{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T16:18:32Z","timestamp":1785169112236,"version":"3.55.0"},"reference-count":66,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2026,3,26]],"date-time":"2026-03-26T00:00:00Z","timestamp":1774483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Successful healing of chronic apical periodontitis after endodontic treatment requires a reduction in the size of the radiolucent area and the healing of the bone. This study aimed to compare the effects of different irrigation activation techniques on healing in single-rooted mandibular premolar teeth with periapical lesions of endodontic origin. Methods: A total of 132 systemically healthy patients with mandibular single-rooted premolar teeth and a periapical index (PAI) score \u2265 3 were assigned to five experimental groups (Sonic activation, Passive ultrasonic irrigation, Photon-Induced Photoacoustic Streaming, Shock Wave Enhanced Emission Photoacoustic Streaming and Manual dynamic activation) and a control group (Conventional Syringe Irrigation). After access cavity preparation, the canals were prepared up to three sizes larger than the initial apical diameter with 5 mL of 2.5% NaOCl used between each file. Final irrigation was performed via the assigned activation system. The root canals were obturated with gutta-percha in a single visit. The effects of the activation systems on healing were compared at 1-year follow-up. The primary outcome measure was the change in lesion diameter. PAI score and fractal dimension (FD) were evaluated as secondary outcomes. Results: At the 1-year follow-up, FD values significantly increased, PAI scores and lesion size decreased in all groups compared with baseline (p &lt; 0.001). However, the increase in FD was comparable among the irrigation groups (p &gt; 0.05). In contrast, lesion size reduction and PAI-based healing rates favored the laser-activated groups. The PAI scores and lesion size in the control group were significantly greater than that in the laser groups (p &lt; 0.05). Conclusions: At the 1-year follow-up, all the groups presented similar FD increases, while the laser irrigation groups presented significantly greater reductions in lesion size than did the control group.<\/jats:p>","DOI":"10.3390\/diagnostics16071003","type":"journal-article","created":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:32:47Z","timestamp":1774611167000},"page":"1003","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Do Laser-Activated Irrigation Protocols Improve Endodontic Success? A Prospective Clinical Comparison of 1-Year Periapical Healing with Sonic, Ultrasonic, Manual Dynamic and Conventional Techniques"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7322-5532","authenticated-orcid":false,"given":"Medine","family":"\u00c7i\u00e7ek","sequence":"first","affiliation":[{"name":"Department of Endodontics, Faculty of Dentistry, Recep Tayyip Erdo\u011fan University, 53100 Rize, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2145-5859","authenticated-orcid":false,"given":"Ahter","family":"\u015eanal \u00c7\u0131kman","sequence":"additional","affiliation":[{"name":"Department of Endodontics, Faculty of Dentistry, Recep Tayyip Erdo\u011fan University, 53100 Rize, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9607-6362","authenticated-orcid":false,"given":"Dilara Nil","family":"G\u00fcna\u00e7ar","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Recep Tayyip Erdogan University, 53100 Rize, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,3,26]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Tosco, V., Monterubbianesi, R., Aranguren, J., Mem\u00e8, L., Putignano, A., and Orsini, G. (2022). Evaluation of the efficacy of different irrigation systems on the removal of root canal smear layer: A scanning electron microscopic study. Appl. Sci., 13.","DOI":"10.3390\/app13010149"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Tonini, R., Salvadori, M., Audino, E., Sauro, S., Garo, M.L., and Salgarello, S. (2022). Irrigating Solutions and Activation Methods Used in Clinical Endodontics: A Systematic Review. Front. Oral Health, 3.","DOI":"10.3389\/froh.2022.838043"},{"key":"ref_3","first-page":"e65","article-title":"Unprepared root canal surface areas: Causes, clinical implications, and therapeutic strategies","volume":"32","author":"Ricucci","year":"2018","journal-title":"Braz. Oral Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1111\/j.1365-2591.2009.01627.x","article-title":"The smear layer in endodontics\u2013a review","volume":"43","author":"Violich","year":"2010","journal-title":"Int. Endod. J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"648","DOI":"10.4103\/JCD.JCD_601_20","article-title":"Conservative shaping combined with three-dimensional cleaning can be a powerful tool: Case series","volume":"23","author":"Iandolo","year":"2020","journal-title":"J. Conserv. Dent."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"406","DOI":"10.1016\/j.joen.2012.10.028","article-title":"Dentin inhibits the antibacterial effect of new and conventional endodontic irrigants","volume":"39","author":"Morgental","year":"2013","journal-title":"J. Endod."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1046\/j.1365-2591.2003.00646.x","article-title":"The capability of two hand instrumentation techniques to remove the inner layer of dentine in oval canals","volume":"36","author":"Wu","year":"2003","journal-title":"Int. Endod. J."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"560","DOI":"10.1111\/iej.12648","article-title":"Impact of needle insertion depth on the removal of hard-tissue debris","volume":"50","author":"Perez","year":"2017","journal-title":"Int. Endod. J."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1016\/j.joen.2009.03.010","article-title":"Review of contemporary irrigant agitation techniques and devices","volume":"35","author":"Gu","year":"2009","journal-title":"J. Endod."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1007\/s00784-024-05758-4","article-title":"Association between the irrigation-agitation techniques and Periapical Healing of large periapical lesions: A Randomized Controlled Trial","volume":"28","year":"2024","journal-title":"Clin. Oral Investig."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1038\/s41368-024-00280-5","article-title":"Expert consensus on irrigation and intracanal medication in root canal therapy","volume":"16","author":"Zou","year":"2024","journal-title":"Int. J. Oral Sci."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1111\/j.1365-2591.2006.01227.x","article-title":"An evaluation of the influence of passive ultrasonic irrigation on the seal of root canal fillings","volume":"40","author":"Shemesh","year":"2007","journal-title":"Int. Endod. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1008","DOI":"10.1016\/j.joen.2011.03.016","article-title":"Disinfection of root canals with photon-initiated photoacoustic streaming","volume":"37","author":"Peters","year":"2011","journal-title":"J. Endod."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"116","DOI":"10.5577\/intdentres.704","article-title":"Laser systems and current applications in endodontics: A review","volume":"15","year":"2025","journal-title":"Int. Dent. Res."},{"key":"ref_15","first-page":"1","article-title":"Photoacoustic endodontics using the novel SWEEPS Er:YAG laser modality","volume":"2017","author":"Lukac","year":"2017","journal-title":"J. Laser Health Acad."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"512","DOI":"10.1111\/iej.13677","article-title":"Present status and future directions: Microbiology of endodontic infections","volume":"55","author":"Siqueira","year":"2022","journal-title":"Int. Endod. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"712","DOI":"10.1111\/iej.13467","article-title":"The global prevalence of apical periodontitis: A systematic review and meta-analysis","volume":"54","author":"Michelon","year":"2021","journal-title":"Int. Endod. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1016\/j.joen.2020.07.007","article-title":"Prevalence of apical periodontitis and conventional nonsurgical root canal treatment in general adult population: An updated systematic review and meta-analysis of cross-sectional studies published between 2012 and 2020","volume":"46","author":"Jakovljevic","year":"2020","journal-title":"J. Endod."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1007\/s10266-011-0053-y","article-title":"Symptomatic and asymptomatic apical periodontitis associated with red complex bacteria: Clinical and microbiological evaluation","volume":"101","author":"Buonavoglia","year":"2013","journal-title":"Odontology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1111\/iej.12402","article-title":"Prognostic value of the full-scale Periapical Index","volume":"48","author":"Kirkevang","year":"2015","journal-title":"Int. Endod. J."},{"key":"ref_21","first-page":"125","article-title":"Fractal Dimension Approach for Quantitative Analysis Radiograph in Periapical Inflammation: A Systematic Review","volume":"59","author":"Azhari","year":"2025","journal-title":"Acta Med. Philipp."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Yuksel, I.B., Abakli Inci, M., Arslan, M.E., Cetin, A., Yalcinkaya Kayhan, Z., and Orhan, K. (2025). Effect of Regenerative Endodontic Treatment on Bone Structure in Children: A Fractal Analysis Approach. Medicina, 61.","DOI":"10.3390\/medicina61101757"},{"key":"ref_23","first-page":"177","article-title":"Evaluation of periapical lesion healing in mandibular molars with chronic apical periodontitis after initial root canal treatment and retreatment at 2-year follow-up using fractal analysis: A retrospective study","volume":"10","year":"2025","journal-title":"Turk. Endod. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"126","DOI":"10.5624\/isd.20240221","article-title":"Using fractal analysis to assess periapical bone formation after endodontic treatment: A systematic review and meta-analysis","volume":"55","author":"Rocha","year":"2025","journal-title":"Imaging Sci. Dent."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2787","DOI":"10.1007\/s00784-023-04862-1","article-title":"Effect of preparation size on the removal of accumulated hard-tissue debris from the mesial root canal system of mandibular molars using SWEEPS technology","volume":"27","author":"Westbomke","year":"2023","journal-title":"Clin. Oral Investig."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"102707","DOI":"10.1016\/j.pdpdt.2021.102707","article-title":"Comparison of three irrigation methods: SWEEPS, ultrasonic, and traditional irrigation, in smear layer and debris removal abilities in the root canal, beyond the fractured instrument","volume":"37","author":"Vatanpour","year":"2022","journal-title":"Photodiagnosis Photodyn. Ther."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/s10103-023-03857-4","article-title":"The efficacy of a novel SWEEPS laser-activated irrigation compared to ultrasonic activation in the removal of pulp tissue from an isthmus area in the apical third of the root canal","volume":"38","author":"Bago","year":"2023","journal-title":"Lasers Med. Sci."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s41547-021-00113-2","article-title":"The comparison of cleaning efficacy and apical extrusion of advanced irrigation activation methods with a novel Er: YAG laser modality: Sweeps","volume":"5","author":"Babacan","year":"2021","journal-title":"Lasers Dent. Sci."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"750","DOI":"10.15311\/selcukdentj.805466","article-title":"Comparison of Er:YAG modalities (PIPS-SWEEPS) on eliminating Enterococcus faecalis populations","volume":"8","year":"2021","journal-title":"Sel\u00e7uk Dent. J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1007\/s10103-022-03697-8","article-title":"Investigation of the effectiveness of sonic, ultrasonic and new laser-assisted irrigation activation methods on smear removal and tubular penetration","volume":"38","author":"Uslu","year":"2023","journal-title":"Lasers Med. Sci."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e821","DOI":"10.4317\/jced.56368","article-title":"A randomized controlled trial of endodontic treatment using ultrasonic irrigation and laser activated irrigation to evaluate healing in chronic apical periodontitis","volume":"12","author":"Verma","year":"2020","journal-title":"J. Clin. Exp. Dent."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"7157","DOI":"10.1007\/s00784-022-04677-6","article-title":"Comparison of Easydo Activator, passive ultrasonic, and needle irrigation techniques on the treatment of apical periodontitis: A study in rats","volume":"26","author":"Ye","year":"2022","journal-title":"Clin. Oral Investig."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1016\/j.joen.2012.06.040","article-title":"Lesion progression in posttreatment persistent endodontic lesions","volume":"38","author":"Yu","year":"2012","journal-title":"J. Endod."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"20210214","DOI":"10.1259\/dmfr.20210214","article-title":"Effects of hyperlipidemia on trabecular and cortical structures of the mandible","volume":"51","year":"2022","journal-title":"Dentomaxillofac Radiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1210","DOI":"10.1111\/iej.13108","article-title":"Penetration depth of irrigants into root dentine after sonic, ultrasonic and photoacoustic activation","volume":"52","author":"Galler","year":"2019","journal-title":"Int. Endod. J."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1111\/iej.12507","article-title":"Endodontic medicine: Connections between apical periodontitis and systemic diseases","volume":"48","year":"2015","journal-title":"Int. Endod. J."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"20150400","DOI":"10.1259\/dmfr.20150400","article-title":"Dental panoramic indices and fractal dimension measurements in osteogenesis imperfecta children under pamidronate treatment","volume":"45","author":"Sindeaux","year":"2016","journal-title":"Dentomaxillofac Radiol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"e41","DOI":"10.1016\/j.tripleo.2008.03.007","article-title":"Mandibular bone changes in sickle cell anemia: Fractal analysis","volume":"106","author":"Aktener","year":"2008","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1650010","DOI":"10.1142\/S0218348X16500109","article-title":"Applicability of fractal dimension analysis in dental radiographs for the evaluation of renal osteodystrophy","volume":"24","author":"Fernandes","year":"2016","journal-title":"Fractals"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1111\/j.1365-2591.2007.01233.x","article-title":"Radiological assessment of periapical status using the periapical index: Comparison of periapical radiography and digital panoramic radiography","volume":"40","year":"2007","journal-title":"Int. Endod. J."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1007\/s11547-019-01102-z","article-title":"Electronic processing of digital panoramic radiography for the detection of apical periodontitis","volume":"125","author":"Nardi","year":"2020","journal-title":"Radiol. Med."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1640","DOI":"10.1016\/j.joen.2017.06.020","article-title":"Accuracy of Orthopantomography for Apical Periodontitis without Endodontic Treatment","volume":"43","author":"Nardi","year":"2017","journal-title":"J. Endod."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1046\/j.1365-2591.2003.00640.x","article-title":"Periapical health and treatment quality assessment of root-filled teeth in two Canadian populations","volume":"36","author":"Dugas","year":"2003","journal-title":"Int. Endod. J."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1682","DOI":"10.1007\/s11547-024-01882-z","article-title":"Diagnostic accuracy of periapical radiography and panoramic radiography in the detection of apical periodontitis: A systematic review and meta-analysis","volume":"129","author":"Stera","year":"2024","journal-title":"Radiol. Med."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1761","DOI":"10.1007\/s00784-016-1957-2","article-title":"A clinical study on single-visit root canal retreatments on consecutive 173 patients: Frequency of periapical complications and clinical success rate","volume":"21","author":"Eyuboglu","year":"2017","journal-title":"Clin. Oral Investig."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1007\/s11282-025-00844-z","article-title":"Impact of endodontic treatment quality on the severity of apical periodontitis in molars teeth: A retrospective CBCT study","volume":"42","year":"2026","journal-title":"Oral Radiol."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Sunde, P.T., Giving, E., Dilshad, T., Handal, T., and \u00d8rstavik, D. (2025). Radiographic Outcome of Endodontic Treatment of Teeth with Primary Apical Periodontitis: Results from a Postgraduate Clinic. Dent. J., 13.","DOI":"10.20944\/preprints202510.1358.v1"},{"key":"ref_48","first-page":"e6","article-title":"The Effect of Lasers on the Healing of Periapical Lesion: A Systematic Review","volume":"15","author":"Hazrati","year":"2024","journal-title":"J. Lasers Med. Sci."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1111\/iej.13250","article-title":"Micro-CT study on the removal of accumulated hard-tissue debris from the root canal system of mandibular molars when using a novel laser-activated irrigation approach","volume":"53","author":"Yang","year":"2020","journal-title":"Int. Endod. J."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1016\/j.joen.2013.06.024","article-title":"Radiographic healing after a root canal treatment performed in single-rooted teeth with and without ultrasonic activation of the irrigant: A randomized controlled trial","volume":"39","author":"Liang","year":"2013","journal-title":"J. Endod."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1111\/aej.12482","article-title":"Comparison of irrigant activation devices and conventional needle irrigation on smear layer and debris removal in curved canals. (Smear layer removal from irrigant activation using SEM)","volume":"47","author":"Andreani","year":"2021","journal-title":"Aust. Endod. J."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Yuksel, I.B., Altiparmak, F., Gurses, G., Akti, A., Alic, M., and Tuna, S. (2025). Radiographic Evidence of Immature Bone Architecture After Sinus Grafting: A Multidimensional Image Analysis Approach. Diagnostics, 15.","DOI":"10.3390\/diagnostics15141742"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1007\/s11282-019-00372-7","article-title":"Evaluation of osseous changes in dental panoramic radiography of thalassemia patients using mandibular indexes and fractal size analysis","volume":"36","author":"Bayrak","year":"2020","journal-title":"Oral Radiol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"382","DOI":"10.1016\/j.oooo.2016.11.005","article-title":"Assessment of the trabecular structure of mandibular condyles in patients with temporomandibular disorders using fractal analysis","volume":"123","author":"Arsan","year":"2017","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1111\/iej.13409","article-title":"The effect of type 2 diabetes mellitus on changes in the fractal dimension of periapical lesion in teeth after root canal treatment: A fractal analysis study","volume":"54","author":"Ocak","year":"2021","journal-title":"Int. Endod. J."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/j.oooo.2021.08.016","article-title":"Fractal analysis and periapical index evaluation of multivisit nonsurgical endodontic retreatment: A retrospective study","volume":"133","author":"Tosun","year":"2022","journal-title":"Oral Surg. Oral Med. Oral Path Oral Radiol."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"634","DOI":"10.2340\/aos.v84.45201","article-title":"Assessment of fractal dimension changes in periapical trabecular patterns following single-visit and multi-visit nonsurgical endodontic treatment with different medicaments: A retrospective study","volume":"84","author":"Kirci","year":"2025","journal-title":"Acta Odontol. Scand."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.tripleo.2008.05.047","article-title":"Fractal dimension analysis of periapical reactive bone in response to root canal treatment","volume":"107","author":"Yu","year":"2009","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1002\/JPER.19-0452","article-title":"Evaluation of trabecular bone changes in patients with periodontitis using fractal analysis: A periapical radiography study","volume":"91","author":"Serindere","year":"2020","journal-title":"J. Periodontol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/s11282-021-00536-4","article-title":"Evaluation of trabecular bone healing using fractal dimension analysis after augmentation of alveolar crests with autogenous bone grafts: A preliminary study","volume":"38","author":"Kaba","year":"2022","journal-title":"Oral Radiol."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1007\/s44445-025-00021-2","article-title":"The outcomes of nonsurgical root canal treatment and retreatment assessed by CBCT: A systematic review and meta-analysis","volume":"37","author":"Almufleh","year":"2025","journal-title":"Saudi Dent. J."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1002\/jrsm.1163","article-title":"Randomization methods in emergency setting trials: A descriptive review","volume":"7","author":"Corbett","year":"2016","journal-title":"Res. Synth. Methods"},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"591","DOI":"10.1111\/iej.13258","article-title":"Immediate clinical and microbiological evaluation of the effectiveness of 0.5% versus 3% sodium hypochlorite in root canal treatment: A quasi-randomized controlled trial","volume":"53","author":"Ulin","year":"2020","journal-title":"Int. Endod. J."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"1745","DOI":"10.1111\/iej.14134","article-title":"The use of 0.5% or 3% NaOCl for irrigation during root canal treatment results in similar clinical outcome: A 6-year follow-up of a quasi-randomized clinical trial","volume":"57","author":"Ulin","year":"2024","journal-title":"Int. Endod. J."},{"key":"ref_65","first-page":"e7736","article-title":"Two-dimensional Periapical, Panoramic Radiography Versus Three-dimensional Cone-beam Computed Tomography in the Detection of Periapical Lesion After Endodontic Treatment: A Systematic Review","volume":"12","author":"Antony","year":"2020","journal-title":"Cureus"},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"361","DOI":"10.2105\/AJPH.94.3.361","article-title":"Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: The TREND statement","volume":"94","author":"Lyles","year":"2004","journal-title":"Am. J. Public Health"}],"container-title":["Diagnostics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/7\/1003\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:56:06Z","timestamp":1774612566000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4418\/16\/7\/1003"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,26]]},"references-count":66,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,4]]}},"alternative-id":["diagnostics16071003"],"URL":"https:\/\/doi.org\/10.3390\/diagnostics16071003","relation":{},"ISSN":["2075-4418"],"issn-type":[{"value":"2075-4418","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,26]]}}}