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Sodium hypochlorite (NaOCl), ethylenediaminetetraacetic acid (EDTA), and calcium hydroxide (Ca(OH) 2 ) are used in root canal treatment. However, further research is needed to assess their effectiveness at time points not considered in previous guidelines. This review complements the systematic review by Rossi-Fedele and Rödig (2023) by considering time points excluded by the latter. A search was conducted in PubMed-MEDLINE, Scopus, EMBASE, Google Scholar, and repositories between March and May 2024. Four studies met the inclusion criteria, providing data from 212 teeth for irrigation and 108 for dressings. No significant differences in pain reduction within 7 days or radiographic reduction of apical lesion size were found between 2% chlorhexidine, 5.25% NaOCl, EDTA, and various NaOCl concentrations. Single and multiple visit protocols also showed no significant differences in postoperative pain. Two studies had a 'low risk' of bias and two 'some concerns'. Evidence suggests that Ca(OH) 2 dressings may not offer additional benefits., (© 2025 The Author(s). Australian Endodontic Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Endodontology Inc.)

Objective: Intracanal medicaments, primarily calcium hydroxide, play a significant role in optimizing root canal disinfection. Recently, calcium silicate-based intracanal medicaments have emerged as potential alternatives. This scoping review sought to map the available evidence concerning the clinical and laboratory properties of these bioceramic medicaments., Data: The study protocol was registered a priori (https://osf.io/rnyuv/) and a systematic search strategy using relevant MeSH terms was employed., Sources: The search was conducted across databases including the Cochrane Library, EMBASE, PubMed/MEDLINE, SciVerse Scopus, and Web of Science., Study Selection: Studies that investigated the clinical and laboratory properties of calcium silicate-based intracanal medicaments were included., Conclusions: Out of 1008 potentially relevant articles, 15 met the inclusion criteria. The majority of the studies came from Brazil, primarily focusing on Bio-C Temp (Angelus). The studies revealed acceptable biocompatibility, alkaline pH, and high calcium ion release. However, they showed reduced antibacterial activity compared to conventional calcium hydroxide formulations. Tooth discoloration beyond clinically acceptable thresholds was also a significant concern. A single clinical case report exhibited potential for periapical healing and root development, though this evidence is very limited. While current evidence is preliminary, high-quality clinical trials are essential to determine their clinical efficacy and safety in endodontic treatments., Clinical Relevance: Calcium silicate-based intracanal medicaments have lower antibacterial activity and potential for tooth discoloration compared to conventional calcium hydroxide-based medicaments. Given the available evidence, they cannot be recommended for routine clinical practice., Competing Interests: Declaration of competing interest The authors declare not having any interest that might be perceived as a conflict of interest or bias, (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Numerous systematic reviews (SRs) have produced conflicting findings on engine-driven nickel-titanium reciprocating instruments (reciprocating instruments) since Yared's seminal study 15 years ago. This umbrella review analysed SRs examining the clinical and laboratory evidence regarding reciprocating instruments for root canal treatment. SRs that evaluated qualitatively and/or quantitatively the outcomes postoperative pain, oral health-related quality of life (OHRQoL), shaping ability, debris extrusion, microbial load, endotoxins reduction, cyclic fatigue, file fracture, dentinal cracks and root canal filling removal were included. The AMSTAR 2 tool was used to evaluate SRs quality, while the ROBIS tool to assess risk of bias (RoB). Forty SRs were included. The SRs revealed predominantly 'high' RoB and 'critically low' quality. Most focused on technical outcomes, exhibiting significant methodological and statistical heterogeneity. Findings suggest comparable efficacy between reciprocating and rotary instruments. However, due to the scarcity of high-quality evidence, future well-designed studies and reviews considering core outcome measures are needed., (© 2024 The Author(s). Australian Endodontic Journal published by John Wiley & Sons Australia, Ltd on behalf of Australian Society of Endodontology Inc.)

Background: The European Society of Endodontology published in 2023, the S3-level clinical practice guidelines, which supersede the Quality Guidelines for Endodontic Treatment published in 2006., Objectives: This review aims to summarize and compare the above guidelines to support their dissemination., Method: A narrative synthesis of the main differences alongside tabulation according to the main themes., Results: Three tables were prepared according to the following themes: diagnosis of pulpal and apical condition; treatment of pulpitis; and treatment of nonvital pulp and apical periodontitis., Conclusions: A compared and simplified message regarding the most recent clinical practice guidelines has been prepared., Registration: Not applicable as a narrative review., (© 2024 The Authors. International Endodontic Journal published by John Wiley & Sons Ltd on behalf of British Endodontic Society.)

This study aimed to evaluate the antimicrobial properties, cell viability, and matrix metalloproteinase (MMP) inhibition capacity of several endodontic materials aimed at vital pulp therapy: Pro Root MTA ® , EndoSequence ® , Biodentine ® , MTA Angelus ® , TheraCal LC ® , and BioC Repair ® . The materials were prepared according to the manufacturer's instructions. Antimicrobial tests were conducted using a microcosm biofilm model, cell viability was assessed using murine fibroblasts (L929), and MMP activity was analyzed through electrophoresis. The results showed that BioC Repair ® , Biodentine ® , and EndoSequence ® exhibited similar antimicrobial properties, while MTA Angelus ® and ProRoot MTA ® had inferior results but were comparable to each other. In terms of cell viability, no significant differences were observed among the materials. EndoSequence ® demonstrated the highest MMP inhibition capacity. In conclusion, BioC Repair ® , Biodentine ® , EndoSequence ® , and TheraCal ® showed better antimicrobial properties among the tested materials. The materials did not exhibit significant differences in terms of cytotoxicity. However, EndoSequence ® displayed superior MMP inhibition capacity.

Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Introduction: Bioceramic-based root canal sealers are novel materials with a bioactivity potential that stands out compared with conventional root canal sealers. However, the term bioactivity may be overused and is often misunderstood. Hence, the objective of this study was to synthesize and map key concepts related to the bioactivity analysis of bioceramic-based root canal sealers., Methods: The present scoping review is reported in accordance with the PRISMA-ScR Statement and is registered in the Open Science Framework. Two blinded reviewers carried out a comprehensive search in six databases up to January 10th, 2022: MEDLINE, Scopus, Embase, Web of Science, Cochrane Library, and Lilacs/BBO. Eligibility was considered for in vitro and in vivo studies that evaluated the bioactivity potential of bioceramic-based root canal sealers., Results: A total of 53 studies were included in the qualitative synthesis. In vitro bioactivity was evaluated through the mineralization potential, formation of carbonated apatite on the surface, and the gene expression related to proteins involved in the mineralization process. Meanwhile, for in vivo studies, staining techniques associated with immunohistochemical tests were mainly used to detect mineralization on the material-host tissue interface., Conclusions: According to the methodology used, the most prevalent methods to assess bioactivity in acellular form were the immersion of the material in Hank's balanced salt solution, followed by surface observation with scanning electron microscopy and energy dispersive X-ray. In cell cultures, the chosen method was usually Alizarin Red staining, followed by the evaluation of alkaline phosphatase enzymatic activity and the use of molecular biology tests.

The main cause of unsuccess in endodontically treated teeth (ETT) is due to bacterial recontamination. The placement of an intraorifice barrier (IOB) has been proposed for preventing this event in cases that the restoration is in an inadequate condition, enhancing the possibilities for predictable long-term success in endodontic therapy. Objectives . To evaluate through a systematic review and meta-analysis if it would be necessary to place an IOB in ETT. Materials and Methods . The present review is in accordance with the PRISMA 2020 Statement and is registered in the Open Science Framework. Two blinded reviewers carried out a comprehensive search in four databases up to July 10 th , 2021: MEDLINE, Scopus, Embase, and Web of Science. Eligible studies were the ones which evaluated the use of an IOB in ETT in reducing microleakage with any material of choice and with any methods employed. Only in vitro studies published in English were included. Results . A total of thirty in vitro studies were included in the qualitative synthesis, and seven of those were included in the quantitative analyses evaluating the following materials: bioceramic cement, glass-ionomer cement (GIC), and resin-based composite (RBC). Most of the included studies placed an IOB at a 3 mm depth. Reduction in microleakage was observed when an IOB was placed, regardless of the material employed ( p ≤ 0.01). Among the materials, GIC and RBC performed similarly ( p > 0.05), with the bioceramic subgroup being statistically superior to the GIC subgroup ( p ≤ 0.05). Conclusions . Although well-designed randomized clinical trials are required, the placement of an intraorifice barrier can significantly reduce microleakage in endodontically treated teeth, and the use of bioceramics as IOB seems to be the best available material for this purpose., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Lucas Peixoto de Araújo et al.)