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Endodontics is the branch of dentistry concerned with the morphology, physiology, and pathology of the human dental pulp and periradicular tissues. Human dental pulp is a highly dynamic tissue equipped with a network of resident immunocompetent cells that play major roles in the defense against pathogens and during tissue injury. However, the efficiency of these mechanisms during dental pulp inflammation (pulpitis) varies due to anatomical and physiological restrictions. Uncontrolled, excessive, or unresolved inflammation can lead to pulp tissue necrosis and subsequent bone infections called apical periodontitis. In most cases, pulpitis treatment consists of total pulp removal. Although this strategy has a good success rate, this treatment has some drawbacks (lack of defense mechanisms, loss of healing capacities, incomplete formation of the root in young patients). In a sizeable number of clinical situations, the decision to perform pulp extirpation and endodontic treatment is justifiable by the lack of therapeutic tools that could otherwise limit the immune/inflammatory process. In the past few decades, many studies have demonstrated that the resolution of acute inflammation is necessary to avoid the development of chronic inflammation and to promote repair or regeneration. This active process is orchestrated by Specialized Pro-resolving lipid Mediators (SPMs), including lipoxins, resolvins, protectins and maresins. Interestingly, SPMs do not have direct anti-inflammatory effects by inhibiting or directly blocking this process but can actively reduce neutrophil infiltration into inflamed tissues, enhance efferocytosis and bacterial phagocytosis by monocytes and macrophages and simultaneously inhibit inflammatory cytokine production. Experimental clinical application of SPMs has shown promising result in a wide range of inflammatory diseases, such as renal fibrosis, cerebral ischemia, marginal periodontitis, and cancer; the potential of SPMs in endodontic therapy has recently been explored. In this review, our objective was to analyze the involvement and potential use of SPMs in endodontic therapies with an emphasis on SPM delivery systems to effectively administer SPMs into the dental pulp space.

Featured Application: 3D-printed metal surgical guides offer several advantages (open-frame, stability) over traditional resin guides. This proof-of-concept study demonstrates the feasibility and the potential use of such guides during endodontic microsurgery procedures. Thanks to recent advances, printed surgical guides are now fully integrated into digital workflows and are beneficial in terms of accuracy in endodontic microsurgery (EMS). The aim of this study was to evaluate the accuracy of new 3D-printed surgical metal guides (SMGs) with open-frame structures in an endodontic surgical simulation model ex vivo based on a pig jaw. Twenty-nine roots were included. SMGs were produced using 3D implant planning software and printed using cobalt-chrome and a laser sintering printer. The SMGs were designed to allow for surgical access at 3 mm from the apex of each root. Virtual planning and postoperative CBCT scans were compared by analysing the apical and angular deviations. To test for deviations equal to zero, a one-sample test was used. The differences between the virtually planned implant and the actual position of the drill path were statistically significant for five SMGs on the eight produced guides, whereas there were no differences for the three others. The mean apical deviation was 3.2 mm ± 1.7 using SMGs, and the angular deviation was measured at 3.10 degrees ± 2.37. Although deviations were observed, the results demonstrate the feasibility and the potential for such guides during EMS procedures. [ABSTRACT FROM AUTHOR]

Introduction: The concept of escape games dedicated to dental students is a new learning experience that has not yet been extensively explored. The aim of this pilot study was to assess the impact and perceived value of an endodontic‐themed escape game as assessed by fourth‐year dental students. Methods: This study was conducted at the University of Nantes, Faculty of Dental Surgery using a cross‐sectional pre‐ and post‐test research design to assess students' changes in performance. Students in the fourth year of dental surgery study (n = 18) were divided in four groups for this study. The answers to the pre‐test/post‐test were 50 true/false questions. Moreover, a 20‐question perception survey was given to all the participants after completion of the escape game. The study data were collected in May 2019. An unpaired t test analysed the mean differences between the groups. Results: The results showed a statistically significant increase in post‐test results (75.33% ± 10.17% of correct answers) compared to the pre‐test results (67.33% ± 5.94% of correct answers) P <.05. Analysis of variance revealed that this change in score was not significantly different between the four groups. The students perceived the endodontic‐themed escape game to be relevant. A one‐sample t test indicated that students' mean (SD) perception 4.4 (0.7) was statistically significantly higher than the mean value of the evaluation scale P <.001. The students found this educational game to be a useful experience that helped them recall/apply knowledge whilst promoting teamwork. Conclusion: Therefore, this type of game can enhance students' learning and motivation. [ABSTRACT FROM AUTHOR]