This study aimed to test the biocompatibility and antibacterial properties of Salvadora persica (S. persica) extract, a natural product, as an intracanal medication in comparison with calcium hydroxide (Metapaste, META BIOMED, Cheongju, Korea). The pH values of both materials were tested. The biocompatibility of S. persica extract and Metapaste was determined using light microscopy and MTT assays. The antibacterial action was tested using the zone of bacterial inhibition on four common bacterial species. In addition, intracanal medication was administered using 68 extracted single-rooted teeth contaminated with Enterococcus faecalis (E. faecalis), and the percentage reduction in colony count (% RCC) at 1, 3, and 7 days was measured. The extension of activity for both materials was assessed using histological sections and scanning electron microscopy. S. persica was found to be acidic in nature. Both materials showed significantly lower cell viability than the positive control cells on days 1 and 3 but not on day 7. S. persica showed better antibacterial effects against E. faecalis and S. mutans. S. persica extract showed 97.6%, 98.9%, and 99.3% RCC values at 1, 3, and 7 days, respectively, which are comparable to those of Metapaste. S. persica herbal extract is a promising material that can be utilized as an intracanal medication, but its use requires further research.

Dental intrusions are a severe type of injury because they impact the neurovascular supply of the tooth as well as the supporting tissues which predispose the tooth to necrosis and root resorption. Management of these injuries requires repositioning of the teeth under close monitoring to avoid complications. The management becomes more comprehensive when an intrusion is combined with other injuries, such as a crown‐root fracture. This case report represents a 4‐year follow‐up of a child who suffered from a concomitant injury of intrusion and complicated crown‐root fracture to the maxillary immature permanent central incisors. The management involved a multidisciplinary approach including endodontics, pedodontics, orthodontics, periodontics, and prosthodontics. Given the guidelines of dental trauma and the circumstances of the case, the fractured teeth were root canal treated, filled with a bioceramic plug and gutta‐percha, and then restored with posts/cores and temporary crowns. The intrusion was managed initially by passive eruption followed by an active orthodontic eruption, after which the teeth were restored with permanent ceramic crowns. Throughout the course of treatment, the teeth showed no complications of root resorption or ankylosis, although one tooth developed a periapical infection which was managed by apical surgery. At the 4‐year follow‐up, the teeth revealed healthy periodontium and good esthetics.

Endodontic microsurgery (EMS) presents a great treatment option for unresolved periradicular pathologies, typically involving the removal of the apical root portion and adjacent inflamed tissues. This case report describes the management of persistent periapical lesions in the lower anterior teeth of a 32-year-old male. Root canal treatment was completed 4 years before presentation. The patient presented to the clinic with tooth mobility and mild discomfort and large radiographical periapical radiolucency. The case was diagnosed with previously treated with asymptomatic apical periodontitis. EMS was performed in conjunction with periodontal-guided tissue regeneration that includes bone graft and resorbable membrane and the teeth showed favorable resolution of the symptoms. Histopathological analysis showed the presence of a radicular cyst. After 3 years of follow-up, cone-beam computed tomography and periapical radiographs demonstrated substantial lesion regression and favorable outcome. This case report offering promising insights into the synergistic potential of combined endodontic and regenerative periodontal therapy in cases with unresolved periapical lesion with extensive bone destruction.