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Introduction: Root-end preparation and restoration with an endodontic material are required when nonsurgical endodontic retreatment has failed or is impossible. The present clinical study reports the treatment outcomes of periradicular surgery using calciumenriched mixture (CEM) cement. Materials and Methods: A prospective outcome study of periradicular surgery using CEM was conducted on 14 permanent teeth with persistent apical periodontitis. Using a standardized surgical protocol, 2-3 mm of the root apex was resected; approximately 3 mm deep root-end cavities were ultrasonically prepared and filled with CEM cement. All patients were available for recall. Results: Clinical and radiographic examination revealed complete healing of periradicular lesions, i.e. regeneration of periodontal ligament and lamina dura in 13 teeth (93% success) during a mean time of 18 months; moreover, the teeth were functional and asymptomatic. Conclusion: Favorable treatment outcomes in this prospective clinical study suggested that CEM cement may be a suitable root-end filling biomaterial. [ABSTRACT FROM AUTHOR]

Introduction: The choice between the two modes of treatment, endodontic treatment and single tooth implants are very different depending on the dentist, design, definition of successful outcomes, evaluation methods, and sample size. The aim of this study was to compare the clinical and radiographic results of single tooth implants versus endodontic treatment with post and crown restoration in patients referred to the School of Dentistry of Islamic Azad University of Isfahan. Materials & Methods: In this cross-sectional analytical study in the academic year 2021, 90 (46 females and during three different time intervals post treatment (under 3 years, 3 to 5 years and Over 5 years) were examined clinically and radiographically (periapical). Outcome of treatment was classified based on clinical and radiographic findings into three categories: successful, surviving and unsuccessful. Data were analyzed using Chisquared test (α = 0.05). Results: In this study, 60% of women and 40% of men had endodontic treatment and 42.2% of women and 57.8% of men had single tooth implants. There was no significant difference between the treatment outcomes in the studied groups (p value > 0.521). There was no statistically significant relationship between gender and type of treatment as well as gender and treatment satisfaction (p value > 0.05). Conclusion: Considering the preservation of natural teeth, if possible, root canal treatment is the main treatment of choice, otherwise a single-tooth implant can be a good alternative to missing or extracted teeth in terms of successful outcomes. [ABSTRACT FROM AUTHOR]

Background: Coronal seal is one of the essential factors that affects the success of endodontic treatment and reinforces the apical seal. The intra-orifice barrier is an efficient alternative approach to decrease coronal leakage in endodontically treated teeth and various materials have been used for this purpose. This study aimed to compare the coronal sealing of flowable composite, resin-modified glass ionomer (RMGI), and mineral trioxide aggregate (MTA) in endodontically treated teeth. Materials and Methods: In this in vitro study, 35 single-canal canine teeth were divided into five groups, including flowable composite, RMGI, MTA, positive control, and negative control groups. The teeth were filled with restorative materials according to the factory's instructions. Afterward, the samples were immersed in 2% methylene blue dye solution for 1 week at 37°C and 100% humidity condition. Finally, the teeth were sectioned longitudinally and dye penetration was measured using a stereomicroscope with ×10. Data were analyzed with Kolmogorov–Smirnov and Kruskal–Wallis tests (α = 0.05). Results: The positive control group showed the highest amount of dye penetration compared to other groups (12.34 ± 0.46). Dye penetration in the MTA group was significantly lower (4.25 ± 0.31) compared to the RMGI group (5.94 ± 0.24) (P = 0.02). Moreover, while the dye penetration in the MTA group was lower than in the flowable composite group (5.65 ± 0.26), the difference was not statistically significant (P = 0.12). Conclusion: MTA reduces the coronal leakage and provides an acceptable coronal seal in endodontically treated teeth, especially compared to RMGI, and therefore, using MTA as an intra-orifice barrier increases the endodontic treatment success rate. [ABSTRACT FROM AUTHOR]

Case selection and treatment plan are important aspects of endodontic treatment. Dentists should organize the treatment plan based on their knowledge, abilities, skills and more importantly the patients' preference and dentition. Indubitably, the treatment plan for each patient is exclusive and “tailor-made” and cannot be used for all patients. Dentists' self-estimation of their abilities opens up treatment options; however, in difficult or complicated cases it is advisable to refer to a specialist. Currently, one of the most challenging aspects in dentistry is the choice between extraction and placement of implant (EPI) instead of a complicated root canal treatment (RCT). Overemphasis on one treatment plan while neglecting other options, not only mislead the dentist but also impose unnecessary charges to the patients. This mini-review compares RCT to EPI from various aspects to help practitioners in routine decision making. [ABSTRACT FROM AUTHOR]