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

Odontogenic maxillary sinusitis(OMS)is a subtype of maxillary sinusitis(MS).It is actually inflammation of the maxillary sinus that secondary to adjacent infectious maxillary dental lesion.Due to the lack of unique clinical features,OMS is difficult to distinguish from other types of rhinosinusitis.Besides,the characteristic infectious pathogeny of OMS makes it is resistant to conventional therapies of rhinosinusitis.Its current diagnosis and treatment are thus facing great difficulties.The multi-disciplinary cooperation between otolaryngologists and dentists is absolutely urgent to settle these questions and to acquire standardized diagnostic and treatment regimen for OMS.However,this disease has actually received little attention and has been underrepresented by relatively low publication volume and quality.Based on systematically reviewed literature and practical experiences of expert members,our consensus focuses on characteristics,symptoms,classification and diagnosis of OMS,and further put forward multi-disciplinary treatment decisions for OMS,as well as the common treatment complications and relative managements.This consensus aims to increase attention to OMS,and optimize the clinical diagnosis and decision-making of OMS,which finally provides evidence-based options for OMS clinical management.

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

Regenerative endodontic procedures (REPs) is a biologic-based treatment modality for immature permanent teeth diagnosed with pulp necrosis. The ultimate objective of REPs is to regenerate the pulp-dentin complex, extend the tooth longevity and restore the normal function. Scientific evidence has demonstrated the efficacy of REPs in promotion of root development through case reports, case series, cohort studies, and randomized controlled studies. However, variations in clinical protocols for REPs exist due to the empirical nature of the original protocols and rapid advancements in the research field of regenerative endodontics. The heterogeneity in protocols may cause confusion among dental practitioners, thus guidelines and considerations of REPs should be explicated. This expert consensus mainly discusses the biological foundation, the available clinical protocols and current status of REPs in treating immature teeth with pulp necrosis, as well as the main complications of this treatment, aiming at refining the clinical management of REPs in accordance with the progress of basic researches and clinical studies, suggesting REPs may become a more consistently evidence-based option in dental treatment.
Humans ; Consensus ; Regenerative Endodontics ; Dental Pulp Necrosis/therapy* ; Dentists ; Professional Role ; Dental Care

Traumatic dental injury (TDI), one of the common dental diseases, is defined as acute injuries to tooth hard tissues, dental pulp and/or periodontal tissues caused by sudden forces. Based on the Guidelines for the Management of TDI by International Association of Dental Traumatology (2012) and the Recommended Guidelines of the American Association of Endodontists for the Treatment of TDI (2013) for the permanent teeth, and combined with the authors′ clinical experiences, the contemporary classification and clinical perspective of TDI were introduced in detail. Dental clinicians should understand and master the international guidelines for the management of TDI, including proper diagnosis, standardized treatments and regular follow-up, so as to obtain the favorable outcomes.

Objective:To prepare a three-dimensional (3D) printing donor tooth model and to observe its application in the peri-operative period.Methods:In part one, 192 cases (2017.9-2019.8) from Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University ［107 males and 85 females, age (34.2±10.7) years］ which need autotransplantation of teeth (ATT) were collected. Whether the donor teeth can be completely extracted was predicted through clinical and imaging examination (first prediction). The second prediction was supplemented by the three-dimensional printing model of the donor teeth. Each of the prediction was compared with the actual results and the coincidence rate was calculated. In part two, 64 cases (2017.9-2019.8) from Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University ［28 males, 36 females, age (30.2±8.3) years］ which need ATT were randomly divided into the model group and the donor group. The time of alveolar fossa preparation, time of donor tooth in vitro, times of trial implantation and time of pulptomy and root canal location were recorded respectively. Results:In part one, the coincidence rate between the second prediction and the actual results ［97.4%(187/192)］ was significantly higher than that of the first prediction ［93.2%(179/192)］ ( P<0.05). In part two, the preparation time of the alveolar fossa in the maxillary and mandibular were (18.8±4.6) and (22.7±3.4) min, the time of the teeth in vitro were (3.0±0.6) and (2.1±0.6) min, the times of trial implantation were (1.3±0.8) and (1.0±0.9), and the time of pulpotomy and root canal location were (4.3±0.6) and (4.0±0.5) min. All values in the model groups were better than those in the donor group ( P<0.05). Conclusions:The 3D printing model is accurate. It can be used in autogenous tooth transplantation to shorten the preparation time of alveolar fossa and time of donor tooth in vitro, and reduce the times of trial implantation of donor teeth, and to help to improve the prediction accuracy of complete extraction of donor teeth and the time of pulpotomy and root canal location.

Root canal therapy is the most widely used method to treat the teeth with pulpal and periapical disorders. However, due to the complexity of root canal system, the existence of extraradicular biofilms and occurrence of true cyst, some teeth with pulpal and periapical diseases couldn′t be treated effectively by non-surgical therapies. Then the combination of the surgical treatment, i.e., endodontic surgery, is necessary. The endodontic microsurgery, under the magnification and illumination provided by the dental operation microscope and with the proper use of micro instruments, ultrasonic retrotips and bioceramics root end filling materials, can treat the teeth with pulpal or periapical disorders precisely and less traumatically with high success rate. This article reviews the indications, contraindications, clinical strategy and latest advancement in endodontic microsurgery.

Objective To evaluate the outcome and the potential prognostic factors of apical microsurgery.Methods The teeth with persistent periapical diseases were treated by microsurgery using micro instruments,ultrasonic retrotips and mineral trioxide aggregate(MTA) under dental operate microscope.The procedure includes incision and flap retraction,osteotomy,apicoectomy,retro-preparation and retro-filling of root canal.Patients were recalled at 1,3,6,and 12-month intervals.The outcome was evaluated by clinical and radiographic examinations,and the potential prognostic factors were analyzed.Results One hundred and eighty cases(240 teeth),including 132 upper anterior teeth,22 lower anterior teeth,31 upper premolars,18 lower premolars,19 upper molars and 18 lower molars,were treated by microsurgery between July 2010 and December 2012.A total of 152 cases(207 teeth) were recalled.The application of the apical microsurgery included failure of previous endodontic treatment,periapical lesion with post,periapical cyst,calcified canals,separated instruments,overfilling,open apex,root facture,failure of previous apical surgery,apical fenestration,and special root canal system.The success rate was 90.8％ (188/207).Age,sex,tooth position,type of periapical radiolucency,fistula and clinical application type appeared to have a negative effect on the outcome.Endo-perio lesion was a significant factor.Eighteen cases (19 teeth) failed mainly because of periodontally involved lesion and vertical root fracture.Conclusions Apical microsurgery,which combines the magnification and illumination provided by the microscope with the proper use of micro instruments,can treat the teeth with persistent periapical diseases precisely and less traumatically with high success rate.Case selection and standardized operations play a key role for success.

Objective To explore the effective method of the prevention and cure of unstable bladder after transurethral resection of prostate(TURP).Methods Ninety patients with benign prostatic hyperplasia(BPH)undergoing TURP under epidural anesthesia were randomly divided into 3 groups(with 30 patients in each group):treatment group,control group I and control group II.Tolterodine combined with diciofenac sodium/lidecaine hydrechloride injection were used after operation in treatment group.Control group I was only given tolterodine,and control group II was only given diclofenac sodium/lidocaine hydrochloride injection.Observed the incidence times and continuous time of unstable bladder after operation in three groups.Results Three cases(10.0%)happened to unstable bladder in treatment group and they were I degree,14 cases(46.7%)happened to unstable bladder in control group I,8 cases were I degree,5 cases were II degree,1 case was III degree;16 cases(53.3%)happened to unstable bladder in control group II,8 cases were I degree,6 cases were II degree,1 case was III degree,1 case was IV degree.There was obvious significance either between treatment group and control group I(P = 0.003)or between treatment group and control group II(P = 0.001).Conclusion Tolterodine combined with diclofenac sodium/ lidocaine hydrochloride injection have obvious effect on preventing the incidence of unstable bladder after TURP,it is easy to perform and can be used widely.