Aim: Root canal treatment (RCT) is a common procedure practiced daily by dentists worldwide. The current systematic review aimed to evaluate and compare clinical studies on the quality of root canal fillings (RCFs) carried out by dentists with different levels of experience conducted worldwide with those conducted specifically in Saudi Arabia (SA). Materials and Methods: A full literature search was conducted in Clarivate Analytics’ Web of Science, Elsevier’s Scopus, Embase, CINHAL, and PubMed, without a restriction to studies published before January 2015. Also, a manual search was carried out by checking papers that may have been missed during the electronic search. The following keywords were used: [(quality of root canal filling(s)) OR (quality of root canal obturation)) and dental practitioners as (general dental practitioners; final year students; endodontist; specialist) AND (root canal obturation) OR (endodontic treatment)]. Parameters of the quality of RCFs, such as length, density, and taper, were assessed and counted. Results: A total of 13 worldwide and nine SA studies were included in this review, published between 2015 and 2023. Molars were the most treated teeth, at 42.3% and 40.2% for the worldwide and SA studies, respectively. Cases treated by final year students had the highest percentage, at 60.0% for both study groups. The percentages of acceptable quality, with regard to the length, density, and taper of RCFs, were 70.9%, 77.6%, and 84.3%, and 73.2%, 64.6%, and 67.8% for the worldwide and SA studies, respectively. Conclusion: The overall acceptable quality of RCFs was marginally higher in worldwide studies than in SA studies. Both prevalences can be considered as good, which indicates that the quality of RCFs is moving in the right direction.

Background: The removal of the smear layer and antimicrobial efficacy are critical factors in endodontic treatment. Conventional chemical irrigants like sodium hypochlorite (NaOCl) and ethylenediaminetetraacetic acid (EDTA) have proven effective but can have adverse effects. Materials and Methods: A total of 60 extracted single-rooted human teeth were randomly assigned to four groups of 15 each. Group 1 was irrigated with 5.25% NaOCl, group 2 with 17% EDTA, group 3 with 10% neem extract, and group 4 with 5% turmeric extract. Smear layer removal was assessed using scanning electron microscopy (SEM) at the coronal, middle, and apical thirds of the root canals. Antimicrobial efficacy was tested against Enterococcus faecalis using the agar diffusion method, and the zones of inhibition were measured in millimeters. Results: Neem extract showed an average smear layer removal score of 2.5 (±0.3) compared to 1.8 (±0.2) for NaOCl, 1.9 (±0.3) for EDTA, and 3.2 (±0.4) for turmeric extract. Neem and turmeric extracts demonstrated significant antimicrobial activity with mean inhibition zones of 16 mm (±1.2) and 14 mm (±1.1), respectively, compared to 18 mm (±1.5) for NaOCl and 15 mm (±1.3) for EDTA. Conclusion: Herbal irrigants, particularly neem extract, show promise as effective alternatives to conventional irrigants for smear layer removal and antimicrobial activity. Their biocompatibility and comparable efficacy suggest potential for use in endodontic practice.

Background/Objectives: Vertical root fractures (VRFs) present significant diagnostic challenges due to their subtle radiographic features and variability across imaging modalities. Artificial intelligence (AI) offers potential to improve detection accuracy, yet evidence regarding its performance across different imaging systems remains fragmented. To critically evaluate current evidence on AI-assisted detection of VRFs across periapical radiography, panoramic radiography, and cone-beam computed tomography (CBCT) and to compare diagnostic performance, methodological strengths, and limitations. Methods: A systematic review of literature up to January 2025 was carried out using databases such as PubMed, Scopus, Web of Science, and the Cochrane Library. The studies included in this review utilized AI-based techniques for detecting VRF through periapical, panoramic, or CBCT imaging. Extracted data encompassed study design, AI models, dataset sizes, preprocessing methods, imaging parameters, validation techniques, and diagnostic metrics. The risk of bias in these studies was evaluated using the QUADAS-2 tool. Results: Ten studies met inclusion criteria; CNN-based models predominated, with performance highly dependent on imaging modality. CBCT-based AI systems achieved the highest diagnostic accuracy (91.4–97.8%) and specificity (90.7–100%), followed by periapical radiography models with accuracies up to 95.7% in controlled settings. Panoramic radiography models demonstrated lower sensitivity (0.45–0.75) but maintained high precision (0.93) in certain contexts. Most studies reported improvements over human performance, yet limitations included small datasets, heterogeneous methodologies, and risk of overfitting. Conclusions: AI-assisted VRF detection shows promising accuracy, particularly with CBCT imaging, but current evidence is constrained by methodological variability and limited clinical validation.

The knowledge of Dentists and Endodontists in Saudi Arabia regarding antibiotic prescriptions during and after endodontic treatment is of interest. A self-designed questionnaire survey was utilized to assess the knowledge of dentists across various cities in Saudi Arabia concerning antibiotic usage guidelines for endodontic purposes. A total of 391 participants were included in the study, and the questionnaire was distributed through social platforms like WhatsApp, Instagram, Facebook Messenger, and email. Results revealed that over 80% of participants acknowledged the need for antibiotics in cases of acute apical abscess with cellulitis, with amoxicillin being the most recommended antibiotic by dentists. Interestingly, there was no statistically significant difference in knowledge based on experience or graduation group. In conclusion, while participants demonstrated adequate knowledge about antibiotic prescriptions in endodontic cases, continued awareness of updated guidelines, including the WHO's Essential Medicines List (EML), guidelines by the European Society of Endodontology (ESE) and American Association Endodontists (AAE) is essential for optimal clinical practice.

Purpose: This study aimed to compare the efficacy of four contemporary retreatment file systems, i.e., R-Endo, XP-Endo Retreatment, HyFlex Remover, and MicroMega Remover, in the solvent-free removal of aged bioceramic sealers from root canals, and to elucidate the relationship between file design and retreatment performance using advanced micro-computed tomography (micro-CT). Methods: Forty extracted human mandibular premolars with single straight canals were prepared and obturated using either Total Fill BC or BioRoot RCS sealers, then aged for one year. Specimens were randomly assigned to four retreatment file systems (n = 5 per subgroup), and retreatment was performed without solvents according to manufacturers’ protocols. Residual filling material was quantified pre- and post-retreatment using micro-CT. Data were analyzed with repeated-measures ANOVA. Results: XP-Endo Retreatment and HyFlex Remover showed superior removal efficiency, particularly in middle and cervical thirds (>84%), whereas R-Endo consistently exhibited the lowest performance, especially apically. MicroMega Remover demonstrated intermediate efficacy, outperforming R-Endo but less effective than XP-Endo Retreatment and HyFlex. No significant differences were observed between Total Fill BC and BioRoot RCS sealers. Results indicated significant effects of canal third and file system (p < 0.001) and a significant canal third × file system × sealer interaction (p = 0.037). Conclusions: File design and metallurgical properties significantly influence the mechanical retrievability of aged calcium silicate–based sealers in solvent-free retreatment. XP-Endo Retreatment and HyFlex Remover provided superior cleaning under in vitro conditions. These findings inform clinicians on the selection of retreatment instruments for predictable removal of bioceramic sealers.

Multidisciplinary evaluation and management are essential for achieving optimal outcomes in complex cases involving recurrent calcifications and chronic pain. This case highlights the rare coexistence of sublingual sialolithiasis, myofascial pain dysfunction syndrome (MPDS), and pulp stones or pulp canal obliteration. A 54-year-old male patient was diagnosed with sublingual sialolithiasis (2 × 1.6 cm), MPDS, and multiple pulp stones. Radiographic investigations, including bitewings and CBCT, revealed and confirmed the size of calculi and showed a significant pulp stone in posterior teeth. The patient underwent transoral sialolith removal and was treated with muscle relaxants and oral physiotherapy for MPDS. This case highlights the complex interplay among sialolithiasis, MPDS, and pulp stones. A multidisciplinary approach is essential for comprehensive management, especially in cases involving recurrent calcifications and chronic pain.