Giornale Italiano di Endodonzia

Endodontics towards the future

2025-03-03T08:17:54+00:00

echnological progress is making great strides among different area, as well as medical and dental fields. In the last years, dentistry is living a radical change thanks to development of advanced operative procedures, use of latest generation materials, modern imaging techniques up to 3D technology. In addition, the recent introduction in several fields of artificial intelligence (AI) would seem to be of a great interest even in dentistry. AI aid should provide solutions able to manage every event or variable, complex cases diagnosis and immediate and successful treatment plans. However, the real feasibility in dentistry is currently under debate. Main limitations might be not only related to ethical issue, but also to the consideration of patient as a person with several variables, risk factors and co-morbidities that have a certain impact on disease occurrence, its progress and prognosis. Specifically, endodontics could benefit from AI use for the morphological characterization of root-canal anatomy, as well as correct analysis of radiographic images and planning of a workflow able to optimize working time. On the other hand, the fundamental principles of “traditional” endodontics cannot be ignored as base of correct therapy and long-term success. In this light, in the present issue of Giornale Italiano di Endodonzia, are presented classic aspects such as irrigants, debridement and post-endodontic restoration, but is also published a very interesting review on AI in endodontics. Since the central role played by clinicians in the therapeutic choice, it’ll be increasingly important to be updated and to develop the appropriate knowledge regarding the biological issue and the precious help provided by technological progress.

Histological evaluation of root canal cleaning by different final irrigation protocols

2025-02-06T08:29:04+00:00

Aim: This study aimed to evaluate in vitro the ability to remove pulp tissue from the mesial root canals of mandibular molars using three different protocols for the final activation time of irrigation with the Easy Clean (EC) rotary instrument.

Materials and Methods: Thirty mandibular molars with vital pulp were instrumented with the ProDesign Logic rotary system and divided into three experimental groups according to the protocol for the final activation time of the irrigants (n=10). Group EC1: the final rinse was performed with 5 mL of 2.5% sodium hypochlorite (NaOCl), followed by 5 mL of 17% ethylenediaminetetraacetic acid (EDTA) and another 5 mL of 2.5% NaOCl solution, with each rinsing agent activated in 3 cycles of 20 seconds. Group EC2 used the same sequence of solutions as group EC1, with each irrigant activated in 6 cycles of 20 seconds. In group EC3, the operation technique and the sequence of solutions were the same as in groups EC1 and EC2, with each rinsing agent being activated in 9 cycles of 20 seconds. At the end, samples from all groups were washed with 20 mL of distilled water using a NavigTip 30-G syringe and needle. The samples were fixed in 10% formaldehyde, cut into micrometers, fixed on histology slides and stained with hematoxylin-eosin (HE). The total area of the canal and remaining tissue was determined using the Image J program to determine the percentage of remaining pulp.

Results: In the cervical third, all groups had similar results. In the middle and apical thirds, EC1 and EC2 had similar percentages of pulp remnants and differed from EC3 (p<0.05).

Conclusions: It can be concluded that the removal of pulp tissue increases with longer contact time of the NaOCl.

Influence of different torque control and apex locator settings on apical debris extrusion

2024-12-17T17:07:28+00:00

Aim: This study evaluated the effects of torque control settings and automatic stop functions on apical debris extrusion during root canal preparation using a continuous rotation file system.

Methodology: Forty-eight extracted human lower premolars were randomly divided into four groups based on two torque control settings and two auto-stop functions. The extruded debris was collected in pre-weighed Eppendorf tubes and subsequently quantified.

Results: Statistical analyses were conducted using SPSS, and the Kruskal–Wallis test and the Mann–Whitney U test revealed that the auto-stop mode significantly reduced debris extrusion, while the torque control settings did not.

Conclusion: These findings suggest that clinicians can potentially minimise debris extrusion by utilising the auto-stop mode during root canal procedures.

Endodontic micro-surgery by means of two different surgical templates performed with selective Piezosurgery^® root resection: a report of two cases

2024-12-17T09:33:12+00:00

Aim. The aim of this case series is to introduce a new surgical template designed for static endodontic microsurgery using Piezosurgery^®. The template, created with computer-aided design/computer-aided manufacturing (CAD-CAM) technologies, aims to enhance the precision of root-end resections by providing individualized guidance for the surgical procedure. This approach seeks to reduce invasiveness, minimize bone loss, and improve surgical outcomes in cases of persistent apical periodontitis or other post-treatment endodontic complications.

Summary. Conventional endodontic treatments can fail in 14-16% of cases due to persistent infections within the root canal system or extraradicular factors. In such cases, endodontic microsurgery, especially when guided by advanced technologies, offers a high success rate of up to 89%. Recent innovations in piezoelectric devices and CAD-CAM-based surgical templates enable more precise, less invasive procedures. The new surgical template presented in this study allows for accurate root-end resections, ensuring optimal root sealing while minimizing damage to surrounding tissues. The template’s design aims to improve accuracy and reduce the risk of surgical errors compared to freehand procedures, promoting better healing and fewer complications.

Key Learning Point

Persistent apical periodontitis after root canal treatment can often be resolved with microsurgical techniques.

The integration of CAD-CAM technology with Piezosurgery® enhances surgical precision, reducing bone loss and tissue trauma.

Surgical templates designed for static endodontic microsurgery provide individualized, accurate guidance, leading to improved surgical outcomes.

The use of piezoelectric devices offers precise cutting with minimal damage to soft tissues, crucial for surgeries near sensitive structures.

-Advances in guided endodontic surgery are improving success rates and minimizing post-operative complications.

Endodontics: the central core within a multidisciplinary approach