PRIDASE 2024 guidelines for reporting diagnostic accuracy studies in endodontics: Explanation and elaboration.

The Preferred Reporting Items for Diagnostic Accuracy Studies in Endodontics (PRIDASE) 2024 guidelines are based on the Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015 guidelines and the Clinical and Laboratory Images in Publications (CLIP) principles, with the addition of items specifically related to endodontics. The use of the PRIDASE 2024 guidelines by authors and their application by journals during the peer review process will reduce the possibility of bias and enhance the quality of future diagnostic accuracy studies. The PRIDASE 2024 guidelines consist of a checklist containing 11 domains and 66 individual items. The purpose of the current document is to provide an explanation for each item on the PRIDASE 2024 checklist, along with examples from the literature to help readers understand their importance and offer advice to those developing manuscripts. A link to the PRIDASE 2024 explanation and elaboration document is available on the Preferred Reporting Items for study Designs in Endodontology (PRIDE) website (https://pride-endodonticguidelines.org/pridase/) and on the International Endodontic Journal website (https://onlinelibrary.wiley.com/page/journal/13652591/homepage/pride-guidelines.htm).

Teaching of magnification in the undergraduate curriculum: A position statement from the British Endodontic Society Teachers of Endodontology Group.

This position statement on undergraduate teaching on the use of magnification in endodontics represents the consensus of the British Endodontic Society Teachers of Endodontology Group. Current clinical and scientific evidence, as well as the expertise of the committee, has been used to develop this statement. The contributors to this position statement consider, as a minimum requirement, the use of dental loupes in non-surgical endodontics at undergraduate level. It is recommended that the use of dental loupes should be integrated into endodontic clinical skills training and the performance of endodontic treatment in the undergraduate curriculum.

Next generation antibacterial strategies for regenerative endodontic procedures: A scoping review.

BACKGROUND: The clinical results following regenerative endodontic procedures (REPs) vary according to numerous parameters, including the presence of bacteria. This limitation reduces the indications for REPs and calls for the development of next generation antibacterial strategies (NGAS) providing alternatives to current antibacterial strategies (CAS) such as double or triple antibiotic paste (DAP/TAP) and (Ca(OH)2). OBJECTIVES: The present scoping review aims to describe the current trends regarding the use of such strategies and highlight future perspectives. METHODS: Four databases (PUBMed, Cochrane, ClinicalTrials and Science Direct) were searched until 1st May 2023. RESULTS: A total of 918 records were identified, 133 were screened and assessed for eligibility, and 87 articles were included. The findings show that (1) clinical studies are only available for CAS, (2) although next generation strategies are the most studied approach since 2017, they are all at the pre-clinical stage, (3) most of the next generation strategies use galenic forms which offer cell support and colonization and which simultaneously contain antibacterial molecules as alternatives to CAS and to antibiotics in general, (4) standardization is required for future research, specifically regarding the bacterial strains studied, the use of biofilm studies and the cellular behaviour assessments. CONCLUSION: Although NGAS are promising strategies to improve REPs in the context of infection, the current evidence is mostly limited to pre-clinical studies. Further methodological improvement is required to allow relevant comparisons between studies and to reduce the time from bench to bedside.

Dental and endodontic-related stress amongst undergraduate students before and during the COVID-19 pandemic: A mixed-methods study.

AIM: To determine and explain the principal sources of stress among preclinical and clinical dental undergraduate students with a particular focus on the stressors linked to endodontics. METHODOLOGY: A mixed-methods study, with an explanatory sequential design, was employed. Volunteer students of second, third and fourth years were asked to complete both the Dental Environment Stress (DES) questionnaire and a bespoke questionnaire for endodontic-related stress assessment, which had 21 questions in common with the DES. The results were analysed by Kruskal-Wallis and Marginal Homogeneity tests. In the second part of the study, a qualitative phase was conducted through focus group interviews of students from each academic year included in the study. Interviews were analysed by inductive content analysis. RESULTS: The DES questionnaire determined that for all years the most stressful domains were 'performance pressure', 'workload' and 'clinical training'. According to the endodontic stress questionnaire, the most stressful domains were 'self-efficacy beliefs', 'endodontic clinical training' and 'faculty and administration' in early years, while they were 'endodontic patient treatment', 'performance pressure in endodontics' and 'clinical training' in later years. Comparing questions common to both questionnaires revealed that the stress score was lower for the endodontic stress questionnaire than in the DES questionnaire for 17 questions, being significantly lower for 13 questions (p < 0.05) and significantly higher for no question. The qualitative study showed that students' dental and endodontic-related stress was linked to different domains: patient, clinical procedure, organization, staff, academic education, evaluation and COVID-19-related issues. Qualitative aspects highlighted the important role that patients and COVID-19 have played in student stress. However, they suggested a possible explanation for the lower endodontic stress observed in this dental university hospital, which was based on: the nature of the teaching in endodontics, the consensus between endodontic supervisors, the use of a logical, progressive procedure and the considerable experience that students gain over the years. CONCLUSION: Students considered endodontics stressful; however, education can play a central role in reducing stress, particularly during the early parts of the undergraduate course.

A critical look at outcome measures: Comparison between four dental research journals by use of a hierarchical model.

AIM: To assess the status quo of outcome measures used in treatment studies in Endodontics, and potentially identify strategies for improvement, by (i) systematically assessing the outcome measures using a conceptual model and (ii) comparing these with measures used in corresponding studies in the adjacent fields. METHODOLOGY: The International Endodontic Journal, Caries Research, The Journal of Clinical Periodontology and The Journal of Oral & Facial Pain and Headache were selected to cover four adjacent dental disciplines. In each journal, the 50 most recent consecutive publications fulfilling inclusion criteria were included. A hierarchical model for diagnostic imaging studies was modified to assess studies related to treatment. The model comprised six levels, with technical as the lowest level and societal as the highest. Extracted data included study origin, study type, and identified outcome measures. Fisher's Exact Tests with Bonferroni corrections compared studies. p < .05 was considered statistically significant. RESULTS: Amongst 756 publications, the 200 most recent studies matching the inclusion criteria were identified. Less than half (36.5%) assessed the clinical, patient, or societal aspects of treatment; 10.0% in International Endodontic Journal, 28.0% in Caries Research, 38.0% in Journal of Clinical Periodontology, and 70.0% in Journal of Oral & Facial Pain and Headache (p < .001). CONCLUSIONS: According to included publications, research on treatment within the endodontic field is mainly focusing on technical and biological outcomes. The benefits of patients and society were less frequently examined than in corresponding journals in adjacent disciplines. When designing studies, including higher-level outcomes should be considered.

Global cone-beam computed tomography adoption, usage and scan interpretation preferences of dentists and endodontists.

AIM: This study investigated the adoption of cone-beam computed tomography (CBCT) by dentists and endodontists around the world, including their preferences in endodontic CBCT usage. METHODOLOGY: An online questionnaire surveyed dental association members in Australia and New Zealand, and endodontic association members in Australia, Britain, Canada, Italy, New Zealand and the USA, about their CBCT training history, considerations in acquisition/interpretation, access to and usage of CBCT, preferred scan interpreter, and preferred endodontic scan settings. Data were analysed with Chi-squared, independent sample t-tests, Cochran's Q and McNemar's tests. RESULTS: Responses from 578 endodontic specialists or postgraduates (Group E) and 185 non-endodontic dentists (Group NE) were included. Continuing professional education (CPE) was the most common source of CBCT training (69.2%). Factors considered in CBCT acquisition/interpretation included beam hardening (75.4%), radiation exposure (61.1%) and patient movement (58.3%). Group E reported higher CBCT usage (90.8%) than Group NE (45.4%, p < .001) and greater workplace access to CBCT (81.1% vs. 25.9%, p < .001). Scans were interpreted by the respondent in most workplace scans (83.3%) and externally taken scans (60.5%); Group E were significantly more likely to interpret themselves than Group NE. Small field of view (83.6%) and high resolution (86.6%) were most preferred as settings for endodontic CBCTs; Group NE were less likely to choose these settings. There were some geographic variations within Group E. CONCLUSIONS: CBCT training was most commonly acquired via CPE. Endodontic respondents reported very high CBCT usage and access in the workplace. There are educational implications regarding CBCT limitations, appropriate applications and interpretation.

Treatment outcomes of regenerative endodontic therapy in immature permanent teeth with pulpal necrosis: A systematic review and network meta-analysis.

AIM: The aim of this study was to assess which treatment modality regarding scaffold selection for immature permanent teeth with pulpal necrosis will be the most successful for regenerative endodontic treatment (RET). METHODOLOGY: PubMed, Cochrane, Web of Science and Embase, and additional records until August 2022 were searched providing a total of 3021 articles, and nine of these articles were included for quantitative synthesis. The reviewers selected eligible randomized controlled trials and extracted pertinent data. Network meta-analysis was conducted to estimate treatment effects for primary outcomes (clinical and radiographic healing) and secondary outcomes (apical closure, root length and root wall thickness increase) following RET [mean difference (MD); 95% credible interval (CrI) and surface under the cumulative ranking curve (SUCRA)]. The quality of the included studies was appraised by the revised Cochrane risk of bias tool, and the quality of evidence was assessed using the GRADE approach. RESULTS: Six interventions from nine included studies were identified: blood clot scaffold (BC), blood clot scaffold with basic fibroblast growth factor, blood clot scaffold with collagen, platelet pellet, platelet-rich plasma (PRP) and platelet-rich fibrin (PRF). The PRP scaffold showed the greatest increase in root lengthening at 6-12 months (MD = 4.2; 95% CrI, 1.2 to 6.8; SUCRA = 89.0%, very low confidence). PRP or PRF achieved the highest level of success for primary and secondary outcomes at 1-6 and 6-12 months. Blood clot scaffold (with collagen or combined with basic fibroblast growth factor (bFGF)) achieved the highest level of success for secondary outcomes beyond 12 months follow-up. A very low to low quality of evidence suggests that both PRP and PRF exhibit the greatest success evaluating primary and secondary outcomes within 12 months postoperatively compared to the traditional blood clot scaffold protocol. CONCLUSION: Limited evidence suggests both PRP and PRF exhibit success in the short-term, not long-term. The value of this information stems in its recommendation for future randomized trials prioritizing both of these materials in their protocol.

Comprehensive review of composition, properties, clinical applications, and future perspectives of calcium-enriched mixture (CEM) cement: a systematic analysis.

This review aims to comprehensively explore calcium-enriched mixture (CEM) cement as a crucial biomaterial in dentistry/endodontics. With its growing clinical relevance, there is a need to evaluate its composition, chemical/physical/biological properties, clinical applications, and future perspectives to provide clinicians/researchers with a detailed understanding of its potential in endodontic procedures. Through systematic analysis of available evidence, we assess the advantages/limitations of CEM cement, offering valuable insights for informed decision-making in dental/endodontic practice. Our findings highlight the commendable chemical/physical properties of CEM cement, including handling characteristics, alkalinity, color stability, bioactivity, biocompatibility, sealing ability, and antimicrobial properties. Importantly, CEM cement has shown the potential in promoting regenerative processes, such as dentinogenesis and cementogenesis. It has demonstrated successful outcomes in various clinical applications, including vital pulp therapy techniques, endodontic surgery, open apices management, root resorption/perforation repair, and as an orifice/root canal obturation material. The efficacy and reliability of CEM cement in diverse clinical scenarios underscore its effectiveness in endodontic practice. However, we emphasize the need for well-designed clinical trials with long-term follow-up to further substantiate the full potential of CEM cement. This review serves as a robust reference for researchers/practitioners, offering an in-depth exploration of CEM cement and its multifaceted roles in contemporary dentistry/endodontics.

Deciphering Pediatric Root Canal Practices in Turkey: A Comparative Study Bridging the Gap between Practice and Literature.

BACKGROUND Pediatric endodontics is a critical area of dental practice, involving the treatment of root canals in primary teeth. Treatment approaches can significantly vary due to a range of factors, potentially impacting the success of the procedure and patient comfort. This variability, often influenced by regional practices, individual dentist preferences, and the pace of dental technology advancements, warrants detailed examination to improve standardization and care outcomes. Accordingly, our study aims to scrutinize the endodontic practices of pedodontists in Turkey and compare them with contemporary literature. MATERIAL AND METHODS We conducted an online survey with 15 questions that 217 Turkish pedodontists answered. The questionnaire sought information about their preferences in canal length measurement, canal sealer, irrigation solution, and other procedural decisions. Chi-square test was used to analyze the responses, with a significance level of p<0.05. RESULTS The majority of respondents were associated with universities (123 out of 217). 103 preferred rotary file sets, and 114 used apex locators for canal length measurement. Iodoform pastes (160) and sodium hypochlorite (180) were the most popular choices for canal sealers and irrigation solution, respectively. 152 participants did not prefer using rubber dam, and 186 did not favor sonic-ultrasonic activators. Many reported using hand files as students (184), with 39 continuing this practice. Post-graduation, 64 participants took root canal treatment courses, while 72 were reluctant to perform the procedure under general anesthesia. CONCLUSIONS No single method stood out as superior for primary root canal treatments in deciduous teeth. Incorporating advanced technology into dental practice may potentially improve treatment success and patient comfort.

Undergraduate Endodontic Training and Its Relation to Contemporary Practice: Multicenter Cross-Sectional Study in Saudi Arabia.

Materials and Methods: An online questionnaire was developed and emailed to all dental schools in Saudi Arabia. This questionnaire was answered by the endodontic undergraduate program director. The data collected were analysed using descriptive statistics. Results: The response rate was 96.15%, which means twenty-five out of twenty-six dental schools participated in the study. The majority of the academic supervisors was endodontists (92%). The use of magnification and ultrasonic tips was not required by 84% and 76% of the dental schools, respectively. The main endodontic treatment techniques were the step-back technique and gates glidden for cleaning and shaping (76%) and cold lateral compaction for obturation (92%). Conclusions: The dental students were supervised by endodontic specialists and trained to use traditional endodontic methods. Encouraging dental educators to train students to use modern technology and equipment would probably improve their graduate clinical skills and performance.

Artificial intelligence in endodontics: Data preparation, clinical applications, ethical considerations, limitations, and future directions.

Artificial intelligence (AI) is emerging as a transformative technology in healthcare, including endodontics. A gap in knowledge exists in understanding AI's applications and limitations among endodontic experts. This comprehensive review aims to (A) elaborate on technical and ethical aspects of using data to implement AI models in endodontics; (B) elaborate on evaluation metrics; (C) review the current applications of AI in endodontics; and (D) review the limitations and barriers to real-world implementation of AI in the field of endodontics and its future potentials/directions. The article shows that AI techniques have been applied in endodontics for critical tasks such as detection of radiolucent lesions, analysis of root canal morphology, prediction of treatment outcome and post-operative pain and more. Deep learning models like convolutional neural networks demonstrate high accuracy in these applications. However, challenges remain regarding model interpretability, generalizability, and adoption into clinical practice. When thoughtfully implemented, AI has great potential to aid with diagnostics, treatment planning, clinical interventions, and education in the field of endodontics. However, concerted efforts are still needed to address limitations and to facilitate integration into clinical workflows.

EUROPEAN SOCIETY OF ENDODONTOLOGY Undergraduate Curriculum Guidelines for Endodontology.

Undergraduate education should accomplish graduates who are skilled to provide quality care for patients, who are aware of their scope of practice, competency level and limits and who are open to referring patients whose needs are beyond their own skills and experience. They should also become self-efficacious. Quality performance begins with good diagnosis and decision-making. Graduates should understand when to treat, why to treat, what to treat and how to treat. These guidelines include a list of capabilities that the graduating student will be expected to have achieved to provide a minimum level of competency in endodontics. Theoretical knowledge, practical skills, understanding and insight should be assessed, with both formative and summative assessment procedures, making use of reflection and feedback. Endodontic procedures should be undertaken within the context of comprehensive patient care and should be evidence based. Students should not perform treatments on patients until they have demonstrated in a pre-clinical setting that they possess the required skills. Only if it is not possible to simulate a specific procedure sufficiently in a pre-clinical setting should students learn this procedure by performing it clinically under close supervision. Clinical endodontics should ideally be supervised by endodontists or by staff with special knowledge, interest and self-efficacy in endodontics. It is advised to ensure that students apply their knowledge and practice their skills periodically throughout the continuum of endodontic education until graduation. A philosophy of lifelong learning and evidence-based practice should be instilled in all dental undergraduates.

PRIDASE 2024 guidelines for reporting diagnostic accuracy studies in endodontics: A consensus-based development.

Studies investigating the accuracy of diagnostic tests should provide data on how effectively they identify or exclude disease in order to inform clinicians responsible for managing patients. This consensus-based project was undertaken to develop reporting guidelines for authors submitting manuscripts, which describe studies that have evaluated the accuracy of diagnostic tests in endodontics. These guidelines are known as the Preferred Reporting Items for Diagnostic Accuracy Studies in Endodontics (PRIDASE) 2024 guidelines. A nine-member steering committee created an initial checklist by integrating and modifying items from the Standards for Reporting of Diagnostic Accuracy (STARD) 2015 checklist and the Clinical and Laboratory Images in Publications (CLIP) principles, as well as adding a number of new items specific to the specialty of endodontics. Thereafter, the steering committee formed the PRIDASE Delphi Group (PDG) and the PRIDASE Online Meeting Group (POMG) in order to collect expert feedback on the preliminary draft checklist. Members of the Delphi group engaged in an online Delphi process to reach consensus on the clarity and suitability of the items in the checklist. The online meeting group then held an in-depth discussion on the online Delphi-generated items via the Zoom platform on 20 October 2023. According to the feedback obtained, the steering committee revised the PRIDASE checklist, which was then piloted by several authors when preparing manuscripts describing diagnostic accuracy studies in endodontics. Feedback from this process resulted in the final version of the PRIDASE 2024 checklist, which has 11 sections and 66 items. Authors are encouraged to use the PRIDASE 2024 guidelines when developing manuscripts on diagnostic accuracy in endodontics in order to improve the quality of reporting in this area. Editors of relevant journals will be invited to include these guidelines in their instructions to authors.

Reporting quality of scoping reviews in endodontics: A meta-research study.

OBJECTIVES: To evaluate the reporting quality of Scoping Reviews (ScRs) in endodontics according to the PRISMA Extension Checklist for Scoping Reviews (PRISMA-ScR) and to analyse their association with a range of publication and methodological/reporting characteristics. METHODS: Pubmed, Scopus, and Web of Science databases were searched up to 31 January 2024 to identify scoping reviews in the field of endodontics. An additional search was performed in three leading endodontic journals. Study selection and appraising the quality of the studies was carried out independently by two reviewers. Each of the 20 PRISMA-ScR items were allocated a score of either 0, 0.5 or 1 to reflect the completeness of the reporting. An item-specific and overall percentage reporting quality score was calculated and reported through descriptive statistics across a range of publication, as well as methodological/reporting characteristics. A univariable and multivariable quantile regression was performed to identify the effect of publication and methodological/reporting characteristics (year of publication, journal, inclusion of an appropriate reporting guideline, and study registration) on the overall percentage reporting quality score. Association of reporting quality score with publication characteristics was then investigated. RESULTS: A total of 40 ScRs were identified and included for appraisal. Most of the studies were published from 2021 onwards. The overall median reporting quality score was 86%. The most frequent items not included in the studies were: a priori protocol registration (22/40 compliant; 55%), and reporting of funding (16/40 compliant; 40%). Other key elements that were inadequately reported were the abstract (7/40 compliant; 18%), the rationale and justification of the ScR (21/40 compliant; 52%) and the objectives of the study (18/40 compliant; 45%). Studies that adhered to appropriate reporting guidelines were associated with greater reporting quality scores (ß-coefficient: 10; 95%CI: 1.1, 18.9; p = .03). ScRs with protocols registered a priori had significantly greater reporting quality scores (ß-coefficient: 12.5; 95%CI: 6.1, 18.9; p < .001), compared with non-registered reviews. CONCLUSIONS: The reporting quality of the ScRs in endodontics varied and was greater when the ScR protocols were registered a priori and when the authors adhered to reporting guidelines.

Artificial intelligence in endodontics: Fundamental principles, workflow, and tasks.

The integration of artificial intelligence (AI) in healthcare has seen significant advancements, particularly in areas requiring image interpretation. Endodontics, a specialty within dentistry, stands to benefit immensely from AI applications, especially in interpreting radiographic images. However, there is a knowledge gap among endodontists regarding the fundamentals of machine learning and deep learning, hindering the full utilization of AI in this field. This narrative review aims to: (A) elaborate on the basic principles of machine learning and deep learning and present the basics of neural network architectures; (B) explain the workflow for developing AI solutions, from data collection through clinical integration; (C) discuss specific AI tasks and applications relevant to endodontic diagnosis and treatment. The article shows that AI offers diverse practical applications in endodontics. Computer vision methods help analyse images while natural language processing extracts insights from text. With robust validation, these techniques can enhance diagnosis, treatment planning, education, and patient care. In conclusion, AI holds significant potential to benefit endodontic research, practice, and education. Successful integration requires an evolving partnership between clinicians, computer scientists, and industry.

Top 100 most-cited scientific articles in regenerative endodontics 2019-2023: A bibliometric analysis.

BACKGROUND: Bibliometric analysis is a critical indicator of the influence and relevance of scientific papers, whilst also highlighting key contributors and gaps in knowledge in a scientific field. OBJECTIVES: To update and analyse the 100 most-cited papers in regenerative endodontics from 2019 to 2023. METHODS: A search of the most-cited recent papers focusing on regenerative endodontics using journals included in the category, 'Dentistry, Oral Surgery & Medicine', in the Clarivate Web of Science database from 2019 to 2023 was performed. Three researchers conducted the study selection and data extraction. Data extraction included publication title and year, authors, number and mean number of citations, institution, country and continent, study design, journal title, keywords and research topic. Citation counts were also collected in Google Scholar and Scopus databases. Graphical bibliometric networks were created using VOSviewer software. RESULTS: The number of citations of the 100 most-cited articles ranged from 6 to 85. Most were published in 2020 (n = 48), principally in the Journal of Endodontics (47%), followed by International Endodontic Journal (13%), Journal of Dental Research (6%) and Dental Materials (6%). Laboratory study was the most common study design amongst the included papers (n = 47), followed by narrative reviews (n = 17) and observational studies (n = 16). The most frequent first author on the top three most-cited papers was Hacer Aksel, whilst Adham A. Azim (n = 6; 89 citations) contributed most to the top 100 articles. The institution from which most articles originated was the University of Hong Kong (China) (n = 5; 81 citations), whereas the corresponding authors were predominantly from the United States of America (USA) (n = 31; 560 citations). The VOSviewer map of co-authorship demonstrated research collaborative clusters. 'Regenerative endodontics' and 'stem-cells' were the most employed keywords (37 and 36 occurrences respectively). DISCUSSION: The current study was designed not only to showcase the most influential papers in regenerative endodontics since 2019 but also to provide a better understanding of global research in this area over the last five years. CONCLUSIONS: This bibliometric analysis highlighted papers, authors, institutions and keywords in regenerative endodontics. The 100 most-cited papers primarily consisted of laboratory studies published in the USA, focusing on evaluating biomaterials and scaffold design strategies in contact with stem cells. Clinical studies and systematic reviews representing higher levels of scientific evidence are currently not the most influential in the regenerative endodontic field.

Microrobotics in endodontics: A perspective.

Microorganisms are the primary aetiological factor of apical periodontitis. The goal of endodontic treatment is to prevent and eliminate the infection by removing the microorganisms. However, microbial biofilms and the complex root canal anatomy impair the disinfection process. Effective and precise endodontic therapy could potentially be achieved using advanced multifunctional technologies that have the ability to access hard-to-reach surfaces and perform simultaneous biofilm killing, removal, and detection of microorganisms. Advances in microrobotics are providing novel therapeutic and diagnostic opportunities with high precision and efficacy to address current biofilm-related challenges in biomedicine. Concurrently, multifunctional magnetic microrobots have been developed to overcome the disinfection challenges of current approaches to disrupt, kill, and retrieve biofilms with the goal of enhancing the efficacy and precision of endodontic therapy. This article reviews the recent advances of microrobotics in healthcare and particularly advances to overcome disinfection challenges in endodontics, and provides perspectives for future research in the field.

What is new in the 2023 European Society of Endodontology S3-level clinical practice guidelines?

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.

Methodological quality of umbrella reviews in endodontics: A cross-sectional study.

INTRODUCTION: In endodontics, the number of umbrella reviews has increased significantly over the last few years, but there is no evidence that they were methodologically sound. The aim of the current study was to appraise the methodological quality of umbrella reviews in endodontics, and to identify possible predictive factors associated with methodological quality. METHODS: Umbrella reviews published in the discipline of endodontics until December 2023 were included. The methodological quality of the reviews was evaluated using a checklist consisting of 11 items. Each item in the checklist was evaluated by two independent assessors who assigned a score of '1' if it was fully addressed, '0.5' if it was partially ddressed, and '0' if it was not addressed. Bootstrapped multiple linear regression analysis was used to examine the association between the total scores awarded and five predictor variables (a priori protocol registration, year of publication, number of authors, journal impact factor (IF) and continent of the corresponding author). The statistical significance level was set as 5%. RESULTS: A total of 27 reviews were included. Ninety-six per cent of the reviews adequately reported: eligibility criteria for selecting the reviews, details of the reviews, techniques for assessing the risk of bias or methodological quality of the individual systematic reviews they included. Only 30% of the reviews adequately managed overlapping primary studies within individual systematic reviews. Among the five predictors analysed, a priori protocol registration and journals with IFs were associated with significantly greater total methodological quality scores. DISCUSSION: Several methodological shortcomings in the umbrella reviews published within the field of endodontics were revealed. Umbrella reviews published in journals with IFs and those with protocols registered a priori had significantly superior methodological quality scores. CONCLUSION: In endodontics, authors intending to publish umbrella reviews should consider the limitations revealed in this study and follow the appropriate rules to ensure their reviews comply with the highest standards and provide accurate and dependable information and conclusions.

Harnessing antimicrobial peptides in endodontics.

Endodontic therapy includes various procedures such as vital pulp therapy, root canal treatment and retreatment, surgical endodontic treatment and regenerative endodontic procedures. Disinfection and tissue repair are crucial for the success of these therapies, necessitating the development of therapeutics that can effectively target microbiota, eliminate biofilms, modulate inflammation and promote tissue repair. However, no current endodontic agents can achieve these goals. Antimicrobial peptides (AMPs), which are sequences of amino acids, have gained attention due to their unique advantages, including reduced susceptibility to drug resistance, broad-spectrum antibacterial properties and the ability to modulate the immune response of the organism effectively. This review systematically discusses the structure, mechanisms of action, novel designs and limitations of AMPs. Additionally, it highlights the efforts made by researchers to overcome peptide shortcomings and emphasizes the potential applications of AMPs in endodontic treatments.