Special Issue "Clinical Research of Endodontic Dentistry"

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Stomatology".

Deadline for manuscript submissions: 31 December 2020.

Special Issue Editor

Prof. Dr. Carlo Prati
Website
Guest Editor
Department of BioMedical and NeuroMotor Sciences – DiBiNem, Endodontic Clinical Section, Alma Mater Studiorum, University of Bologna, Italy
Interests: development of new bioceramic materials for bone regeneration; bacteria contamination of root canal; histology of periapical bone; scanning electron microscopy and EDX of dentin; mechanical properties of endodontic instruments; ultrasounds in endodontics; systemic disease and endodontology

Special Issue Information

Dear Colleagues, 

It is a pleasure to invite you to contribute to this Special Issue on Clinical Research of Endodontic Dentistry. Over the last years, a great number of innovative instruments and biomaterials have been introduced for application in endodontic clinical practice. New techniques for root canal shaping, improved rotary and reciprocating NiTi instruments and novel biomaterials for root canals fillings have been developed as demonstrated by several dedicated research investigations. These new techniques may result in significant changes in endodontic clinical practice. 

This Special Issue will cover several classes of new biomaterials developed for endodontic application: bioceramic materials, polymeric materials, biocomposites, carbon post, fiber-glass, nano-apatites, ceramic and zirconia, silicates, graphene, etc. and their impact on clinical results. All these novel and innovative biomaterials may change endodontic practice and improve clinical results. Pulp capping, root reimplantation, specification, and epigenesis can be positively affected by new materials for tissue regeneration. Pulpal stem cells and mesenchymal cells represent a promising research area with future clinical applications in the endodontic area. 

This Special Issue will publish papers on how to manage endodontic practices in patients affected by systemic disease and explore whether clinical research can guide endodontic to new positive results. Special attention is dedicated to the relationship between endodontic and cardiovascular, neurological, rheumatological diseases, and their related clinical problems. For example, determining whether arteriosclerosis affected or induced by endodontic disease. 

Contributions addressing the role of bacteria and viruses in endodontic disease and how they can influence the clinical practice are also of particular interest. Recent and dramatic improvements in microbiology, genetic, and proteomic fields have made it possible to observe endodontic practice with different angulation. Methods of removing bacteria and other pathogens are other future challenges.

Prof. Dr. Carlo Prati
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • clinical trials in endodontic
  • root filling technique
  • sealer
  • bioceramic cement
  • rotary instrument
  • NiTi instrument
  • endodontic disease
  • cystitis
  • root fracture
  • apicogenesis

Published Papers (6 papers)

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Research

Open AccessArticle
Effect of Sonic Agitation of a Binary Mixture of Solvents on Filling Remnants Removal as an Alternative to Apical Enlargement—A Micro-CT Study
J. Clin. Med. 2020, 9(8), 2465; https://doi.org/10.3390/jcm9082465 - 01 Aug 2020
Abstract
Background: This work aimed to evaluate the efficacy of sonic agitation of a binary mixture of solvents (methyl ethyl ketone/tetrachloroethylene) on filling remnants removal and compare the effects of solvent agitation with the enlargement to the next instrument size. Methods: Twenty-four mandibular incisors [...] Read more.
Background: This work aimed to evaluate the efficacy of sonic agitation of a binary mixture of solvents (methyl ethyl ketone/tetrachloroethylene) on filling remnants removal and compare the effects of solvent agitation with the enlargement to the next instrument size. Methods: Twenty-four mandibular incisors were prepared with ProTaper Next (X1, X2) and obturated with the single-cone technique and AH Plus sealer. The teeth were retreated with ProTaper Universal Retreatment and ProTaper Next and divided into two groups (n = 12) according to the final instrument (X3 or X4). All canals were submitted to a supplementary procedure consisting of a mixture of solvents―methyl ethyl ketone/tetrachloroethylene, agitated with EndoActivator. The volume of filling remnants was assessed through micro-computed tomography in the apical 5 mm. Statistical analysis was performed with a significance level of 5%. Results: The supplementary procedure of agitation of the solvent mixture was beneficial in both groups (p < 0.05). There were no statistically significant differences between canals re-prepared until X4 and canals re-prepared until X3 plus solvent (p > 0.05). Conclusions: An additional step with a two-solvent solution potentiated by EndoActivator showed to be very effective for the removal of gutta-percha and resinous sealer remnants from apical root canals of mandibular incisors, avoiding further enlargement. Full article
(This article belongs to the Special Issue Clinical Research of Endodontic Dentistry)
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Open AccessArticle
Sodium Hypochlorite Reduces Postoperative Discomfort and Painful Early Failure after Carious Exposure and Direct Pulp Capping—Initial Findings of a Randomized Controlled Trial
J. Clin. Med. 2020, 9(8), 2408; https://doi.org/10.3390/jcm9082408 - 28 Jul 2020
Abstract
In this randomized controlled single-center clinical trial on 96 adult patients with parallel experimental groups (n = 48), the effects of washing a dentin/pulp wound in non-symptomatic teeth with extremely deep caries and pulpal exposure were compared between a 2.5% sodium hypochlorite [...] Read more.
In this randomized controlled single-center clinical trial on 96 adult patients with parallel experimental groups (n = 48), the effects of washing a dentin/pulp wound in non-symptomatic teeth with extremely deep caries and pulpal exposure were compared between a 2.5% sodium hypochlorite (NaOCl) solution and a chemically-inert physiological saline control solution. After the allocated wound lavage, the pulps were capped with a mineral trioxide aggregate, covered by a glass-ionomer/resin liner, and the teeth were immediately restored with a resin-bonded-composite. In this first report, the early events were analyzed: postoperative discomfort (on an NRS-11 scale) at day-3 and -7 after intervention, and the occurrence of unbearable pain causing patients to contact the principal investigator to perform a root canal treatment (pulpectomy) during the first three months. The NaOCl solution caused a highly significant reduction in post-operative discomfort (p = 0.0010 day 3; p = 0.0007 day 7) and early painful failures (p = 0.0008) compared with the control. These novel findings highlight the importance of infection control in teeth with extremely deep carious lesions. Based on these observations, the use of an NaOCl solution to wash the exposed dentin/pulp wound in the vital pulp treatment is highly recommended in order to reduce pain and early failure. Full article
(This article belongs to the Special Issue Clinical Research of Endodontic Dentistry)
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Open AccessArticle
Prognostic Factors of Long-Term Outcomes in Endodontic Microsurgery: A Retrospective Cohort Study over Five Years
J. Clin. Med. 2020, 9(7), 2210; https://doi.org/10.3390/jcm9072210 - 13 Jul 2020
Abstract
The aim of this study was to analyze the long-term outcomes of endodontic microsurgeries in a cohort and identify their association with prognostic factors. A cohort of endodontic microsurgeries followed up periodically with complete clinical and radiographic records for at least 5 years [...] Read more.
The aim of this study was to analyze the long-term outcomes of endodontic microsurgeries in a cohort and identify their association with prognostic factors. A cohort of endodontic microsurgeries followed up periodically with complete clinical and radiographic records for at least 5 years were reviewed retrospectively. Their survival and healing status and profile characteristics were analyzed by Pearson chi-square test and logistic regression (α = 0.05) to identify prognostic factors that influenced outcomes. Of 652 cases in the cohort, 225 (34.5%) were included. The mean follow-up period was 90.4 months (range, 60–168 months). The long-term success rate was 80.5%, and the 5-year survival rate was 83.5%. Logistic regression showed higher success in anteriors compared to molars (OR = 5.405, (95% CI, 1.663–17.571; p = 0.005)) and in teeth with crown restorations (OR = 10.232, (95% CI, 3.374–31.024; p < 0.001)). Conversely, lower success was found in teeth with periodontal disease (OR = 0.170, (95% CI, 0.032–0.900; p = 0.037)) and maxillary sinus involvement (OR = 0.187, (95% CI, 0.035–0.994; p = 0.049)). Endodontic microsurgery has a highly favorable long-term outcome. Tooth position, crown restoration, periodontal disease, and maxillary sinus involvement were identified as main prognostic factors. Full article
(This article belongs to the Special Issue Clinical Research of Endodontic Dentistry)
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Open AccessArticle
Rapid Chairside Microbial Detection Predicts Endodontic Treatment Outcome
J. Clin. Med. 2020, 9(7), 2086; https://doi.org/10.3390/jcm9072086 - 03 Jul 2020
Abstract
Background. The aim of this longitudinal, one-year cohort study was to explore the hypothesis that fluorescence sampling of the root canal space prior to obturation could predict the outcome of root canal treatment (RCT). Methods. Sixty-five teeth underwent primary RCT and were followed [...] Read more.
Background. The aim of this longitudinal, one-year cohort study was to explore the hypothesis that fluorescence sampling of the root canal space prior to obturation could predict the outcome of root canal treatment (RCT). Methods. Sixty-five teeth underwent primary RCT and were followed up clinically and radiographically. The outcome was determined radiographically with periapical radiographs (PR) and cone beam computed tomography (CBCT) scans. Results. Success at 12 months was predictable based on the fluorescence score. When the fluorescence score (defined as the percentage of signal over total signal including background) was lower than 67, there was a 4.5 times (Odds ratio (OR) = 0.028; 95% confidence interval (CI): 0.003, 0.291, p = 0.001) greater chance of success (90% overall). When the readings were above this threshold, the success rate was 20%. Conclusion. A chairside sampling method is able to predict the outcome of RCT, through the use of paper point sampling and fluorescence staining. This has reduced the prevalence of persistent infections by guiding the optimum time for obturation. ClinicalTrials.gov trial NCT03660163. Full article
(This article belongs to the Special Issue Clinical Research of Endodontic Dentistry)
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Open AccessArticle
The Efficacy of Rotary, Reciprocating, and Combined Non-Surgical Endodontic Retreatment Techniques in Removing a Carrier-Based Root Canal Filling Material from Straight Root Canal Systems: A Micro-Computed Tomography Analysis
J. Clin. Med. 2020, 9(6), 1989; https://doi.org/10.3390/jcm9061989 - 25 Jun 2020
Abstract
The aim of this study is to analyze and compare the efficacy of three non-surgical endodontic retreatment techniques in removing a carrier-based root canal filling material from straight root canal systems. The study was performed on 99 single-rooted extracted teeth using the ProTaper [...] Read more.
The aim of this study is to analyze and compare the efficacy of three non-surgical endodontic retreatment techniques in removing a carrier-based root canal filling material from straight root canal systems. The study was performed on 99 single-rooted extracted teeth using the ProTaper Gold endodontic rotary system up to the F2 file (Dentsply Maillefer, Baillagues, Switzerland), which were sealed with GuttaCore (Dentsply Maillefer, Ballaigues, Switzerland) and AH plus epoxy resin sealer (Dentsply DeTrey, Konstanz, Germany) and randomly assigned to the following non-surgical retreatment techniques: ProTaper Retreatment endodontic rotary instruments (D1–D3 files, Dentsply Maillefer, Ballaigues, Switzerland; n = 33, PTR), Reciproc Blue endodontic reciprocating instrument (R50, VDW, Munich, Germany; n = 33, RCB50), and a combined root canal retreatment technique between Gates-Glidden drills (sizes #3 and #2, Dentsply Maillefer, Ballaigues, Switzerland) and Hedstrom files (file size 35, 30, and 25, Dentsply Maillefer, Ballaigues, Switzerland; n = 33; H-GG). All of the teeth were submitted twice to a micro-computed tomography (micro-CT) scan, before and after non-surgical endodontic retreatment procedures. The volume of root canal filling material (mm3), volume of remaining root canal filling material (mm3), non-surgical endodontic retreatment working time (min), proportion of remaining root canal filling material (%), and efficacy of root canal filling material removal between the non-surgical endodontic retreatment techniques were analyzed using ANOVA one-way statistical analysis. Statistically significant differences were observed between the proportions of remaining root canal filling material of PTR and H-GG (p = 0.018), between the non-surgical endodontic retreatment working times (min; p < 0.001), and between the efficacies of root canal filling material removal by the non-surgical endodontic retreatment techniques (p = 0.009). However, the non-surgical endodontic retreatment systems allow for similar carrier-based root canal filling material removal. Full article
(This article belongs to the Special Issue Clinical Research of Endodontic Dentistry)
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Open AccessArticle
Secondary Root Canal Treatment with Reciproc Blue and K-File: Radiographic and ESEM-EDX Analysis of Dentin and Root Canal Filling Remnants
J. Clin. Med. 2020, 9(6), 1902; https://doi.org/10.3390/jcm9061902 - 18 Jun 2020
Abstract
Secondary root canal treatment requires the complete removal of filling materials with different chemical-physical properties. A newly developed single-use NiTi instrument (Reciproc Blue, RB) may be more effective in root canal retreatment. The aim of the present study was to evaluate morphology and [...] Read more.
Secondary root canal treatment requires the complete removal of filling materials with different chemical-physical properties. A newly developed single-use NiTi instrument (Reciproc Blue, RB) may be more effective in root canal retreatment. The aim of the present study was to evaluate morphology and composition of remnants after retreatment with RB compared to traditional K-File technique, in canals obturated with Thermafil/AH Plus. Twenty-four single-rooted human teeth were shaped with NiTi obturated with AH-Plus/Thermafil and retreated using RB NiTi instruments or manual K-Files. Radiographs were taken to evaluate endodontic space and radiopacity of residual filling-material before/after procedures. After retreatment, samples were longitudinally split and observed by environmental scanning electron microscopy connected to energy dispersive X-Ray spectroscopy (ESEM-EDX) to analyze the debris/remnant position, microchemistry, and dentinal surface morphology. Time for retreatments was recorded and compared using one-way ANOVA (p-value = 0.05). Radiopaque filling residuals were found in both groups. RB system resulted statistically faster than manual K-File in retreatment procedure (p < 0.001). Root canal space radiographic appearance obtained after retreatment with RB was wider than K-File (p < 0.05). ESEM-EDX revealed 4 different morphological dentin area. Area-1: debris-free with typical Ca, P, and N composition of dentin and detected in 70% of the surface. Area-2: presence of deproteinized smear layer free from N and debris in 15% of the surface. Area-3: a thick packed smear layer N-free and with fine debris consisting of trace elements from sealer in 10% of the surface. Area-4: packed with debris and trace elements. No difference was observed between both instruments regarding root canal space appearance and ESEM-EDX analysis. Both systems were able to remove filling material but created a dentine morphology composed of packed debris and filling materials embedded into the smear layer. Dentin surface composition resulted in collagen depleted by irrigation procedures. The reciprocating system required less time to complete retreatment. Full article
(This article belongs to the Special Issue Clinical Research of Endodontic Dentistry)
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