OBJECTIVES: We aimed to compare the apical sealing properties of three endodontic sealers, namely, C-Root SP (C-R), iRoot SP, and GuttaFlow Bioseal (GFB) in vitro. METHODS: Eighty-two single-rooted premolars and anterior teeth were prepared by using M3 machine with nickel-titanium file and randomly divided into six experimental groups (n=12) and two control groups (n=5). Group A1: single-cone technique (SC)+C-R; group B1: SC+iRoot SP; group C1: SC+GFB; group A2: single-cone with ultrasonic activation (SU)+C-R; group B2: SU+iRoot SP; group C2: SU +GFB; group D: positive control group, and group E: negative control group. Dye penetration length and lateral root canal filling in each group were measured by dye penetration test. A scanning electron microscope (SEM) was used to observe the interface between gutta pertscha, root canal sealer, and dentin wall. Dye penetration length was measured and analyzed by Kruskal-Wallis test, and data on lateral root canal filling were evaluated using Chi-square. RESULTS: The dye penetration length in group A1 was lower than that in groups C1 and A2 (P<0.05) but was not significantly different from the other groups (P>0.05). Lateral root canal filling was not significantly different among all groups (P>0.05). SEM showed that GFB was slightly better than C-R and iRoot SP in binding to gutta pertcha and dentin wall. CONCLUSIONS GFB, C-R, and iRoot SP demonstrate excellent apical sealing ability. Under the conditions tested in this study, SU did not yield significantly improve the apical sealing ability of the three root canal sealers.
Root Canal Filling Materials/chemistry* ; Humans ; Gutta-Percha ; Microscopy, Electron, Scanning ; Root Canal Obturation/methods* ; Ceramics ; Dimethylpolysiloxanes ; Drug Combinations

Fused teeth are usually formed by the partial or complete fusion of two normal tooth germs during the development process and belong to dental developmental abnormalities. Fused teeth are relatively rare clinically, and those occurring in the posterior tooth area are even rarer. This article reports a case of fused teeth between the first permanent molar and the second permanent molar in the right mandible. This fused tooth had a complex root canal anatomical structure (seven root canals). The number and location of the root canals were analyzed by cone beam computed tomography, and root canal treatment was successfully completed with the assistance of microscope.
Humans ; Molar/diagnostic imaging* ; Mandible ; Dental Pulp Cavity/abnormalities* ; Cone-Beam Computed Tomography ; Root Canal Therapy/methods* ; Fused Teeth/surgery*

OBJECTIVES: This study aimed to evaluate the clinical application value of in-situ crown reattachment technique combined with pulpotomy in the treatment of complicated crown-root fractures in young permanent anterior teeth. METHODS: A prospective study was conducted on 50 children with complicated crown-root fractures in young permanent anterior teeth, who were treated at the Pediatric Dentistry Department, Hospital of Stomatology, Xi'an Jiaotong University from June 2023 to June 2024. All patients underwent in-situ crown reattachment technique combined with pulpotomy. Clinical examinations, radiographic evaluations, and subjective satisfaction surveys (using a Likert scale of 1-10) were conducted at 1, 6, and 12 months postoperatively. Data were analyzed using SPSS 23.0. RESULTS: The loss-to-follow-up rate was 12% (6/50), with 44 cases completing the 12 months of evaluation. The clinical success rate was 93.18% (41/44), and the radiographic success rate was 97.73% (43/44). The subjective satisfaction scores showed a significant improvement in masticatory function from 7.03±0.52 at 1 month to 8.07±0.92 at 12 months postoperatively (P<0.05), whereas the scores for aesthetics, comfort, and quality-of-life impact showed no statistically significant differences (P>0.05). CONCLUSIONS In-situ crown reattachment technique combined with pulpotomy effectively treats complicated crown-root fractures in young permanent anterior teeth, demonstrating a high short-term clinical success rate, significantly improved masticatory function, and minimally invasive preservation of pulp vitality and root development potential. This technique provides an optimized treatment option for dental trauma in children, although its long-term efficacy requires further validation.
Humans ; Pulpotomy ; Tooth Fractures/surgery* ; Child ; Prospective Studies ; Male ; Female ; Tooth Root/injuries* ; Tooth Crown/injuries* ; Treatment Outcome ; Incisor/injuries* ; Child, Preschool

Dental trauma is one of the relatively common emergencies in clinical dental practice, with a high incidence rate, and the maxillary central incisors are the most frequently affected. This article reports a case of a 17-year-old female patient who suffered traumatic complete avulsion of teeth 11 and 21, with tooth 21 lost after avulsion. The prognosis for replantation was poor due to the absence of the buccal alveolar bone wall of tooth 11. Therefore, tooth 11 was treated with extracorporeal root canal therapy and then replanted into the alveolar socket of tooth 21, which had better conditions, followed by elastic splint fixation. After 20 months of follow-up observation, the affected tooth maintained a stable functional position, with no periapical inflammation or ankylosis observed. Subsequently, delayed implant restoration at the site of tooth 11 was performed, ultimately achieving a favorable treatment outcome. This case may provide new insights and references for future clinical practices in tooth replantation.
Humans ; Female ; Tooth Replantation/methods* ; Incisor/injuries* ; Adolescent ; Tooth Avulsion/therapy* ; Maxilla ; Root Canal Therapy

Animal experiments are crucial in evaluating the preclinical safety and efficacy of new dental materials, drugs, instruments, and equipment by identifying and eliminating potential health risks to humans. An international team of several dental experts formulated a guideline named Preferred Reporting Items for Animal Studiesin Endodontology (PRIASE) 2021. Consisting of 11 domains, 43 individual items, and a flowchart. PRIASE provides guidance for animal experiments in dentistry and improves the quality of experiment design and reporting. This work introduces the process and basic content of the guideline and interprets the key items of its checklist with specific examples to provide reference for the reporting of animal experiment in dentistry in China.
Animals ; Animal Experimentation/standards* ; Checklist ; China ; Endodontics ; Guidelines as Topic ; Research Design

OBJECTIVES: This study aimed to evaluate the filling effects of three biomaterial root canal sealers [iRoot SP, C-Root SP, and GuttaFlow Bioseal (GFB)] by using Micro-CT. METHODS: Sixty single-canal detached premolars were selected. After crown amputation, their uniform working length was set at 12 mm and prepared to a 06 taper 30# with M3 nickel-titanium file. The samples were randomly divided into six groups with different sealers and obturation techniques: iRoot SP+single-cone technique (SC), C-Root SP+SC, GFB+SC, iRoot SP+single cone-mediated ultrasonic technique (SU), C-Root SP+SU, and GFB+SU. Samples were scanned by Micro-CT, and the total and segmented filling rates were calculated with Mimics 22.0 software after 3D reconstruction. RESULTS: The overall filling rate of the three biomaterial root canal sealers was higher than 90%. The overall and coronal third and middle third segment filling rate of groups iRoot SP+SC, C-Root SP+SC was higher than that of group GFB+SC (P<0.01), with no significant difference between groups iRoot SP+SC and C-Root SP+SC (P>0.05). On the apical third, no significant difference was found among each group (P>0.05). The overall and segment filling rate of groups iRoot SP+SU and C-Root SP+SU was higher than that of GFB+SU (P<0.01), with no significant difference between groups iRoot SP+SU and C-Root SP+SU (P>0.05). The filling rate of the apical 1/3 of group C-Root+SC was lower than that of group C-Root+SU (P<0.01), and the filling rate of the coronal 1/3 of group GFB+SC was higher than that in the GFB+SU (P<0.01). Nevertheless, no significant difference was found in other filling rate of two obturation techniques (P>0.05). CONCLUSIONS The overall filling rate of the three biomaterial root canal sealers using SC and SU are satisfactory. iRoot SP and C-Root SP have similar filling rates, which are significantly higher than that of GFB. C-Root SP combined with SU technique can improve the filling quality of the root apical.
Root Canal Filling Materials ; X-Ray Microtomography ; Humans ; Root Canal Obturation/methods* ; Gutta-Percha ; Dimethylpolysiloxanes ; Drug Combinations ; Dental Pulp Cavity/diagnostic imaging* ; Bicuspid

OBJECTIVE: To evaluate the filling quality of single cone obturation in root canal model with irregular structure (Hus&Kim Ⅴ, Yin Ⅱ-type isthmus) which established by 3D printing technology using slices and radiographic methods, in order to provide reference for clinical practice. METHODS: (1) Extracted fresh premolars with Hus&Kim Ⅴ and Yin-type Ⅱ isthmus were collected and scanned by cone-beam computed tomography (CBCT), then standard root canal models were designed and printed. Rhodamine B staining and bias fitting were used to verify the availability of the models. (2) 30 root canal models were randomly divided into 3 groups according to different filling methods (n=10). CONTROL GROUP: vertical compaction obturation; Experimental group 1: single cone obturation with 0.06-taper cone (30#); Experimental group 2: single cone obturation with 0.04-taper cone (35#), GuttaFlow 2 as canal sealers. Slices were taken at 2, 4, 6, and 8 mm from the root apex in the direction perpendicular to the long axis of the root and observed under a stereomicroscope to calculate the percentage of filling area (PAV), percentage of gutta-percha-filled area (PGFA), percentage of sealer filled area (PSFA). (3) On the basis of the above results, two groups (n=4) were selected to further analyze the filling quality by micro-computed tomography (Micro-CT), the filling volume of main root canal and the isthmus were obtained, and the percentage of filling volume (PFV) was calculated. Two-way ANOVA was used to evaluate the differences between the groups, and Tukey' s multiple comparison was used to compare the data between the groups and within the groups. RESULTS: (1) Rhodamine B staining solution could overflow the apical foramen, and the main root canal system and the isthmus area were stained, showed no remnants of support material. The 3D standard deviation of the printed model data was 0.03 mm, and the average fitting distance was 0.02 mm. (2) The PFA of the two experimental groups were both significantly lower than that of the control group (F=45.04, P < 0.01). There was no statistical difference of the PFA at apical 2 and 4 mm between the two experimental groups (P>0.01), but at the middle and coronal portions of the root canal (6, 8 mm), the PFA of the experimental group 1 was higher than that of the experimental group 2 (P < 0.01). PFA in the apical 2, 4 mm of the two experimental groups were both lower than that in the middle and coronal portions 6, 8 mm of the canal (P < 0.01). There was no difference in the PGFA and PSFA between the two experimental groups at the apical 2, 4 mm (F=2.383, P>0.01). (3) The results of Micro-CT showed that the PFV of the experimental group 1 was statistically different with the control group (F=47.33, P < 0.01). The PFV of the experimental group 1 was 54.33%±4.35% in the isthmus and 78.31%±4.21% in the main root canal, which were both lower than the PFV of the control group of 76.48%±4.89% (isthmus) and 86.90%±3.29% (main root canal, P < 0.01). The PFV of the main root canal in the experimental group 1 was higher than that in the isthmus (P < 0.01), while there was no difference between the isthmus and the main root canal in the control group (P>0.01). CONCLUSION In the irregular root canal structure with isthmus, using large-taper gutta-percha can improve the filling quality of the middle and upper part of the canal, but the percentage of filling volume in the isthmus is lower than that of the main canal, and more technical improvements are needed.
Humans ; Root Canal Obturation/methods* ; Cone-Beam Computed Tomography ; Root Canal Filling Materials ; Dental Pulp Cavity/diagnostic imaging* ; Printing, Three-Dimensional ; In Vitro Techniques ; Gutta-Percha ; Bicuspid

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*