The main goal of root canal treatment (RCT) is to eradicate or essentially diminish the microbial population within the root canal system and to prevent reinfection by a proper chemo-mechanical preparation and hermetic final obturation of the root canal space. The aim of this study was to assess the quality of the root canal filling and the number of visits needed for completing RCT by operators with different experience, including dentistry students (4th and 5th year), general dental practitioners (GDPs), and endodontists. Data from medical records of 798 patients were analyzed, obtaining 900 teeth and 1773 obturated canals according to the inclusion and exclusion criteria. A similar number of teeth was assessed in each group in terms of density and length of root canal filling and number of visits. The larger number of visits and the lower quality of treatment was observed for 4th year students than for other groups (p < 0.05); in contrast, the endodontists needed the lowest number of visits to complete RCT and more often overfilled teeth than other operator groups (p < 0.05). Interestingly, no statistical difference in quality of root canal filling was noted between 5th year students, GPDs and endodontists. The treatment of lower teeth demanded statistically more visits than that of upper teeth (p < 0.05). The results of the study emphasize that most of the root canal filling performed by operators was considered adequate, regardless of tooth type, files used and number of visits.

Background and objectives: Pulp stones are hard tissue structures formed in the pulp of permanent and deciduous teeth. Few studies have evaluated their morphology and chemical composition. However, their formation, composition, configuration and role played in overall health status are still unclear. Clinically, they may be symptomatic; technically, they impede access during endodontic therapy, increasing the risk of treatment errors. Thus, this study aimed to morphologically analyze pulp stones and present their chemical quantification, identifying their main chemical elements. It also correlates the results with their possible induction mechanisms. Materials and Methods: Seven pulp nodules were collected from molar teeth needing endodontic treatment. The morphology of the stones was analyzed by scanning electron microscopy (SEM), and their chemical composition was determined by X-ray dispersive energy spectroscopy (EDX). Results: These structures varied considerably in shape, size and topography. The site of the stones in the pulp cavity was the factor that most affected the morphology. The majority of the stones found in the pulp chambers presented nodular morphology, while those in the root canals presented a diffuse shape, resembling root canal anatomy. The topography of the nodules showed heterogeneous relief, revealing smooth and compact areas contrasting with the rugged and porous ones. The chemical composition varied depending on the location of the nodule in the pulp cavity and the relief of the analyzed area. Radicular stones presented considerably lower calcium and phosphorus content than coronary nodules. Conclusions: The high cellularity rate of the coronal pulp predisposes this region to nodular mineralizations around injured cells. The presence of larger caliber vascular bundles and higher collagen fiber content in radicular pulp determines a diffuse morphological pattern in this region. Understanding the morphology and chemical composition of the pulp stones allows future translational pathways towards the prevention or treatment of such conditions.

Pulp stones (PSs) are calcified masses that can be found in the pulp cavity of any deciduous or permanent tooth. They can be observed in healthy, diseased, and even unerupted or impacted teeth. Calcifications within the pulp may lead to a poorer outcome of a root canal procedure, as they can block access to the root canals, and hinder their subsequent cleaning and shaping. The paper describes 4 clinical cases of denticles located in the coronal and radicular pulp. Therapeutic methods of PS removal with different techniques and instruments are discussed. Specialist root canal treatment (RCT) was performed in aseptic conditions with the use of long-shank rose-head burs and an endodontic ultrasonic device under the magnification of a dental operative microscope (OM). During endodontic treatment, all PSs were totally removed, which allowed the further preparation, and finally obturation of the canal system. The use of modern diagnostic and therapeutic methods - three-dimensional (3D) diagnostic radiology, endodontic techniques, such as ultrasounds used during the removal of PSs and the irrigation of the canals, and the thermoplastic methods of canal obturation - can provide good results of treatment of this pathology. The removal of PSs from the pulp cavity is a complex and difficult procedure, requiring skill, dexterity, and appropriate equipment and facilities. The clinical approach introduced in this paper allows endodontists to avoid potential complications like perforation, the unnecessary removal of hard tissues or the weakening of the tooth structure.

The aim of this retrospective cohort study was to determine the prevalence and correlations between root canal treatment, periapical status, and coronal restoration detected using cone beam computed tomography (CBCT) in the elderly Polish population (60-79 years). A total of 480 CBCT images were assessed. Collected data included: age, gender, the tooth location, direct restoration, decay, single crown, abutment of fixed bridge, the quality of the restoration, root canal treatment, post and core, apical periodontitis (AP), and quality of root filling. The number of teeth in the elderly patients decreased, while the number of endodontically treated teeth increased with age. More teeth were preserved in mandible, the most common group of teeth were incisors. AP was more often detected in the maxilla in general, and in mandibular molars. The over-filling was observed more frequently in maxilla, in maxillary molars and in mandibular premolars, while the short-filling in maxillary and mandibular molars. AP was significantly more often observed in short-filled root canals than in other length criteria (overfilled, adequately, lack of filling). Inadequate prosthetic restoration, presence of post, pulpotomy, missed canals and root canal treated teeth were associated with increased prevalence of AP. The article indicates the need of treatment of elderly population in Poland. There is the demand to enhance the quality of endodontic and restorative treatment in this population. Additionally, CBCT examination, if indicated, should be implemented in the course of endodontic therapy to provide adequate information to clinicians.

Introduction: Determining the length of a root canal is a significant outcome predictor for endodontic treatment. The aim of this retrospective, clinical study was to evaluate the accuracy of working length (WL) determination using pre-existing conebeam computed tomography (CBCT) images and to compare them with data of the clinical WL determined with an electronic apex locator (EAL) in treated teeth, found in patient records. Materials and methods: Thirty five medical records of patients who underwent root canal treatment (RCT) by an endodontist in a private dental practice in Łódź, Poland were analysed. Evaluations were conducted on the data concerning: the WL of the treated tooth as found in the patient’s records, the RadioVisioGraphy (RVG) image after final obturation used as a control, and the CBCT scan before RCT. The Shapiro–Wilk normality test and Student’s t-test were used in statistical analysis. The significance level was set at p < 0.05. Results: There were no statistically significant differences between compared groups in terms of WL determined with an EAL than CBCT (p > 0.05). In the case of medical diagnosis (pulpitis vs. necrotic pulp) and treatment (primary vs. retreatment), the obtained results were also statistically insignificant (p > 0.05). Conclusions: This retrospective, clinical study showed that CBCT scans can be successfully used for endodontic WL determination. Future investigations are needed to evaluate whether pre-existing CBCT scans may replace initial periapical radiographs (PARs).