Comparison of the Effect of Root Canal Preparation by Using Wave One and ProTaper on Postoperative Pain: A Randomized Clinical Trial

Introduction: WaveOne is a single-file reciprocating instrumentation system with the benefits of M-Wire alloy that has increased flexibility and improved resistance to cyclic fatigue over the conventional alloy. Root canal preparation techniques may cause postoperative pain. The goal of the present study was to compare the intensity and duration of postoperative pain when using WaveOne or ProTaper Universal systems for instrumentation of root canals. Methods: Forty-two patients who fulfilled specific inclusion criteria were assigned to 2 groups according to the root canal instrumentation technique used, WaveOne or ProTaper Universal. Root canal treatment was carried out in 2 appointments, and the severity of postoperative pain was assessed by numerical rating scale (NRS) score after each session until complete pain relief was achieved. Analgesic consumption, duration of pain, and root canal preparation time were also recorded. Results: The mean NRS score and duration of pain after both appointments were significantly higher in the WaveOne group (P < .05); however, the mean analgesic consumption was only significantly higher in the WaveOne group after the first appointment (P < .05). In all groups the highest mean NRS score was seen 6 hours after each therapeutic appointment. Canal preparation time was significantly shorter in the WaveOne group (P < .001). Conclusions: Postoperative pain was significantly lower in patients undergoing canal instrumentation with ProTaper Universal rotary instruments compared with the WaveOne reciprocating single-file technique

Successful root canal treatment of an atypical mandibular canine with a boomerangshaped root and canal system with a large periapical lesion—A case report with 9-year follow-up

Aim This report describes an atypical mandibular canine with a single boomerang-shaped root and root canal system with a large periapical lesion managed by root canal treatment. Methods The chief complaint of a 16-year-old male was acute pain and an abnormal sensation in the right mandibular canine (#27). The clinical examination revealed that tooth #27 had an unusual coronal morphology. The buccal aspect of the tooth resembled that of a normal canine but was significantly broader than expected. On the lingual aspect of the crown, however, there was an unusual cusp-like structure with ridges that was slightly less prominent than the buccal incisal tip. The intraoral periapical radiographs revealed a complex root with an obvious cow horn-shaped canal mesially and distally, but with the suggestion of a root structure joining the mesial and distal extensions. A large periapical lesion was present, Computed tomography revealed the presence of a single root and canal system shaped like a boomerang. Root canal treatment was performed, and the patient was followed-up for 9 years. Results Following root canal treatment, the patient had no symptoms, no mobility, no periodontal pockets, or root resorption. At 9 years, the cone beam computed tomography images confirmed that satisfactory healing of the periapical tissues had occurred. Conclusion The mandibular right canine had a unique boomerang-shaped root and canal system. Effective shaping and cleaning of the complex canal shape plus thermoplastic root filling aided the successful healing of the periapical lesion

PRILE 2021 guidelines for reporting laboratory studies in Endodontology: explanation and elaboration

Guidance to authors is needed to prevent their waste of talent, time and resources in writing manuscripts that will never be published in the highest-quality journals. Laboratory studies are probably the most common type of endodontic research projects because they make up the majority of manuscripts submitted for publication. Unfortunately, most of these manuscripts fail the peer-review process, primarily due to critical flaws in the reporting of the methods and results. Here, in order to guide authors, the Preferred Reporting Items for study Designs in Endodontology (PRIDE) team developed new reporting guidelines for laboratory-based studies: the Preferred Reporting Items for Laboratory studies in Endodontology (PRILE) 2021 guidelines. The PRILE 2021 guidelines were developed exclusively for the area of Endodontology by integrating and adapting the modified CONSORT checklist of items for reporting in vitro studies of dental materials and the Clinical and Laboratory Images in Publications (CLIP) principles. The process of developing the PRILE 2021 guidelines followed the recommendations of the Guidance for Developers of Health Research Reporting Guidelines. The aim of the current document is to provide authors with an explanation for each of the items in the PRILE 2021 checklist and flowchart with examples from the literature, and to provide advice from peer-reviewers and editors about how to solve each problem in manuscripts prior to their peer-review. The Preferred Reporting Items for study Designs in Endodontology (PRIDE) website (http://pride-endodonticguidelines.org/prile/) provides a link to the PRILE 2021 explanation and elaboration document as well as to the checklist and flowchart

Endodontic Advances and Evidence-Based Clinical Guidelines

Endodontic Advances and Evidence-Based Clinical Guidelines provides a comprehensive and up-to-date description of recent research findings and their impact on clinical practice. Using an innovative approach to the field, the book enables readers to translate the current body of knowledge on endodontic diseases and treatment into guidelines for enhancing patient care. Divided into four parts, the book first addresses new research findings and advances in technology, techniques, materials, and clinical management. In addition, it provides revised clinical guidelines for a variety of areas within the specialty, such as endodontic diagnosis, treatment planning, management of endodontic emergencies, regenerative endodontic procedures, three-dimensional imaging, and the use of systemic antibiotics. Each chapter contains numerous high-quality illustrations and clinical cases highlighting current research directions, key concepts, and new trends in clinical techniques and education. Endodontic Advances and Evidence-Based Clinical Guidelines: Presents the latest understanding of current literature, evidence, and clinical practice Examines new trends, treatments, and advanced diagnostic techniques in the field Covers a wide range of topics, including management of root canals, repair of perforation defects, removal of root filling materials, and alternatives to root canal treatment Endodontic Advances and Evidence-Based Clinical Guidelines is an invaluable resource for undergraduate and postgraduate dental students, general dental practitioners, endodontic specialists, researchers in the field of endodontics, and clinicians, researchers, and educators in other fields of dentistr

Reporting guidelines enhance the quality and impact of research in Dental Traumatology.

Reporting guidelines assist basic scientists, translational healthcare researchers and clinicians to publish manuscripts of the highest standard by improving the accuracy, transparency and completeness of the publications they submit to journals. This paper provides an overview of reporting guidelines relevant for the specialty of dental traumatology and discusses their application, significance and potential impact. The Preferred Reporting Items for study Designs in Endodontology (PRIDE) suite of reporting guidelines includes a range of study designs that can be used within the broad field of Endodontics but they are also applicable to dental traumatology and other dental disciplines (Preferred Reporting Items for Case reports in Endodontics [PRICE] 2020, Preferred Reporting Items for RAndomized Trials in Endodontics [PRIRATE] 2020; Preferred Reporting Items for Animal Studies in Endodontology [PRIASE] 2021; Preferred Reporting Items for Laboratory studies in Endodontology [PRILE] 2021 and Preferred Reporting items for OBservational studies in Endodontics [PROBE] 2023). The PRIDE guidelines were developed by an extensive network of globally renowned academics, researchers and expert clinicians working within dentistry using an accepted and validated consensus methodology. The aim of the PRIDE guidelines is to improve the overall quality of manuscripts describing case reports, randomized trials, animal research, laboratory studies and observational studies. Although attention to reporting guidelines adds a degree of complexity when writing reports, such guidelines provide a template for authors to develop standardized manuscripts of the highest quality, which will allow colleagues, readers and the wider public to have confidence that their findings are valid and robust. They also provide evidence to editors that manuscripts submitted to journals comply with the highest global standards of reporting within their respective discipline. Endorsement of the PRIDE guidelines by editors will lead to improvements in the reporting quality of manuscripts submitted to their journals

Tooth, root, and canal anatomy

Knowledge of root and canal morphology is a prerequisite for successful endodontic treatment. The external and internal morphological features of roots are variable and complex. Current advancements in non-destructive digital image systems, such as cone-beam computed tomography (CBCT) and micro-computed tomography (micro-CT), allow detailed qualitative and quantitative analyses of root and canal morphology. This growing body of knowledge has paved the way for revising several historical concepts and introducing new perspectives for more accurate descriptions of root and canal morphology in teaching, research, and clinical practice. This chapter aims to provide an update on the application of a new system for classifying root and canal morphology, accessory canals, and anomalies, to discuss anatomy of the root apex and apical foramen, and to present the growing body of knowledge on root and canal morphology in all tooth types

Outcome measures to assess the effectiveness of endodontic treatment for pulpitis and apical periodontitis for use in the development of European Society of Endodontology S3‐level clinical practice guidelines: A consensus‐based development

AIMS The European Society of Endodontology (ESE) is in the process of developing S3-level clinical practice guidelines for the treatment of pulpal and apical disease. In order to support robust systematic literature reviews, appropriate outcome measures (OMs) with minimum follow-up times must first be identified. Hence, the current project aimed to identify the appropriate OMs with minimum/maximum follow-up time to assess the effectiveness of endodontic treatment for pulpitis and apical periodontitis for use in the development of ESE S3-level guidelines through a standard consensus-based methodology. METHODOLOGY After a literature search, lists of relevant OMs were identified by the guideline development group (GDG) for the treatment of pulpitis (working group [WG] 1), the non-surgical treatment of apical periodontitis (WG 2), the surgical treatment of apical periodontitis (WG 3) and the regenerative treatment of apical periodontitis (WG 4). OMs relevant to each WG were ranked by the 43 members of the GDG in their importance to the patient using a 9-point Likert scale. Items with a score of 7–9 (critical importance) by more than 70% and items with a score of 1–3 (limited importance) by less than 30% of members were included, whereas the items with a score of 1–3 by more than 70% and items with a score of 7–9 by less than 30% were excluded. Several online Delphi meetings established an edited list of only important OMs. The ranked OMs were discussed by the GDG and harmonized to produce ‘most critical’, ‘critical’ and ‘important’ measures. After establishing the final ranked measures, the minimum and maximum length of follow-up related to each OM was defined by the guideline steering group. RESULTS The Delphi survey took place over two rounds. The patient-reported outcome measure (PROM) ‘tooth survival’ was rated the ‘most critical measure’ in all four WGs, while other PROMs including ‘pain’ and ‘need for medication’ were considered ‘critical’, alongside the clinician-reported outcome measures (CROM), ‘radiographic assessment’. The PROMs ‘The need for further intervention’ and ‘oral-health-related-quality-of-life’ (OHRQoL) were included, but as ‘important’ not ‘critical’ measures. Differences occurred between WGs with ‘vitality testing’ defined as critical in WG1 and ‘increased length and width of the root’ defined as ‘critical’ in WG4. A minimum of 1-year and maximum of ‘as long as possible’ for all OMs were deemed necessary, except ‘pain’, ‘swelling’, ‘medication’ and ‘OHRQoL’, where shorter follow-up was accepted. CONCLUSIONS The GDG consensus process established the PROM "tooth survival" as the "most-critical". The identified OMs and length of follow-up will be applied to all the commissioned systematic reviews that will inform the subsequent process when developing the ESE S3-level clinical practice guidelines

The development of a dental light curable PRFe-loaded hydrogel as a potential scaffold for pulp-dentine complex regeneration: An in vitro study

Aim The study aimed to develop a bicomponent bioactive hydrogel formed in situ and enriched with an extract of platelet-rich fibrin (PRFe) and to assess its potential for use in pulp-dentine complex tissue engineering via cell homing. Methodology A bicomponent hydrogel based on photo-activated naturally derived polymers, methacrylated chitosan (ChitMA) and methacrylated collagen (ColMA), plus PRFe was fabricated. The optimized formulation of PRFe-loaded bicomponent hydrogel was determined by analysing the mechanical strength, swelling ratio and cell viability simultaneously. The physical, mechanical, rheological and morphological properties of the optimal hydrogel with and without PRFe were determined. Additionally, MTT, phalloidin/DAPI and live/dead assays were carried out to compare the viability, cytoskeletal morphology and migration ability of stem cells from the apical papilla (SCAP) within the developed hydrogels with and without PRFe, respectively. To further investigate the effect of PRFe on the differentiation of encapsulated SCAP, alizarin red S staining, RT-PCR analysis and immunohistochemical detection were performed. Statistical significance was established at p <  .05. Results The optimized formulation of PRFe-loaded bicomponent hydrogel can be rapidly photocrosslinked using available dental light curing units. Compared to bicomponent hydrogels without PRFe, the PRFe-loaded hydrogel exhibited greater viscoelasticity and higher cytocompatibility to SCAP. Moreover, it promoted cell proliferation and migration in vitro. It also supported the odontogenic differentiation of SCAP as evidenced by its promotion of biomineralization and upregulating the gene expression for ALP, COL I, DSPP and DMP1 as well as facilitated angiogenesis by enhancing VEGFA gene expression. Conclusions The new PRFe-loaded ChitMA/ColMA hydrogel developed within this study fulfils the criteria of injectability, cytocompatibility, chemoattractivity and bioactivity to promote odontogenic differentiation, which are fundamental requirements for scaffolds used in pulp-dentine complex regeneration via cell-homing approaches

Technology enhanced education

Dental education has evolved through the years, and various advanced technologies are being incorporated into the curriculum to improve the quality of teaching and learning. The use of electronic devices and software programs continues to be at the forefront of e-learning modules, including in the field of Endodontology. This chapter aims to discuss current advances in dental education and applications of e-learning in Dentistry. Advances and applications of e-learning tools and virtual reality combined with more recent improvements in knowledge and clinical practice in the field of Endodontology will also be discussed