Search Results (587)

Background/Objectives: Activated irrigation techniques improve intracanal disinfection, but their impact on the clinical and radiographic healing of apical periodontitis remains unclear. This systematic review and meta-analysis evaluated the efficacy of passive ultrasonic irrigation (PUI) and laser-assisted irrigation (LAI), without adjunctive systemic antibiotics, on periapical healing compared with conventional irrigation in adult patients. Methods: Following PRISMA guidelines and prospective registration in PROSPERO (CRD420261413401), PubMed, Scopus, Embase, and Web of Science were searched up to February 2026. Randomized controlled trials (RCTs) involving adults with apical periodontitis comparing PUI or LAI against conventional syringe irrigation—with a minimum of 6 months follow-up—were included. Risk of bias was assessed using RoB 2, evidence certainty via GRADE, and a random-effects meta-analysis calculated pooled odds ratios (ORs) and 95% confidence intervals (CIs). Results: Of 1115 records identified, five randomized controlled trials involving 451 teeth fulfilled the eligibility criteria and were included in the qualitative synthesis and quantitative meta-analysis. Activated irrigation significantly increased periapical healing probability compared with conventional irrigation (OR = 2.25; 95% CI: 1.29–3.93; p = 0.004), with no statistical heterogeneity (I² = 0%). Subgroup analyses showed significant benefits for both PUI (OR = 1.95; 95% CI: 1.08–3.54) and LAI (OR = 6.77; 95% CI: 1.63–28.12). The overall certainty of evidence was moderate due to risk of bias concerns. Conclusions: Activated irrigation techniques (PUI and LAI) were significantly associated with improved clinical and radiographic healing of apical periodontitis compared with conventional irrigation alone. Enhanced intracanal disinfection contributes to a more predictable resolution of periapical lesions without adjunctive systemic antibiotics. Further high-quality RCTs with standardized protocols and long-term CBCT-based follow-up are required to confirm these findings. Full article

Sodium hypochlorite (NaOCl), as the most commonly used irrigant solution, offers strong antibacterial and organic tissue dissolving properties and has the potential to express a strong corrosive effect. The aim of the study was to evaluate the effects of NaOCl on corrosion behavior and cyclic fatigue in five different types of NiTi rotary endodontic instruments. The study examined: ProTaper Universal, ProTaper Next, Twisted File, HyFlex CM, and BioRace, each with 24 samples. Each group was divided into a control subgroup and a subgroup exposed to electrochemical testing of corrosion in 5.25% NaOCl. All instruments were exposed to a cyclic fatigue test in artificial canals with a curvature angle of 60 degrees and radius of 2 mm. The corrosion potential of NaOCl was determined in all groups of instruments. ProTaper Universal had a significantly lower corrosion resistance than ProTaper Next (p < 0.05), Twisted File, BioRace, and HyFlex CM (p < 0.001). HyFlex CM showed significantly higher resistance to cyclic fatigue compared to all the other groups of instruments (p < 0.001). Surface corrosion reduced cyclic fatigue resistance in most of the instrument groups, except in heat-treated instruments with controlled memory. HyFlex CM has proven to have the highest resistance to corrosion and cyclic fatigue. Full article

Odontogenic cutaneous sinus tracts represent an uncommon clinical manifestation of chronic dental infection and are frequently misdiagnosed due to the absence of dental symptoms and their resemblance to dermatologic lesions. This case report describes the nonsurgical endodontic management of a cutaneous sinus tract of dental origin in a 13-year-old patient. The patient presented with a persistent extraoral lesion in the mandibular region, initially evaluated by non-dental specialists. Clinical and radiographic examination revealed a necrotic mandibular first molar associated with a periapical radiolucency and intraoral sinus tract. Nonsurgical root canal treatment was performed using chemomechanical debridement with sodium hypochlorite irrigation and calcium hydroxide as an intracanal medicament. Complete obturation was achieved following resolution of intracanal exudation. No surgical intervention of the cutaneous lesion was undertaken. Progressive healing of the periapical lesion and spontaneous resolution of the extraoral sinus tract were observed over a 6-month follow-up period. This case is noteworthy because it combines a prolonged diagnostic delay, an atypical extraoral manifestation in a child, and successful resolution by nonsurgical endodontic therapy alone without surgical excision of the cutaneous lesion. The 6-month follow-up confirms sustained clinical and radiographic healing, underscoring the importance of early recognition and conservative management in pediatric patients. Early identification and elimination of the dental source can prevent unnecessary surgical procedures and minimize the risk of permanent scarring. Full article

The middle reaches of the Minjiang River, shaped by the Dujiangyan irrigation system, provide a typical setting for studying long-term human–water interactions. During the Little Ice Age, the water management system as a whole experienced a full cycle of recovery, expansion, and decline from 1644 to 1949 (Qing to Republican period), although subregions exhibited marked spatial heterogeneity. This heterogeneity makes the area an ideal case for comparative analysis; however, previous studies have neither quantitatively reconstructed river–canal changes nor systematically disentangled the composite natural and anthropogenic drivers across different subregions. Using archival documents, historical maps, remote sensing imagery, and water cultural heritage sites, this study reconstructs the evolution and quantifies two change types: anthropogenic construction, including new construction, reconstruction, and modification, and environmentally driven changes such as rerouting, damage, and maintenance. Correlations were analyzed among the four subregions: Inner River, Outer River, Nanhe River, and the Lower Basin to identify driving mechanisms. Results indicate that anthropogenic construction is constrained by natural conditions and driven by population growth, whereas environmentally driven changes are primarily caused by floods and worsened by canal head maintenance failure. The four spatially differentiated driving patterns are: Inner River—human-dominated intervention type; Outer River—flood stress type; Nanhe River—low-disturbance stable type; and Lower Basin—natural–human composite type. This study offers new insights into long-term human–water interactions in large irrigation districts under climate change. Full article

The aim of this systematic review was to assess the influence of different final irrigation protocols and activation methods on the dentinal tubular penetration of calcium silicate-based sealers (CSSs). The review followed the PRISMA 2020 guidelines, and the protocol was registered in the Open Science Framework (OSF; DOI: 10.17605/OSF.IO/5HTVN). A PICOS-based research question was formulated, and a comprehensive literature search was conducted in MEDLINE, Scopus, Embase, Web of Science, and SciELO up to October 2025. After study selection, a qualitative synthesis of methodologies and outcomes was performed, and methodological quality was assessed using the QUIN tool. Twenty-one in vitro studies were included, all of which used single-rooted teeth or single roots. The available evidence suggests that final irrigation protocols may influence CSS penetration, although the magnitude and consistency of this effect varied substantially across studies. Sodium hypochlorite (NaOCl) and 17% EDTA were the most frequently investigated irrigants and were generally associated with improved penetration, but no irrigation protocol or activation technique can currently be considered superior. Current research trends include the evaluation of chelating agents, continuous chelation protocols, and irrigant activation systems such as passive ultrasonic irrigation, sonic activation, laser activation, and XP-Endo Finisher. Future studies should standardize irrigation protocols, activation methods, sealer types, obturation techniques, microscopy-based assessment procedures, and penetration outcome measures, while also including larger samples and more anatomically complex root canal systems. Full article

Areas where mining activities overlap with agricultural production may promote the mobilization of potentially toxic elements (PTEs) into soils and water resources, thereby creating exposure pathways for populations living or working in these environments. This study analyzes the concentration of PTEs in agricultural soils and irrigation water from Santa Rosa, southern Ecuador, and assesses the associated health risks for exposed agricultural workers. For this purpose, 35 soil samples were collected from farms and 12 water samples from the irrigation canal during the dry season of 2025. The concentration of PTEs in soil and water was determined using X-ray fluorescence (XRF) and inductively coupled plasma mass spectrometry (ICP-MS), respectively. The PTE concentration in both matrices was compared with the maximum permissible limits (MPL) established by Ecuadorian regulations. Non-carcinogenic hazard indices ($\mathrm{H}\mathrm{I}$) and carcinogenic risk ($\mathrm{T}\mathrm{C}\mathrm{R}$) were estimated following the U.S. EPA methodology. In soil, As and Cr were the PTEs of greatest concern, exceeding the MPL in 93% of the samples and by up to 4.4 and 2.4 times, respectively, while in water, all PTEs were below the MPL. Non-carcinogenic risk was below the recommended limit for soil and water ($\mathrm{H}{\mathrm{I}}_{\mathrm{s}\mathrm{o}\mathrm{i}\mathrm{l}}$ = 3.00 × 10⁻² and $\mathrm{H}{\mathrm{I}}_{\mathrm{w}\mathrm{a}\mathrm{t}\mathrm{e}\mathrm{r}}$ = 2.00 × 10⁻³), with As as the dominant contributor. Cancer risk was tolerable in soil ($\mathrm{T}\mathrm{C}{\mathrm{R}}_{\mathrm{s}\mathrm{o}\mathrm{i}\mathrm{l}}$ = 4.34 × 10⁻⁵), while in water it remained at a low level ($\mathrm{T}\mathrm{C}{\mathrm{R}}_{\mathrm{w}\mathrm{a}\mathrm{t}\mathrm{e}\mathrm{r}}$ = 1.65 × 10⁻⁶). These findings identify As and Cr as priority contaminants and support targeted monitoring and source-control measures in mining-influenced agricultural areas. Overall, by integrating agricultural soil and irrigation water quality with an occupational health risk assessment in Santa Rosa, this study contributes evidence to support future research in mining–agriculture coexistence areas. Full article

Background/Objectives: The aim of this study was to compare the effectiveness of the Reciproc Blue (RB) and MicroMega Remover (MR) systems in removing root canal filling material and to evaluate the effect of passive ultrasonic irrigation (PUI) on remaining filling material (RFM) using micro-computed tomography (micro-CT)-based three-dimensional (3D) analysis. Methods: Forty single-rooted mandibular premolar teeth were included in the study. The root canals were prepared up to size F2 using the ProTaper Gold rotary file system and obturated with the lateral compaction technique. After the initial micro-CT scan, the teeth were randomly divided into four groups: Group RB, Group MR, Group RB + PUI, and Group MR + PUI (n = 10). Following retreatment, a second micro-CT scan was performed. The percentage of RFM was calculated, and statistical analyses were performed using Kruskal–Wallis and Mann–Whitney U tests with Bonferroni correction. A rank-based factorial analysis was additionally performed (p < 0.05). Results: RFM was observed in all groups. No significant difference was found between the RB (7.37%) and MR (7.31%) systems (p > 0.05). However, the groups treated with PUI (RB + PUI and MR + PUI) showed significantly lower RFM values than the groups without PUI (p = 0.001). Factorial analysis revealed no significant effect of file system or file system × PUI interaction, whereas PUI significantly reduced RFM (p < 0.001). Conclusions: The RB and MR systems demonstrated similar effectiveness in removing root canal filling material. Although complete canal cleanliness could not be achieved, under the in vitro conditions of the present study, PUI significantly reduced the amount of micro-CT-measured RFM. Full article

Under the dual constraints of global food security and ecological protection, conventional agriculture is hampered by low resource efficiency and sluggish environmental response. Crop digital twin technology establishes a dynamic virtual reality system that integrates crops, environment, and water to enable real-time interaction and optimization. Based on the existing literature, this paper reviews the concept, architecture, and core modules of this technology and summarizes its applications in precision irrigation and crop monitoring. There are three major bottlenecks that persist, including limited high-frequency multi-source sensing and spatiotemporal fusion, insufficient parameter calibration and dynamic updating, and weak cross-scale integration from plant to watershed. Water is increasingly recognized as the key constraint and control variable and acting as both the central physiological driver of crop growth and the mass-flow link that connects the soil–plant–atmosphere continuum. The spatiotemporal dynamics of crop water deficit, compensatory root water uptake, evapotranspiration feedback, and the hydraulic behavior of irrigation-district canal systems constitute the core hydrological processes that must be simulated within the digital twin. Synchronizing crop water demand, soil moisture dynamics, atmospheric evapotranspiration, and irrigation scheduling within a unified spatiotemporal framework establishes a complete sensing, diagnosis, prediction and regulation technical chain. This chain offers a core pathway for alleviating agricultural water scarcity, improving irrigation efficiency, and ensuring food security. Full article

Background: Effective root canal disinfection is essential for successful nonsurgical root canal treatment (RCT). Although sodium hypochlorite (NaOCl) remains the standard irrigant, it carries a risk of chemical tissue injury if extruded beyond the root canal system and may have limited penetration into anatomically complex regions. Underwater discharge plasma (UDP) generates reactive oxygen and nitrogen species (RONS) through high-frequency, high-voltage electrical discharge in aqueous media, and preclinical and in vitro studies have reported broad-spectrum antimicrobial activity. This study evaluated the clinical and radiographic outcomes of nonsurgical RCT performed using physiological saline-based UDP irrigation without NaOCl in a heterogeneous real-world clinical cohort. Methods: This single-center retrospective cohort study included 186 teeth from 134 patients treated with the PLAZEN RCT^® UDP device and physiological saline irrigation, without NaOCl. The median follow-up period was 16 months. Radiographic outcomes were assessed using the Periapical Index (PAI) system, and treatment success was evaluated according to prespecified Strict and Loose criteria incorporating both radiographic and clinical findings. Stratified analysis was performed according to preoperative PAI score: Group A (PAI 1–2) and Group B (PAI 3–5). UDP-related adverse events, defined as thermal tissue injury caused by discharge heat, were ascertained through retrospective review of clinical records, operative notes, and serial periapical radiographs. Results: Among the 186 treated teeth, radiographic outcomes were classified as Healed (85.5%), Healing (3.8%), and Unhealed (10.8%). Overall Strict and Loose success rates were 79.6% and 82.3%, respectively. Initial treatment showed numerically higher success rates than retreatment. In the stratified analysis, Group A showed an 84.1% success rate with 100% tooth survival, whereas Group B demonstrated Strict and Loose success rates of 68.5% and 83.3%, respectively. Exploratory multivariable analysis showed that periodontal pocket depth > 3 mm was the most consistent factor associated with lower odds of treatment success, whereas associations involving canal obliteration and higher preoperative PAI score were less stable across sensitivity analyses and should be interpreted with caution. No UDP-related adverse events were recorded during follow-up. Attrition sensitivity analyses were performed, and the outcome estimates should be interpreted with caution, given the retrospective design and substantial loss to follow-up. Conclusions: In this preliminary observational cohort, physiological saline-based UDP irrigation without NaOCl was associated with favorable observed periapical healing outcomes and no recorded UDP-related adverse events over a median follow-up of 16 months. However, loss to follow-up was substantial; when all 116 teeth lost to follow-up were classified as treatment failures, the worst-case Strict success rate decreased to 49.0%. Therefore, these findings should be interpreted as preliminary descriptive evidence of clinical feasibility rather than as evidence of comparative efficacy or definitive clinical safety. Adequately powered randomized controlled trials with concurrent NaOCl control arms and long-term follow-up are warranted to evaluate the comparative effectiveness, safety, and reproducibility of physiological saline-based UDP irrigation protocols. Full article

Background: The objective was to synthesize and critically appraise systematic reviews with meta-analysis evaluating the association between irrigation, instrumentation, and obturation procedures and post-operative endodontic pain. Methods: An umbrella review was conducted following PRISMA guidelines. Electronic searches identified systematic reviews published between 2016 and 2025. Eligible studies are systematic reviews that include meta-analyses, published in English and correlating the presence of post-operative pain in 3 different critical stages of root canal treatments, namely irrigation, instrumentation and obturation. Methodological quality was assessed using the AMSTAR 2 tool. Outcomes included pain prevalence and intensity at different time points. Results: Out of 368 records, 25 systematic reviews with meta-analysis met the inclusion criteria: 9 on irrigation, 8 on instrumentation, and 8 on obturation. NaOCl concentrations, irrigant activation, and intracanal cryotherapy were repeatedly reported as being associated with reduced short-term post-operative pain. For instrumentation, most reviews reported lower pain with rotary systems, but two studies found no difference or favored reciprocating kinematics. Apical patency did not appear to increase pain and foraminal enlargement may increase early pain. No clinically consistent differences were observed between bioceramic/calcium silicate-based and resin-based sealers, although calcium silicate sealers seem to support periapical healing. However, the certainty of these findings was limited by heterogeneity, methodological weaknesses, and overlap among primary studies. Methodological limitations were identified across reviews, mainly related to no protocol registration (n = 4), incomplete reporting of excluded studies with justification (n = 11), limited assessment of publication bias, and poor reporting of funding sources for primary studies. Conclusions: Based on current evidence, irrigation, instrumentation, and obturation procedures may influence short-term post-operative pain. However, these findings remain tentative because of heterogeneity, methodological weaknesses, variable review quality, and overlap among primary studies. Further high-quality reviews and clinical trials are needed. Full article

Background: The biological response of the periodontal ligament (PDL) following endodontic treatment remains insufficiently investigated. This systematic review aimed to evaluate the influence of endodontic treatment modalities on PDL-related healing outcomes and periapical tissue repair. Methods: A systematic review was conducted according to PRISMA 2020 guidelines. PubMed, Scopus, Web of Science, and the Cochrane Library were searched for randomized clinical trials published between 2015 and 2025. Studies evaluating the effects of endodontic interventions on clinical, radiographic, or biological outcomes associated with PDL healing. Risk of bias was assessed using the Cochrane RoB 2 tool. Results: Ten randomized clinical trials involving approximately 710 participants were included. Endodontic treatment was generally associated with favorable healing outcomes, reflected by reductions in periapical lesion size, improvement of radiographic parameters, and resolution of clinical symptoms. Single-visit and multiple-visit treatments demonstrated comparable long-term healing outcomes, although single-visit protocols were associated with increased short-term postoperative discomfort. Activated irrigation techniques appeared to enhance healing compared with conventional irrigation methods. Most studies were judged as having some concerns regarding risk of bias. Conclusions: Current evidence suggests that endodontic treatment can promote favorable healing of the periodontal ligament–periapical complex through effective infection control and resolution of inflammation. However, the certainty of evidence remains moderate because of methodological heterogeneity and the limited availability of studies directly assessing biological PDL outcomes. Further well-designed randomized clinical trials with standardized outcome measures and longer follow-up periods are required. Full article

The aim of this study was to evaluate the effect of two laser-assisted disinfection techniques on the porosity and bond strength (BS) of a new premixed calcium silicate sealer. Forty extracted human single-rooted premolars with one root canal were prepared up to 50/05. Samples were randomly assigned to the groups (n = 10 each): 1. shock wave-enhanced emission of photoacoustic streaming (SWEEPS) (20 mJ, 15 Hz, 0.60 W, pulse duration 25 µs), 2. diode laser (975 nm, 1.5 W), 3. conventional needle and syringe irrigation (CI), and 4. control (C), with no final irrigation protocol. Root canals were filled with a premixed calcium silicate sealer using the single-cone obturation technique. Micro-CT scans were performed after two weeks to determine the presence of voids in the filling. Dentinal discs from the middle third were prepared for push-out testing. Kruskal–Wallis and post hoc Dunn tests were used, with significance set at 5%. Micro-CT analysis detected porosity in all samples, with no significant differences among the groups (p > 0.05). SWEEPS showed the highest BS values (median 3.233 MPa) and outperformed CI and C (median 1.923 and 1.989 MPa) (p < 0.05) overall. SWEEPS enhanced the BS compared with CI. Voids were present in all experimental groups. Full article

Punjab, Pakistan, is experiencing severe groundwater depletion due to excessive and unplanned extraction, declining surface water availability, rapid population growth, and increasing climate variability. Groundwater has become the primary source of irrigation and drinking water across the province, contributing about 50%, 90% and 95% of the requirements of agricultural, domestic, and industrial water demands. Natural recharge rates have been reduced due to construction, pavements, and the lining of irrigation channels. This study presents the first pilot-scale Managed Aquifer Recharge (MAR) initiative implemented by the Irrigation Research Institute (IRI) of the Punjab Irrigation department. Floodwater has been diverted into the bed of the abandoned Old Mailsi Canal (OMC), which off-takes from Islam Headworks. About 144 recharge wells have been constructed in the bed of the OMC. During the 2025 flood season, approximately 12,000 acre-feet of floodwater was diverted and stored through engineered ponding, canal-bed rehabilitation, and recharge wells. A comprehensive monitoring program was established, including piezometers, automated data loggers, groundwater quality sampling, pumping tests, geophysical surveys, and sediment analyses. The results indicate a maximum groundwater level rise of up to 11 ft., with average increases ranging from 2.6 to 5.2 ft across the recharge ponds. Groundwater quality also showed an improvement following MAR implementation; electrical conductivity decreased from 900 to 650 μS/cm in Pond-I and from 850 to 750 μS/cm in Pond-III. These findings demonstrate that repurposing abandoned canal infrastructure for floodwater-based MAR provides a technically feasible, environmentally sustainable, and climate-resilient strategy for enhancing groundwater availability for sustainable management in Punjab and other water-stressed regions. Full article

Canal discharge identification is essential for irrigation water metering, water management, and ecological protection. With the rapid advancement of UAV aerial photogrammetry, UAV-based large-scale field flow field observations have emerged as a prominent research focus. Given the capability to accurately retrieve canal surface flow velocities, a critical challenge remains in UAV remote sensing-based canal hydrological monitoring: how to identify key cross-sections, obtain high-resolution surface flow field information, and enable timely canal cross-section discharge estimation during sudden flood events. To address the aforementioned challenges, this manuscript combines deep learning algorithms with Kalman filtering and monocular ranging techniques. Artificial square sheet tracers are released into the canal, based on which a YOLO-DeepSort deep tracking framework is constructed. Based on the established UAV-based canal flow velocity perception platform using deep learning, this manuscript achieves mAP@0.5 of 0.995, with precision and recall both reaching 1.0 for real-time tracer detection and flow velocity identification via UAV low-altitude remote sensing. The average relative error of velocity estimation is within 7%, and discharge inversion errors are 1.7%, 6.4%, and 4.6% for the three canal sections, respectively. The surface flow field and cross-sectional velocity distribution of the observed sections are obtained accurately. This manuscript is expected to provide a systematic scientific basis for UAV low-altitude remote sensing-based canal discharge monitoring. Full article

The declining productivity, fertilizer inefficiencies, and rising energy cum production costs are the key issues in crop production, especially in semi-arid regions with alkaline soils. Integration of crop management strategies needs to be adopted to address these issues within the water–energy–food nexus (WEFN). For this purpose, a case study was conducted in semi-arid region of central Punjab, Pakistan, to evaluate the interactive effects of irrigation water source [canal water (CW) and tubewell water (TW)], phosphorus fertilizer source [diammonium phosphate (DAP) vs. phosphoric acid_25% (PA)], and fertilizer application levels [100% and 80% of recommended dose of fertilizer (RDF)] on maize productivity, energy efficiency and economic performance. The experiment comprises eight treatments under raised bed planting (RBP) and one control treatment under ridge-furrow sowing (RFS). Each treatment had three replicates, and the experiment was laid out under a randomized complete block design (RCBD). Maize growth, yield, water productivity, energy efficiency, and economic performance were analyzed using field measurements, energy equivalents, and partial budget analysis. The T1 (RBP+CW+PA+100%RDF) produced the highest maize yield, and it varied from 6.36 to 7.90 t ha⁻¹ under other treatments. CW significantly showed better water productivity (1.14–1.37 kg m⁻³) than that under TW (1.13–1.31 kg m⁻³); however, total energy input was higher under TW-based treatments (29,269–41,033 MJ t ha⁻¹) than that under CW-based treatments (24,129–29,681 MJ ha⁻¹). This results in lower energy productivity under TW-based treatments compared with CW-based treatments (0.17–0.23 kg MJ⁻¹ vs. 0.25–0.31 kg MJ⁻¹, respectively). Moreover, T2 (RBP+CW+PA+80%RDF) produced the highest energy use efficiency (0.59). Economic analysis revealed that production costs were nearly 15–17% higher under TW-based treatments, mainly due to the cost associated with groundwater pumping, and it reduced net profit to USD 1134–1385 ha⁻¹. Better net profits were achieved by CW-based treatments (USD 1244–1593 ha⁻¹), while those produced by BCR ranged from 3.11 to 3.69, with the highest value under T2 (RBP+CW+PA+80%RDF). Overall, irrigation water source emerged as the dominant driver of WEFN performance, while phosphoric acid significantly improved phosphorus availability, energy productivity, and economic returns, particularly under reduced fertilizer input. This study evidenced better maize productivity, less energy consumption, and improved farm profitability in semi-arid irrigated systems through the integration of canal water irrigation with optimized phosphorus management. Full article