Dentin caries is a multifactorial pathological process characterized by bacterial colonization and biofilm formation that result in concurrent acid-mediated demineralization and matrix metalloproteinase (MMP)-mediated degradation of the collagenous matrix. While remineralization therapies offer minimal invasiveness, their long-term efficacy is compromised by ongoing collagen degradation and persistent bacterial acid production that counteract remineralization efforts. To address these limitations, we designed PAMAM-G4@EG (PGE) nanoparticles (NPs) using polyamide amine (PAMAM) dendrimers as mineral deposition templates, with antimicrobial peptide G(IIKK)₄I–NH₂ (G4) grafted onto the external surface groups and epigallocatechin gallate (EG) encapsulated within the internal cavities to provide biofilm disintegration and collagen protection for comprehensive dentin caries intervention. First, the PGE NPs reach lesion surfaces and accelerate EG release under acidic conditions. EG loosens Streptococcus mutans (S. mutans) biofilms, followed by G4-mediated disruption of planktonic S. mutans cell membranes. In vitro antimicrobial assays demonstrated a bactericidal efficacy of 99.75% after PGE intervention. Upon deeper lesion penetration, PGE releases EG to inhibit MMP activity and preserve the collagen scaffold, achieving a 74% reduction in hydroxyproline (HYP) levels. Simultaneously, PAMAM promotes controlled hydroxyapatite (HA) deposition, facilitating dentin remineralization. Treatment with PGE in artificial saliva containing collagenase restored dentin hardness to 89.88% of intact values. In vivo validation using a rat caries model confirmed therapeutic efficacy through significant reductions in Keyes scores, decreased salivary S. mutans counts, and increased molar mineral density. These findings demonstrate the therapeutic efficacy of PGE in dentin caries prevention and treatment, supporting its potential for clinical application.

Large language models (LLMs) exhibit significant potential for clinical decision support, yet their application in endodontic disease remains underexplored. This study assessed the decision-making capabilities of three advanced LLMs (GPT-4o, Claude 3.5, and Grok2) in specialized endodontic contexts. A question bank of 421 multiple-choice questions was constructed across 27 core endodontic topics, including theory, procedures, and 35 complex cases. The three LLMs were tested using standardized prompts, with performance evaluated via topic-stratified accuracy analysis. Claude 3.5 achieved the highest overall accuracy (73.39 %), followed by Grok2 (66.27 %) and GPT-4o (46.32 %). Grok2 excelled in complex case analysis (69.57 %). The models performed strongly in theoretical domains (e.g., clinical examination, structural function, pharmacology) but showed limitations in complex scenarios and procedural techniques. LLMs hold promise as endodontic decision support tools, though domain-specific refinement is essential for effective clinical application.

The management of pleural infection remains highly challenging. Rational selection of appropriate local treatment strategies is crucial for successful mana

Regenerative pulp therapy's efficacy is constrained by root canal disinfectants' effects on residual dental pulp stem cells. This study investigates sodium hypochlorite's influence on dental pulp stem cells (DPSCs) viability, mitochondrial function, and osteogenic differentiation, providing cellular and molecular foundations for optimizing clinical protocols. Human deciduous teeth-derived DPSCs were treated with sodium hypochlorite (0.5%–5%) for 1 min. Cell viability, cytoskeletal integrity, and mitochondrial morphology were assessed via CCK-8, immunofluorescence, and MitoTracker labeling. Osteogenic potential was evaluated through ALP activity, mineralized nodule quantification, and osteogenic marker expression. A juvenile rat model validated findings through immunohistochemistry and molecular analysis of periapical tissues. Sodium hypochlorite exhibited concentration-dependent effects. At ≤1%, DPSCs maintained >80% viability with intact cytoskeleton, while ≥3% significantly inhibited proliferation and induced mitochondrial autophagy. Low concentration (0.5%) minimally affected osteogenic differentiation markers, while higher concentrations progressively suppressed osteogenic potential. In vivo experiments corroborated these findings. Low-concentration sodium hypochlorite (≤0.5 %) preserves DPSC viability, mitochondrial function, and differentiation capacity, whereas higher concentrations impair cellular functions through autophagy induction. These findings support using lower concentrations in regenerative endodontics to maintain stem cell potential while ensuring adequate disinfection.

Li JJ. J Dent Anesth Pain Med. 2026 Apr;26(2):155-167. https://doi.org/10.17245/jdapm.2026.26.2.155