Knowledge, Attitude, and Perception Among Endodontists Toward Regenerative Endodontics: A Cross-sectional Survey of Four Indian Universities

Evaluating the effectiveness of a novel training model in dental preclinical regenerative endodontic education

AIM

Regenerative endodontic procedures (REPs) are tissue engineering-based treatments aimed at regenerating the pulp-dentin complex. However, these procedures are not widely practiced or well-known among dentists due to a lack of training. This study aims to develop a practical hands-on training model for REPs to enhance students' theoretical knowledge and practical skills.

METHODOLOGY

A cost-effective, easy-to-operate, and reusable training model for preclinical training of REPs was developed. A total of 125 undergraduates were divided into an experimental group (REPs model) and a control group (traditional teaching). The students' theoretical knowledge and operational skills were assessed through examinations and practical assessments. Student perceptions were assessed by questionnaires.

RESULTS

The experimental group achieved higher scores in theoretical knowledge and operational skills compared to the control group (p < .001). The process evaluation of the experimental group demonstrated a high level of proficiency in executing root canal disinfection steps, with pass rates ranging from 93.5% to 95.2%. Students in both groups perceived the model as valuable for improving critical thinking, stimulating interest, and enhancing their confidence and proficiency.

CONCLUSION

The developed REPs training model is a practical and effective tool for teaching and training regenerative endodontics. It bridges the gap between preclinical and clinical education, enhancing students' confidence and clinical competence.

Evaluation of the effect of different irrigation solutions used in regenerative endodontic treatment of necrotic molar teeth with open apex on postoperative pain- randomized clinical trial

OBJECTIVES

This study evaluates the effect of different irrigation solutions for postoperative pain in the regenerative endodontic treatments (RET) of necrotic teeth with open apex.

MATERIALS AND METHODS

This study included necrotic, deeply carious lower molars of 42 patients. Access cavities of the teeth were opened and working lengths were measured at the first visit. In Group 1, the root canals were irrigated with 1.5% sodium hypochlorite (NaOCl) and 17% Ethylenediaminetetraacetic-acid (EDTA), in Group 2, with 1.5% NaOCl and 10% citric acid, and in the Group 3, with 1.5% NaOCl and 9% Etidronic acid (HEDP) mixture solution. Final irrigation was performed with distilled water. The canals were dried, filled with calcium hydroxide paste, and sealed with Cavit. Postoperative pain was assessed using a numerical rating scale, and Paracetamol was prescribed. At the second visit, calcium hydroxide was removed with 1.5% NaOCl, irrigated with chelators, and sealed with Sure-Seal PT 3 mm below the cementoenamel junction before composite resin filling.

RESULTS

Postoperative pain was higher in Group 3 (p < 0.05), but analgesic consumption did not show a significant difference (p > 0.05).

CONCLUSIONS

HEDP caused significantly more postoperative pain than EDTA and citric acid (p < 0.05). While the study provided information regarding the effects of irrigation solutions on postoperative pain, further research is needed as it did not include detailed assessments of long-term periapical healing and apex closure.

CLINICAL RELEVANCE

When HEDP is used as a chelation agent in RETs, it shows a higher degree of postoperative pain than EDTA and citric acid solutions.

CLINICAL TRIAL REGISTRATION

The study protocol was registered at www.

CLINICALTRIALS

gov (ID: NCT06386991).

Healing potentiality of blood clot, S-PRF and A-PRF as scaffold in treatment of non-vital mature single rooted teeth with chronic peri-apical periodontitis following regenerative endodontic therapy: randomized clinical trial

OBJECTIVES

This randomized prospective controlled trial investigated the effectiveness of different strategies of regenerative endodontic therapy on necrotic mature anterior teeth with chronic periapical periodontitis with 18 months follow up.

METHODS

A total analyzed 51 adult participant with mature single rooted teeth having necrotic pulp with chronic periapical periodontitis (PAI ≥ 3) were selected. Patients had been randomly categorized into three distinct groups (n = 17 each group). All groups received the same treatment on the first visit. After 2 weeks, regenerative treatment was performed using either blood clot technique, Standard-PRF and Advanced-PRF approach. A standardized radiograph was taken, and the patients instructed for 6, 12 and 18 months follow up periods. Fisher's exact test was applied to compare the frequency of PAI scores at different follow-up intervals between the three groups.

RESULTS

The results showed radiographic success at 18 months (58.8% in blood group, 94.1% in S-PRF group and 76.5% in A-PRF group). There was no statistically significant difference between the three groups according to incidence of healing at 6, 12 and 18 months. Clinical success was 82.4% in blood group and 88.2% in both S-PRF and A-PRF groups. There was no significant difference between the three groups (p = 1). The overall success (clinical and radigraphic) was 76.5%. Incidence of the gaining sensitivity after 12 and 18 months was 29.4% with A-PRF group and 41.2% within the S-PRF group, 17.6% with BC group.

CONCLUSION

PRF based regenerative technique may outperform the blood clot technique in treatment of non-vital mature teeth with chronic periapical periodontitis. There is a need for future randomized clinical studies to consolidate procedures in this field with more prolonged evaluation periods.

CLINICAL TRIAL REGISTRATION

The study was retrospectively registered with ClinicalTrials.gov (ID: NCT04606719 ) in 28/10/2020.

Evaluation of Attitude and Knowledge of Endodontic, Pedodontic and SBARD Residents in Saudi Arabia toward Regenerative Endodontics-A National Survey

Background and Objectives: There are no guidelines on the regenerative endodontic procedures that should be followed in dental treatment. Thus, it is essential to learn the knowledge, attitudes, and opinions about regenerative endodontics among dental practitioners, particularly endodontists, as they are the first providers of this type of dental treatment. Aim: This study aimed to assess the knowledge and attitudes among residents of the Saudi Board of Advanced Restorative Dentistry (SBARD) in Saudi Arabia. Methods & Materials: A questionnaire-based survey was conducted among 128 residents of endodontics, pedodontics, and the SBARD in Saudi Arabia. The questionnaire was distributed to participants using the available electronic measures such as emails and social media. The questionnaire was made by Google Forms, and responses were received directly in the excel sheet in the email. The data were exported as an excel file, coded, and analyzed, and the p-value < 0.05 was set as significant. Results: More than 50% (74 dentists) of the participants reported receiving continuing education in regenerative treatment, with a significant difference found among specialty (p = 0.023). No significant association was found between knowledge, gender, and type of postgraduate study. The vast majority (89.1%) of the participants believed regenerative endodontics should be incorporated into dentistry curricula. About two-thirds (78.2%) of the participants declared their ability to attend future training courses in a regenerative endodontic, whereas 10.9% did not, and 10.9% were unsure. Conclusions: The dental practitioners were enthusiastic and interested in regenerative and stem cell treatment. The results also suggested incorporating regenerative treatment into the dental curriculum and signaled the need for more continued training courses.