Apical microsurgery is accurate and minimally invasive, produces few complications, and has a success rate of more than 90%. However, due to the lack of awareness and understanding of apical microsurgery by dental general practitioners and even endodontists, many clinical problems remain to be overcome. The consensus has gathered well-known domestic experts to hold a series of special discussions and reached the consensus. This document specifies the indications, contraindications, preoperative preparations, operational procedures, complication prevention measures, and efficacy evaluation of apical microsurgery and is applicable to dentists who perform apical microsurgery after systematic training.
Microsurgery/standards* ; Humans ; Apicoectomy ; Contraindications, Procedure ; Tooth Apex/diagnostic imaging* ; Postoperative Complications/prevention & control* ; Consensus ; Treatment Outcome

Pulpotomy, which belongs to vital pulp therapy, has become a strategy for managing pulpitis in recent decades. This minimally invasive treatment reflects the recognition of preserving healthy dental pulp and optimizing long-term patient-centered outcomes. Pulpotomy is categorized into partial pulpotomy (PP), the removal of a partial segment of the coronal pulp tissue, and full pulpotomy (FP), the removal of whole coronal pulp, which is followed by applying the biomaterials onto the remaining pulp tissue and ultimately restoring the tooth. Procedural decisions for the amount of pulp tissue removal or retention depend on the diagnostic of pulp vitality, the overall treatment plan, the patient's general health status, and pulp inflammation reassessment during operation. This statement represents the consensus of an expert committee convened by the Society of Cariology and Endodontics, Chinese Stomatological Association. It addresses the current evidence to support the application of pulpotomy as a potential alternative to root canal treatment (RCT) on mature permanent teeth with pulpitis from a biological basis, the development of capping biomaterial, and the diagnostic considerations to evidence-based medicine. This expert statement intends to provide a clinical protocol of pulpotomy, which facilitates practitioners in choosing the optimal procedure and increasing their confidence in this rapidly evolving field.
Humans ; Calcium Compounds/therapeutic use* ; Consensus ; Dental Pulp ; Dentition, Permanent ; Oxides/therapeutic use* ; Pulpitis/therapy* ; Pulpotomy/standards*

Enamel demineralization, the formation of white spot lesions, is a common issue in clinical orthodontic treatment. The appearance of white spot lesions not only affects the texture and health of dental hard tissues but also impacts the health and aesthetics of teeth after orthodontic treatment. The prevention, diagnosis, and treatment of white spot lesions that occur throughout the orthodontic treatment process involve multiple dental specialties. This expert consensus will focus on providing guiding opinions on the management and prevention of white spot lesions during orthodontic treatment, advocating for proactive prevention, early detection, timely treatment, scientific follow-up, and multidisciplinary management of white spot lesions throughout the orthodontic process, thereby maintaining the dental health of patients during orthodontic treatment.
Humans ; Consensus ; Dental Caries/etiology* ; Dental Enamel/pathology* ; Tooth Demineralization/etiology* ; Tooth Remineralization

Intentional tooth replantation (ITR) is an advanced treatment modality and the procedure of last resort for preserving teeth with inaccessible endodontic or resorptive lesions. ITR is defined as the deliberate extraction of a tooth; evaluation of the root surface, endodontic manipulation, and repair; and placement of the tooth back into its original socket. Case reports, case series, cohort studies, and randomized controlled trials have demonstrated the efficacy of ITR in the retention of natural teeth that are untreatable or difficult to manage with root canal treatment or endodontic microsurgery. However, variations in clinical protocols for ITR exist due to the empirical nature of the original protocols and rapid advancements in the field of oral biology and dental materials. This heterogeneity in protocols may cause confusion among dental practitioners; therefore, guidelines and considerations for ITR should be explicated. This expert consensus discusses the biological foundation of ITR, the available clinical protocols and current status of ITR in treating teeth with refractory apical periodontitis or anatomical aberration, and the main complications of this treatment, aiming to refine the clinical management of ITR in accordance with the progress of basic research and clinical studies; the findings suggest that ITR may become a more consistent evidence-based option in dental treatment.
Humans ; Tooth Replantation/methods* ; Consensus ; Periapical Periodontitis/surgery*

Instrument separation is a critical complication during root canal therapy, impacting treatment success and long-term tooth preservation. The etiology of instrument separation is multifactorial, involving the intricate anatomy of the root canal system, instrument-related factors, and instrumentation techniques. Instrument separation can hinder thorough cleaning, shaping, and obturation of the root canal, posing challenges to successful treatment outcomes. Although retrieval of separated instrument is often feasible, it carries risks including perforation, excessive removal of tooth structure and root fractures. Effective management of separated instruments requires a comprehensive understanding of the contributing factors, meticulous preoperative assessment, and precise evaluation of the retrieval difficulty. The application of appropriate retrieval techniques is essential to minimize complications and optimize clinical outcomes. The current manuscript provides a framework for understanding the causes, risk factors, and clinical management principles of instrument separation. By integrating effective strategies, endodontists can enhance decision-making, improve endodontic treatment success and ensure the preservation of natural dentition.
Humans ; Root Canal Therapy/adverse effects* ; Consensus ; Root Canal Preparation/adverse effects*

Palatogingival groove (PGG) is a common developmental deformity, which is prone to retain plaque, leading to local periodontal inflammation. Furthermore, the infection can spread to the dental pulp tissue through the PGG, eventually resulting in combined periodontal-endodontic lesions. The treatment methods include PGG treatment, periodontal treatment, endodontic treatment, etc. The abnormal anatomical structure of PGG will influence the treatment and prognosis of the affected tooth. Teeth with combined periodontal-endodontic lesions often have poor curative effect and prognosis. How to early intervene and improve its prognosis has become a hot and difficult issue for dentists in recent years. This article analyzes the challenges in the treatment of PGG and puts forward the corresponding strategies, so as to provide reference for the clinical diagnosis and treatment of PGG.

For the treatment of pulp calcification,dynamic navigation technology could assist in the establishment of pathways and avoid the occurrence of root canal complications such as lateral root canal perforation that might occur during free hand manipulation.This short paper reported a case of dynamic navigation assisted treatment of maxillary central incisor pulp calcification.The treatment were effective at 3,6 and 12 months after operation.

Objective:To characterize the bacterial communities present in the root apical regions associated with persistent apical periodontitis(PAP).Methods:6 periapical lesion samples were collected from the teeth with PAP.DNA was extracted and ampli-fied by PCR based on the V3-V4 region of 16S rRNA gene.Illumina high throughput sequencing was applied to achieve the infor-mation of microbial community.Results:In total,447 OTUs were assigned,the average number of OTUs for the samples was 164.83±56.24.The phyla Firmicutes,Actinobacteria,Bacteroidetes,Proteobacteria and Fusobacteria were detected with high rela-tive abundances in all samples.At the genus level,the prevalent bacterial genera were Bifidobacterium,Streptococcus,Bacillus,En-terococcus and Porphyromonas,which were abundantly detected in all samples.The 6 samples were divided into 2 groups by hierar-chical cluster analysis.Prevotella and Treponema were abundant in group A,Bifidobacterium,Streptococcus and Enterococcus were abundant in group B.Conclusion:The bacterial profiles of root apical region of the teeth with PAP can be illustrated that diverse bacterial communities located in apical lesions.The bacterial composition of PAP can be divided into 2 microbial pattern and the re-lationship between different bacteria may guide new strategies to control infection.

Palatogingival groove (PGG) is a common developmental deformity, which is prone to retain plaque, leading to local periodontal inflammation. Furthermore, the infection can spread to the dental pulp tissue through the PGG, eventually resulting in combined periodontal-endodontic lesions. The treatment methods include PGG treatment, periodontal treatment, endodontic treatment, etc. The abnormal anatomical structure of PGG will influence the treatment and prognosis of the affected tooth. Teeth with combined periodontal-endodontic lesions often have poor curative effect and prognosis. How to early intervene and improve its prognosis has become a hot and difficult issue for dentists in recent years. This article analyzes the challenges in the treatment of PGG and puts forward the corresponding strategies, so as to provide reference for the clinical diagnosis and treatment of PGG.

For the treatment of pulp calcification,dynamic navigation technology could assist in the establishment of pathways and avoid the occurrence of root canal complications such as lateral root canal perforation that might occur during free hand manipulation.This short paper reported a case of dynamic navigation assisted treatment of maxillary central incisor pulp calcification.The treatment were effective at 3,6 and 12 months after operation.