Diagnosis is a key aspect in endodontic treatment, in a decade where invasive interventions are misapprehended as social tendency instead of medical necessity. All diagnostic facets should be considered before intending the operative phase. Intraoral endodontic radiology-based diagnosis has been shown to be limited. Periapical X-ray is the most used endodontic imaging, yet it does not provide high accuracy. Traditionally, dentists have been trained to diagnose a cyst by certain aspects (size, shape and appearance); hence, an assumption that teeth are affected by “periapical cyst” were subjected to unnecessary extraction or apicoectomy. The aim of this systematic review is to critically appraise the publications that relate the histological diagnosis of a periapical lesion (considered the gold standard) to intraoral X-ray investigation. Ovid Medline, PubMed, ScienceDirect, Mendeley and Scopus were searched for English-language studies comparing periapical diagnosis obtained by using two techniques (histopathology and X-ray). Sixteen articles were included for the final analysis (qualitative and quantitative evaluation) out of which only two supported the statement that periapical diagnosis can be coherently assessed through periapical imaging. Although there is not enough evidence to deliver a definitive conclusion, there are many publications that refute the diagnosis of a cyst via periapical X-ray.

The duration of denture use, oral hygiene, smoking and male sex were identified as risk factors for oral mucosal lesions. As it is well known, all the oral mucosal lesions associated with risk factors have an important degree of malignity. Chronic mechanical irritation can be another cause of oral cancer and it is produced by the constant action of a deleterious agent from the oral cavity. Autophagy represents a complex evolutionary conserved catabolic process in which cells self-digest intracellular organelles in order to regulate their normal turnover and remove the damaged ones with compromised function to further maintain homeostasis. Autophagy is modulated by mTOR kinase and indirectly by PI3K/AKT survival pathway. Due to its dual capacity to either induce cell death or promote cell survival, important evidence pointed that autophagy has a two-faced role in response to chemotherapy in cancer. In conclusion, understanding how to overcome cytoprotective autophagy and how to take advantage of autophagic cell death is critical in order to enhance the cancer cells sensitivity to particular therapeutic agents.

Interdisciplinary decision-making significantly influences both the therapeutic potential and clinical outcomes, shaping clinical attitudes and management strategies. As the integration between endodontic and restorative-prosthetic considerations becomes increasingly prevalent, it is essential to understand how different dental specialists, particularly general dental practitioners, prosthodontists and endodontists, approach clinical decision-making and collaborate to optimize patient care. Objectives: This study aims to identify practice disparities in post-endodontic crown placement to inform national policy reforms, including standardised timing protocols and interdisciplinary referral criteria. Methods: A structured questionnaire was distributed to dentists practicing in Romania, yielding 238 collected responses. Results: Substantial variability was found in clinical approaches: diagnostic imaging preferences indicated frequent use of periapical radiography (83.49%) and CBCT (53.67%). Over 70% expressed high confidence in CBCT’s diagnostic precision, significantly higher than periapical radiography (Wilcoxon Signed-Rank test, p < 0.00001). A statistically significant majority (69.3%, binomial test, p < 0.001) preferred delaying definitive crown placement until radiographic healing of periapical lesions. Logistic regression analysis showed endodontists were significantly less likely to choose invasive treatments compared to other specialists (p = 0.027). Although clinicians widely recognize the significance of prosthetic planning, its early integration into the overall treatment strategy has been inconsistent. Conclusions: This study points out the necessity for standardised guidelines that clearly integrate prosthetic planning into endodontic decision-making, enhancing predictability and tooth preservation.