This cross-sectional study evaluated the prevalence of apical periodontitis (AP) and the technical quality of root canal fillings in an adult Kuwaiti subpopulation using cone-beam computed tomography (CBCT) images.

Two experienced examiners analyzed 250 CBCT images obtained from Kuwaiti patients aged 15–65 years who attended government dental specialist clinics between January 2019 and September 2020. The assessment followed the radiographic scoring criteria proposed by De Moor for periapical status and the technical quality of root canal filling. Chi-square and Fisher’s exact tests were used for statistical analysis, with significance level set at p < 0.05.

Among the 2,762 examined teeth, 191 (6.91%) exhibited radiographic signs of AP, and 176 (6.37%) had undergone root canal filling. AP prevalence in root canal-treated teeth was 32.38%, with a significant difference between males and females. Most of the endodontically treated teeth exhibited adequate root canal filling (71.5%).

The study demonstrated a comparable prevalence of AP and satisfactory execution of root canal treatment compared to similar studies in different countries.

This study aimed to present the results and analyses of clinical trials, including updates on the different functions of root canal sealers.

In June 2023, we performed a comprehensive search of ClinicalTrials.gov to identify interventional clinical trials pertaining to root canal sealers. In total, 23 clinical trials conducted up to June 2023 were included in this study.

Approximately half of the trials (11 out of 23) were completed, while none were terminated or withdrawn. Each included trial had a minimum of 10 participants, with 11 trials having more than 100 participants. None of the assessed trials provided outcomes, and the majority (17 out of 23) lacked associated publications. In terms of geographic distribution, the USA and Canada did not contribute to any root canal sealer trials.

This study highlights the lack of diversity in trial locations, the absence of reported results, and a scarcity of clinical trials examining the physicochemical properties of different sealers. Most published trials primarily focused on assessing the post-operative pain effect of these sealers, but no significant difference was found regarding post-operative pain control.

This systematic review and meta-analysis aimed to assess the association of cigarette smoking with the prevalence of post-endodontic apical periodontitis in humans.

We searched through PubMed/Medline, Web of Science, and Scopus from inception to December 2020. Risk of bias was performed by using the Newcastle-Ottawa Scale for cross-sectional, cohort, and case-control studies. We performed the statistical analysis in Review Manager 5.3 (RevMan 5.3).

6 studies met the inclusion criteria for qualitative and quantitative synthesis. Statistical analysis of these studies suggests that there were no differences in the prevalence of post endodontic apical periodontitis (AP) when comparing non-smokers vs smoker subjects regarding patients (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.31–1.49; I2 = 58%) and teeth (OR, 1.71; 95% CI, 0.99–2.93; I2 = 72%).

Our findings suggest that there was no association between cigarette smoking and post-endodontic apical periodontitis, as we did not find statistical differences in the prevalence of post-endodontic AP when comparing non-smokers vs smoker subjects. Therefore, smoking should not be considered a risk factor associated with endodontic failure.

The aim of this study was to evaluate the effects of endodontic treatment on levels of substance P (SP) and calcitonin gene-related peptide (CGRP) in the saliva of patients with symptomatic apical periodontitis.

Twelve patients with mandibular molars with symptomatic apical periodontitis were enrolled in this study. An initial saliva sample was collected just before administration of anesthesia for root canal treatment, which was performed at the first visit. A second saliva sample was collected at a control visit 1 week after treatment. Salivary SP and CGRP levels were evaluated quantitatively using biochemical assays. The data were analyzed using Pearson correlation analysis, the paired samples t-test, and the Mann-Whitney U test (p = 0.05).

The postoperative salivary level of SP was significantly lower than the preoperative level (p = 0.005). However, the postoperative salivary level of CGRP was similar to the preoperative level (p = 0.932). Visual analog scale (VAS) scores of patients' subjective pain were found to be positively correlated with salivary levels of SP (r = 0.421; p = 0.040). No statistically significant correlations were observed between salivary levels of CGRP and VAS scores for patients' subjective percussion tenderness (p = 0.533) or VAS scores for patients' subjective pain (p = 0.459).

According to the results of the present study, salivary SP levels may be used as an objective indicator in the diagnosis and assessment of the degree of pain in endodontic diseases.

Thai Clinical Trials Registry Identifier: TCTR20161228001

To evaluate the outcome of in vitro studies comparing the effectiveness of QMix irrigant in removing the smear layer in the root canal system compared with other irrigants.

The research question was developed by using Population, Intervention, Comparison, Outcome and Study design framework. Literature search was performed using 3 electronic databases PubMed, Scopus, and EBSCOhost until October 2019. Two reviewers were independently involved in the selection of the articles and data extraction process. Risk of bias of the studies was independently appraised using revised Cochrane Risk of Bias tool (RoB 2.0) based on 5 domains.

Thirteen studies fulfilled the selection criteria. The overall risk of bias was moderate. QMix was found to have better smear layer removal ability than mixture of tetracycline isonomer, an acid and a detergent (MTAD), sodium hypochlorite (NaOCl), and phytic acid. The efficacy was less effective than 7% maleic acid and 10% citric acid. No conclusive results could be drawn between QMix and 17% ethylenediaminetetraacetic acid due to conflicting results. QMix was more effective when used for 3 minutes than 1 minute.

QMix has better smear layer removal ability compared to MTAD, NaOCl, Tubulicid Plus, and Phytic acid. In order to remove the smear layer more effectively with QMix, it is recommended to use it for a longer duration.

This study aimed to summarize the outcome of in vitro studies comparing the antibacterial effectiveness of QMix with other irrigants against Enterococcus faecalis.

The research question was developed by using population, intervention, comparison, outcome, and study design framework. The literature search was performed using 3 electronic databases: PubMed, Scopus, and EBSCOhost until October 2019. The additional hand search was performed from the reference list of the eligible studies. The risk of bias of the studies was independently appraised using the revised Cochrane Risk of Bias tool (RoB 2.0).

Fourteen studies were included in this systematic review. The overall risk of bias for the selected studies was moderate. QMix was found to have a higher antimicrobial activity compared to 2% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA), 2% chlorhexidine (CHX), mixture of tetracycline isonomer, an acid and a detergent (MTAD), 0.2% Cetrimide, SilverSol/H2O2, HYBENX, and grape seed extract (GSE). QMix had higher antibacterial efficacy compared to NaOCl, only when used for a longer time (10 minutes) and with higher volume (above 3 mL).

QMix has higher antibacterial activity than 17% EDTA, 2% CHX, MTAD, 0.2% Cetrimide, SilverSol/H2O2, HYBENX, GSE and NaOCl with lower concentration. To improve the effectiveness, QMix is to use for a longer time and at a higher volume.

PROSPERO International prospective register of systematic reviews Identifier: CRD42018096763

The aim of this study was to compare postoperative pain intensity after root canal treatment with One G (OG) vs. R-Pilot (RP) files used for glide path preparation.

Ninety-three single-canaled mandibular premolar teeth with asymptomatic non-vital pulp were randomly assigned into 3 groups (n = 31): OG, RP, or without glide path (WGP). After creating the glide path, the root canals were prepared using sequential Mtwo rotary files to size 30/0.05. One endodontic specialist carried out single-visit endodontic treatment. The patients were asked to rate the severity of postoperative pain on a visual analogue scale at 24, 48, and 72 hours after the visit. They were also asked to record their intake of prescribed analgesics taken. The data were analyzed using the χ², Friedman, Kruskal-Wallis, and Mann-Whitney U tests.

In all 3 groups, postoperative pain decreased significantly at each time interval (p < 0.05). At 24 hours, the OG group had less postoperative pain than the WGP group (p < 0.05). However, no significant difference was found between the RP group and the others. No statistically significant difference was found among the WGP, OG, and RP groups in postoperative pain intensity at 48 or 72 hours or in analgesic tablet intake at the 3 assessed time intervals.

The OG group had less postoperative pain than the WGP group in the first 24 hours. The OG and RP systems were similar regarding postoperative pain intensity and analgesic intake.

The purpose of this research was to identify the top 10 most-cited articles on the management of fractured or broken instruments and to perform a bibliometric analysis thereof.

Published articles related to fractured instruments were screened from online databases, such as Web of Science, Scopus, PubMed, and ScienceDirect, and highly cited papers, with at least 50 citations since publication, were identified. The most-cited articles were selected and analysed with regard to publication title, authorship, the journal of publication, year, institution, country of origin, article type, and number of citations.

The top 10 most-cited articles were from various journals. Most were published in the Journal of Endodontics, followed by the International Endodontic Journal, and Dental Traumatology. The leading countries were Australia, Israel, Switzerland, the USA, and Germany, and the leading institution was the University of Melbourne. The majority of articles among the top 10 articles were clinical research studies (n = 8), followed by a basic research article and a non-systematic review article.

This bibliometric analysis revealed interesting information about scientific progress in endodontics regarding fractured instruments. Overall, clinical research studies and basic research articles published in high-impact endodontic journals had the highest citation rates.