Giornale Italiano di Endodonzia

Novel non-obturation based concept of regeneration

Kavalipurapu Venkata Teja — 2024-06-14

Aim: This systematic review aimed to evaluate the healing achieved through a novel SealBio technique and assess the inherent complications or failures caused during treatment of endodontic diseases.

Methodology: The present review was conducted according to the PRISMA guidelines and was registered in PROSPERO (Registration number – CRD42020201943). The research question was formulated based on the PICO strategy. A comprehensive electronic literature search was conducted across PubMed/Medline, Google Scholar and Cochrane Database independently by two reviewers. Articles published on SealBio up to May 2024 were included. Based on the specified inclusion and exclusion criteria, the selected articles were subjected to quality assessment, and the risk of bias was conducted using the Cochrane risk of the bias assessment tool.

Results: A total of 4 studies were included in the present systematic review and reported success rates with the SealBio technique around 97-100%. However, all included papers demonstrated a high overall risk of bias and some limitations.

Conclusion: Based on the present study, SealBio technique did not furnished concrete evidence to replace the standard endodontic protocol. However, additional evidences provided by standardized and well conducted clinical trials with low risk of bias are needed.

Endodontic management of mesial middle canal in mandibular molars with symptomatic irreversible pulpitis

Almedin Berisha — 2024-05-20

Aim: This article aims to present three endodontic treatment cases of mandibular molars with three mesial canals and two distal canals.

Summary: Three patients were admitted in our clinic with a description of toothache while having hot and cold drinks. Clinical examinations revealed deep decay of teeth, but no pain to percussion. Radiographic images confirmed an intact periapical tissue with deep decay in each tooth, and teeth were diagnosed as symptomatic irreversible pulpitis. Root canal treatments were completed in single appointments. Studies suggest that mandibular molars with MMCs could be recognized more precisely with CBCT. Endodontic treatment of mandibular molars with mesial middle canal (MMC) can cause various challenges for every clinician, thus a proper understanding of root canal anatomical variations is a cornerstone in reaching endodontic success.

Key Learning Points:

To identify the presence of an MMC, the isthmus between the ML and MB canal should be probed with a straight endodontic probe. In case of engagement of the probe at a specific point, it may be legitimate to look for the presence of the MMC.
In root treatments, it is important not only to recognize the shape of the root canals, but also the variations of their course and possible fusion, respectively.
It is of great importance to pay attention to the possible existence of an isthmus between the root canals, which must be completely cleaned and filled.

The modern management of endodontic complications

Sandro Rengo — 2024-03-21

not available

Assessing dentinal tubule penetration of an innovative bioactive glass-based root canal sealer through confocal laser scanning microscopy: an in vitro analysis

Sourabh Barbhai — 2024-03-26

Aim: To assess and compare the dentinal tubule penetration of zinc oxide eugenol (ZOE)-based, resin-based, bioceramic, and novel bioactive glass-based root canal sealers using a confocal laser scanning microscope (CLSM).

Methods: A total of 48 single-rooted permanent teeth were categorized into four groups (n=12) and treated with gutta-percha along with ZOE sealer (Tubli-Seal EWT), resin-based sealer (AH Plus), bioceramic sealer (BioRoot RCS), and bioactive glass (Nishika Canal Sealer-BG). Cross-sections of the roots at 3 mm and 6 mm from the apex were examined under a CLSM to evaluate dentinal tubule penetration.

Results: Results indicated that bioceramic sealers exhibited the highest depth of dentinal tubule penetration at both levels, followed by bioactive glass and resin-based sealers. ZOE-based sealer demonstrated the least tubule penetration. Bioactive glass displayed the highest percentage of sealer penetration at 3 mm and 6 mm, with no statistically significant difference observed between bioceramic and bioactive glass groups regarding depth and percentage of dentinal tubule penetration at both levels.

Conclusions: Of particular significance is the bioactive glass group, demonstrating the most substantial sealer penetration percentage compared to the other groups at both examined depths.

Applicability of photobiomodulation and antimicrobial photodynamic therapy for pain management after endodontic treatment: a randomized clinical trial

Monique de Carvalho Souza — 2024-04-09

Aim: To evaluate the use of photobiomodulation (PBM), alone or combined with antimicrobial photodynamic therapy (aPDT), for pain management after endodontic treatment.

Methodology: Randomized parallel-group superiority trial. The allocation sequence was generated using an online true random number generator. To ensure blinding, participants were informed about the study and the devices that would be used, but not about group allocation. Ninety mandibular molars diagnosed with symptomatic irreversible pulpitis were selected and randomly divided into three groups (n=30): Group 1, control (CT); Group 2, photobiomodulation (PBM); and Group 3, PBM + aPDT. All canals were instrumented by the Reciproc system in a single visit. The incidence and intensity of pain were evaluated before and 6, 12, 24, and 48 hours after endodontic treatment, using a visual analogue scale (VAS). The results were analysed using the Kruskal–Wallis test followed by Dunn’s test.

Results: The combination of PBM and aPDT after conventional endodontic treatment resulted in a significant reduction in pain compared to conventional endodontic treatment alone or followed by PBM alone (p<0.05). Preoperative pain was significantly greater than pain at 6, 12, 24, and 48 hours after endodontic treatment (p<0.05) in all groups. There were no adverse effects attributable to low-level light therapy in any participants.

Conclusion: Our findings suggest that the combination of photobiomodulation and photodynamic therapy is a promising alternative for this purpose.