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Epigenetic modulation, including histone modification, alters gene expression and controls cell fate. Histone deacetylases (HDACs) are identified as important regulators of dental pulp cell (DPC) mineralisation processes. Currently, there is a paucity of information regarding the nature of histone modification and HDAC expression in the dentine–pulp complex during dentinogenesis. The aim of this study was to investigate post-translational histone modulation and HDAC expression during DPC mineralisation and the expression of Class I/II HDACs during tooth development and in adult teeth. HDAC expression (isoforms −1 to −6) was analysed in mineralising primary rat DPCs using qRT-PCR and Western blot with mass spectrometry being used to analyse post-translational histone modifications. Maxillary molar teeth from postnatal and adult rats were analysed using immunohistochemical (IHC) staining for HDACs (1–6). HDAC-1, -2, and -4 protein expression increased until days 7 and 11, but decreased at days 14 and 21, while other HDAC expression increased continuously for 21 days. The Class II mineralisation-associated HDAC-4 was strongly expressed in postnatal sample odontoblasts and DPCs, but weakly in adult teeth, while other Class II HDACs (-5, -6) were relatively strongly expressed in postnatal DPCs and adult odontoblasts. Among Class I HDACs, HDAC-1 showed high expression in postnatal teeth, notably in ameloblasts and odontoblasts. HDAC-2 and -3 had extremely low expression in the rat dentine–pulp complex. Significant increases in acetylation were noted during DPC mineralisation processes, while trimethylation H3K9 and H3K27 marks decreased, and the HDAC-inhibitor suberoylanilide hydroxamic acid (SAHA) enhanced H3K27me3. These results highlight a dynamic alteration in histone acetylation during mineralisation and indicate the relevance of Class II HDAC expression in tooth development and regenerative processes. [ABSTRACT FROM AUTHOR]

The article focuses on the challenges and limitations of current diagnostic methods in endodontics, highlighting the need for more accurate and reliable techniques to assess the condition of the dental pulp. Topics discussed include the classification of pulpal disease, shortcomings of sensibility tests, advancements in vitality testing methods, and future trends in pulpal diagnostic technology.

The article discusses the prevalence and evaluation of postoperative pain following root canal treatment. It highlights the increase in clinical trials focusing on postoperative pain as a primary outcome, but questions the relevance of short-term pain studies in determining the efficacy of different irrigation protocols. The article emphasizes the subjective nature of pain and the presence of confounding factors that make it challenging to attribute pain solely to irrigation. It suggests that longer-term follow-up or the control of various variables is necessary for more meaningful results. The article concludes by suggesting the consideration of objective surrogate outcomes, such as inflammatory markers, in future studies. [Extracted from the article]

Background: The ESE previously published quality guidelines for endodontic treatment in 2006; however, there have been significant changes since not only in clinical endodontics but also in consensus and guideline development processes. In the development of the inaugural S3‐level clinical practice guidelines (CPG), a comprehensive systematic and methodologically robust guideline consultation process was followed in order to produce evidence‐based recommendations for the management of patients presenting with pulpal and apical disease. Aim: To develop an S3‐level CPG for the treatment of pulpal and apical disease, focusing on diagnosis and the implementation of the treatment approaches required to manage patients presenting with pulpitis and apical periodontitis (AP) with the ultimate goal of preventing tooth loss. Methods: This S3‐level CPG was developed by the ESE, with the assistance of independent methodological guidance provided by the Association of Scientific Medical Societies in Germany and utilizing the GRADE process. A robust, rigorous and transparent process included the analysis of relevant comparative research in 14 specifically commissioned systematic reviews, prior to evaluation of the quality and strength of evidence, the formulation of specific evidence and expert‐based recommendations in a structured consensus process with leading endodontic experts and a broad base of external stakeholders. Results: The S3‐level CPG for the treatment of pulpal and apical disease describes in a series of clinical recommendations the effectiveness of diagnosing pulpitis and AP, prior to investigating the effectiveness of endodontic treatments in managing those diseases. Therapeutic strategies include the effectiveness of deep caries management in cases with, and without, spontaneous pain and pulp exposure, vital versus nonvital teeth, the effectiveness of root canal instrumentation, irrigation, dressing, root canal filling materials and adjunct intracanal procedures in the management of AP. Prior to treatment planning, the critical importance of history and case evaluation, aseptic techniques, appropriate training and re‐evaluations during and after treatment is stressed. Conclusion: The first S3‐level CPG in endodontics informs clinical practice, health systems, policymakers, other stakeholders and patients on the available and most effective treatments to manage patients with pulpitis and AP in order to preserve teeth over a patient's lifetime, according to the best comparative evidence currently available. [ABSTRACT FROM AUTHOR]

These may be related to a "structure" (such as anatomy), a "disease" (such as pulp and periapical diseases), a "material" (such as bioceramic materials) or a "procedure" (such as diagnostic and root canal treatment procedures). Consensus, controversial terms, endodontics, root canal treatment, glossary 5 Ahmed, H.M.A., Versiani, M.A., De-Deus, G. & Dummer, P.M.H. (2017) A new system for classifying root and root canal morphology. Keywords: consensus; controversial terms; endodontics; glossary; root canal treatment EN consensus controversial terms endodontics glossary root canal treatment 788 791 4 06/13/23 20230701 NES 230701 INTRODUCTION Scientific terminology is an essential tool of communication as it plays a critical role in the understanding of scientific and technical terms and their associated definitions (Sageder, [34]). [Extracted from the article]