Root canal treatment — a tooth-saving treatment or a source of chronic disease?

Aim of the study: To analyze the influencing factors of tooth retention within 5 years after root canal treatment (RCT) in patients with cracked teeth and chronic irreversible pulpitis, and to construct a nomogram model so as to provide a basis for the selection of clinical treatment regimen for such patients.

Results: Successful and improved teeth were recorded as tooth survival. According to whether the teeth were retained within 5 years, the enrolled patients were categorized into survival group (265 cases) and non-survival group (30 cases), with the 5-year tooth survival rate of 89.9%. Multivariate analysis identified 2-3 RCT visits (Odds Ratio (OR) [95% Confidence Interval (CI)] = 0.15 [0.05, 0.50]), probing depth > 5 mm (OR [95% CI] = 2.99 [1.26, 7.09]), and crown restoration (OR [95% CI] = 0.28 [0.09, 0.83]) as independent predictors of 5-year tooth loss (p < 0.05). The nomogram was constructed based on multivariate results and the area under the ROC curve of the prediction model was 0.73 (0.62,0.84). H-L test revealed p = 0.682, and the calibration curve of the model had a high overlap degree with the ideal curve. The risk threshold ranged from 4 to 68%. The nomogram model line was located at the upper right of the None line and the All line.

Aim of the study: To assess the impact of non-endodontic factors like periodontitis and chronic disease medication (CDM) mostly affecting elderly people's health on the outcome of non-surgical root canal treatment (NSRCT). An increasing number of elderly people with high prevalence of marginal periodontitis and CDM benefit from adequate endodontic therapy, if irreversible pulpitis or apical periodontitis occurs.

Results: Periodontitis and CDM had no effect on endodontic outcome. Chronic intake of anticoagulants showed a significant association with endodontic outcome. Root-filled teeth with preoperative periapical lesions had a significantly higher rate of endodontic failure than those without preoperative lesion. The overall success rate of NSRCT was 87.1% with 81 healed teeth. Periodontitis and CDM have no impact on the endodontic outcome of NSRCT in a population 60 years or more.

Aim of the study: The purpose of this systematic review and meta-analysis was to evaluate utilisation of supplementary techniques for pain control during root canal treatment of lower molars with irreversible pulpitis. The literature was searched using electronic databases up to year 2012.

Results: the inferior alveolar nerve block. Changing the injection techniques or supplemental injection had no significant effect on pulp anaesthesia compared to the standard treatment (P = 1.00 or P = 0.14), whereas changing anaesthetic features and increasing anaesthetic volumes resulted in significantly higher rates of anaesthesia than those of the standard treatment (P = 0.03 and P = 0.007, respectively). Premedication with non-steroidal anti-inflammatory drugs (NSAIDs) also significantly increased the success rate of anaesthesia (P = 0.001). Taken together, increased anaesthetic volumes and premedication with NSAIDs provide predictable anaesthesia and more pain control during endodontic treatment of lower molars with irreversible pulpitis.

Aim of the study: Apical periodontitis is an inflammatory response of periradicular tissues caused by microbial infection within the root canal system. Alopecia areata (AA) is a T-cell mediated, autoimmune condition affecting hair follicles causing nonscarring hair loss, clinically characterised by small patches of baldness on the scalp and/or around the body.

Results: The second case was followed up for 9 months, with a complete healing of AA following the affected tooth extraction, whereas the third case demonstrates complete hair regrowth after 4 months following the single-visit endodontic therapy. This article highlights the impact of oral infection on endogenic immune-inflammatory mediators, although causality cannot be inferred from these observations alone. There is a need for an interdisciplinary approach in cases of idiopathic AA, in the absence of other aetiological factors, to preclude unnecessary pharmacological interventions. Due to these limitations, more epidemiological studies would be beneficial to investigate any possible association between AA and apical periodontitis.

Aim of the study: Objective: To report the conservative management of a complex failed apexification in a permanent premolar complicated by severe internal root resorption, irregular apical calcification, and exceptionally thin root canal walls and to evaluate its long-term (56-month) clinical and radiographic outcomes. Methods: A 27-year-old male presented with chronic apical periodontitis in the right mandibular first premolar.

Results: Results: At the 3-month follow-up, the patient was completely asymptomatic, and radiographs indicated initial periapical bone healing. The 56-month follow-up demonstrated progressive formation of mineralized tissue, apparent thickening of the root canal walls at root apex, complete resolution of periapical radiolucency, and a stable, functional occlusion. Conclusions: This case demonstrates that teeth with severe structural compromise and internal resorption following failed apexification are not necessarily hopeless. A tailored conservative approach, integrating advanced laser-assisted disinfection, bioceramic apical barriers, internal resin reinforcement, and meticulous occlusal management, can yield highly successful long-term outcomes, ensuring the preservation of the natural dentition.

Aim of the study: This study describes the treatment of tooth #9 exhibiting external cervical root resorption (ECR) and apical root resorption. A therapeutic approach-including root canal therapy with MTA apexification, surgical debridement of resorptive tissue at the ECR site, and sealing of the defect-was necessary to eliminate the infection.

Results: This study describes the treatment of tooth #9 exhibiting external cervical root resorption (ECR) and apical root resorption. A therapeutic approach-including root canal therapy with MTA apexification, surgical debridement of resorptive tissue at the ECR site, and sealing of the defect-was necessary to eliminate the infection.