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Open research questions in Endodontics and Root Canal Treatments

1,021 gap statements mined from Endodontics and Root Canal Treatments papers in our 7.9M-paper local library, which holds 11,329 papers on the topic — drawn mostly from each paper's own stated research gap, future-work, challenge and limitation notes, and its abstract. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one.

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What the literature leaves open

  • Whether this particle concentration and activation intensity produce deleterious morphological alterations remains to be determined in future studies. Finally, this investigation evaluated a single particle dimension (5 µm); the optimal particle size and concentration for particulate-enhanced irrigation remain to be determined in future studies.

    Effect of Irrigation with Zirconia Microparticles Combined with Different Activation Techniques on Smear Layer Removal: An Ex Vivo Study · 2026 · DOI

  • Within the limitations of this study, no statistically significant differences were observed among the three NiTi systems in terms of cleaning efficacy, with all instruments leaving residual material, particularly in the apical third.

    Impact of Taper Design on Cleaning Efficacy, Stress Generation, and Irrigant Performance: A Combined Experimental, Finite Element Analysis, and Computational Fluid Dynamics Assessment · 2026 · DOI

  • Further research is needed to investigate the impact of heat treatment on the properties and performance of NiTi files at various temperatures. Within the limitations of this study, the operating temperature can exert a notable influence on the cyclic fatigue resistance and cutting efficiency of both blue- and gold heattreated NiTi reciprocating files.

    Influence of Operating Temperature on the Properties and Performance of Two Heat-Treated Reciprocating NiTi Instruments: An In Vitro Study · 2026 · DOI

  • Direct measures of the point at which a site becomes suitable for definitive treatment were largely absent from the reviewed literature, and patient-reported outcomes linked to specific follow-up intervals and imaging modalities remain underreported, which limits how precisely these thresholds can be defined.

    Success After Endodontic Microsurgery: A Critical, Time- and Modality-Dependent Interpretation · 2026 · DOI

  • Within the limitations of this study, the NaOCl-DR HEDP protocol was associated with less pronounced reductions in dentin microhardness than the NaOCl/EDTA protocol and preserved dentin microhardness to a similar extent as EDTA alone.

    Influence of Continuous Chelation on Root Dentin: A Laboratory Study · 2026 · DOI

  • This cautious perception is consistent with the limited evidence regarding the long-term clinical superiority of minimally invasive access cavity designs over traditional access designs. The ESE does not recommend routine CBCT use, but rather its use in selected situations in which conventional imaging is insufficient and the additional information obtained may influence treatment decisions.

    Self-Perceived Knowledge and Self-Reported Clinical Use of Minimally Invasive Endodontics Among General Dentists and Endodontists in Türkiye: A Cross-Sectional Survey · 2026 · DOI

  • The effectiveness of different irrigation solutions and activation techniques in removing calcium hydroxide from standardized artificial grooves located in the apical third of root canals is not well understood.

    Different irrigation solutions in calcium hydroxide removal: Do high-frequency ultrasonic and laser activation make the difference? · 2026 · DOI

  • However, the clinical relevance of these findings remains to be established.

    Antimicrobial activity of ginsenoside Rh2 against Enterococcus faecalis and its biofilm · 2026 · DOI

  • Two-dimensional radiography may underestimate persistent disease. CBCT offers improved detection of apical radiolucency, but its use is not widespread. There is a need to investigate the frequency of apical periodontitis and its relationship with root canal filling quality and procedural variables.

    Factors associated with CBCT-detected periapical radiolucencies in root-filled teeth: a retrospective cross-sectional study · 2026 · DOI

  • Our AI framework mitigates this challenge by automating the most technically demanding design steps, although complete automation of the entire guide architecture warrants further investigation. In clinical practice, the principle of vertically resecting 3 mm of the apex may not be applicable in all scenarios.

    An In vitro study on the application of artificial intelligence in trephination pathway planning for endodontic microsurgery: a key step in digital guide design · 2026 · DOI

  • The study identifies the challenge of managing oroantral communications due to the lack of standardized guidelines. The study highlights the challenge of selecting appropriate materials for treating oroantral communications. The study notes the challenge of ensuring practitioner confidence in treating oroantral communications.

    Management strategies and determinants of clinical decision-making in oroantral communication among dental practitioners · 2026 · DOI

  • Future research could focus on systematically evaluating how various prompting strategies influence LLM output quality, accuracy, and specificity in the field of REPs. The primary limitation of this study is that the AI models evaluated may have become outdated by the time of publication owing to intense competition and rapid development in the field, with end-users potentially accessing newer versions.

    The Impact of Language Variability on Artificial Intelligence Performance in Regenerative Endodontics · 2025 · DOI

  • Future research should focus on improving long-term stability, optimizing immunomodulation, and standardizing protocols for stem cell isolation and application. Although the efficacy of cell-based therapy for pulp regeneration has been demonstrated, the precise mechanisms by which the transplanted cells promote pulp regeneration and root development remain unclear.

    Endodontic Regeneration Therapy: Current Strategies and Tissue Engineering Solutions · 2025 · DOI

  • However, certain complex canal situations remain unknown, particularly in the maxillary fourth premolars, which are among the most commonly fractured and treated teeth in dogs.

    Primary Evaluation of Three-Dimensional Printing-Guided Endodontics in the Dog Maxillary · 2025 · DOI

  • The question of which Ni-Ti instruments are the easiest to use for students and less experienced practitioners remains unclear, highlighting the need for studies like this one to guide instrument selection for educational and clinical purposes.

    Comparison of Four Ni-Ti Rotary Systems: Dental Students’ Perceptions in a Multi-Center Simulated Study · 2025 · DOI

  • Future research should consider employing blinded study designs to minimize operator-related biases and improve the objectivity of the findings. Future research should address these limitations by incorporating larger and more different samples, using natural teeth, and evaluating the instruments in clinical settings.

    Comparison of Four Ni-Ti Rotary Systems: Dental Students’ Perceptions in a Multi-Center Simulated Study · 2025 · DOI

  • The data were obtained using a retrospective study design, which may show risks of obtaining inconsistent data, but this was not a problem in this research because the evaluation and data collection for all patients included in this study were recorded at the same dental clinics in 2023.

    Clinical Outcomes and Complication Rates of Endodontically Treated Teeth with Fixed Dental Prostheses: A Retrospective Study · 2025 · DOI

  • Within the limitations of this study, our results suggest that a combined protocol integrating mechanical, chemical, and ultrasonic cleaning procedures provides the most effective debridement of endodontic instruments, supporting the recommendation for adopting such comprehensive methods.

    Quantitative Evaluation of Debris Removal from NiTi Rotary Endodontic Instruments After Different Cleaning Procedures · 2025 · DOI

  • Although the clinical significance of such residues remains unclear, they could act as irritants, antigens, or infective agents. In dental practices, various methods are employed for cleaning instruments prior to sterilization, yet universally accepted standard cleaning procedures have not been established.

    Quantitative Evaluation of Debris Removal from NiTi Rotary Endodontic Instruments After Different Cleaning Procedures · 2025 · DOI

  • Within the limitations of this study, it can be concluded that intracanal medicaments formulated with 10% and 25 % (w/w) of biosynthesized CaO NPs are effective against Enterococcus faecalis, produce consistently high levels of alkaline pH and demonstrate a satisfactory microleakage and cytotoxicity profile.

    In Vitro Evaluation of the Influence of Biosynthesized Calcium Oxide Nanoparticles on the Antibacterial Activity, pH, Microleakage and Cytotoxicity of Conventional Intracanal Medicaments · 2024 · DOI

  • The formation of C. albicans biofilm is a key virulence factor. The biofilm protects C. albicans from antifungal agents. The need to find effective antifungal agents that can penetrate the biofilm.

    The Effectiveness of Silver Nanoparticles Mixed with Calcium Hydroxide against Candida albicans: An Ex Vivo Analysis · 2024 · DOI

  • Conditional (> 70%) In traumatized permanent incisors, the use of non-surgical endodontic protocols for teeth with symptomatic or asymptomatic apical periodontitis or acute abscess with varying grades of periapical radiolucency is indicated in cases that fail to respond to RET.

    Consensus‐Based Recommendations on Pulp Therapies in Primary and Permanent Teeth: IAPD Porto Forum · 2026 · DOI

  • These decision points are rarely studied directly; in practice, clinicians proceed to definitive restoration once symptoms have resolved and radiographic healing appears adequate, often guided by consensus follow-up thresholds rather than by a measure of stability over time.

    Success After Endodontic Microsurgery: A Critical, Time- and Modality-Dependent Interpretation · 2026 · DOI

  • Based on a comprehensive review of the existing literature, this review is the first to propose that the integration of bacterial infection, immune imbalance, and oxidative stress in necroptosis may contribute to the progression of pulpitis from reversible inflammation to irreversible necrosis.

    Role of necroptosis in pulpitis: integration of bacterial infection, immune imbalance, and oxidative stress · 2025 · DOI

  • The study did not address the clinical significance of dressing the root canals with antibacterial materials. The study only investigated the effects of CHX on E. faecalis. The sample size was determined based on power analysis, but the details of the analysis are not fully described.

    Mechanistic Insight into the Anti-Bacterial/Anti-Biofilm Effects of Low Chlorhexidine Concentrations on Enterococcus faecalis—In Vitro Study · 2024 · DOI

Most-cited papers in Endodontics and Root Canal Treatments

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Open questions raised by papers listed on this page include: (1) Whether this particle concentration and activation intensity produce deleterious morphological alterations remains to be determined in future studies (“Effect of Irrigation with Zirconia Microparticles Combined with Different…”, 2026); (2) Further research is needed to investigate the impact of heat treatment on the properties and performance of NiTi files at various temperatures (“Influence of Operating Temperature on the Properties and Performance of Two…”, 2026); (3) The effectiveness of different irrigation solutions and activation techniques in removing calcium hydroxide from standardized artificial grooves located in the apical third of root canals is not well understood (“Different irrigation solutions in calcium hydroxide removal: Do high-frequency…”, 2026); (4) The clinical relevance of these findings remains to be established (“Antimicrobial activity of ginsenoside Rh2 against Enterococcus faecalis and its…”, 2026); (5) There is a need to investigate the frequency of apical periodontitis and its relationship with root canal filling quality and procedural variables (“Factors associated with CBCT-detected periapical radiolucencies in root-filled…”, 2026). 1,021 gap statements have been mined from Endodontics and Root Canal Treatments papers in our 7.9M-paper local library, which holds 11,329 papers on the topic; the gaps come from whichever of those papers state one. They are mostly the research gaps the authors state and the papers' abstracts, plus future-work, limitations and challenges passages. The ones listed below are a selection still marked open; each names the study that raised it, with a DOI link where the paper has one, so you can read the original claim in context.

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