Purpose: This study aimed to evaluate the amount of apical extrusion produced by four contemporary rotary systems (XP-endo Rise, ProTaper Ultimate, TruNatomy, and One Curve). Because apical extrusion is associated with postoperative pain, inflammation, and delayed healing, identifying instrumentation techniques that minimize this phenomenon remains clinically important.
Methods: Eighty extracted human mandibular premolars with <20° curvature were decoronated and mounted on a modified Myers and Montgomery apparatus. Pre-weighed samples were randomly allocated into four groups (n=20) according to the system used. Extruded debris and irrigant were collected in pre-weighed Eppendorf tubes, and the difference between initial and final weights was recorded as the amount of apical extrusion.
Results: All systems produced apical extrusion. ProTaper Ultimate exhibited the highest mean (0.15±0.22×10-4
g), followed by TruNatomy (0.14±0.13×10-4 g), One Curve (0.11±0.08×10-4 g), and XP-endo Rise (0.08±0.05×10-4
g). Despite these numerical variations, no statistically significant difference was found among the groups (p=0.529).
Conclusion: All rotary systems resulted in apical extrusion, and none demonstrated superiority in minimizing it. These findings suggest that differences in design and kinematics alone may not substantially
influence extrusion behavior under standardized conditions.

Purpose: Bibliometric analyses are useful for evaluating scientific productivity. However, no study has been reported comparing international and national databases on cone-beam computed tomography (CBCT) in endodontics.
Methods: This study quantitatively analyzed CBCT related endodontic publications indexed in the Web of Science (WoS) and TR Dizin. Data covering 1999–2024 were collected in March 2025 using the keywords “root canal anatomy,” “root canal form,” “CBCT in endodontics,” and “cone-beam computed tomography.” Letters to the editor, case reports, and non-endodontic studies were excluded. The WoS dataset was examined for document type, indexing, journal productivity, annual trends, country rankings, and keyword networks, while TR Dizin was evaluated for subject classifications, publication trends, and institutional and city-level research distribution.
Results: A total of 710 CBCT-related publications were found in WoS and 61 in TR Dizin. In WoS, 648 were original articles and 421 were SCI-E indexed. Annual output rose steadily, reaching 45 publications in 2024; Türkiye contributed 9.7% of SCI-E papers. In TR Dizin, 44 publications were research articles, with peaks in 2021 and 2024. Ankara and İstanbul were the leading centers.
Conclusion: Findings show parallel research themes across databases, with Türkiye demonstrating
strong and increasing contributions to global CBCT endodontic literature.

Purpose: This study aimed to evaluate the effectiveness of rotary VDW.ROTATE (ROTATE), HyFlex EDM (HEDM), and reciprocating Reciproc Blue (RPCB) nickel–titanium file systems in reducing bacterial load in root canals infected with Enterococcus faecalis (E. faecalis).
Methods: Thirty-four mandibular premolar teeth canals were contaminated with E. faecalis for four weeks and prepared using file systems (ROTATE, HEDM, or RPCB; n=10). Four uncontaminated teeth served as a negative control. Bacterial load was quantified via the plate culture method. Scanning electron microscopy (SEM) was used to assess the impact of preparation on biofilm. Bacterial reduction was calculated, and data were analyzed using one-way ANOVA at a 5% significance level.
Results: Before preparation, all contaminated samples exhibited bacterial growth with an average bacterial load of 7.26 log CFU. All file systems reduced intracanal bacterial load (p<0.05), with no significant differences between systems (p>0.05). SEM images revealed disrupted biofilm-like structures in all groups, but bacteria were not completely eliminated in any canal section. Apical sections exhibited more smear layer than coronal sections.
Conclusion: Microbiological analysis and SEM images confirmed that none of the tested file systems completely eliminated E. faecalis from root canals. No significant differences in bacterial reduction were observed among the file systems.

Purpose: This study aimed to evaluate and compare the fracture resistance of simulated immature teeth filled with Biodentine (Septodont, St-Maur-des-Fossés, France) and BIOfactor MTA (Imicryl Dental, Konya, Türkiye) used as apical plugs.
Methods: In this study, 74 single-rooted mandibular premolars with root lengths standardized to 10±1mm were used. The teeth were divided into two main experimental groups—Biodentine and BIOfactor MTA (n=30)—and two control groups (n=7). The Biodentine and BIOfactor MTA groups were further divided into two subgroups according to apical plug thickness. In one subgroup, a 4 mm apical plug was placed, while in the other, the canals were completely filled with Biodentine or BIOfactor MTA. In the negative control group, root canals were prepared retrogradely without creating an access cavity. In the positive control group, canals were instrumented after access cavity preparation but left unfilled. Each specimen was subjected to a fracture resistance test using a universal testing machine, and the
maximum force required to cause fracture was recorded in Newtons (N). Data were analyzed using the
One-Way ANOVA test.
Results: The negative control group exhibited the highest fracture resistance compared to all other groups (p<0.05). No significant difference was observed between the 4 mm apical plug and full canal filling subgroups for either Biodentine or BIOfactor MTA (p>0.05). The highest fracture resistance was found in the negative control group.
Conclusion: BIOfactor MTA showed similar fracture resistance to Biodentine. Apical plug thickness did
not significantly influence the fracture resistance of immature teeth.

Purpose: The popularity of artificial intelligence-based chatbots in healthcare is increasing rapidly. In dentistry, they are used for various purposes, including patient education, diagnosis, and treatment planning. This study aimed to evaluate the accuracy and quality of three different AI chatbots, including ChatGPT-4, DeepSeek R1, and Gemini, in answering frequently asked patient questions.
Methods: 25 questions, which were frequently asked by patients in the subject of periapical surgery, were posed to ChatGPT-4, DeepSeek R1, and Gemini. Two independent raters recorded and assessed the recorded responses using a 5-point Likert scale. Also, the quality of the answers was scored using the EQIP scale. ANOVA and Kruskal-Wallis tests were used for the variables. The Spearman correlation test was used to determine the correlation between Likert and EQIP scores.
Results: Geminis’ Likert score was significantly lower than ChatGPT-4 and DeepSeek R1 (p<0.001). There was no significant difference between ChatGPT-4 and DeepSeek R1 (p=0.48). The difference between quality scores was not statistically significant. EQIP and Likert scores within groups showed poor correlation.
Conclusion: Artificial intelligence-based large language models can provide reliable information to patients about periapical surgery. However, there are differences in accuracy and quality between different platforms.

Purpose: This study evaluated the effects of coronal enlargement files with different tapers, apical diameters, and heat treatments on canal transportation in standardized S-shaped simulated canals.
Methods: Sixty resin blocks with a 50° double curvature were assigned to four groups (n=15): UniGold Sx, UniBlue Sx, N1, and Control. All canals were prepared to size 25/.04 using the K7 system. Pre- and post-instrumentation images were superimposed in Fiji, and transportation was measured at five levels. ANOVA and Bonferroni tests were used (α=0.05).
Results: No significant differences were observed at the apical constriction. At 2 mm, coronal enlargement groups showed transportation opposite the furcation, whereas the control group showed transportation toward it (p<0.05). At 5 and 8 mm, the N1 group exhibited the least transportation (p<0.05). UniGold Sx showed the highest transportation at 11 mm (p<0.05).
Conclusion: Minimally invasive, flexible files reduced transportation in critical areas, while all forms of
coronal preparation improved apical shaping safety.

Purpose: This study aimed to investigate the knowledge and opinions of general dentists, pedodontists, endodontists, pedodontics and endodontic research assistants in Türkiye regarding regenerative endodontic treatment (RET) protocols for the necrotic immature teeth.
Methods: This survey-based study used an online platform and was administered on a voluntary basis. The first section included six demographic questions about participants’ general characteristics. The second section consisted of 22 multiple-choice questions assessing the opinions and knowledge of general dentists, pedodontists, endodontists, and pedodontics assistants and endodontics research assistants regarding RET protocols.
Results: Statistically significant correlations across specialties (p<0.05) were found for responses to the following questions: “What was the source of your RET clinical protocol?”, “In which situations do you prefer RET?”, “How many visits do you complete RET?”, “Which irrigation protocol method do you prefer for the first RET visit?”, “Which method do you use for local anesthetic, irrigation solution, and scaffolding during the scaffolding visit?”, “Which coronal barrier material do you use for RET?”, and “What are the success criteria for RET?”.
Conclusion: Variations in the application of RET protocols were observed among the branches examined. Specialists preferred this treatment more frequently and possessed more knowledge than general dentists.

Purpose: To evaluate whether the accuracy of responses generated by large language model–based systems to dental avulsion–related questions differs according to language.
Methods: Dental avulsion questions based on International Association of Dental Traumatology guidelines were administered to ChatGPT (version 5.1) and Meta AI in Turkish and English. Queries were submitted using two independent user accounts over seven consecutive days. All responses were restricted to a true–false format and assessed for guideline compliance. Paired comparisons were performed using the McNemar test.
Results: A total of 2,800 responses were analyzed. ChatGPT showed comparable accuracy in Turkish and English. In contrast, Meta AI demonstrated higher accuracy in English than in Turkish. When compared under identical conditions, ChatGPT exhibited higher overall accuracy, primarily due to differences in Turkish responses.
Conclusion: Language may influence the performance of large language model–based systems in dental avulsion scenarios in a model-dependent manner, underscoring the need to consider linguistic factors when evaluating AI-generated clinical information.

Purpose: This study aimed to evaluate the relationship between the interorificial distance (IOD) and buccolingual distance (BLD) in mandibular incisors with two canals and apical termination, along with demographic (age and gender) and anatomical factors (number of canals and Vertucci classification) in the Turkish subpopulation using cone beam computed tomography (CBCT).
Methods: High-quality CBCT scans of patients with all mature mandibular incisors present and without previous endodontic treatment, root resorption, calcification, cracks, fractures, or restorations were screened in terms of demographic data, Vertucci canal configurations, IOD, BLD, and apical termination types. Data were statistically analyzed.
Results: A total of 1344 mandibular incisors from 336 patients were analyzed, revealing that 25% had two canals, with no significant differences by gender, age, or tooth side. The most common canal configuration was Vertucci Type I, while Types III and II were mainly found in teeth with two canals. BLD decreased significantly with age (p<0.05). The BLD/IOD ratio was significantly decreased in teeth with two distinct apical foramina (p<0.05). A significant positive correlation was found between BLD and IOD (p<0.05).
Conclusion: The correlation between BLD and IOD offers a practical reference for predicting canal configurations, while the differences in apical termination types highlight the need for tailored clinical approaches. Understanding these anatomical variations is crucial for achieving optimal outcomes

Purpose: To assess patients’ knowledge, awareness, experiences, and attitudes toward root canal treatment (RCT) and to explore how education level and prior treatment experience are associated with treatment preferences.
Methods: A descriptive cross-sectional survey was administered to 689 adults presenting to Uşak University Faculty of Dentistry. The two-section questionnaire captured demographics and 16 items on sources of information, past experiences, fear, awareness, and preferences. Data were analysed using descriptive statistics, the Pearson chi-square test or Fisher’s exact test, and binary logistic regression (α=0.05).
Results: A total of 689 participants were included in the study. Of these, 79.7% reported having previously undergone RCT, and 88.2% of those individuals evaluated their treatment experience positively. Overall, 79.7% perceived RCT as a successful treatment modality, and 78.2% reported that they would prefer RCT over extraction or implant placement for an infected tooth. Pain related concerns were identified as the most common source of fear by 46.2% of participants. Educational level was significantly associated with self-reported knowledge regarding RCT (p<0.001), and higher knowledge levels were associated with perceiving RCT as successful (p=0.002) and preferring RCT as a treatment option (p<0.001). However, in multivariable analysis, treatment preference was associated primarily with the
perception that RCT weakens the tooth rather than with knowledge level itself (p<0.001). The vast majority of participants (96.2%) indicated that the public should be more thoroughly informed about RCT.
Conclusion: This study demonstrates that patients’ attitudes and treatment preferences regarding root canal treatment are shaped by perceptions and expectations rather than by knowledge level alone. Expectations related to pain and assumptions about tooth durability play a notable role in the decision-making process. In particular, the widespread belief that root canal treatment weakens the tooth may negatively influence patients’ attitudes toward conservative treatment options. These findings indicate that patient education should extend beyond the provision of factual information and be supported by patient centered and evidence-based communication strategies that address misconceptions and expectations. Clear and accessible public information may help promote appropriate treatment choices.

Purpose: To assess periapical trabeculation of endodontically treated mandibular first molars before (T0) and after (T1) orthodontic treatment using fractal dimension (FD) analysis, and the effect of sex on these changes.
Methods: The study included 32 patients (15 males and 17 females, mean age 17.32±1.71 years). The study group consisted of endodontically treated teeth, and their healthy contralateral counterparts served as controls. FD analysis was performed on 40×40 pixel ROIs from panoramic radiographs at T0 and T1. Paired t-tests were used for comparisons between the study group and their contralateral controls, as well as for T0–T1 comparisons. Independent t-tests were used to evaluate sex-related differences (p<0.05).
Results: FD values of the study group were significantly lower than controls at T0 and T1 (p<0.001), with a greater T0–T1 increase in the study group. At T0, female FD values were significantly lower than males in the study group (p=0.014), but this difference was not significant at T1 (p>0.05). Significant T0–T1 FD increases were observed in both sexes and groups (p<0.05).
Conclusion: Periapical trabeculation during the healing of endodontically treated teeth was not adversely affected by orthodontic treatment, and sex-related differences tend to balance over time.

Purpose: This study aims to conduct a comprehensive bibliometric analysis of global research trends on fiber post systems used in the restoration of endodontically treated teeth from 1996 to 2025.
Methods: A systematic search was conducted in the Web of Science Core Collection using selected keywords related to fiber-reinforced posts. Only original articles were included. Metadata were exported and analyzed using Biblioshiny (Bibliometrix R-package). Citation-based indicators, co-authorship networks, keyword co-occurrence, and thematic evolution across three time periods (1996–2005, 2006–2015 and 2016–2025) were examined. Citation differences were evaluated using nonparametric statistical tests (Kruskal–Wallis and Mann–Whitney U).
Results: A total of 651 articles were identified. The annual number of publications increased steadily over time, with a peak in 2008 (39 articles). The most productive authors included M. Ferrari and C. Goracci, while Brazil was the most prolific country, followed by Italy, Germany, the United States, and Türkiye. The Journal of Prosthetic Dentistry was the leading source. Keyword analysis revealed a shift from basic bonding and mechanical testing in earlier years toward themes of adhesion, clinical rehabilitation, and dental trauma. Significant differences in citation counts were observed across publication periods (p<0.001).
Conclusion: Over the past 29 years, research on fiber posts has evolved from mechanical investigations to more clinically focused applications. The growing global collaboration and thematic shift highlight the maturing nature of this field. These findings can help inform future clinical research and development in post-endodontic restoration.

Purpose: Amidst increasing gingival recession, xerostomia, and poor access to restorative care, root caries has emerged as an important concern in older adults. Silver diamine fluoride (SDF) is the most applied minimally invasive approach for the arrest and prevention of caries, but there is still debate over its efficacy on teeth among geriatric individuals. This review aimed to examine the effectiveness of SDF in arresting and preventing root caries in adults aged ≥55 years compared to a placebo, no treatment, or other topical agents.
Methods: A systematic review and meta-analysis were carried out according to PRISMA 2020 guidelines and a previously registered protocol (PROSPERO CRD420251231424). A literature search in PubMed, Embase, Web of Science, and Scopus from the database inception until November 2025 was carried out. The search included studies that examined SDF for the arrest or prevention of root caries in older adults; therefore, randomized controlled trials, quasi-experimental studies, and cohort studies were considered. Study selection, data extraction, and risk of bias assessment were conducted independently by two reviewers, using RoB 2.0 and the Newcastle-Ottawa Scale. Random-effects models were used to determine the standardized mean differences (SMD) and odds ratios (OR) with 95% confidence intervals (CI). I² was used to quantify heterogeneity, and Doi plots and the LFK index were used to assess publication bias.
Results: A total of eleven studies met the inclusion criteria (n=1,958 participants). The pooled SMD did not show any statistically significant difference between SDF and placebo for arresting root caries (SMD –0.02; 95% CI –0.15 to 0.11; I²=98.9%). Similarly, pooled dichotomous data showed no significant association between SDF and caries arrest (OR 0.60; 95% CI 0.26–1.41; I²=91.9%). Substantial heterogeneity and asymmetry in the Doi plot suggested methodological differences and potential publication bias.
Conclusion: Available evidence does not show consistent benefit of SDF over placebo or other preventive agents in arresting root caries among older adults. Considerable heterogeneity, methodological limitations, and small-study effects restrict the certainty of current findings. Well-designed multicentre randomized trials with standardized protocols, defined application intervals, and ≥24-month follow-up are required to clearly establish SDF effectiveness in geriatric populations.

Purpose: This study aims to examine scholarly communication patterns in high-impact endodontic journals through a bibliometric analysis of Türkiye-affiliated publications in the Journal of Endodontics, International Endodontic Journal, and Australian Endodontic Journal.
Methods: A total of 753 Web of Science–indexed articles published between 1983 and 2024 were analyzed using Bibliometrix in R with supplementary statistical analyses. Publications were evaluated in terms of document types, subject categories, citation performance, authorship and institutional productivity, multidisciplinary structures, and national and international collaboration patterns.
Results: Root canal preparation and irrigation–disinfection were the most frequently investigated topics, and laboratory-based studies predominated. The highest citation impact was observed in the Journal of Endodontics. Hacettepe University was the most productive institution, and Hakan Arslan the most prolific author. International collaborations were most frequently established with the United States.
Conclusion: This bibliometric analysis provides an overview of Türkiye-affiliated research productivity and trends in high-impact endodontic journals. Building on these findings, fostering interdisciplinary collaboration and expanding international partnerships may further strengthen scientific visibility and impact. Research performance should be evaluated not only by the number of publications but also by citation metrics and the h-index to provide a more accurate and balanced assessment of academic impact.

External inflammatory root resorption (EIR) is a pathological process that typically develops as a result of trauma, infected necrotic pulp, or orthodontic forces causing damage to the periodontal tissues. In this case report, intentional reimplantation (IR) was performed on a 42-year-old systemically healthy male patient presenting with EIR and a periapical lesion in the right mandibular second molar. The treatment involved orthograde root canal retreatment followed by tooth extraction, microscopic evaluation of the root surfaces, apical resection, retrograde filling with mineral trioxide aggregate, and reimplantation of the tooth into its socket. All extraoral procedures were completed within 12 min, during which the root surfaces were continuously irrigated with sterile saline. Clinical and radiographic follow-up revealed a reduction in the lesion size and that the tooth remained asymptomatic and functional. IR is considered an effective and tooth-preserving approach in the management of EIR.