Background: This ambispective study evaluated the prognostic factors for long-term survival and success of endodontically treated teeth (ETT) in patients treated at an educational hospital. Methods: Patients who received root canal treatment (RCT) at Princess Nourah bint Abdulrahman University (2018–2023) were included if the following criteria were met: follow-up time of a minimum of 12 months was available, and clear pre- and post-treatment periapical radiographs. Two calibrated examiners assessed RCT quality along with pre-treatment and follow-up periapical index (PAI) scores. Coronal restorations were evaluated for quality, type, and timing. Data on oral hygiene, smoking, systemic health, periodontal status, and occlusal factors were collected. Tooth survival was defined as a functional, asymptomatic tooth, while success required a clinically asymptomatic tooth with a PAI score ≤ 2. Multivariate regression analysis was performed to assess the influence of the collected variables on tooth survival and success. Statistical significance was set at p < 0.05. Results: A total of 461 ETT from 242 patients were analyzed. The survival rate was 89%, while 81% met the treatment success criteria. Most patients were female (65%), and only 8.9% had a healthy periodontium. Multivariate analysis identified preoperative PAI score, obturation density, and coronal restoration quality as significant predictors of survival and success (Nagelkerke R² = 0.338). Conclusions: ETT demonstrated high survival and success rates. Preoperative PAI score, obturation density, and coronal restoration quality were key predictors of long-term treatment outcomes, highlighting the importance of comprehensive pre-treatment assessment and high-quality endodontic and restorative procedures.

This study aims to evaluate the effect of chitosan (CS) scaffold, alone, and the potential synergistic effect when impregnated with simvastatin (SIM), on immortalized human bone-marrow mesenchymal stem cells (hbMMSCs) compared to CollaCote (CL). CS scaffolds were fabricated and seeded with immortalized hBMMSCs. Samples were divided into control groups (negative with no added material and positive with CL added) and four experimental groups: CS alone, CS/SIM 0.01, 0.03, and 0.05 mg, respectively. Cell viability, osteoblastic differentiation and calcium deposition were investigated via AlamarBlue, alkaline phosphate activity assays and alizarin red S staining at 1 and 14 days, respectively. At day one, no significant difference was noted between the groups regarding cell viability. However, all CS/SIM groups showed significant cutback at day 14 in cell proliferation compared to CS alone and CL groups (p < 0.001). All groups supported osteoblastic differentiation with no significant difference. Alkaline phosphate activity increased in both time periods in the CS/SIM 0.05 mg group compared to the other SIM groups, with no significant difference among the experimental groups. Chitosan scaffold is a bioactive compatible material capable of regenerative potential of hBMMSCs and a promising material to be used for perforation repair.

This study aimed to evaluate the healing of furcation when repaired with Chitosan (CS) scaffold impregnated or not with Simvastatin (SIM) compared with CollaCote (CL) in goat premolar teeth. Root canal treatment was performed in 52 mandibular premolars followed by furcal perforation induction. The perforation was repaired with CL, CS, or CS with SIM after leaving it untreated for 4 weeks. White mineral trioxide aggregate was carried into the furcal site followed by a 2–3 mm resin-modified glass ionomer. The perforation was left untreated, and the access cavity was left open without coronal filling in the control group. The animals were sacrificed after one and three months. Block sections of the premolars were prepared and examined histologically to evaluate the inflammation and type of healing. Hard tissue formation was found in CL, CS, and CS/SIM groups in both periods. At one month, no significant differences were detected among the experimental groups, whereas at three months, CS without SIM showed significantly better performance compared to CL and CS/SIM groups (p = 0.040). Therefore, repairing furcal perforation with CS scaffolds shows desirable biological responses and healing characteristics in favor of bone regeneration at three months.