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Recent Advancement and Challenges in Endodontics

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A special issue of Applied Sciences (ISSN 2076-3417). This special issue belongs to the section "Applied Dentistry and Oral Sciences".

Deadline for manuscript submissions: closed (20 December 2021) | Viewed by 25704

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Special Issue Editor

Prof. Dr. Seok Woo Chang

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Guest Editor

Department of Conservative Dentistry, School of Dentistry, Kyung Hee University, Seoul, Korea
Interests: root canal morphology; endodontic NiTi rotary instruments; regenerative endodontic treatment; endodontic biomaterials; endodontic microbiology; and so on

Special Issue Information

Dear Colleagues,

I am pleased to welcome you to submit your research to “Recent Advancements and Challenges in Endodontics”. Endodontics is a branch of dental science which mainly aims to “save the tooth”. Endodontics has a long history of research and clinical practice which have contributed to improving the health and wellbeing of people. Based on this firm and long-lasting scientific basis, endodontics has made recent advancements in clinical practice, materials/equipment, and related basic research. Recent advancements in endodontics include the following.

Advancements in clinical practice:
Surgical and nonsurgical endodontic treatment using operating microscopes
Computer-guided endodontics
Regenerative endodontics
Vital pulp therapy with modern concepts
Advancements in materials/equipment

-Bioactive materials such as tricalcium silicate cement

-Electronic apex locators

-NiTi rotary instruments with various concepts

-Cone beam CT

Advancements in endodontic research

- Research using stem cells which is related to endodontics

This Special Issue “Recent Advancements and Challenges in Endodontics” aims to reflect recent advancements in endodontics which will encourage us to cope with the challenges of endodontics. Any submissions related to abovementioned topics are welcome.

Topics of interest include, but are not limited to, the following areas:

Root canal anatomy
Endodontic biomaterials
NiTi rotary instrument
Vital pulp therapy
Regenerative endodontics
Cone beam CT in endodontics
Science related to endodontics

We hope this Special Issue will serve as a roadmap for all endodontic researchers and practitioners.

Prof. Dr. Seok Woo Chang
Guest Editor

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Published Papers (6 papers)

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Research

14 pages, 1091 KiB

Open AccessFeature PaperArticle

Influence of Root Canal Fillings on Alveolar Bone Crest Level—An Observational Cross Sectional CBCT Analysis

by Marco Lubrich, David Donnermeyer, Edgar Schäfer and Sebastian Bürklein

Appl. Sci. 2021, 11(18), 8583; https://doi.org/10.3390/app11188583 - 15 Sep 2021

Viewed by 2547

Abstract

The aim of this study was to compare the alveolar bone crest (ABC) level of root canal filled (RCF) teeth without apical periodontitis with corresponding non-filled teeth in the same individual using three-dimensionally cone-beam computed tomography (CBCT) data. Two hundred and thirty-five matching pairs of RCF teeth and corresponding teeth without RCF were selected from a pool of 580 random CBCT-images (voxel size 160–200 µm). Teeth with apical periodontitis, perio-endodontic lesions or surgical endodontic treatment were excluded. The distance between the cemento–enamel-junction (CEJ) and the ABC was assessed centrally mesial, distal, palatal/lingual and buccal at each tooth (∑1880 measuring points) in a standardized manner. Topographic, gender, and age-related relationships were also noted. Data were analyzed using the Kruskal–Wallis-test. The ABC-level between RCF teeth (2.64 ± 1.25 mm) and teeth without RCF (2.61 ± 1.16 mm) did not differ significantly (p > 0.05). No differences concerning localization (maxilla/mandible, tooth type) and gender (p > 0.05) occurred. Overall, ABC-level in the maxilla (2.74 ± 1.48 mm) was significantly lower (p < 0.001) compared to mandibular teeth (2.50 ± 1.41 mm). Patients > 41 years had significantly lower ABC-levels than younger patients (p < 0.05). Men showed a reduced bone level compared to women (p < 0.05). In conclusion, RCF teeth are identical to their non-RCF counterparts, at least in terms of crestal bone level, regardless of the location or type of tooth and the gender of the patient. Thus, root canal treatment is an essential pillar for long-term tooth preservation. Full article

(This article belongs to the Special Issue Recent Advancement and Challenges in Endodontics)

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11 pages, 2189 KiB

Open AccessFeature PaperArticle

Evaluation of Cyclic Fatigue and Bending Resistance of Coronal Preflaring NiTi File Manufactured with Different Heat Treatments

by Soram Oh, Su-Young Moon, Antonis Chaniotis, Eugenio Pedullá, Adel Saeed Al-Ghamdi, Fawzi Ali Al-Ghamdi, Ayman Omar Mandorah, Hiran Perinpanayagam, Kee-Yeon Kum, Ove A. Peters and Seok Woo Chang

Appl. Sci. 2021, 11(16), 7694; https://doi.org/10.3390/app11167694 - 21 Aug 2021

Cited by 3 | Viewed by 2727

Abstract

Coronal preflaring NiTi files should possess proper hardness, resistance to fracture and flexibility. This study compared the bending resistance and cyclic fatigue resistance of three orifice preflaring NiTi files. HyFlex EDM Orifice opener (#25/12), HyFlex CM (#25/08) and One Flare (#25/09) were tested (n = 46/instrument). Bending resistance was assessed with the stress when perpendicular displacement was applied to a 3 mm point from the file tip, and was performed at either room temperature (RT, n = 10) or body temperature (BT, n = 10). Cyclic fatigue resistance was tested with an artificial ceramic root canal at RT (n = 10) and BT (n = 10), and the number of cycles to failure (NCF) was obtained. The bending resistance and the NCF results were analyzed by two-way ANOVA and Tukey’s test. Differential scanning calorimetry (DSC) and X-ray diffraction (XRD) analyses were performed (n = 3, respectively). HyFlex EDM exhibited the highest bending resistance, followed by One Flare and HyFlex CM (p < 0.05), irrespective of the tested temperature. At RT, HyFlex CM demonstrated the highest NCF (p = 0.001), while HyFlex EDM had the highest NCF at BT (p < 0.001). The tested NiTi files were composed of austenite and martensite according to the DSC and XRD results. HyFlex EDM had the highest bending resistance and NCF measured at BT. Full article

(This article belongs to the Special Issue Recent Advancement and Challenges in Endodontics)

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11 pages, 1172 KiB

Open AccessFeature PaperArticle

Influence of Blood Contamination on Push-Out Bond Strength of Three Calcium Silicate-Based Materials to Root Dentin

by Cristina Rodrigues Paulo, Joana A. Marques, Diana B. Sequeira, Patrícia Diogo, Rui Paiva, Paulo J. Palma and João Miguel Santos

Appl. Sci. 2021, 11(15), 6849; https://doi.org/10.3390/app11156849 - 26 Jul 2021

Cited by 10 | Viewed by 3209

Abstract

A proper bond between root canal filling materials and dentin surface is essential to resist dislodgement and guarantee long-term success. Blood exposure is likely to occur in various clinical situations in which calcium silicate-based materials are used; therefore, it is fundamental to render data concerning the influence of blood on bond strength. The present study aims to evaluate the effect of blood contamination on the push-out bond strength obtained with three different biomaterials to root canal dentin; Ninety extracted human mono-radicular permanent teeth were selected. The root canals were prepared with Gates Glidden burs until a diameter of 1.10 mm was achieved. Teeth were then randomly divided into six experimental groups (n = 15) according to the presence/absence of blood contamination and biomaterial used for root canal filling (ProRoot^® MTA, Biodentine^TM, and TotalFill^® BC Putty). After one week, each root was sectioned in three segments (coronal, middle, and apical regions). Specimens were then submitted to push-out bond strength tests. Fracture pattern evaluation was performed. The significance level was set at 5%.; Blood contamination did not affect the push-out bond strength of any of the three tested calcium silicate-based cements (p > 0.05). Regardless of blood contamination, TotalFill showed statistically higher push-out bond strength when compared with Biodentine (p = 0.040) and MTA (p = 0.004). Biodentine exhibited higher bond strength than MTA (p = 0.043). Biomaterials’ comparison within each radicular segment revealed statistically superior bond strength of both Biodentine and TotalFill over MTA (p < 0.05) in the coronal segment. TotalFill presented higher push-out bond strength regarding the apical segment compared to Biodentine (p = 0.003). Fractures were mostly adhesive.; Overall results indicate TotalFill presents the highest push-out bond strength values, followed by Biodentine and, lastly, MTA. Blood contamination did not affect the dislodgement resistance. Biomaterials’ comparison within each radicular segment revealed both TotalFill and Biodentine as the preferable alternatives for application in the coronal region. TotalFill might be the biomaterial of choice for placement in the apical region. Full article

(This article belongs to the Special Issue Recent Advancement and Challenges in Endodontics)

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10 pages, 4976 KiB

Open AccessArticle

Non-Thermal Atmospheric Pressure Plasma-Conditioned Root Dentin Promotes Attraction and Attachment of Primary Human Dental Pulp Stem Cells in Real-Time Ex Vivo

by Yeon-Jee Yoo, Min-Ji Kang, Hiran Perinpanayagam, Joo-Cheol Park, Seung-Ho Baek and Kee-Yeon Kum

Appl. Sci. 2021, 11(15), 6836; https://doi.org/10.3390/app11156836 - 25 Jul 2021

Cited by 1 | Viewed by 2455

Abstract

This study investigated if non-thermal atmospheric pressure plasma (NTAPP) treatment of root dentin surfaces promotes human dental pulp stem cell (hDPSCs) adhesion. Freshly extracted human single-rooted teeth (n = 36) were decoronated and cut (first vertically, then horizontally) into root dentin slices (3 mm thick). Primary hDPSCs cultures were seeded onto slices randomly assigned to pretreatment groups (n = 9/group): NaOCl (1.5%), EDTA (17%) then NTAPP (Group I); NaOCl then NTAPP (Group II); NaOCl then EDTA (Group III); and NaOCl alone (Group IV). Cell viability and proliferation were measured using MTT assay with log-linear statistical analysis. Cell attachment and spreading morphologies on dentin slices (n = 3/group) were examined through scanning electron microscopy. Early cell adhesion events and subcellular activities were observed in real time by live-cell imaging through holotomographic microscopy. Cell viability and proliferation were significantly higher on NTAPP-treated dentin (p < 0.05), without interactions with EDTA (p > 0.05). The attachment, spreading, extensions and multiple layers of hDPSCs were heightened on NTAPP-treated dentin. Cell adhesion, spreading, and dentinal tubule penetration were hastened on NTAPP-treated dentin surfaces in real-time, with elevated subcellular activities and intracellular lipid droplet formation. NTAPP-treated root dentin surfaces support enhanced cellular responses, potentially promoting pulp-dentin regeneration. Full article

(This article belongs to the Special Issue Recent Advancement and Challenges in Endodontics)

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13 pages, 3666 KiB

Open AccessArticle

Need for Standardization: Influence of Artificial Canal Size on Cyclic Fatigue Tests of Endodontic Instruments

by Sebastian Bürklein, Paul Maßmann, David Donnermeyer, Karsten Tegtmeyer and Edgar Schäfer

Appl. Sci. 2021, 11(11), 4950; https://doi.org/10.3390/app11114950 - 27 May 2021

Cited by 9 | Viewed by 2600

Abstract

The aim was to evaluate the influence of artificial canal size on the results of cyclic fatigue tests for endodontic instruments. Dynamic cyclic fatigue at body temperature using continuous tapered nickel–titanium F6-SkyTaper instruments (Komet, Lemgo, Germany), size 25/.06 with an amplitude of 3 mm, was tested in four different simulated root canals: (A) size of the instrument +0.02 mm (within the tolerances of the instruments); (B) +0.05 mm; (C) +0.10 mm; (D) parallel tube with 1.25 mm in diameter. The artificial canals (angle of curvature 60°, radius 5.0 mm, center of curvature 5.0 mm) were produced by a LASER-melting technique. Time and cycles to fracture, and lengths of the fractured instruments were recorded and statistically analyzed (Student–Newman–Keuls; Kruskal–Wallis test). Time to fracture significantly increased with increasing size of the artificial canals in the following order: A < B, C < D (p < 0.05). Length of separated instruments continuously decreased with increasing canal sizes. The parallel tube produced the significantly shortest fragments (p < 0.05). Within the limitations of this study, dynamic cyclic fatigue of endodontic instruments depends on the congruency of the instruments’ dimensions with that of the artificial canals. In future cyclic fatigue testing, due to the closer match of canal and instrument parameters, it is necessary to adjust the artificial canal sizes to the size of the instruments within the manufacturing tolerances of the instruments. Full article

(This article belongs to the Special Issue Recent Advancement and Challenges in Endodontics)

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8 pages, 749 KiB

Open AccessFeature PaperArticle

Sonic Activation Improves Bioceramic Sealer’s Penetration into the Tubular Dentin of Curved Root Canals: A Confocal Laser Scanning Microscopy Investigation

by Ruth Pérez-Alfayate, Juan Algar-Pinilla, Montse Mercade and Federico Foschi

Appl. Sci. 2021, 11(9), 3902; https://doi.org/10.3390/app11093902 - 26 Apr 2021

Cited by 7 | Viewed by 2888

Abstract

Background—The aim was to determine the influence of sonic activation in the tubular dentine penetration of bioceramic sealers. Methods—Forty mesiobuccal curved root canals of mandibular molars with an apical diameter smaller than #30 were prepared, divided into two groups, and filled with EndoSequence BC sealer, with or without sonic activation during its placement. Roots were sectioned at 3 mm, 6 mm, and 9 mm from the apex, producing a sample size of 120. The samples were evaluated using a confocal laser scanning microscope and comparing these images to the images obtained from an operatory microscope. The percentage of sealer penetration and maximum sealer penetration were evaluated. Statistical analysis was performed using the two-tailed Mann–Whitney U test, where statistical significance was set to p < 0.05. Results—Sonic activation showed higher values for the percentage of sealer penetration when compared at the 9 mm level (p = 0.03). A higher value of maximum sealer penetration was observed at all levels when the sealer was activated. Conclusions—The sonic activation of bioceramic cement resulted in higher sealer penetration into dentinal tubules. Full article

(This article belongs to the Special Issue Recent Advancement and Challenges in Endodontics)

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