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Endodontic microsurgery is a vital treatment modality for teeth with persistent periradicular pathoses that have not responded to nonsurgical retreatment. The principle is to determine the reason for failure, completely eliminate the infection and promote periapical healing. Within recent years, endodontic microsurgery has evolved to become standardized and presents with a high success rate. However, its outcome is still influenced by many factors, including anatomy, periodontal condition, crown-to-root ratio, occlusion, the type of periradicular lesion, and prosthesis. Moreover, endodontists always concentrate on “the apex”, paying little attention to the general preoperative evaluation, accurate diagnosis, and comprehensive treatment plan. This article reviews the latest literature on these issues and the clinical experience of our research group and discusses the correlation between endodontic microsurgery and other oral disciplines, including periodontology, prosthodontics, oral implantology, oral and maxillofacial surgery and orthodontics. The oral interdisciplinary assessment should be made with comprehensive consideration of the root canal system, periradicular lesion, adjacent anatomical relationships, periodontal condition, occlusion, and esthetic rehabilitation. Based on these findings, the continuity of treatment will be optimized, and the best treatment plan will be proposed to provide clinical strategies for the diagnosis and treatment of complex periradicular diseases.

Background: The general education course, Oral Science, has been offered by Guanghua School of Stomatology, Sun Yat-sen University for many years in order to improve students' knowledge of oral health. Information about the oral health knowledge, status, and behaviors among undergraduates who had taken Oral Science was collected to evaluate the impact of this course, and to provide a basis for further improvement of the course teaching quality. Methods: Undergraduates taking Oral Science as an elective course were selected as the research subjects. The research time is the second semester of the 2022 academic year, from February 2023 to June 2023. Undergraduates who had not taken the course served as the control group. To investigate the oral health knowledge, status, and behaviors among undergraduate students who have taken the general education course of Oral Science, course students and non-course students were asked to fill out the same questionnaire at both the beginning and end of semester. The answer scores and accuracy of these two groups were compared and analyzed. Before and after the first lesson, and at the end of the semester, course students were asked to fill out the same oral knowledge questionnaire. Another questionnaire was released in week 10 to collect the data of the course students' oral health status and behaviors. The control group completed the same oral knowledge questionnaire at the beginning and end of the semester, respectively. SPSS 20.0 statistical software was used to analyze the data. Statistical significance level was set at 0.05 for all tests. Results: At the beginning of the semester, there was no significant difference in the accuracy of the 16 questions nor the scores between two groups (P > 0.05). After one semester of learning, the accuracy of the 16 questions answered by the course students at the end of the semester was significantly higher (P < 0.05), as well as the score of the course students. Conclusion: The general education course of Oral Science can significantly improve undergraduates' general knowledge of dentistry and effectively improve their oral hygiene behavior. [ABSTRACT FROM AUTHOR]

Human dental pulp stem cells (hDPSCs) play a vital role in the regeneration of the pulp-dentin complex after pulp disease. While the regeneration efficiency relies on the odontoblastic differentiation capacity of hDPSCs, this is difficult to regulate within the pulp cavity. Although nicotinamide riboside (NR) has been found to promote tissue regeneration, its specific role in pulp-dentin complex regeneration is not fully understood. Here, we aimed to explore the role of NR in the odontoblastic differentiation of hDPSCs and its underlying molecular mechanism. It was found that NR enhanced the viability and retarded senescence in hDPSCs with higher NAD+/NADH levels. In contrast to the sustained action of NR, the multi-directional differentiation of hDPSCs was enhanced after NR pre-treatment. Moreover, in an ectopic pulp regeneration assay in nude mice, transplantation of hDPSCs pretreated with NR promoted the formation of a dentin-like structure surrounded by cells positively expressing DMP-1 and DSPP. RNA-Seq demonstrated inhibition of the HIF-1 signaling pathway in hDPSCs pretreated with NR. The number of HIF-1α-positive cells was significantly decreased in hDPSCs pretreated by NR in vivo. Similarly, NR significantly downregulated the expression of HIF-1α in vitro. The findings suggested that NR could potentially regulate hDPSC odontoblastic differentiation and promote the development of innovative strategies for dental pulp repair. [ABSTRACT FROM AUTHOR]