicates that AD-SVF Exo can enhance human dental pulp stem cell (hDPSC) migration and proliferation, particularly at low concentrations, but their detailed time- and dose-dependent proliferative effects remain unclear. This study aimed to investigate the time- and dose-dependent effects of low-concentration AD-SVF Exo on hDPSC proliferation …

Retrospective Cbct Evaluation Of Missed Root Canals And Their Association With Periapical Lesions In A Makkah-Based Population, Mashael Alqahtani, Samia Mohamed Elsherief, Ibtesam Kamel Afifi

Journal of Dentistry Indonesia

Background: Missed root canals are common and can cause persistent periapical disease, making the assessment of their prevalence essential for improving diagnostic accuracy and treatment outcomes. This study aimed to investigate the prevalence of missed canals and evaluate their association with periapical lesions in root canal–treated teeth in the Makkah population.

Methods: This retrospective cross-sectional study analysed 815 cone-beam computed tomography scans obtained from Umm Al-Qura University between 2019 and 2024. Missed canals and their association with periapical lesions were assessed by two independent observers. Statistical analysis was performed using the chi-square test.

Results: Missed canals were …

Micro-Ct Evaluation Of Root Canal Transportation And Centering Ability In Mesial Canals Of Mandibular First Molars, Selen Ince Yusufoglu, Esma Saricam, Mert Ocak, Ferhat Geneci, Burak Bilecenoğlu

Journal of Dentistry Indonesia

Background: This study aimed to evaluate canal transportation, centering ability, structure model index (SMI), surface area, and root canal volume changes in the mesial canals of mandibular first molars using micro-CT.

Methods: Twenty-four mandibular first molars with two separate mesial canals and moderate curvature were included. Teeth were scanned using micro-CT before instrumentation and randomly divided into three groups (N = 8). Root canals were prepared using OneShape, OneCurve, and Rotate file systems, followed by post-instrumentation micro-CT scanning (10µm/pixel resolution). Changes in canal volume, surface area, transportation, centering ability, and SMI were analyzed at the apical, middle, and …

In Silico Model Of Musa Acuminata Stem As An Anticancer On Oral Squamous Cell Carcinoma Against Egfr, Nevrila Dewi Rachmayani, Amy Nindia Carabelly, I Wayan Arya Krishnawan Firdaus, Maharani Laillyza Apriasari, Juliyatin Putri Utami

Journal of Dentistry Indonesia

Background: Oral squamous cell carcinoma (OSCC) is characterized by overexpression of the epidermal growth factor receptor (EGFR). Citral, eucalyptol, and caffeic acid phenethyl ester (CAPE), which are derived from Musa acuminata, have shown anticancer activity. This study evaluated the potential of citral, eucalyptol, and CAPE from Musa acuminata as anticancer agents for OSCC by targeting EGFR using an in silico approach.

Methods: Potential biological activity was predicted using Prediction of Activity Spectra for Substances (PASS) Online. Molecular docking was conducted with AutoDock Vina, and BIOVIA Discovery Studio was used to analyze binding affinity, interaction types, and bond …

Dens Invaginatus Prevalence In Maxillary Lateral Incisors In Egyptian Population: Cone Beam Computed Tomography 3-Dimensional Analysis, Marwa Ezz, Sherif Heidar, Mahinaz Reda Abdelhamed

Dentistry

Introduction: Dens invaginatus also called dens in dente is frequent developmental anomaly, most commonly affect maxillary lateral incisors. It can create an inflammatory and microbial pathway that may compromise pulp vitality. Once detected, intervention must be planned. Aim of the study : This study investigated Dens invaginatus prevalence in maxillary lateral incisors in Egyptian population and its categorization according to Oehlers classification using CBCT. Materials and Methods This study assessed 296 cone beam computed tomography scans including a total number of 592 maxillary lateral incisor. Two experienced examiners: an oral and maxillofacial radiologist and an endodontist, inspected Dens invaginatus in …

Comparative Evaluation Of The Antimicrobial Efficacy Of 2% Chlorhexidine And 10% Dimethyl Sulfoxide At The Resin–Tooth Bond Interface: A Pilot In Vitro Study, Kashmiri Chowdhury, Delphine Priscilla Antony, Praveen Kumar Elango, Amee Sanghavi

International Arab Journal of Dentistry

Objectives: To evaluate and compare the effectiveness of chlorhexidine (CHX) versus dimethyl sulfoxide (DMSO) in preventing Streptococcus mutans adhesion at the resin-tooth bond interface. H0 states no significant difference in antimicrobial efficacy between CHX and DMSO.

Methods: Fifteen extracted molars were randomly assigned to three groups: 2% CHX, 5% DMSO, and saline (control). Surfaces were treated for 60 seconds, bonded with a two-step etch-and-rinse adhesive, and restored with composite resin. Samples were incubated with S. mutans in BHI broth at 37°C for 14 days with broth changes every 48 hours. Confocal laser scanning microscopy (CLSM) assessed microbial viability.

Results: CHX …

Comparative Evaluation Of Irrigants On Sealer Penetration: An In Vitro Confocal Laser Scanning Microscopy Study, Savani Purohit, Priyanka Zinge, Roshan Samuel, Aayush Bhatt, Rucha Pawar

International Arab Journal of Dentistry

Objectives: Effective smear layer removal enhances sealer penetration in endodontics. Chelating agents vary in their efficacy, influencing treatment outcomes. In this study, the depth of penetration of AH Plus and Bio-C root canal sealers into dentinal structures was analysed using confocal laser scanning microscopy (CLSM), following the application of four final irrigants: 17% EDTA, 20% citric acid, 0.2% chitosan, and 5% fulvic acid.

Methods: Ninety-six single-rooted human premolars were prepared and irrigated with sodium hypochlorite. Final irrigation used one of four agents: 17% EDTA, 20% citric acid, 0.2% chitosan, or 5% fulvic acid, followed by sonic activation. Canals were obturated …

Effect Of Root Canal Sealer Type On Obturation Density: An In Vitro Comparison Of Ah Plus, Bioactive Rcs, Novel Bioactive Glass-Based Bioceramic Sealer, And Zinc Oxide Eugenol, Poulomi Guha, Pradeep Solete, Nishitha Arun, Praveen Kumar Elango, Sanyukta Singh

International Arab Journal of Dentistry

Objectives: To compare the obturation density of four root canal sealers—AH Plus, Bioactive RCS, a novel bioactive glass-based bioceramic sealer, and zinc oxide eugenol (ZOE) using a standardized single-cone obturation technique.

Methods: Forty extracted premolars were endodontically prepared to a 15 mm working length and divided into four groups (n=10). Each group was obturated with the same F2-sized guttapercha cones and one of the sealers being evaluated. Weight variations pre-obturation and postobturation, and after complete sealer setting were used to calculate obturation density. Data were analyzed using one-way ANOVA and Tukey’s post hoc test (p < 0.05) to test for group differences.

Results: The bioactive glass-based sealer …

Oral Rehabilitation Of A Pediatric Patient With A Dental Anomaly: A Case Report, Enas Almasri, Mohamed Altinawi, Shadi Azzawi, Imad Katbeh, Anas Abdo

International Arab Journal of Dentistry

Objective: Tooth fusion is an uncommon dental abnormality, occurring in 0.1% of permanent dentition. Fusion of a normal permanent tooth and a supernumerary tooth is unusual. This case report delineates a multidisciplinary strategy for the management of a child with a fused tooth and a concomitant supernumerary tooth. The objective is to progressively illustrate the aesthetic and functional restoration of a smile impacted by a dental fusion abnormality.

Case Report: A 9-year-old boy was referred to the pediatric dental clinic with the chief complaint of a large upper anterior tooth. Intraoral and radiographic investigations showed fusion of the permanent maxillary …

Successful Regenerative Endodontic Therapy Of An Immature Dens Evaginatus Mandibular Second Premolar With Apical Periodontitis Case Report, Jake Horowitz D.D.S., Prashant Sukhani D.M.D., Aaron Brandwein D.D.S., Fagd, Ficd, James Sconzo D.M.D.

The New York State Dental Journal

Background: Dens evaginatus cusps typically have pulpal tissue, and fracturing of the cusp leads to necrosis. Immature permanent teeth with pulp necrosis have traditionally been treated with apexification, which eliminates infection but does not promote root development.

Methods: Regenerative endodontics utilizes revascularization by infiltrating stem cells from the apical papilla and using them to treat an immature necrotic tooth with periapical infection.

Results: Periapical radiolucency completely resolved, root length and thickness increased, and vitality returned at the one-year follow-up.

Conclusion: Regenerative protocols promote root development, reducing fracture risk. This treatment offers improved outcomes with fewer appointments and shorter treatment duration.

Artificial Intelligence Versus Human Dental Expertise In Diagnosing Periapical Pathosis On Periapical Radiographs: A Multicenter Study, Fatma E.A Hassanen, Radwa R. Hussein, Mohamed Riad Elgarhy, Shaymaa Mohamed Maher, Marwa Ezz, Ahmed Hassen, Sherif Heidar, Amr Edress, Asmaa Abou-Bakr

Dentistry

Periapical pathosis in periapical radiographs must be properly diagnosed for the success of endodontic treatment but is often muddled by 2D imaging limitations and subjective interpretation. Artificial intelligence (AI) offers a solution, but whether the diagnostic granularity of AI versus human clinicians in everyday clinical practice has been adequately explored remains to be addressed. The purpose of this study was to evaluate the diagnostic accuracy of ChatGPT-5 in detecting periapical radiographic abnormalities compared with the three-expert consensus reference standard. Methods: In this diagnostic accuracy retrospective study, 270 periapical radiographs were independently read by a large language model (ChatGPT-5) and a …

Computational Network Biology Of Host Microbe Crosstalk In Persistent Endodontic Inflammation, Janaki O’Callaghan, Shilpa Bhandi, Shankargounga Patil, Frank W. Licari

Annual Research Symposium

Persistent endodontic infections can endure despite technically adequate root canal treatment, reflecting a biological transition from microbial invasion to a host-driven chronic inflammatory state. This study applied a computational network biology approach to model host–microbe molecular interactions in chronic apical periodontitis and to identify key network hubs sustaining inflammation and periapical bone resorption.

J Mich Dent Assoc February 2026

The Journal of the Michigan Dental Association

Each month, the Journal of the Michigan Dental Association delivers news, information, and features about Michigan dentistry to our state's oral health community and the MDA's 6,200+ members. It remains the main publication reaching Michigan dentists and is available worldwide through ADA Commons.

The February 2026 (Volume 108, No. 2) issue of the Journal is published in a digital format to provide updates and insights for Michigan's oral health community and MDA members. Print editions occur every other month beginning with January.

This issue includes feature articles on Risk Management and 2025 Servant Leadership as well as a clinical reprint …

Adapt Vr In Dental Education: Boosting Preclinical Skill And Self-Confidence, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

Introduction: Preclinical dental training requires extensive feedback and repetition, which traditional manikin exercises often lack. Adapt VR is a cost-effective, immersive system that delivers interactive, adaptive training with real-time feedback. Methods: This comparative study aimed to evaluate the effectiveness of the Adapt VR system in preclinical training. A total of 126 third-year dental students were randomly assigned to an Adapt VR Group 1 (n = 63), acquiring VR learning experience before practicing on laboratory simulators, or a control group (n = 63) who started their training on simulators directly. After practising Class I and II cavity preparations, laboratory performance was …

A Virtual-Reality-Based Dental Simulator For Endodontics With Automated Formative Feedback, Yousef Salah Abo El Ela

Theses and Dissertations

Advancements in virtual reality (VR) and haptic technology are transforming the landscape of medical and dental education, offering new avenues for safe, immersive, and repeatable training experiences. Within dentistry, endodontics presents unique challenges for preclinical education due to anatomical complexity, limited access to extracted teeth, ethical concerns, and the shortcomings of conventional plastic models. Despite endodontics specific plastic teeth being available, they fall short of replicating the hardness of real extracted teeth, are relatively costly compared to generic plastic teeth, and are ultimately a disposable item which makes them inadequate as a sustainable long-term solution. Extracted teeth do a much …

Negative Pulp Sensibility Responses Do Not Necessarily Indicate Pulp Necrosis In Teeth Associated With Cystic Or Cyst-Like Lesions, Le Lu, Xiang Zhang, Ya Shen, He Liu

Journal of Dental Sciences

No abstract provided.

Cytocompatibility, Osteogenic Potential, Antibacterial And Antibiofilm Efficacy Of A Calcium-Silicate-Based Intracanal Medication, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

This study assessed the biological and antimicrobial properties of a calcium silicate-based material and calcium hydroxide (CH) when used as intracanal medications. MTT assay, osteogenic differentiation of human periodontal stem cells (hPDLSCs), cell mineralization-assay, and determination of ALP activity were assessed to investigate the biological properties. While the agar well diffusion, crystal violet (CRV) assay and LIVE/DEAD staining of dentin slices infected with a mature E. faecalis biofilm were used to assess the antimicrobial properties. Normally distributed data were analyzed using one and two-way ANOVA and post hoc Tukey test, while for non-normally distributed data Kruskal Wallis and Dunn's tests …

Automatic Teeth Segmentation In Panoramic Radiographs Using Attention U-Net, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

Aim: The aim of this study is to investigate the effectiveness of the Attention U-Net architecture for teeth segmentation in panoramic dental images. By exploring the potential of Attention U-Net, the study aims to contribute to the development of more precise and automated dental imaging analysis, which could enhance diagnosis, treatment planning, and computer-aided dental systems. Subjects and methods: The TUFTS University dataset consisting of 1000 de-identified panoramic radiographs was used for training and testing an Attention U-Net architecture with 10-fold cross-validation. These scores surpass those of all other networks implemented on the same dataset. using a newly available benchmark …

Enhancing Severely Compromised Premolar Strength: Role Of Cusp Reduction Design In Cad/Cam Composite Restorations, Shehabeldin Mohamed Saber Prof.Dr.

Dentistry

The objective of this study was to assess the effect of different designs and depths of cusp reduction on fracture resistance of maxillary permanent premolars restored with CAD/CAM composite restorations. A total of 42 sound maxillary premolars were used. Standardized MOD cavities were prepared in all specimens. Teeth were randomly divided according to form of cusp reduction into three main groups (n = 14); G1:MOD cavities restored with inlays with no cusp reduction, G2:MOD cavities restored with overlays with buccal and palatal anatomical cusps reduction, G3; MOD cavities restored with overlays with buccal and palatal flat cusps reduction. Groups 2 …

Endodontic Access Through Zirconia Crowns: A Comparative Evaluation Of 3d Guided Versus Free-Handed Techniques, Maryam Alrughaib

Theses and Dissertations

Objective:

Accessing canals through full-coverage zirconia crowns is challenging and may increase the risk of misdirection, excessive dentin removal, and prolonged chair time. Guided endodontic access has been proposed to improve efficiency and precision. This study compared the accuracy and time efficiency of guided versus free-hand endodontic access through zirconia restorations. The hypothesis was that guided access would enhance canal localization precision and significantly reduce access time.

Methods:

Thirty-two extracted maxillary premolars were restored with 1-mm–reduced monolithic zirconia crowns (3Y-TZP, Katana HTML, Kuraray, Japan) and mounted in Modupro models. Teeth were assigned to two groups (n = 16 each): guided …

Comparative Evaluation Of The Solubility Of Three Commonly Used Root Canal Sealers When Exposed To Xylene And Endosolv: An In Vitro Study, Aparna Palekar, Piyush Mantri, Basawaraj Biradar, Mukund Singh, Vaidehi Joshi, Pushpal Ingle

International Arab Journal of Dentistry

Objectives: This in vitro study compared the solubility of three root canal sealers, AH Plus (epoxy resin-based), MTA Fillapex (MTA-based), and Cerafill RCS (bioceramic), in two solvents: Xylene and Endosolv.

Methods: Sixty standardized cylindrical specimens were prepared using the three sealers of interest. The specimens were divided into six groups (n = 10) and immersed in either Xylene or Endosolv for 10 minutes. Solubility was assessed by calculating the percentage weight loss before and after immersion. Data were analysed using one-way ANOVA and Tukey’s post hoc test (α= 0.05).

Results: All sealers exhibited statistically significant solubility in both solvents (p …

Musculoskeletal Disorders In Dentistry: An Insight Into Dental Techniques And Practices, Mehwash Kashif, Aman Ashar, Amna Rehman, Abdul Aleem, Sidra-Tul-Muntaha Hashmi, Muhammad Yousuf Ali

Journal of Dentistry Indonesia

Objective: Musculoskeletal disorders (MSDs) are common workplace hazards in dentistry resulting from poor ergonomics and static postures, which lead to back, neck, and upper limb (shoulder, elbow, wrist, and hand) problems among dentists, resulting in harm to their health, productivity, and career. This study aimed to assess the frequency of MSDs, risk factors related to MSDs, and awareness of ergonomics among clinicians. Methods: Data were collected from 400 dental professionals, including house officers, postgraduate trainees, general dentists, and teachers/consultants, each with at least 12 months of practice. Data were collected using a structured, closed-ended questionnaire. Before data collection, ethical approval …

Matrix Metalloproteinase-9 (Mmp-9) Levels In Dentinal Fluid As A Diagnostic Biomarker For Irreversible Pulpitis, Aryo Megantoro, Valeria Widita Wairooy, Ratna Meidyawati, Endang Winiati Bachtiar

Journal of Dentistry Indonesia

Objective: Pulpitis is an inflammatory condition of the dental pulp. The inflammatory status can be accurately assessed by histological examination. Biomarkers, such as matrix metalloproteinases (MMPs), are effective indicators of inflammation severity. Among these, matrix metalloproteinase-9 (MMP-9) has emerged as a key mediator of inflammatory processes associated with pulpitis. However, its clinical application as a biomarker remains limited owing to challenges in its extraction. This study aimed to evaluate the effectiveness of MMP-9 extracted from the dentinal fluid as a biomarker for pulpitis. Methods: Dentinal fluid was collected using the blunt tip of a sterile paper point, following clean …

Automated Assessment Of Periapical Health Based On The Radiographic Periapical Index Using Yolov8, Yolov11, And Yolov12 One-Stage Object Detection Algorithms, Shehabeldin Mohamed Saber Prof.Dr., Ahmed A. Torky Phd

Dentistry

This study investigates the application of recent YOLO (You Only Look Once) algorithms for automated detection and classification of apical periodontitis using the Periapical Index (PAI) scoring system (1–5). A dataset of 699 digital periapical radiographs was collected from diverse sources, de-identified, and annotated by calibrated experts before splitting into training, validation, and testing sets. Three deep learning models (YOLOv8m, YOLOv11m, YOLOv12m) were trained and their performance was evaluated using Precision, Recall, F1 score, mean average precision (mAP50), Intersection over union (IoU), and confusion matrices. Two-sided McNemar’s exact test was further conducted to compare models on lesion-level outcomes. The results …

Articulator Volume 31, Issue 4

Metro Denver Dental Society Articulator Magazine

The 4^th Quarter 2025 of the MDDS Articulator Magazine offers a preview of the 2026 Rocky Mountain Dental Convention, taking place January 22–24 in Denver. The collection spotlights RMDC speakers and the future of dentistry, from the rise of AI and the shift toward integrated whole-health care to the hidden challenges of chronic illness, and a commitment to preserving natural dentition. The articles challenge dental professionals to rethink assumptions, embrace interdisciplinary collaboration and adopt more personalized and evidence-driven approaches to care.

Comparative Evaluation Of Heat-Treated Retreatment Files On Canal Transportation And Dentin Thickness In Endodontically Treated Teeth: An In Vitro Cbct Study, Monisha Bhate, Pradeep Solete, Aparna Mohan

International Arab Journal of Dentistry

Introduction: Non-surgical retreatment is a conservative approach for managing recurrent endodontic infections requiring efficient removal of obturating material while preserving dentin. Retreatment file systems,through their design and function,plays a vital role in ensuring effective cleaning and minimal structural compromise.

Methods: Forty-five extracted mandibular molars were decoronated and obturated at a standardized root length of 16 mm in both mesial canals. Samples were divided into three groups (n=15): Group 1 – SoliteRS3, Group 2 – Dentsply Protaper Universal Retreatment Files and Group 3 – Neoendo Retreatment Files. Pre- and postoperative CBCT scans were used to assess remaining dentin thickness, …

Cytotoxicity And Osteogenic Potentials Of Mesenchymal Stem Cells Via A Novel Formulation Of Mineral Trioxide Aggregate: An In Vitro Study, Ahmed Elgendi, Ehab Hassanien, Mohamed Nagy, Iman Fathy, Ashraf Abu Seida, Elhassan Hassanein

International Arab Journal of Dentistry

Objectives: Root perforations can lead to periodontitis and alveolar bone loss. This study compared cytotoxicity and osteogenic potential of zirconia-containing mineral trioxide aggregate (MTA) Matreva (MAT group) to MTA Angelus (ANG group) as root perforation repair materials.

Methods: Bone marrow mesenchymal stem cells (BM-MSCs) were extracted from two albino rats and cultivated. The cytotoxicity of the studied materials was determined using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl tetrazolium bromide (MTT) assay at three time points: 3, 7, and 14 days. The evaluated materials were employed to guide the osteogenic differentiation of BM-MSCs into osteoblasts. The osteogenic impact was evaluated by assessing calcium …

Evaluation Of Anti-Bacterial Efficacy Of Ginger, Resin Gum, And Nigella Sativa Irrigants Against Enterococcus Faecalis: An In Vitro Study, Iman El Ghazzawy, Leen Imad Hasbini, Reem Chamseddine, Wael Betbout, Roula Abiad

International Arab Journal of Dentistry

Objectives: To evaluate the antibacterial efficacy of Ginger, Resin Gum, and Nigella Sativa, against Enterococcus Faecalis.

Methods: Thirty-eight extracted single-rooted premolars were inoculated with E.faecalis, except the negative control, and incubated for 4 weeks. After instrumentation samples were divided into 4 groups (n=7) according to final irrigation: NaOCl+EDTA (Group A), Nigella sativa (B), Resin Gum (C), Ginger (D), plus 2 control groups (n=5): Saline (E), and Saline without bacterial inoculation (F). Cultures were collected at baseline and after irrigation.

Results: One-way ANOVA showed that in groups A-D a statistically significant reduction of bacterial load was observed at …