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Dentistry Journal
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Endodontics: From Technique to Regeneration
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Endodontics: From Technique to Regeneration

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

Deadline for manuscript submissions: 20 June 2025 | Viewed by 12198

Special Issue Editor

Prof. Dr. David E. Jaramillo

E-Mail Website
Guest Editor
Department of Endodontics, School of Dentistry, University of Texas Health Science Center at Houston, Houston, TX 77054, USA
Interests: endodontics; root canal system

Special Issue Information

Dear Colleagues,

Root canal treatment has always been a very challenging dental treatment. Our main goal to preserve teeth means that the science of endodontics must keep moving forward, looking for new strategies and technologies to help to tackle a range of challenging situations, from preserving the radicular formation of the tooth by promoting revascularization techniques to finding new ways to treat the very complex root canal system and root canal obturation. New strategies to treat failed root canal treatment are also of paramount importance. 

This Special Issue aims to promote research with the aim of understanding the process of revascularization techniques, root canal instrumentation, new root canal irrigation technology, and root canal obturation techniques and materials, as well as retreatment options. Case reports that allow a better understanding of challenging clinical cases are also invited.

Prof. Dr. David E. Jaramillo
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 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 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. Dentistry Journal 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 2000 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

  • revascularization
  • root canal instrumentation
  • root canal retreatment

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Published Papers (7 papers)

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Research

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12 pages, 1282 KiB  
Article
Quantitative Assessment of Apically Extruded Debris During Retreatment Procedures Using Three Nickel-Titanium Rotary Systems: An In Vitro Comparative Study
by Luigi Generali, Federica Veneri, Francesco Cavani, Vittorio Checchi, Carlo Bertoldi, Angela Lucia Ingrosso, Giusy Rita Maria La Rosa and Eugenio Pedullà
Dent. J. 2024, 12(12), 384; https://doi.org/10.3390/dj12120384 - 26 Nov 2024
Viewed by 89
Abstract
Objectives: Apical extrusion of debris can affect the success of endodontic treatments, and the specific performance of certain retreatment systems has not been studied yet. Therefore, the aim of this in vitro study was to quantitatively assess the amount of apically extruded [...] Read more.
Objectives: Apical extrusion of debris can affect the success of endodontic treatments, and the specific performance of certain retreatment systems has not been studied yet. Therefore, the aim of this in vitro study was to quantitatively assess the amount of apically extruded debris produced during retreatment procedures using three rotary NiTi retreatment systems in mature non-resorbed straight roots. Methods: Thirty extracted permanent human teeth with single straight roots were selected. The root canals were prepared with the ProTaper Next system up to size 30 and obturated with gutta-percha and AH Plus sealer using the continuous wave of condensation technique. The samples were stored for 30 days and randomized by computer sequence into three retreatment groups (n = 10): (1) ProTaper Universal Retreatment; (2) HyFlex Remover; and (3) VDW.Rotate Retreatment. Apically extruded debris was collected in Eppendorf tubes and weighed with a microbalance (10−5 g) before and after retreatment procedure. As the data were not normally distributed, the Kruskal–Wallis test was applied for comparing data among groups, with an alpha level set at α = 0.05. Dunn’s test was considered for post-hoc analyses, if appropriate. Results: Hyflex Remover was associated with the highest amount of extruded debris (0.85 ± 0.82 mg), followed by VDW.Rotate Retreatment (0.78 ± 0.41 mg) and ProTaper Universal Retreatment (0.62 ± 0.28 mg). However, the differences were not statistically significant (p > 0.05). Conclusions: All the retreatment systems tested were associated with apical extrusion of debris in vitro, with no significant quantitative differences between them, suggesting that clinicians can choose a retreatment system with features appropriate to the specific clinical situation without risk of increasing the amount of apically extruded debris. Full article
(This article belongs to the Special Issue Endodontics: From Technique to Regeneration)
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11 pages, 1853 KiB  
Article
Accuracy and Efficiency of the Surgical-Guide-Assisted Fiber Post Removal Technique for Anterior Teeth: An Ex Vivo Study
by Ryota Ito, Satoshi Watanabe, Kazuhisa Satake, Ryuma Saito and Takashi Okiji
Dent. J. 2024, 12(10), 333; https://doi.org/10.3390/dj12100333 - 18 Oct 2024
Viewed by 604
Abstract
Background/Objectives: This study compared the accuracy and efficiency of different surgical-guide (SG)-assisted and freehand drilling techniques for removing fiber posts from maxillary anterior teeth performed by differently experienced operators. Methods: A fiber post was bonded to the root canal of 54 extracted maxillary [...] Read more.
Background/Objectives: This study compared the accuracy and efficiency of different surgical-guide (SG)-assisted and freehand drilling techniques for removing fiber posts from maxillary anterior teeth performed by differently experienced operators. Methods: A fiber post was bonded to the root canal of 54 extracted maxillary anterior teeth. After mounting the teeth in the jaw models, SGs were designed by integrating cone-beam computed tomography (CBCT) and intraoral scanner data. Each SG included a custom sleeve. An experienced or inexperienced operator drilled the post using three different techniques: (i) SG-assisted incremental drilling at 2–3 mm (SG1), (ii) SG-assisted one-time drilling to a predetermined depth (SG2), and (iii) freehand incremental drilling without SG (FH; n = 9 in each group). Deviations in coronal, sagittal, and horizontal planes and the angle of deviation were measured. Results: The SG1 and SG2 groups showed significantly smaller sagittal and horizontal deviations than the FH group, regardless of the operator’s experience. The SG2 group had a significantly shorter working time than the SG1 and FH groups. In the FH group, the experienced operator required a significantly shorter working time than the inexperienced operator. Conclusions: SG-assisted drilling techniques enhanced the accuracy and efficiency of removing fiber posts from the anterior teeth, irrespective of the operator’s experience. Full article
(This article belongs to the Special Issue Endodontics: From Technique to Regeneration)
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11 pages, 1223 KiB  
Article
Prevalence and Classification of C-Shaped Canal and Radix in Mandibular Molars Using Cone-Beam Computed Tomography on Mexican Population
by Hugo Bojorquez Armenta, Angel Gustavo Romo Mireles, Javier Solis Martinez, Jesus Pescador Alvarez, Yarely Ramos Herrera, Omar Tremillo Maldonado, Oscar Almeda Ojeda, Jose Salas Pacheco, Gamaliel Ortiz Sarabia, Francisco Xavier Castellanos-Juarez and Sergio Salas Pacheco
Dent. J. 2024, 12(7), 212; https://doi.org/10.3390/dj12070212 - 10 Jul 2024
Viewed by 1175
Abstract
The diverse morphological configurations in teeth present clinical challenges in root canal treatment, complicating instrumentation and irrigation processes, which can lead to treatment failure. Understanding anatomical variations, such as C-shaped canals and radix entomolaris, enhances clinical skills and improves long-term endodontic treatment success [...] Read more.
The diverse morphological configurations in teeth present clinical challenges in root canal treatment, complicating instrumentation and irrigation processes, which can lead to treatment failure. Understanding anatomical variations, such as C-shaped canals and radix entomolaris, enhances clinical skills and improves long-term endodontic treatment success rates. Cone-beam computed tomography (CBCT) offers superior diagnostic capabilities over conventional radiography, enabling the pre-operative detection of root configurations and canal numbers, facilitating personalized endodontic treatments. A total of 2173 teeth of a Mexican population, including 1057 first mandibular molars and 1116 s mandibular molars, were studied using only CBCT to identify C-shaped canals and radix configurations of patients who were treated from 2018 to 2023 at the Department of Radiology at the Faculty of Dentistry, Juarez University of the State of Durango, Mexico. C-shaped canals were identified in 160 teeth, with a prevalence of 0.2% in first mandibular molars and 14.1% in second mandibular molars. The highest frequency was in the left second mandibular molar (3.7) at 14.8%. Gender differences were significant, with higher prevalence in females (27.3%) compared to males (13.3%). The most common C-shaped canal configuration was type C2 (39.3%). Radix entomolaris was found in 52 teeth, with a prevalence of 3.4% in first mandibular molars and 1.4% in second mandibular molars. This research on a Mexican population using cone-beam computed tomography (CBCT) highlights significant findings in the prevalence and types of C-shaped canals and radix entomolaris in mandibular molars for this population. The left second mandibular molar (3.7) showed the highest prevalence at 14.8%, followed closely by the right second mandibular molar (4.7) at 13.5%, with a significant difference (p < 0.001). We found a significant difference in the prevalence of C-shaped canals between genders (p = 0.004, OR 1.78). Additionally, radix entomolaris (p < 0.001) was more frequently identified in first mandibular molars to a significant degree. These insights underscore the importance of CBCT in diagnosing complex root anatomies, which can greatly enhance the success rates of endodontic procedures by allowing for more tailored and precise treatments for this population. Full article
(This article belongs to the Special Issue Endodontics: From Technique to Regeneration)
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15 pages, 8522 KiB  
Article
40-Year Outcome of Old-School, Non-Surgical Endodontic Treatment: Practice-Based Retrospective Evaluation
by Roland Frankenberger, Stephan Becker, Benedicta Beck-Broichsitter, Susanne Albrecht-Hass, Charlotte J. Behrens, Matthias J. Roggendorf and Andreas Koch
Dent. J. 2024, 12(4), 90; https://doi.org/10.3390/dj12040090 - 1 Apr 2024
Viewed by 1549
Abstract
(1) Background: Non-surgical endodontic treatment has been shown to be clinically successful; however, clinical long-term data are scarce. This practice-based retrospective clinical investigation evaluated endodontic outcomes over 40 years and identified relevant clinical co-factors. (2) Methods: Two experienced dental practitioners in two different [...] Read more.
(1) Background: Non-surgical endodontic treatment has been shown to be clinically successful; however, clinical long-term data are scarce. This practice-based retrospective clinical investigation evaluated endodontic outcomes over 40 years and identified relevant clinical co-factors. (2) Methods: Two experienced dental practitioners in two different private dental practices treated 174 patients with 245 teeth from 1969 to 1993. After root canal obturation, either a new direct restoration (amalgam, resin composite, or glass-ionomer cement) or the re-cementation of a pre-existing prosthetic restoration or renewal of prosthetic restoration followed. Metal posts (operator A) or metal screws (operator B) were inserted when coronal substance loss was significant. The primary outcome (i.e., tooth survival) was achieved when the endodontically treated tooth was, in situ, painless and had full function at the end of the observation period. A secondary outcome, the impact of different prognostic factors on survival rate, was evaluated. (3) Results: The overall mean survival was 56.1% of all treated teeth after 40 years of clinical service, resulting in an annual failure rate of 1.1%. Most investigated clinical co-factors (jaw, tooth position, intracanal dressings, post/screw placement, and gender) showed no significant influence on survival. (4) Conclusions: Even with materials and techniques from the 1970s and 1980s, successful root canal treatment was achievable. Except for post-endodontic restorations, most of the evaluated factors had no significant influence on the clinical long-term survival of root canal-treated teeth. Full article
(This article belongs to the Special Issue Endodontics: From Technique to Regeneration)
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11 pages, 1387 KiB  
Article
Comparative Analysis of Endodontic 0.15 Stainless-Steel K-Files: Exploring Design, Composition, and Mechanical Performance
by Abayomi Omokeji Baruwa, Filipa Chasqueira, Sofia Arantes-Oliveira, João Caramês, Duarte Marques, Jaime Portugal and Jorge N. R. Martins
Dent. J. 2024, 12(2), 29; https://doi.org/10.3390/dj12020029 - 31 Jan 2024
Cited by 2 | Viewed by 2022
Abstract
To establish a glide path, smaller files (up to size 0.15) with tapers of 2% are commonly used as pathfinding files. They pre-shape the root canal space before transitioning to larger taper endodontic instruments, aiming to prevent procedural errors. This study aimed to [...] Read more.
To establish a glide path, smaller files (up to size 0.15) with tapers of 2% are commonly used as pathfinding files. They pre-shape the root canal space before transitioning to larger taper endodontic instruments, aiming to prevent procedural errors. This study aimed to compare the design, metal wire composition, and mechanical characteristics of seven different ISO size 15 stainless-steel hand files (K-File and C-File+). Ninety-one new stainless-steel ISO 15 K-files were mechanically tested. All files were inspected for deformations before the assessment. Dental operating microscope, scanning electron microscope (SEM), and optical microscope analyses were conducted on four randomly selected instruments from each group, and two instruments per group underwent an energy-dispersive X-ray spectroscopy (EDS) analysis. Buckling mechanical tests were performed using an Instron universal testing machine, and microhardness was assessed using a Vickers hardness tester. The statistical analysis employed the nonparametric Mood’s median test, with a significance level set at 0.05. The instrument design analysis unveiled variations in the active blade area length and the number of spirals, while maintaining consistent cross-sections and symmetrical blades. Distinct tip geometries and surface irregularities were observed. While the energy-dispersive X-ray spectroscopy confirmed similar compositions, the buckling strength and microhardness values exhibited variability across for all tested files. Notably, the Dentsply ReadySteel C-File+ recorded the highest buckling value (2.10 N), and the Dentsply ReadySteel K-File exhibited the lowest (1.00 N) (p < 0.05). Moreover, the Dentsply ReadySteel K-File recorded the highest microhardness value (703 HVN), while the SybronEndo Triple-Flex had the lowest (549 HVN) (p < 0.05). While similarities in cross-section design and metal wire composition were noted among the files, variations in the number of spirals and mechanical performance were also observed. Thus, all of these factors should be considered when selecting suitable files for an efficient root canal treatment. Full article
(This article belongs to the Special Issue Endodontics: From Technique to Regeneration)
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10 pages, 1630 KiB  
Article
Effect of Dentin Conditioning with EDTA and Diode Lasers on Expression of Odontoblast-like Cell Markers of Dental Pulp Stem Cells
by Gabriela Martín, Valentín Preve, Kenneth Hargreaves, Anibal Diogenes, Carolina Inostroza, Nicole Saint-Jean and Claudia Brizuela
Dent. J. 2023, 11(9), 210; https://doi.org/10.3390/dj11090210 - 4 Sep 2023
Viewed by 2854
Abstract
Regenerative endodontic procedures rely on the delivery of mesenchymal stem cells into the root canal and on the effect of local growth factors from the dentin and blood clot. The aim of this study was to assess the effect of dentin conditioning with [...] Read more.
Regenerative endodontic procedures rely on the delivery of mesenchymal stem cells into the root canal and on the effect of local growth factors from the dentin and blood clot. The aim of this study was to assess the effect of dentin conditioning with ethylenediamine tetraacetic acid (EDTA) and diode lasers with different wavelengths (808 nm and 980 nm) on the expression of odontoblast-like cell markers. Forty dentin cylinders were divided into four groups according to the irrigation protocol: EDTA, EDTA + 808 nm diode laser, EDTA + 980 nm diode laser, and phosphate-buffered saline as the control group. Dental pulp stem cells were seeded into the previously conditioned cylinders and incubated for 14 days. The quantitative real-time polymerase chain reaction was used to evaluate the expression of dentin sialophosphoprotein (DSPP), dentin morphoprotein-1 (DMP-1), and transforming growth factor-beta 1 (TGF-β1). Data analysis was performed using the Kruskal–Wallis test. The activation of EDTA with 980 nm and 808 nm diode lasers resulted in lower DSPP and DMP-1 expression than that for EDTA alone (p < 0.05 and p < 0.01, respectively). The expression of TGF was similar among all groups. The highest level of expression of odontoblast-like differentiation markers was observed with EDTA alone. However, the use of an 808 nm diode laser during EDTA irrigation reduced the expression of odontoblastic differentiation markers. Full article
(This article belongs to the Special Issue Endodontics: From Technique to Regeneration)
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Review

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12 pages, 457 KiB  
Review
Retreatment Strategies for Cases Containing Calcium Silicate-Based Root Canal Sealers: A Comprehensive Review
by Hussain Al akam, Hyeon-Cheol Kim and Ji Wook Jeong
Dent. J. 2024, 12(2), 41; https://doi.org/10.3390/dj12020041 - 18 Feb 2024
Cited by 1 | Viewed by 2871
Abstract
This review explores the field of retreatment strategies for cases filled with calcium silicate-based root canal sealers. Since the introduction of calcium silicate-based materials in dentistry, calcium silicate-based root canal sealers have become popular among dentists because of their biocompatibility, bioactivity, and sealing [...] Read more.
This review explores the field of retreatment strategies for cases filled with calcium silicate-based root canal sealers. Since the introduction of calcium silicate-based materials in dentistry, calcium silicate-based root canal sealers have become popular among dentists because of their biocompatibility, bioactivity, and sealing ability. Therefore, effective retreatment strategies are indispensable. This article aims to identify the challenges associated with the removal of calcium silicate-based sealers themselves and removal of gutta-percha with the sealers during retreatment, evaluate current techniques and materials, and provide future directions for research in this field. Regarding the strategies of removal of root canal sealers, calcium silicate-based sealers are still relatively new materials for clinicians compared with traditional sealers such as epoxy- or eugenol-based sealers. First, no clinically established solvents have been reported. Second, calcium silicate-based sealers are currently utilized by clinicians in either the cold sealer-based technique or the warm vertical condensation technique. Third, the setting process of calcium silicate-based sealers generates byproducts, primarily calcium hydroxide and secondarily hydroxyapatite, that could interact with dentine. Lastly, there is a lack of clinical studies evaluating the efficacy of retreatment protocols for teeth filled with calcium silicate-based sealers. Therefore, it is important to investigate the chemo-mechanical properties of calcium silicate-based sealers themselves and their reactions to solvents and/or mechanical instruments and identify the interfacial properties of calcium silicate-based sealers with respect to dentine and gutta-percha. In addition, researchers in the clinical field need to actively gather and report data on retreatments of teeth filled with calcium silicate-based sealers. Full article
(This article belongs to the Special Issue Endodontics: From Technique to Regeneration)
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