Modern Endodontics

A special issue of Dentistry Journal (ISSN 2304-6767).

Deadline for manuscript submissions: 10 March 2025 | Viewed by 17857

Special Issue Editor

Special Issue Information

Dear Colleagues,

In modern endodontics, a complete chemomechanical cleaning of the complex root canal system is essential to achieving success, which is gained through adequate shaping, 3D cleaning, and the tridimensional obturation of the endodontic area. In recent years, satisfactory results could be obtained with modern technologies such as an operative microscope, CBCT, ultrasonic tips, modern rotary files, devices to activate irrigation, and tridimensional obturation techniques. This Special Issue focuses on all technologies available today to increase the chemomechanical cleansing and obturation of the entire and complicated endodontic system. This Special Issue plans to overview the most recent advances in modern endodontics.

This Special Issue aims to provide selected contributions on advances in the diagnosis, access cavity, shaping, 3D cleaning, obturation, and endodontic retreatments in modern endodontics.

Potential topics include, but are not limited to:

  • Operative microscope;
  • CBCT;
  • Irrigant activation techniques;
  • Antimicrobial nanoparticles;
  • Regenerative endodontics;
  • Modern rotary files;
  • Biosealers;
  • Endodontic surgery.

Dr. Alfredo Iandolo
Guest Editor

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Keywords

  • endodontics
  • cleaning
  • obturation
  • endodontic surgery
  • shaping
  • ultrasonics

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Published Papers (10 papers)

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Editorial

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2 pages, 170 KiB  
Editorial
Modern Endodontics
by Alfredo Iandolo
Dent. J. 2023, 11(1), 11; https://doi.org/10.3390/dj11010011 - 30 Dec 2022
Cited by 1 | Viewed by 1925
Abstract
The goal of modern endodontics is the complete removal of damaged tissue and bacteria from the endodontic space [...] Full article
(This article belongs to the Special Issue Modern Endodontics)

Research

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13 pages, 3854 KiB  
Article
Comparative Assessment of Push-Out Bond Strength and Dentinal Tubule Penetration of Different Calcium-Silicate-Based Endodontic Sealers
by Mihai Merfea, Sanda Ileana Cimpean, Radu Stefan Chiorean, Aurora Antoniac, Ada Gabriela Delean, Iulia Clara Badea and Mindra Eugenia Badea
Dent. J. 2024, 12(12), 397; https://doi.org/10.3390/dj12120397 - 6 Dec 2024
Viewed by 400
Abstract
Background: Adhesion within endodontic obturation material and root canal walls improves the efficacy of the endodontic treatment by establishing a barrier that inhibits reinfection and entombs residual bacteria. This study evaluates the push-out bond strength (POBS) of calcium silicate sealers compared to an [...] Read more.
Background: Adhesion within endodontic obturation material and root canal walls improves the efficacy of the endodontic treatment by establishing a barrier that inhibits reinfection and entombs residual bacteria. This study evaluates the push-out bond strength (POBS) of calcium silicate sealers compared to an epoxy-resin-based sealer. Methods: A total of 36 extracted mono-radicular teeth were prepared with Pro Taper Ultimate and irrigated with 5.25% sodium hypochlorite and 17% EDTA. The specimens were randomly split into three groups (n = 12) according to the endodontic sealer and filling technique used as follows: Ah Plus with the continuous wave condensation technique (CWC), Ah Bioceramic (Ah Bio) with the single-cone technique, and Total Fill Hi-Flow (FKG Hi-Flow) with the CWC technique. The material was allowed to set for 4 weeks, and afterwards, the roots were placed in acrylic resin and sectioned into 1 mm transverse slices. A POBS test was conducted using a universal testing machine, and the mode of bond failure was assessed at 4× magnification using a stereomicroscope. Six specimens from each group were selected for SEM-EDX examination to evaluate dentinal tubule penetration. The data were analysed using analysis of variance and Tukey and Bonferroni post hoc tests. Results: The POBS tests revealed higher values for Ah Plus in comparison to both calcium silicate sealers (p < 0.001), while FKG Hi-Flow showed superior results to Ah Bio (p < 0.001). The cohesive mode of failure was prevalent in all three groups. Conclusions: In conclusion, the resin-based sealer showed higher bond strength and better dentinal tubule penetration than the two calcium silicate sealers tested, while FKG Hi-Flow outperformed AH Bio. Full article
(This article belongs to the Special Issue Modern Endodontics)
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12 pages, 276 KiB  
Article
Current Endodontic Practices among Romanian Dental Practitioners: A Cross-Sectional Study
by Cezar Tiberiu Diaconu, Lelia Mihaela Gheorghiță, Anca Elena Diaconu, Mihaela Jana Țuculină, Alexandru Gliga, Carlo Gaeta, Simone Grandini, Iulia Roxana Marinescu, Marina Olimpia Amărăscu and Oana Andreea Diaconu
Dent. J. 2024, 12(9), 283; https://doi.org/10.3390/dj12090283 - 3 Sep 2024
Viewed by 801
Abstract
Root canal therapy (RCT) is usually performed in Romania by general dentists (GDPs) because they are more readily available and more reasonably priced than endodontists. Concerns have been raised about the quality of RCTs performed by GDPs, possibly due to insufficient equipment or [...] Read more.
Root canal therapy (RCT) is usually performed in Romania by general dentists (GDPs) because they are more readily available and more reasonably priced than endodontists. Concerns have been raised about the quality of RCTs performed by GDPs, possibly due to insufficient equipment or knowledge; therefore, this study aims to investigate current endodontic practices in Romania. Materials and Methods: A cross-sectional study was conducted via a questionnaire distributed to 400 randomly selected Romanian dentists, with 285 fully validated completed responses (71.25% response rate). Respondents were grouped by speciality, and statistical analysis, including cross-tabulation and the χ2 (chi-square) test, was used, with a significance level set at p ≤ 0.05 for all tests. Results: Significant differences were found in the use of magnification, rubber dam, sodium hypochlorite concentration, and bioceramics (p < 0.001). No significant differences were observed in preferences for measuring working length (p = 0.166) or rotary instrument motion (p = 0.289). Approximately 6% of the respondents used laser technology with no significant difference across specialities (p = 0.571). Additionally, 77.9% preferred using sodium hypochlorite, with no significant difference between groups (p = 0.006) regarding concentration. Conclusions: Most participants, including GDPs, use modern equipment and techniques during RCT, indicating their awareness and competence in current endodontic practices. Full article
(This article belongs to the Special Issue Modern Endodontics)
8 pages, 974 KiB  
Article
Impact of Different Glidepath Techniques on the Overall Performance of WaveOne Gold in an Artificial S-Shape Canal
by Vlad Mircea Lup, Olivia Andreea Marcu, Carlo Gaeta and Gabriela Ciavoi
Dent. J. 2024, 12(6), 182; https://doi.org/10.3390/dj12060182 - 13 Jun 2024
Viewed by 1347
Abstract
Objectives: The article’s aim is to test if rotary or reciprocating glide path influences the overall performance of WaveOne Gold in S-shaped canals. Methods: Sixty endo training blocks with an S-shape curvature were divided into three groups based on the glide path method [...] Read more.
Objectives: The article’s aim is to test if rotary or reciprocating glide path influences the overall performance of WaveOne Gold in S-shaped canals. Methods: Sixty endo training blocks with an S-shape curvature were divided into three groups based on the glide path method used: no glide path; glide path preparation with ProGlider; glide path preparation with WaveOne Gold Glider. All blocks were then shaped with WaveOne Gold Primary. The time for shaping, the incidence in reaching working length and the number of pecking motions were recorded. ANOVA with Turkey’s test was used, and the p-value was set to 0.05. Results: WaveOne Gold Primary reached working length faster in the control group when comparing total working times. No significant differences in the ability of the WaveOne Gold Primary to reach working length in all groups (p > 0.05). The mean number of pecking motions was higher in the control group compared to other groups. Conclusions: No significant differences in the time needed to achieve a glide path between Proglider and WaveOne Gold Glider. WaveOne Gold Primary can shape a double curved canal faster if a glide path is present but takes less time to reach length if it is the only file used. No difference in the ability to reach working length. Full article
(This article belongs to the Special Issue Modern Endodontics)
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10 pages, 797 KiB  
Article
Spectrophotometric Analysis of Coronal Discoloration In Vitro Induced by Bioceramic Cements
by Joana A. Carvalho, Carlos Franco, Luís Proença, João Albernaz Neves, Mário Polido, José João Mendes and Ana Mano Azul
Dent. J. 2023, 11(7), 180; https://doi.org/10.3390/dj11070180 - 24 Jul 2023
Cited by 1 | Viewed by 1565
Abstract
The aim of this study was to evaluate and quantify, in vitro, the extent of coronal discoloration induced by bioceramic materials over time. In total, 44 human monoradicular teeth were divided into four groups (n = 11), according to the applied material: [...] Read more.
The aim of this study was to evaluate and quantify, in vitro, the extent of coronal discoloration induced by bioceramic materials over time. In total, 44 human monoradicular teeth were divided into four groups (n = 11), according to the applied material: Negative control (NC); White MTA ProRoot® (WMTAP); Biodentine (BD); and TotalFill® BC RRM Putty (TF). Teeth were immersed in saline solution and incubated at 37 °C; the following periods of time were defined: before incubation: [t0]—without bioceramic material, t1—immediately after the bioceramic material placement; after incubation: t24h—24 h, t7d—7 days, and 30d—30 days. Descriptive and inferential statistical analysis were performed. Cochran’s Q test was used to evaluate coronal discoloration across the different groups, while the Kruskal–Wallis test was employed to determine differences in discoloration among the groups at each time interval. Additionally, the Friedman test was applied to analyze the variations in discoloration within each group over time. A significance level of 5% was set. All experimental groups revealed coronal discoloration over time: NC (p = 0.001), WMTAP (p < 0.001), BD (p = 0.001), and TF (p = 0.006). No significant differences were observed between groups for each time interval (p > 0.05). The WMTAP group varied the most considering the intervals [t0—t1] and [t24h—t7d] (p = 0.037) compared to the remaining experimental groups. Full article
(This article belongs to the Special Issue Modern Endodontics)
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14 pages, 1800 KiB  
Article
Knowledge, Attitude, and Practice towards Chelating Agents in Endodontic Treatment among Dental Practitioners
by Anna Mikheikina, Nina Novozhilova, Maria Polyakova, Inna Sokhova, Anastasia Mun, Alexandr Zaytsev, Ksenia Babina and Irina Makeeva
Dent. J. 2023, 11(7), 156; https://doi.org/10.3390/dj11070156 - 21 Jun 2023
Cited by 4 | Viewed by 2326
Abstract
The use of chelating agents (CAs) in the endodontic irrigation protocol is required to dissolve the inorganic components of the smear layer. We aimed to assess the knowledge, attitude, and practice of dental professionals regarding the use of CAs during root canal treatment. [...] Read more.
The use of chelating agents (CAs) in the endodontic irrigation protocol is required to dissolve the inorganic components of the smear layer. We aimed to assess the knowledge, attitude, and practice of dental professionals regarding the use of CAs during root canal treatment. A cross-sectional anonymous online survey was conducted among specialized endodontists and general dentists who routinely perform endodontic treatment and work in government-funded or private clinics in Moscow. The 8 min survey consisted of four parts: basic demographic data, knowledge (five items), attitude (four items), and practice (five items). We collected 376 completed questionnaires; a majority of the respondents were general dentists (87.5%) and worked in private clinics (77.4%). Most respondents (83.5%) showed a fair knowledge of the CAs used in endodontics, while 16.5% showed a poor knowledge of the topic. Small yet significant differences were found between endodontists and general practitioners and between dentists employed by private and government-funded clinics. A majority of dental practitioners (83%) demonstrated a positive attitude towards the use of CAs in endodontic treatment, and there were no differences among the study subgroups. Almost a third of the respondents always used chelating solutions during endodontic treatment, while 17% of the respondents did not use them at all. There were significant differences in this parameter between dentists working in private and government-funded clinics. Practice significantly correlated with attitude towards chelating agents and with knowledge of the topic. In conclusion, dental practitioners demonstrated a fair knowledge of CAs. Despite a positive attitude, 71% of the respondents did not use CAs for all endodontic patients. Full article
(This article belongs to the Special Issue Modern Endodontics)
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11 pages, 4668 KiB  
Article
A Novel Self-Assessment Method for Training Access Cavity on 3D Printed Endodontic Models
by Matteo Meglioli, Giovanni Mergoni, Francesco Artioli, Benedetta Ghezzi, Maddalena Manfredi, Guido Maria Macaluso and Simone Lumetti
Dent. J. 2023, 11(6), 152; https://doi.org/10.3390/dj11060152 - 13 Jun 2023
Cited by 1 | Viewed by 2218
Abstract
Background: New technologies can facilitate the transition from pre-clinical to clinical settings. We investigate students’ satisfaction with a novel learning method adopted in access cavity exercises. Methods: Students performed their access cavity on inexpensive, in-house 3D printed teeth. Their performances were evaluated by [...] Read more.
Background: New technologies can facilitate the transition from pre-clinical to clinical settings. We investigate students’ satisfaction with a novel learning method adopted in access cavity exercises. Methods: Students performed their access cavity on inexpensive, in-house 3D printed teeth. Their performances were evaluated by scanning the prepared teeth with an intraoral scanner and visualized using a mesh processing software. Then, the same software was used to align the tooth prepared by the student and the teacher’s one for self-assessment purposes. Students were asked to answer a questionnaire about their experiences with this new learning method. Results: From the teacher’s perspective, this novel learning approach was easy, straightforward and affordable. Overall, student feedback was positive: 73% found that access cavity assessment by scanning was more useful compared to a visual inspection under magnification and 57% reported that they had a better understanding of errors and mishaps. On the other hand, students pointed out that the material used to print teeth was too soft. Conclusion: The use of in-house 3D printed teeth in pre-clinical training is a simple way to overcome some of the drawbacks associated with extracted teeth, such as limited availability, variability, cross-infection control, and ethical constraints. The use of intraoral scanners and mesh processing software could improve student self-assessment. Full article
(This article belongs to the Special Issue Modern Endodontics)
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15 pages, 2939 KiB  
Article
Determination of a Representative and 3D-Printable Root Canal Geometry for Endodontic Investigations and Pre-Clinical Endodontic Training—An Ex Vivo Study
by Michael Kucher, Martin Dannemann, Niels Modler, Robert Böhm, Christian Hannig and Marie-Theres Kühne
Dent. J. 2023, 11(5), 133; https://doi.org/10.3390/dj11050133 - 15 May 2023
Cited by 1 | Viewed by 1591
Abstract
Models of artificial root canals are used in several fields of endodontic investigations and pre-clinical endodontic training. They allow the physical testing of dental treatments, the operating of instruments used and the interaction between these instruments and the tissues. Currently, a large number [...] Read more.
Models of artificial root canals are used in several fields of endodontic investigations and pre-clinical endodontic training. They allow the physical testing of dental treatments, the operating of instruments used and the interaction between these instruments and the tissues. Currently, a large number of different artificial root canal models exist whose geometry is created either on the basis of selected natural root canal systems or to represent individual geometrical properties. Currently, only a few geometric properties such as the root canal curvature or the endodontic working width are taken into consideration when generating these models. To improve the representational capability of the artificial root canal models, the aim of the current study is therefore to generate an artificial root canal based on the statistical evaluation of selected natural root canals. Here, the approach introduced by Kucher for determining the geometry of a root canal model is used, which is based on the measurement and statistical evaluation of the root canal center line’s curvatures and their cross-sectional dimensions. Using the example of unbranched distal root canals of mandibular molars (n = 29), an artificial root canal model representing the mean length, curvature, torsion and cross-sectional dimensions of these teeth could be derived. Full article
(This article belongs to the Special Issue Modern Endodontics)
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Other

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11 pages, 10236 KiB  
Case Report
A Novel Diagnostic and Treatment Approach to an Unusual Case of Dens Invaginatus in a Mandibular Lateral Incisor Using CBCT and 3D Printing Technology
by Lindsey LaLonde, Mazin Askar and Susan Paurazas
Dent. J. 2024, 12(4), 107; https://doi.org/10.3390/dj12040107 - 13 Apr 2024
Cited by 1 | Viewed by 1826
Abstract
Background: This case report demonstrates the use of three-dimensional (3D) models produced from a cone beam computed tomographic (CBCT) volume to develop a treatment strategy for a rare type of dens invaginatus (DI) in a mandibular incisor. Methods: A patient with DI Type [...] Read more.
Background: This case report demonstrates the use of three-dimensional (3D) models produced from a cone beam computed tomographic (CBCT) volume to develop a treatment strategy for a rare type of dens invaginatus (DI) in a mandibular incisor. Methods: A patient with DI Type IIIa presented for endodontic treatment. Following CBCT evaluation, the complex morphologic nature of the invagination required additional diagnostic tools for treatment planning. The fabrication of 3D models provided clarity regarding the treatment strategy. Treatment involved intracanal medication with calcium hydroxide Ca(OH)2, nonsurgical root canal therapy (NS-RCT) of the main canal, and endodontic surgery for the DI anomaly using mineral trioxide aggregate (MTA), bone graft, and platelet-rich fibrin (PRF) membrane. Results: The use of 3D models provided an invaluable guide for proper treatment. Complicating factors were diagnosed and planned for accordingly. Conclusions: It is difficult to appreciate the anatomical complexity, the extent, and the nature of the invagination of rare Type III DI morphology. CBCT imaging and 3D models played a critical role in the pre-treatment planning to ensure a predictable outcome. A 3D model is recommended as a diagnostic tool in treating complex cases where the DI morphology is wide, oblique, or the foraminal opening is irregular. Full article
(This article belongs to the Special Issue Modern Endodontics)
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8 pages, 1338 KiB  
Brief Report
Histological Evaluation of Root Canals by Performing a New Cleaning Protocol “RUA” in Endodontic Surgery
by Alfredo Iandolo, Alessandra Amato, Massimo Pisano, Giuseppe Sangiovanni, Dina Abdellatif, Roberto Fornara and Michele Simeone
Dent. J. 2023, 11(3), 78; https://doi.org/10.3390/dj11030078 - 9 Mar 2023
Cited by 1 | Viewed by 2199
Abstract
Aim: To enhance cleaning during retro-preparation in endodontic microsurgery. Materials and Methods: Forty mandibular premolars were instrumented, filled with a single cone technique, and then retro-preparation was performed and assigned to experiment A. In group A1, the cavity created by the retro preparation [...] Read more.
Aim: To enhance cleaning during retro-preparation in endodontic microsurgery. Materials and Methods: Forty mandibular premolars were instrumented, filled with a single cone technique, and then retro-preparation was performed and assigned to experiment A. In group A1, the cavity created by the retro preparation was cleansed with 2 mL of normal sterile saline. In group A2, the retro cavity was cleaned with 2 mL of sterile saline after the retro preparation. All the irrigation solutions mentioned above were delivered using an endodontic needle with a lateral vent and a gauge of 30. Subsequently, in group A2, 17% EDTA gel and 5.25% gel were inserted into the cavity and activated using ultrasonic tips. After the irrigation protocols, the specimens were decalcified for histological evaluation. Results: In the experiment, the amount of hard tissue debris was significantly greater in group A1 compared to group A2 (p < 0.05). Conclusions: The samples in group A2, where the new protocol was performed, showed statistically significant results. Full article
(This article belongs to the Special Issue Modern Endodontics)
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