The consequences of traumatic injuries are pulp necrosis, periapical inflammation, and possible external cervical resorption (ECR). The concomitant cessation of root maturation and dentinogenesis in premature teeth result in a fragile tooth. Revascularization of the pulp might be an alternative treatment option. A 12-year-old patient was referred for retreatment of chronic apical periodontitis with acute exacerbation after root canal treatment of an upper central incisor. During gutta-percha removal, an ECR was detected. First, it was closed internally with Biodentine, followed by an external composite closure after a cone beam computed tomography evaluation. In the first session, chemomechanical cleaning was aided with sodium hypochlorite and hyperpure chlorine dioxide, and the canal was dressed with Ca(OH)₂ until the next session. In the next session, only the low-toxicity, but adequate, bactericide hyperpure chlorine dioxide was applied for irrigation, before the provocation of periapical bleeding into the canal. The blood clots were covered with Biodentine, and the tooth was restored with composite filling. During the 24-month follow-up, clinical signs/symptoms had disappeared, and the periapical lesion was resolved. Increased root thickness in the apical third and decreased size of the apical foramen were detected. In conclusion, regenerative endodontic procedures could potentially be used to retreat immature teeth with persistent apical periodontitis and external cervical resorption.

Vital pulp therapy (VPT) preserves dental pulp and its functions, offering a minimally invasive alternative to root canal therapy. However, the impact of patient-related factors on success remains unclear. This study aimed to estimate the sample size for a multivariate model predicting VPT success for assessing capping material, age, sex, and pulp conditions. A prospective cohort study was conducted with the inclusion of twenty-seven adult patients with carious pulp exposure in mature permanent teeth. Treatment comprised direct pulp capping, partial pulpotomy, or complete pulpotomy with Mineral Trioxide Aggregate Plus (MTA+) or Biodentine. Success rates were evaluated at 6 months through clinical and radiographic examinations. Statistical analysis included Pearson’s Chi-square tests and logistic regression. The success rates were 64% in the Biodentine group and 92% in the MTA+ group (OR: 0.15; p = 0.108). Sex and age had no significant effect. Success declined with increasing pulp condition severity and treatment invasiveness. MTA+ had a higher incidence of discoloration, while Biodentine showed none. Sample size calculations suggested 140 participants would be needed to detect a significant effect of pulp condition. Both materials were effective, though MTA+ showed higher success based on the strict success criteria. More severe pulpitis correlated with lower success, but a larger study is needed for predictive models.

Background: Achieving a three-dimensional seal of the root canal system is considered essential for long-term endodontic success. Because no clinically acceptable threshold for void formation has been established, comparisons with clinically validated reference materials are needed to interpret the sealing quality of newer calcium silicate-based sealers (CSBSs). AH Plus is a well-established epoxy resin-based sealer (ERBS) with documented long-term clinical performance. This systematic review and meta-analysis compared the quality of root canal fillings produced with CSBSs and AH Plus using different obturation techniques in permanent mature extracted and artificial teeth. Methods: MEDLINE (PubMed), EMBASE, Cochrane Library, and Web of Science were systematically searched for randomized in vitro studies up to 1 July 2025. The primary outcomes were the percentages of void volume or area. Mean values and mean differences (MDs) with corresponding 95% confidence intervals (CIs) were calculated for the total filling volume and, where available, for the apical, middle, and coronal thirds of the root canal. Risk of bias and certainty of evidence were assessed. Results: Twenty-one studies met the eligibility criteria, and 18 articles were included in the quantitative analysis. No statistically significant differences were observed in total void volume between CSBSs placed with the single-cone technique and AH Plus used with either the single-cone or warm vertical compaction technique in extracted teeth. Similarly, no significant differences were observed between the investigated groups in the apical, middle, or coronal thirds of the root canal. Evidence for other obturation techniques and artificial teeth was limited. Conclusions: Within the limitations of the available in vitro evidence, no statistically significant differences in void formation were detected between the investigated sealer–technique combinations. Further standardized in vitro studies and well-designed clinical investigations are warranted.

Background/Objectives: Alternative nicotine-containing products have gained popularity in recent years. Our aim is to compare clinical periodontal outcomes following non-surgical periodontal therapy (NSPT) among patients with periodontitis according to nicotine exposure status: cigarette smokers (CS), former smokers (FS), quitters (Q), users of electronic cigarettes (EC), smokeless tobacco users (ST), and non-smokers (NS). Methods: A systematic search of four electronic databases (PubMed, EMBASE, Web of Science, CENTRAL) was performed until January 2025. Sixty-seven studies were included in the qualitative synthesis, of which 56 studies were included in a frequentist network meta-analysis. Two researchers independently collected data on probing pocket depth (PPD), clinical attachment loss, bleeding on probing, plaque index, full mouth plaque score, gingival index, and gingival crevicular fluid volume. Results: NS had significantly higher change in PPD compared with CS (MD: 0.25; CI: 0.13, 0.37; 50 studies; 1359 patients; moderate certainty), EC (MD: 0.98; CI: 0.47, 1.49; 2 studies; 56 patients; very low certainty), and ST (MD: 0.99; CI: 0.49, 1.49; 2 studies; 82 patients; low certainty). Q (MD: 0.02; CI: −0.56, 0.60; 2 studies; 52 patients; low certainty) and FS (MD: 0.03; CI: –0.62, 0.69; 4 studies; 267 patients; low certainty) did not differ significantly from NS. In secondary outcomes, NS, FS, or Q were ranked first. Conclusions: FS and Q showed no statistically significant differences from NS; EC and ST generally had less favorable treatment rankings than CS. The certainty of evidence varied across exposure groups and outcomes. Further studies are needed to support firm clinical recommendations.