Diversity of possible anatomical variations and configurations of dens invaginatus limits the possibility to conduct its complex treatment in a fully standardized protocol manner. Thus, the objective of the present case report was to approbate targeted approach to Type II dens invaginatus treatment, which may also be interpreted as part of a sequential management strategy with the intention to keep the vitality of a pulp within the main root canal in the first place. The present case report also opens a topic for discussion if “partial success” definition may be applicable for assessment of Type II dens invaginatus treatment outcomes. A 16‐year‐old patient referred to the dentist complaining of painful percussion in the area of Tooth 12. Clinical examination methods (visual examination, sensitivity testing, percussion, and probing) were used for the diagnostics of problematic Tooth 12. To confirm the diagnosis of dens invaginatus, Type II CBCT examination was held. The following treatment was provided: root canal treatment of the invaginated canal only in the first place, while root canal treatment of the main canal was planned to be provided on demand if needed. From the perspective of the presented case report, targeted endodontic treatment of invagination has resolved all the symptoms from the very beginning; meanwhile, the recurrence of the symptoms after some time was due to the involvement of the main root canal. Sequential management with primary targeted invagination treatment of Oehlers′ Type II dens invaginatus presented in this case report seems to be a possible approach for a carefully selected clinical situation aimed at minimizing the level of iatrogenic intervention; however, in the described case report, the end tooth required full endodontic treatment. Considering the risk of potential endodontic complications, development periodical screening of patients, who have undergone primary targeted invagination treatment, seems to be beneficial and reasonable to provide.

Objective: Given the growing integration of artificial intelligence (AI) into dental diagnostics and clinical decision-support systems, a comprehensive assessment of existing publications addressing AI applications in the context of separated endodontic instruments is highly relevant. Such an assessment is essential for guiding future research priorities, promoting standardisation of reporting frameworks, and facilitating the transition from experimental AI prototypes towards clinically reliable tools aimed at minimising the incidence of intra-canal instrument separation. To critically evaluate the current landscape of AI models addressing endodontic instrument separation and to determine whether available models support a transition from post-separation detection towards predictive and preventive risk-assessment strategies. Methods: A qualitative evidence synthesis was conducted to summarise published studies evaluating AI and machine learning approaches related to separated endodontic instruments. This scoping review was structured in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) principles to ensure transparent study selection and reporting. Results were mapped and synthesised descriptively in 3 layers: study mapping, model mapping, and performance mapping. Results: Of the 8 eligible studies, only 2 (25%) were experimental investigations focused on preventive monitoring and prediction of endodontic instrument separation-related changes. Radiology-based detection was the dominant research direction, represented in 6 of 8 studies (75%). For periapical radiograph-based detection of separated instruments, AI-based models reported accuracy values ranging from 0.795 to 0.982, with the highest values observed for Mask Region-based convolutional neural network (accuracy =0.982) and YOLOv8 (accuracy=0.974). Performance was generally lower for panoramic radiographs. In the cone-beam computed tomography (CBCT)-based approach, true-positive detection was reported at 80.8%, although detailed comparative metrics were limited. Conclusion: Most available AI models related to endodontic instrument separation focus on digital radiological images, including both two-dimensional modalities (panoramic and periapical radiographs) and three-dimensional imaging (CBCT), whereas only a few studies have addressed monitoring the functional condition of instruments during their performance to verify potential critical changes related to the risk of separation. Convolutional neural networks were the dominant methodological approach, whereas traditional ML algorithms were used mainly in preventive experimental studies.

This systematic review aimed to evaluate whether cross-sectional geometry is associated with cyclic fatigue resistance of nickel–titanium (NiTi) endodontic instruments and to identify the geometric and materials-related features most frequently associated with improved fatigue performance. The protocol was prospectively registered on the Open Science Framework (OSF). PubMed, Scopus, Embase, Web of Science, and WorldCat were searched in April 2026 in accordance with PRISMA 2020. Eligible studies were comparative in vitro investigations that explicitly evaluated cross-sectional geometry or a related geometric parameter as a prespecified study factor and reported quantitative cyclic fatigue outcomes. Of 107 screened records, 66 full-text reports were assessed and 23 studies were included in the qualitative synthesis. Twenty-two studies had a medium risk of bias and one had a low risk of bias according to the Quality Assessment Tool for In Vitro Studies (QUIN). Cyclic fatigue resistance was most often reported as time to fracture or number of cycles to failure. Instruments with reduced metal mass, smaller core volume, lower cross-sectional area, and greater flexibility tended to demonstrate higher fatigue resistance in curved canals. S-shaped and double-S-shaped cross-sections were most consistently associated with favorable outcomes; however, this association is more plausibly related to reduced bending stiffness and canal-wall contact forces than to increased intrinsic material fatigue strength. Flat-side designs did not show a consistent advantage. The evidence was limited by heterogeneous testing protocols and residual confounding by alloy, heat treatment, taper, manufacturing, surface condition, and kinematics. No meta-analysis or quantitative dimensional correlation was feasible because testing conditions and detailed geometric parameters were inconsistently reported.