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*

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*

Endodontic diseases are a kind of chronic infectious oral disease.Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha.However,it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy(RCT).Recent research,encompassing bacterial etiology and advanced imaging techniques,contributes to our understanding of the root canal system's anatomy intricacies and the technique sensitivity of RCT.Success in RCT hinges on factors like patients,infection severity,root canal anatomy,and treatment techniques.Therefore,improving disease management is a key issue to combat endodontic diseases and cure periapical lesions.The clinical difficulty assessment system of RCT is established based on patient conditions,tooth conditions,root canal configuration,and root canal needing retreatment,and emphasizes pre-treatment risk assessment for optimal outcomes.The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT.These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.

The dental operative microscope has been widely employed in the field of dentistry, particularly in endodontics and operative dentistry, resulting in significant advancements in the effectiveness of root canal therapy, endodontic surgery, and dental restoration. However, the improper use of this microscope continues to be common in clinical settings, primarily due to operators' insufficient understanding and proficiency in both the features and established operating procedures of this equipment. In October 2019, Professor Jingping Liang, Vice Chairman of the Society of Cariology and Endodontology, Chinese Stomatological Association, organized a consensus meeting with Chinese experts in endodontics and operative dentistry. The objective of this meeting was to establish a standard operation procedure for the dental operative microscope. Subsequently, a consensus was reached and officially issued. Over the span of about four years, the content of this consensus has been further developed and improved through practical experience.
Humans ; Dentistry, Operative ; Consensus ; Endodontics ; Root Canal Therapy ; Dental Care

Objective To investigate the status quo of cancer pain level and cancer pain self-efficacy in the patients with cancer pain and to analyze the influencing factors of cancer pain self-efficacy.Methods The cross sectional investigation was adopted.A total of 200 inpatients with cancer pain in the Affiliated Hospital and Affiliated Hospital of Traditional Chinese Medicine of Southwest Medical University from February to September 2016 were recruited as the respondents by using the convenience sampling method.The questionnaire investigation was performed by adopting the general data questionnaire from,pain degree scale and chro nic pain self-efficacy scale.Results The total score of cancer pain self-efficacy was (45.82±15.47) points,and the score of pain management self-efficacy,symptom coping self-efficacy and somatic function self-efficacy were (10.32 ± 2.93),(17.34 ± 6.22) and (18.16 ± 8.38) points respectively.The five factors of maximal influence degree on cancer pain self-efficacy were the physical exercise situation after illness(| b| =9.96),family economic status(| b| =6.89),maximal pain degree at nearest 24 h(| b | =5.44),average pain degree at nearest 24 h(| b| =4.31) and age(|b| =0.27).Conclusion The cancer pain self-efficacy in the respondents was in the middle-to-low level.The patients with smaller age,good family economic status,usual physical exercise after illness and milder degree in maximal pain within 24 h had higher cancer pain self-efficacy.

Objective To evaluate the efficacy of endoscopic ultrasonography(EUS)guided implantation of 5-FU seeds for progressive gastric cancer.Methods A total of 23 patients with progressive gastric cancer and outflow obstruction were enrolled into the study.During the endoscopy procedure, 45-60 5-FU seeds were implanted into the tumors with guidance of EUS, with an average dose of 100 mg.Volumes of tumor were examined with 3D-EUS before and after the treatment.Results A total of 33 procedures of 5-FU implantation were performed.By measurements of 3D-EUS, the numbers of patients with complete respons, partial response, no change, progressive disease were 1, 15, 6 and 1, respectively.In terms of outflow obstruction improvement, significant effect, obvious effect and average effect were achieved in 6, 7 and 9 patients, respectively, with an overall response rate at 91.4%.Conclusion EUS-guided 5-FU seed implantation in progressive gastric cancer is safe,reliable and effective with few complications.3D-EUS may be a new method to evaluate curative effect.