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Clinical Advances in Endodontic Dentistry
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Clinical Advances in Endodontic Dentistry

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: 20 April 2026 | Viewed by 556

Special Issue Editors

Dr. Luciano Giardino

E-Mail Website
Guest Editor
Independent Researcher, 88900 Crotone, Italy
Interests: endodontic diseases; endodontic irrigants; histopathology; implant preservation; oral biofilm; periodontal regeneration; root canal shaping and cleaning; root canal anatomy; endoperiodontal-lesions
Special Issues, Collections and Topics in MDPI journals
Dr. Luigi Generali

E-Mail Website
Guest Editor
Department of Surgery, Medicine, Dentistry and Morphological Sciences, University of Modena and Reggio Emilia, 41124 Modena, Italy
Interests: endodontics; restorative dentistry; biomaterials; dental materials; endodontic instruments; dental erosion; pH modulation in oral care; nutritional impact on enamel erosio
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue, "Clinical Advances in Endodontic Dentistry", aims to bring together articles covering relevant scientific topics on endodontics and recent advances in the development and optimization of all branches of endodontics such as instrumentation; endodontic anatomy; root canal cleaning systems; biomaterials; the use of tools such as CLSM, Micro-CT, etc.; cytotoxicity; the endodontic microbiome; antimicrobials; and irrigants. Therefore, this Special Issue welcomes contributions from all researchers working in dentistry, biomolecular sciences, or material processing in relation to endodontics, regenerative endodontics, and dental restoration. This Special Issue will be a timely approach to survey the recent progress in the development and optimization of these subjects. We are pleased to invite you to share your studies in this Special Issue by proposing new clinical proposals or research based on these topics.

Dr. Luciano Giardino
Dr. Luigi Generali
Guest Editors

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 submissions that pass pre-check are 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 250 words) can be sent to the Editorial Office for assessment.

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 semimonthly 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 2600 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

  • antimicrobial agents
  • biofilm
  • confocal laser scanning microscopy
  • endodontic materials
  • irrigants
  • microbiome
  • micro-CT
  • regenerative endodontics

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Published Papers (2 papers)

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13 pages, 4670 KB  
Article
Dentinal Tubule Penetration of an Endodontic Sealer in the Apical Third of Root Canals After Different Final Irrigation Techniques
by Noelia Santamaria, Jaime Bascones, Carlos Gallego-Garcia and Lucia Gancedo-Caravia
J. Clin. Med. 2026, 15(3), 930; https://doi.org/10.3390/jcm15030930 - 23 Jan 2026
Viewed by 157
Abstract
Background/Objectives: This study evaluates the penetration of a calcium silicate-based sealer (BC Universal) into dentinal tubules after different final irrigation protocols. Methods: Eighty-four single-rooted extracted teeth were instrumented with ProTaper Gold to size F4 and assigned to four groups (n [...] Read more.
Background/Objectives: This study evaluates the penetration of a calcium silicate-based sealer (BC Universal) into dentinal tubules after different final irrigation protocols. Methods: Eighty-four single-rooted extracted teeth were instrumented with ProTaper Gold to size F4 and assigned to four groups (n = 21) according to the final irrigation protocol as follows: conventional needle irrigation (CNI), sonic agitation with EndoActivator (EA), ultrasonic activation (UA), and XP-Endo Finisher (XPF). A total of 20 canals from each group were filled with BC Universal sealer mixed with fluorescein and the single-cone obturation technique. The remaining specimen in each group served as a negative control to assess potential imaging bias. Specimens were sectioned 3 mm from the apex and analyzed under confocal laser scanning microscopy. Sealer penetration was assessed by penetration area (PA), maximum depth (MaxD), mean depth (MeanD), and percentage of canal perimeter infiltrated (P). Data were analyzed using Kruskal–Wallis or ANOVA tests (α = 0.05). Results: All activation/agitation techniques showed significantly higher penetration than CNI across all variables (p < 0.001). No significant differences were found among EA, PUI, and XPF for PA, MaxD, and MeanD. However, XPF exhibited the highest perimeter infiltration, which was significantly greater than EA and UA (p < 0.001). Conclusions: Irrigant activation significantly enhanced dentinal tubule penetration of BC Universal sealer compared to CNI. XPF provided superior P, suggesting superior circumferential distribution. These findings suggest a more effective cleaning of the root canal in the apical third achieved by the tested irrigant activation/agitation techniques, which may improve the sealing potential of BC Universal sealer. Full article
(This article belongs to the Special Issue Clinical Advances in Endodontic Dentistry)
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60 pages, 1134 KB  
Systematic Review
Cytotoxicity of Root Canal Sealers and Potential Clinical Implications: A Comprehensive Systematic Review of In Vitro Studies
by Mirko Piscopo, Angelo Aliberti, Roberta Gasparro, Gilberto Sammartino, Noemi Coppola and Pietro Ausiello
J. Clin. Med. 2026, 15(3), 973; https://doi.org/10.3390/jcm15030973 - 25 Jan 2026
Viewed by 185
Abstract
Background: Root canal sealers may come into direct contact with periapical tissues, particularly in cases of apical extrusion, potentially influencing periapical healing and treatment outcomes. Cytotoxicity assessment represents a clinically relevant parameter when selecting endodontic sealers. However, evidence derived from in vitro [...] Read more.
Background: Root canal sealers may come into direct contact with periapical tissues, particularly in cases of apical extrusion, potentially influencing periapical healing and treatment outcomes. Cytotoxicity assessment represents a clinically relevant parameter when selecting endodontic sealers. However, evidence derived from in vitro studies remains heterogeneous and challenging to interpret from a clinical perspective. Therefore, the aim of this systematic review was to critically evaluate the in vitro cytotoxicity of all root canal sealers that have been commercially marketed over the years, excluding experimental materials, and to contextualize the findings in relation to clinically relevant experimental conditions. Methods: This systematic review was conducted according to PRISMA guidelines and preregistered on the Open Science Framework. PubMed, Scopus, and the Cochrane Library were searched up to 30 November 2025. In vitro studies evaluating the cytotoxicity of commercially available root canal sealers using validated cell viability or proliferation assays were included. Data extraction focused on sealer composition, setting condition, extraction protocols, exposure parameters, and cytotoxic outcomes. Due to marked methodological heterogeneity, a qualitative synthesis was performed. Results: Ninety-eight in vitro studies were included. All categories of root canal sealers demonstrated some degree of cytotoxicity, particularly when tested in freshly mixed conditions, at higher extract concentrations, or after prolonged exposure. Bioactive and calcium silicate-based sealers generally showed a more favorable cytotoxicity profile compared with conventional materials, especially after complete setting and at diluted concentrations, although cytotoxic effects were reported under specific experimental conditions. Resin-based sealers, including AH Plus, exhibited condition-dependent cytotoxicity, while zinc oxide–eugenol and glass ionomer sealers tended to display higher cytotoxic potential. Conclusions: In vitro cytotoxicity of root canal sealers varies according to material composition and experimental conditions. Bioactive sealers generally exhibit a more favorable biological profile, which may be clinically relevant in situations involving sealer extrusion or prolonged tissue contact. Standardized testing protocols and further translational studies are required to support evidence-based clinical material selection. Full article
(This article belongs to the Special Issue Clinical Advances in Endodontic Dentistry)
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