Erroneous pulpal and periapical diagnoses can lead to inappropriate treatment planning, unnecessary procedures, and compromised patient outcomes. While undergraduate endodontic education emphasises history taking, clinical testing and radiographic assessment, less is known about how consistently students document diagnostic conclusions in clinical records. To evaluate the completeness and compliance of endodontic diagnostic documentation among undergraduate dental students, benchmarked against British Endodontic Society (BES) and European Society of Endodontology (ESE) standards, and to explore trends across different stages of training. Records of 196 root canal treatments completed by Year 3–5 Bachelor of Dental Surgery students (2022–2024) were reviewed. Audit standards were based on the British Endodontic Society Guide to Good Endodontic Practice (2022) and United Kingdom record-keeping guidance. Parameters included history-taking, sensibility testing, radiographic justification and reporting, and documentation of provisional and definitive diagnoses. Compliance was analysed descriptively, with limited inferential comparison where appropriate. Compliance with core record keeping elements was high across all cohorts. Documentation of diagnostic conclusions and signs and symptoms varied across student groups and academic years. Provisional diagnoses were recorded in 12.37% of cases overall, whereas definitive diagnoses were documented in 66.31%, with the highest compliance observed in Year 5. Documentation of signs and symptoms was 65.83% in 2022–2023, increasing to 67.76% in 2023–2024. Undergraduate dental students consistently document clinical findings relevant to endodontic diagnosis; however, explicit recording of diagnostic conclusions, particularly provisional diagnoses, and documentation of signs and symptoms remain inconsistent. Strengthening educational emphasis on documenting diagnostic reasoning may support preparedness for independent practice.
This systematic review aimed to synthesise evidence on the microbiome of deep or extremely deep caries associated with a range of different pulp conditions, by analysing studies using next-generation sequencing (NGS) approaches. The review reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines and protocol was registered prospectively at the Open Science Framework (https://osf.io/vnwjh/). A literature search was carried out in the following databases: MEDLINE via PubMed, Scopus, Cochrane Database for Systematic Reviews (CDSR), Web of Science, the clinicaltrials.gov, and the Open Science Framework, in English language without time restriction. The last search was performed on May 1st 2025. An additional online search of the four major journals in the field of endodontics (International Endodontic Journal, Journal of Endodontics, Australian Endodontic Journal and the European Endodontic Journal) was also carried out independently starting from January 1st, 2010 to May 1st 2025. Only original research articles that used an NGS approach and investigated the microbiome of deep or extremely deep caries associated with different pulp diagnoses, assessed preoperatively, were included. The Johanna Brigg's Institute (JBI's) Critical Appraisal Instrument for Studies Reporting Prevalence Data was used to assess the risk of bias of included studies. Among 1914 articles initially identified, four were considered eligible for inclusion and further assessed for certain parameters. The overall risk of bias of the three and one included studies was characterised as 'unclear' and 'high'. Firmicutes were the most prevalent phylum in all cases. In cases of irreversible pulpitis, Firmicutes prevalence increased compared with cases of normal pulp and reversible pulpitis, while the prevalence of Actinobacteria, Proteobacteria and Bacteroidetes decreased. Lactobacillus was the most abundant genus in all cases, with its abundance in cases of symptomatic irreversible pulpitis increasing substantially. The NGS studies evaluated in this review create a preliminary, but comprehensive map of the microbiome of deep caries associated with a range of pulpal diagnoses. Α shift in microbiome as the asymptomatic cases become progressively symptomatic seems to occur, which may be relevant to management of deep caries in terms of complete or selective caries removal.
Generative large language models (LLMs) are increasingly used in dentistry, yet their guideline-based diagnostic accuracy and reproducibility remain uncertain. Position statements from the American Association of Endodontists and the European Society of Endodontology provide rigorous, evidence-based standards, making them an ideal benchmark to assess alignment of LLM outputs with endodontic best practices. This study was conducted according to Transparent Reporting of a Multivariable Model for Individual Prognosis or Diagnosis-Large Language Models guidelines, evaluated 11 LLMs: ChatGPT 5, ChatGPT 4o, ChatGPT o3, Gemini 2.5 Flash, Gemini 2.5 Pro, Claude Sonnet 4, Claude Opus 4, Perplexity R1 1776, Perplexity Sonar, DeepSeek, and DeepSeek DeepThink R1. Sixty multiple-choice questions derived from American Association of Endodontists and European Society of Endodontology position statements were administered to each model in 5 rounds, generating 3300 responses. The primary outcome was all-correct accuracy and the secondary outcome was intra-model consistency. Comparisons were performed with chi-square tests and Bonferroni adjustment. All-correct accuracy varied significantly (χ2 = 50.56, df = 10, P < .001). ChatGPT 4o and Claude Opus 4 achieved 95.0% accuracy, followed by ChatGPT 5, Claude Sonnet 4, Gemini 2.5 Flash, and Gemini 2.5 Pro (93.3%), and ChatGPT o3 (90.0%). DeepSeek DeepThink R1 scored 86.7%, Perplexity R1 1776 83.3%, Perplexity Sonar 81.7%, and DeepSeek 63.3%. Consistency exceeded 90% for most models, peaking at 98.3% for top performers but falling to 75.0% for DeepSeek. Most LLMs demonstrated high accuracy and reproducibility when benchmarked against authoritative endodontic guidelines. Despite notable progress over earlier generations, performance variability and confidently incorrect outputs highlight the need for rigorous validation and expert oversight before clinical integration.
This study compared the accuracy and repeatability of responses generated by three advanced language models (ChatGPT-4, Gemini, and DeepSeek) in determining the necessity and appropriate regimen of antibiotic prophylaxis in endodontic treatment. 15 questions on the basis of guidance published by the European Society of Endodontics in 2018 were developed and presented to each model by three different users, three times per day over 10 consecutive days. Accuracy was evaluated for individual questions and overall performance, and repeatability across days and times was statistically analysed. All models consistently provided correct responses for patients with penicillin allergy and those with a history of infective endocarditis. Significant differences were observed in responses regarding joint prosthesis, high-dose radiation to the jaws, bypass surgery history, and controlled diabetes, although overall accuracy did not differ significantly among models. These findings highlight the potential clinical value of the models, but their responses must be verified before clinical use.
The aim of the current scoping review is to provide an in-depth view of the disinfection methods using various forms of nanoparticles in endodontics. After registration (https://osf.io/jwq37), a search was conducted in PubMed, Scopus, Ebsco, and Lilacs. The research question based on the Population, Concept, and Context model framework was, "What are the efficient nanoparticles used for disinfection in the field of endodontics?" Studies that investigated different types of nanoparticles for disinfection in natural teeth (ex vivo) were included, while those from laboratory studies without involving natural dentin were excluded. Out of 1039 studies, 60 articles met the inclusion criteria and were included. Studies used a variety of nanoparticles in different forms, including nanoparticle-incorporated solutions, irrigants, medicaments, and sealers, tested against different organisms (mono-species and multispecies biofilms). These findings provide insights into the disinfection potentials of various nanoparticles in ex vivo models. While the clinical research remains uncertain, the results of the current review highlight the antimicrobial effect of nanoparticles under controlled conditions. Further clinical studies are necessary to establish effectiveness and translational potential in endodontic practice.
This study investigates the impact of regular testing on learning outcomes in undergraduate endodontic education. Specifically, it examines whether students perform better at the end of the course on previously tested material compared to non-tested material and explores the role of students' engagement and perceptions of testing in this effect. A within-participants experimental design was employed with 81 third-year dental students enrolled in a preclinical endodontics course. Students were tested on half of the course lectures (tested material) immediately after each lecture, while the remaining lectures served as a control (non-tested material). Testing was conducted using multiple-choice questions on the Blackboard Learn platform with immediate automated feedback. Final exam scores for tested and non-tested material were compared, and a subset of students (n = 44) completed a questionnaire assessing cognitive engagement, emotional engagement, and perceptions of testing. Students scored significantly higher on tested material (Mean = 25.284, SD = 4.202) compared to non-tested material (Mean = 21.111, SD = 3.847). The mean difference between the two scores was statistically significant with a very large effect size (F1,80 = 108.329, p < 0.001, ηp 2 = 0.575). The difference remained significant with a moderate to large effect size after accounting for the grade in the previous course and sex (F1,78 = 9.392, p = 0.003, ηp 2 = 0.107). Emotional engagement was found to moderate the effectiveness of testing, with students reporting higher emotional engagement showing greater gains from the intervention. The findings demonstrate a robust testing effect in undergraduate endodontic education, supporting the hypothesis that retrieval practice enhances learning outcomes. These results suggest that integrating regular, low-stakes testing into dental curricula can enhance dental students' learning outcomes at the end of the course.
Sodium hypochlorite (NaOCl) is frequently employed in endodontic procedures; however, improper application can result in significant soft tissue damage. This study investigated the incidence, characteristics, and outcomes of complications associated with NaOCl and identified contributing factors such as the operator's level of expertise, timing of intervention, and treatment modality. A retrospective analysis was conducted on 60 patients who sustained soft tissue injuries due to sodium hypochlorite; additionally, a minority of non-NaOCl agents (lidocaine, chlorhexidine, and articaine) were included for comparison between 2018 and 2023. The study recorded demographic data, procedure type, operator status, injury severity, and treatment methods. Statistical comparisons were performed using chi-square and Fisher's exact tests. The mean age of the patients was 36.4 ± 11.2 years, with a female representation of 65%. Root canal therapy accounted for 73.3% of the cases. Sodium hypochlorite was responsible for 53.3% of the injuries and was significantly associated with necrosis (43.7%) and scarring (75%, P=.019). Dental students exhibited higher complication rates compared to experienced operators (P=.032). Early intervention, defined as occurring within 24 hours, was associated with a reduced risk of permanent damage (18% vs. 62%, P=.004). Surgical management resulted in improved outcomes, with 80% of operated cases showing improvement. The mean follow-up period was 6.8 months. Sodium hypochlorite-induced soft tissue injuries can result in enduring functional and aesthetic consequences. Early detection, operator proficiency, and timely intervention are crucial for enhancing patient outcomes. These findings advocate for the implementation of preventive protocols and the enhancement of endodontic training.
This randomised clinical study assessed and compared the healing outcomes, both clinical and radiographic, of platelet-rich fibrin (PRF) and human amniotic membrane (HAM) scaffolds in regenerative endodontic therapy for necrotic mature permanent teeth with apical periodontitis. The study protocol was registered on the Clinical Trial Registry (CTRI/2023/12/060979). Thirty participants presenting with necrotic mature permanent teeth and apical lesions were assigned to either the PRF or HAM group (n=15 each) randomly. Follow-up evaluations were performed at baseline, 6 months, and 12 months, with clinical assessments and periapical radiographs conducted at all 3 time points, while cone-beam computed tomography (CBCT) imaging was obtained at baseline and at 12 months. Standardised regenerative endodontic procedures were performed by a single operator. Examiner calibration was completed prior to data collection to ensure consistency in measurements. At the 12-month follow-up, both groups demonstrated favourable clinical outcomes, with resolution of symptoms and radiographic evidence of periapical healing. The CBCT analysis revealed significant reductions in lesion volume for both PRF (65.26%) and HAM (64.75%) groups (P < .005), without a statistically significant difference between the groups. Periapical healing scores improved similarly in both groups. Sensibility tests revealed no return of pulp responsiveness in any case throughout the study period. Both PRF and HAM scaffolds supported periapical healing in necrotic mature permanent teeth. However, biological regeneration of the functional pulp-dentin complex could not be confirmed, indicating that periapical healing occurred without verified neurovascular re-establishment. The restricted sample size and limited follow-up duration suggest the need for further studies with larger populations and extended observation periods to substantiate these findings.
The objective of this article is to conduct a comprehensive review of the applications of artificial intelligence (AI) in endodontics, focusing on optimizing diagnosis, supporting clinical decision-making, and predicting treatment outcome. Additionally, its limitations and areas for improvement are analysed. Information was gathered through a search in scientific databases such as PubMed, Scopus, ScienceDirect, and Google Scholar, selecting studies published in English between 2016 and 2025. After applying exclusion criteria and removing duplicates, 51 articles were included. The main applications of AI in endodontics are grouped into three areas. In Diagnosis, AI models based on convolutional neural networks (CNNs), such as Diagnocat, have demonstrated accuracy greater than 90% in detecting periapical lesions using radiographs and cone-beam computed tomography (CBCT). Likewise, AI algorithms have successfully identified vertical root fractures with high precision in CBCT images. In the analysis of root and canal morphology, deep learning models have shown high accuracy in detecting C-shaped root canals and other anatomical variations. Regarding treatment, deep learning models can predict case complexity and improve treatment planning. Additionally, neural network-based algorithms have outperformed traditional electronic apex locators in determining root canal length. In terms of prognosis, AI models have achieved 95.6% accuracy in predicting pain after root canal treatment (RCT). AI also aids in predicting the success of non-surgical endodontic retreatments. This study demonstrates how AI is revolutionising endodontics by improving diagnostic accuracy, treatment planning, and outcome prediction. However, it faces limitations such as the need for large datasets, high costs, and lack of self-development. Future studies should address these challenges to enhance its integration into clinical practice. (EEJ-2025-05-072).
The key to the success of any endodontic treatment is proper irrigation of the canal system in order to eliminate bacterial infections, pulpal tissues, and debris created during the shaping of the canal. Due to the complex anatomy of the canals and the limitation of conventional irrigation in providing complete irrigant penetration into the root apical third as well as existing lateral canals, more effective methods are mandatory. The aim of this study was to compare the efficacy of 4 irrigation protocols, through irrigant penetration into the main and lateral canals. Twenty-eight single-rooted teeth with 1 canal were randomly divided into 4 groups: Irriflex (n=7), EndoActivator (EA) (n=7), XP Finisher (n=7), and XP Finisher R (n=7). Four lateral canals were created in each tooth at 2 mm and 4 mm from the apex for a total of 112 lateral canals. Each group was subject to cone beam computed tomography scans and retroalveolar images. A significant difference in main canal penetration was observed when comparing Irriflex to the EA, XP Finisher, and XP Finisher R (P < .05). There was no significant difference in lateral canal penetration between the 4 techniques. While EA, XP Finisher, and XP Finisher R expressed better performance of irrigant penetration into the main canal, these 3 techniques offered the same outcome when compared to each other. No technique was able to significantly outperform the others in delivering the irrigation solution into lateral canals.
This study aimed to evaluate the prevalence of technically satisfactory root canal treatments (RCTs) performed by undergraduate dental students and to identify pre- and intraoperative factors associated with unsatisfactory outcomes. A cross-sectional analysis of 462 RCTs performed by third- and fourth-year students at two Brazilian dental schools was conducted. Radiographic assessments followed European Society of Endodontology (ESE) guidelines using two criteria: No sealer extrusion (NSE) and accepted sealer extrusion (ASE). Pre- and intraoperative variables, including tooth type, instrumentation method, root canal curvature, and apical root resorption, were analyzed through bivariate and multivariate logistic regression. The prevalence of satisfactory RCTs was 45.9% (NSE) and 62.3% (ASE). Root canal curvature was the most significant predictor of unsatisfactory technical quality in both models (NSE: >7°, ASE: >12°, p < 0.001). Apical root resorption was also associated with failure in the NSE model (p = 0.028). Instrumentation type and tooth type were not significantly associated with technical outcome. Root canal curvature strongly influences the technical quality of student-performed RCTs, regardless of instrumentation technique or tooth type. Undergraduate curriculum should optimize the development of the ability to recognize case complexity, while dental educators should continually develop strategies to improve undergraduate and supplementary professional training.
Nickel-titanium (NiTi) rotary instruments have revolutionized endodontic practice through continuous advancements in metallurgy and design. Despite these improvements, mechanical failure remains a clinical concern. This study aimed to evaluate and compare the design features, metallurgical properties, and buckling resistance of five widely used NiTi rotary endodontic systems. A total of 250 new NiTi rotary instruments from five systems (ProTaper Next, Mtwo, ProFile, EndoSequence, and GT Series X) were analyzed. Design features were assessed using dental microscopy and scanning electron microscopy. Metallurgical properties were evaluated through energy-dispersive X-ray spectroscopy and differential scanning calorimetry. Buckling resistance was measured using a universal testing machine equipped with a 1 kN load cell, applying a compressive load at 1 mm/min until 1 mm of lateral displacement was achieved. Statistical analysis was performed using the Shapiro-Wilk test to assess normality, followed by the non-parametric Kruskal-Wallis test to compare groups. A significance level of p<0.05 was adopted. ProFile instruments exhibited the highest number of spirals (19) and spiral density (1.19 spirals/mm), while GT Series X featured the shortest cutting blade length (≤12 mm). All systems demonstrated near-equiatomic nickel-titanium ratios. ProTaper Next and GT Series X showed higher R-phase and austenitic transformation temperatures. Buckling resistance was significantly greater in the ProFile (0.04 and 0.06 taper) and EndoSequence 35/.06 and 40/.06 instruments (p<0.05). In contrast, EndoSequence 0.04 files, Mtwo, and ProTaper Next exhibited lower resistance. Design features, taper, and metallurgical composition significantly influence the buckling resistance of NiTi rotary endodontic instruments.
To evaluate the effects of cleaning solutions on dentin impregnated with an epoxy resin-based endodontic sealer, using a self-etch adhesive system applied at different time-points, to understand how these factors affect the bonding of final restoration. This experimental study used 150 bovine incisors. Three cleaning protocols (ethanol (ET), xylol (XY) or an experimental solution (EX)) and 2 time-points of adhesive system application (immediate or after 7 days) were evaluated. The persistence of residues (PR), open dentinal tubules (ODT), microshear bond strength, failure mode, and dentinal penetrability of the adhesive system were analyzed. Kruskal-Wallis/Dunn's tests or 2-way ANOVA/Tukey's test (α = 0.05) were used. Ethanol resulted in greater PR and fewer ODT, negatively affecting adhesive penetrability and bond strength, with worse results when adhesive system application is delayed (P < .05). The EX and XY solutions were more effective in removing sealer residues, opening dentinal tubules, adhesive penetrability, and microshear bond strength, regardless of the time-point of adhesive system application. Xylol and EX solutions showed superior performance compared to ET. The findings suggest that while XY and EX allow the final restoration to be performed either immediately or after 7 days, the use of ET requires the restoration to be executed in the same session to ensure more favourable bonding to dentin.
To evaluate periapical healing at a 6-month follow-up after single-visit endodontic treatment using 3 commonly employed sealers-zinc oxide-eugenol (C-Gross), epoxy resin-based (AH Plus), and calcium silicate-based (Bio-C Sealer)-assessed through 3-dimensional cone-beam computed tomography (CBCT) volumetric analysis. A comparative, parallel, non-randomised, double-blinded clinical design was used. Seventy-five patients with pulp necrosis and chronic apical periodontitis were enrolled; 70 completed follow-up (AH Plus:n=25; Bio-C: n=23; C-Gross: n=22). Treatments were performed by 10 supervised postgraduate operators following a standardised protocol. Preoperative and 6-month CBCT scans were segmented by 2 calibrated, blinded radiologists (κ = 0.90). Lesion volumes were obtained using manual boundary tracing and automated 3D reconstruction. Intragroup and intergroup comparisons were evaluated using non-parametric statistics. All 3 sealers showed significant intragroup reductions in lesion volume over 6 months (P < .001). Median volumes decreased from 81.0 to 15.0 mm3 (AH Plus), 63.0 to 12.0 mm3 (Bio-C), and 36.0 to 4.5 mm3 (C-Gross). Percentage reductions were similarly high across groups (median 79.7%-84.9%). No significant differences were observed among sealers for absolute volumetric change (P=.096) or percentage reduction (P=.912). Periapical healing was comparable across AH Plus: n=25; Bio-C: n=23; C-Gross: n=22. When disinfection, 3-dimensional obturation, and coronal sealing are optimally achieved, sealer composition has minimal influence on tissue repair. Healing appears primarily host-driven, governed by inflammatory resolution and bone remodelling rather than sealer-derived bioactivity.
To present the successful management of an immature necrotic tooth through intentional replantation (IR) following the failure of a regenerative endodontic procedure (REP), highlighting IR as a viable alternative in complex cases. A 9-year-old patient presented with necrotic tooth 45 complicated by right mandibular cellulitis. After initial infection management, REP was attempted following European Society of Endodontology (ESE) guidelines. Despite adherence to protocol, REP failed, as evidenced by persistent symptoms and a recurring fistula. IR was chosen given the unfavourable conditions for apexification and the patient's young age. During atraumatic extraction, the root fractured at a pre-existing defect, necessitating a modified reimplantation approach. The canal was treated ex vivo and sealed with calcium silicate-based cement (CSBC) before reimplantation. At a 36-month follow-up, the tooth remained functional and symptom-free, with no signs of reinfection. While REPs are promising for managing necrotic immature teeth, failures necessitate alternative strategies. This case highlights IR as a viable treatment, preserving function and aesthetics when regenerative efforts are unsuccessful. Careful case selection, meticulous execution, and long-term follow-up are crucial for optimizing outcomes.
This study aimed to assess the efficacy of a novel retrograde irrigation protocol involving ultrasonic activation, compared with conventional techniques, using two complementary experimental models. Experiment 1: Sixty extracted human mandibular premolars were endodontically prepared, obturated, and randomly assigned to three groups (n=20): Group 1 (saline irrigation), Group 2 (ultrasonically activated 17% EDTA gel and 5.25% NaOCl gel), and Group 3 (no irrigation). Following 1 mm apical resection and 3 mm retrograde cavity preparation, rootend cleanliness was assessed using scanning electron microscopy (SEM). Three calibrated, blinded examiners evaluated smear layer and debris scores. Experiment 2: A 3d-printed artificial canal system with lateral extensions containing bovine pulp tissue was used to simulate organic material. Groups received: Group 1 (saline), Group 2 (ultrasonically activated 5.25% NaOCl gel), Group 3 (no irrigation). Pulp dissolution was measured using a high-precision analytical microbalance. Data were analysed using the Kruskal-Wallis test and Dunn-Bonferroni post hoc (Experiment 1), and one-way ANOVA with Tukey HSD (Experiment 2). A significance level of p<0.05 was adopted. In Experiment 1, Group 2 showed significantly lower debris and smear layer scores than Groups 1 and 3 (p<0.001). In Experiment 2, only Group 2 achieved complete pulp tissue dissolution (p<0.001). Ultrasonically activated EDTA and NaOCl gel significantly enhance cleaning efficacy and organic tissue dissolution in retrograde endodontic surgery, allowing for a more conservative apical resection approach.
The purpose of this study was to evaluate the influence effects of different endodontic treatments ���, such as chelation ng solutions and antimicrobial photodynamic therapy (aPDT), on the rreductionng the amount of endotoxin levels in root canals. Eighty human single-rooted teeth had their crowns sectioned, and the root canals were prepared. All samples and materials were sterilized using Cobalt-60 irradiation. Subsequently, 10 ��L of fresh lipopolysaccharide (LPS) was inoculated into the root canals and incubated for 3 days. On the fourth day, experimental treatments were applied to the root canals according to the groups (n=10): [1] pyrogen-free water, [2] 0.005% methylene blue, [3] diode LASER, and [4] 0.005% methylene blue + diode LASER (PDT), [5] 2.5% sodium hypochlorite, [6] 17% trisodium ethylenediaminetetraacetic acid (EDTA), [7] 10% tetrasodium EDTA, [8] 18% etidronate (HEBP). The exposure time for each solution and light irradiation was 5 minutes. The samples collected after treatment were analyzed using the Limulus Amebocyte Lysate test to quantify endotoxins. The data obtained were subjected to Kruskal-Wallis analysis followed by Dunn's test. All treatments demonstrated efficacy in reducing endotoxin levels in root canals compared to the use of pyrogen-free water (control). A statistically significant reduction was observed in the groups treated with 17% EDTA and 18% HEBP compared to the control group. Short-term application (5 minutes) of 17% EDTA and 18% HEBP chelating solutions significantly reduced LPS in root canals and may be effective adjuncts in endodontic therapy. (EEJ-2025-03-032).
This study aimed to investigate the effectiveness of various commercial temporary restorative materials in preventing microleakage with a pre-endodontic sealing technique (PES). Ninety-six human single-rooted premolars were prepared for endodontic access and randomly allocated to five groups according to the material to restore the cavity (n=16): CON: Control group, Tetric N-bulk, Ivoclar; COL: Coltosol, Coltene; KET: Ketac Molar, 3M; FUJ: Gold Label Fuji II, GC; CLI: Clip F; and two experimental conditions (n=8): COT: conventional technique and, PES technique. Methylene blue dye penetration was measured in mm. Two-way ANOVA and Bonferroni post-hoc were used (p<0.05) Results: For most materials, PES exhibited statistically significantly lower values of dye penetration (p < 0.001), except for KET and COL. The highest dye penetration was found in FUJ using the COT technique. The PES technique was more effective in preventing microleakage when polymer-based materials were used. (EEJ-2025-02-027).
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This retrospective study aimed to compare the survival outcomes between crowns with repaired endodontic access cavities and intact crowns and to identify factors that influence restoration longevity. Clinical records of patients who underwent root canal treatment through existing crowns (crowns with repaired access cavities, CRA) or received crowns after root canal treatment (intact crowns, IC) between 2012 and 2023 were analysed. A 1: 1 propensity score matching was applied based on age, sex, tooth type, and crown type. The outcomes of the matched cases were classified as survival or non-survival. Kaplan-Meier analysis and logrank tests were used to compare outcomes between the two groups over time. For CRA, multivariable Cox proportional hazards regression analysis was conducted to identify potential predisposing factors. Among 608 eligible endodontically treated teeth, 120 CRA and 488 IC met the inclusion criteria. After matching, 120 samples per group were analysed. The survival rate was significantly lower for CRA (85.8%) than for IC (91.7%) (p=0.004). Occlusal parafunctional habits or interferences were the only significant factors affecting CRA survival. CRA demonstrated lower survival rates than IC, with occlusal parafunctional habits or interferences as key factors influencing their longevity.