This in vitro study aims to compare the accuracy and active drilling time of an autonomous robot-assisted system (RAS) and a dynamic navigation system (DNS) during access cavity preparation in extracted single-rooted human teeth. Sixty-four sound, single-rooted human extracted teeth were randomly assigned to either the RAS or the DNS group (n = 32 per group). Under simulated clinical conditions, an experienced endodontist performed access cavity preparation on the specimens using the allocated system for each group. Postoperative cone beam computed tomography (CBCT) images were superimposed on preoperative images and compared with planned pathways to quantify deviations between planned and actual pathways, namely coronal deviation, apical deviation, and angular deflection. Additionally, we compared tooth substance loss, active drilling time, and procedure failures between the two groups. Coronal deviation, angular deflection, and substance loss in the RAS group were significantly lower than those in the DNS group (p < 0.05). In both anterior teeth and premolar subgroups, the RAS group exhibited lower angular deflection (p < 0.001) and substance loss (p < 0.01) than the DNS group. Both systems achieved a 93.75

Root canal therapy (RCT) is the primary treatment modality for pulpal and periapical diseases. Although the fundamental objective of RCT has remained unchanged for over a century, its technical details have been continuously refined and transformed. Preoperative diagnostic approaches have evolved from two-dimensional imaging to three-dimensional volumetric reconstructions and, more recently, to artificial intelligence-assisted analytical frameworks. Treatment modalities have progressed from manual instrumentation to motor-driven systems and guided or robotic-assisted interventions. Disinfection strategies have also begun to shift from passive chemical irrigation towards actively guided nano-enabled systems. Moreover, obturation materials have advanced from inert substances to bioactive compounds and, prospectively, to adaptive trends. These transitions reflect not only technological progress but also the continuing efforts of endodontists to improve precision, safety, efficiency, and biological outcomes. However, the primary goal of RCT remains the effective elimination of infection and the prevention of reinfection. In this review, the term 'Smart RCT' is used as a conceptual framework that integrates digital intelligence, engineering-based operative assistance, and material-based biological functions. We systematically synthesise contemporary evidence on the development and application of smart technologies across the major stages of RCT. By critically evaluating both the potential and current limitations of these technologies, this review aims to provide an evidence-based perspective on the integration of intelligent advances into contemporary endodontic decision-making and clinical practice.

AIM:This study aimed to investigate the spatial cellular architecture and molecular interactions in healthy and inflamed dental pulp using spatial transcriptomics (Visium HD), to elucidate the pathological mechanisms of pulpitis and identify potential therapeutic targets for vital pulp therapy. METHODOLOGY:Spatial transcriptomic sequencing was performed on dental pulp tissues from two healthy individuals and two pulpitis patients, with integrated analyses including Seurat clustering, cell trajectory inference, GO enrichment, CellphoneDB interaction network modelling and PROGENy pathway activity assessment to compare cellular heterogeneity and signalling regulation. RESULTS:Nine major cell types (fibroblasts, progenitor cells, endothelial cells, neural cells, plasma cells, B cells, T cells, monocytes and macrophages) were identified, and their spatial distribution was mapped. Subclustering and differential expression analysis revealed that fibroblast (e.g., APOL2+/CCN2+) and progenitor cell (e.g., CDK5R1+/CCRL2+) subclusters exacerbated fibrosis and immune activation, while TMPRSS4+/CST5+ fibroblasts were critical for homeostasis. Pro-inflammatory endothelial subclusters (IGHG1+/CXCL13+) expanded, while anti-inflammatory subclusters (SERPINA5+/SERPINA3+) diminished, may lead to vascular-immune imbalance. Upregulation of immunoglobulin genes and downregulation of MBP disrupted neural function, while inflamed pulp showed increased B cells and macrophages, decreased T cells and monocytes. Inflammatory pathways (PI3K, EGFR, TGFβ, MAPK, Oestrogen, NF-κB) were upregulated, with enhanced TGFβ signalling in endothelial cells. Intercellular interaction analysis showed altered APP-CD74 signalling in endothelial-macrophage interactions and disrupted CXCL14-mediated communication between immune and endothelial cells. CONCLUSIONS:For the first time, we have identified nine cell populations in dental pulp with their spatial localization and intercellular crosstalk using spatial transcriptomic sequencing technology, and mapped the inflammatory landscape of dental pulp. Cellular remodelling-driven by APP suppression, CXCL14 deficiency and TGFβ activation-is a central mechanism in pulpitis progression. These findings provide a preliminary spatial transcriptomic foundation that may inform the development of targeted strategies for vital pulp therapy.

Segmental root developmental arrest (SRDA) is an uncommon developmental pattern in immature permanent teeth with apical periodontitis, in which a separated apical segment continues to develop independently of the main root. This retrospective study evaluated the frequency, clinical features, and factors associated with SRDA after regenerative endodontic procedures (REPs) or apexification. A total of 103 immature permanent teeth with apical periodontitis treated with REPs or apexification were retrospectively reviewed. Clinical records and radiographs were assessed for SRDA. Data collected included age, sex, tooth type, etiology, Nolla root developmental stage, treatment modality, timing of SRDA detection, and apical inflammation. Associations between candidate factors and SRDA were analyzed using the chi-square test or Fisher exact test, with Bonferroni correction for pairwise comparisons. SRDA was identified in 12 of 103 teeth (11.65

Endodontic microsurgery is a critical treatment option that is often considered when conventional root ca-nal therapy fails or when complex periapical diseases cannot be resolved through non-surgical treatment.The clinical out-comes of endodontic microsurgery are influenced by multiple factors.Among these,the size of the periapical lesion is considered a key variable that can significantly impact surgical design,operative difficulty,postoperative infection con-trol,and tissue healing.This article systematically discusses the mechanisms by which the size of periapical lesions af-fects the efficacy of endodontic microsurgery,preoperative assessment methods,intraoperative management strategies,and prognostic correlations.On the basis of existing evidence from evidence-based medicine,clinical management re-commendations are proposed to provide a theoretical foundation and operational guidance for clinical practice.

Persistent infection and unresolved inflammation remain major obstacles to successful vital pulp therapy. Strategies capable of simultaneously controlling bacterial burden and regulating the inflamed pulp microenvironment remain limited. In this study, we investigated the effects of the innate defense regulator peptide IDR-1002 on pulp repair under inflammatory conditions. IDR-1002 showed antibacterial activity against multispecies biofilms, Streptococcus mutans, and Enterococcus faecalis. In human dental pulp stem cells, IDR-1002 reduced LPS-induced expression of IL-6, IL-1β, and TNF-α, attenuated intracellular reactive oxygen species accumulation, and improved wound closure. It also enhanced odontogenic differentiation, as evidenced by increased DSPP and DMP1 expression and enhanced mineral deposition. Exploratory transcriptomic analysis identified enrichment of biological processes potentially associated with IDR-1002 treatment, including extracellular matrix organization, receptor signaling, and tissue repair. To develop a local, microenvironment-responsive delivery system, IDR-1002 was incorporated into an MMP-responsive hydrogel. Biologically active IDR-1002 was released following MMP-9-triggered hydrogel degradation. In a rat pulpitis model, IDR-1002 reduced inflammatory cell infiltration, decreased IL-6 and IL-1β expression, and improved tissue organization at the exposure site. Collectively, these findings demonstrate that IDR-1002 possesses antibacterial, anti-inflammatory, antioxidative, and pro-regenerative properties in the experimental models used in this study and support further investigation of host-regulatory peptides as potential adjunctive agents for biologically based vital pulp therapy.

Aim or purpose: Glucose metabolism plays a pivotal role in regulating a wide array of cellular physiological activities, encompassing osteogenic differentiation. Despite this, the potential benefits of targeting energy metabolism for enhancing bone regeneration remain largely unexplored. In this study, we delved into the impact and underlying mechanisms of the salt-induced kinase 2/3 (SIK 2/3) inhibitor, YKL-05-099 (YKL), on mandibular bone defects. Materials and methods: We generated mandibular defect models with YKL local application and analyzed the new bone formation. Orofacial bone-marrow-derived mesenchymal stem cells (OMSCs) were cultured to evaluate the function and mechanism of YKL in osteogenic differentiation. Results: YKL successfully enhanced new bone formation within the mandibular defect area without causing any organ damage. Furthermore, it promoted osteogenic differentiation of OMSCs by inhibiting SIK 2/3, which was accompanied by an increase in glucose uptake and ATP production. Mechanistically, glucose transporter 4 (Glut4) acted as a modulator of osteogenic differentiation by limiting AMPK pathway and preventing RUNX2 ubiquitinated degradation, and SIK 2/3 suppresses Glut4’s expression through the HDAC4/PGC-1α pathway. Conclusions: Collectively, our findings demonstrated YKL can promote osteogenic ability of OMSCs through Glut4-dependent glucose uptake, and SIK 2/3 negatively regulated level of Glut4 via HDAC4/PGC-1α pathway. These insights not only uncover a novel mechanism but also provide a solid foundation for the application of YKL in the context of mandibular bone defects.

To explore the feasibility of applying the digital evaluation system in the homogeneous training and qualification evaluation of teaching faculty in the preclinical simulation teaching of G.V. Black Class II cavity tooth preparation in operative dentistry. Eighteen clinicians who graduated with Ph.D. and were about to participate in the operative dentistry preclinical teaching at the Hospital of Stomatology, Sun Yat-sen University, were selected to practice the G.V. Black Class II cavity tooth preparation of the left mandibular first molar by using the Aizhixing Digital Dental Virtual Teaching Evaluation System DHC210. Through continuous practice and assessment, we evaluated whether there were changes in their examination scores and operation time after practicing with multiple teeth. Meanwhile, we evaluated the condition of Class II cavity tooth preparation before and after practices using Fair Grader 2000, a Dental Digital Teaching Practice Evaluation System, and combined it with questionnaires to examine the teaching effectiveness of this training. As the number of exercises increased, there was a tendency for the result scores of the four tests of Aizhixing to increase (P > 0.05), and the operating time was progressively less (P < 0.05). The results of Fair Grader 2000 showed that dental clinicians who had completed their standardized residency training had higher and more stable scores than those who were ongoing (P < 0.05). The questionnaire survey results showed that it was necessary to apply Aizhixing to Class II cavity tooth preparation teaching activities, which can effectively improve students' theoretical knowledge and the level of cavity preparation skills. The application of the digital real-time evaluation system of Aizhixing and the digital evaluation system help to improve the efficiency and objective assessment of Class II cavity tooth preparation, which provides a certain reference basis for achieving high-quality and homogeneous teaching and reform of oral endodontics.

Pulpotomy, which belongs to vital pulp therapy, has become a strategy for managing pulpitis in recent decades. This minimally invasive treatment reflects the recognition of preserving healthy dental pulp and optimizing long-term patient-centered outcomes. Pulpotomy is categorized into partial pulpotomy (PP), the removal of a partial segment of the coronal pulp tissue, and full pulpotomy (FP), the removal of whole coronal pulp, which is followed by applying the biomaterials onto the remaining pulp tissue and ultimately restoring the tooth. Procedural decisions for the amount of pulp tissue removal or retention depend on the diagnostic of pulp vitality, the overall treatment plan, the patient’s general health status, and pulp inflammation reassessment during operation. This statement represents the consensus of an expert committee convened by the Society of Cariology and Endodontics, Chinese Stomatological Association. It addresses the current evidence to support the application of pulpotomy as a potential alternative to root canal treatment (RCT) on mature permanent teeth with pulpitis from a biological basis, the development of capping biomaterial, and the diagnostic considerations to evidence-based medicine. This expert statement intends to provide a clinical protocol of pulpotomy, which facilitates practitioners in choosing the optimal procedure and increasing their confidence in this rapidly evolving field.

Background The study aims to investigate Streptococcus cristatus, an oral commensal bacterium, as a probiotic for dental caries prevention by modulating the oral microbiome.Methods Saliva from four healthy donors was used to establish 24-h microcosm biofilms in an in vitro 96-well peg model. The preformed biofilms were then exposed to biofilm medium containing 0.2% sucrose (BM), with or without S. cristatus. They were grown for 48 h under two conditions: a constant pH-neutral regime (BM supplemented with 76 mM K2HPO4 and 15 mM KH2PO4, pH 7.0) or cariogenic pH-cycling regime (8 h pH-neutral and 16 h in BM containing 100 mM acetic acid, pH 5.5). Phosphate and acetate buffers were used to control pH. After 72 h, the biofilms were analyzed for biomass, lactic acid production, hydrogen peroxide (HP) concentrations, and microbial composition via 16S rRNA gene sequencing.Results S. cristatus successfully integrated into 24-h preformed microcosm biofilms derived from individual saliva. Under pH-neutral conditions, it reduced biofilm biomass and lactate production while increasing hydrogen peroxide (HP) generation in a donor-dependent manner. Conversely, under cariogenic pH-cycling conditions, these inhibitory effects on biomass and lactate production were consistent across all donors, although HP was undetectable. Microbiome analysis revealed that S. cristatus increased species richness and mitigated the compositional shifts caused by pH-cycling. This was achieved by inhibiting Streptococcus salivarius/vestibularis across all donors, while promoting Streptococcus mitis group and Streptococcus anginosus in a donor-dependent manner.Conclusions S. cristatus represents a promising microbiome modulator with the potential to substantially mitigate the cariogenicity of oral microcosms.

PURPOSE:The aim of this study is to determine whether the virtual simulation platform for root canal filling facilitates a quicker transition for students from theoretical coursework on root canal filling to practical experimental operations. METHODS:One hundred and twenty-six fourth-year dental students were divided into four groups: two pre-class groups and two in-class groups. A theoretical test was taken before all hands-on training. Usage feedback was collected following the extraoral training phase. Students from pre-class groups had access to virtual learning before the experimental class, while those from in-class groups engaged in virtual learning after the first-day hands-on course. For submitted operational assignments, filling length and filling density were assessed as indicators of filling quality. Grades of root canal filling operation assignments were analyzed and compared. RESULTS:The timing of conducting virtual simulation experiments has no significant impact on students' understanding of the theoretical content taught. Pre-class groups achieved higher grades in root canal filling of three-dimensional (3D) plastic premolars. There were no statistical differences among groups in the grades of root canal filling for 3D plastic incisors. Most students preferred to undergo virtual simulation experiments before operation class. CONCLUSION:Although the virtual simulation platform for root canal filling did not improve the quality of root canal fillings performed by undergraduate students, it could have a positive effect on the smooth transition from theoretical courses to laboratory operations. The virtual simulation platform for root canal filling can serve as an effective supplementary resource for preclinical root canal filling education.

Aim or purpose: To investigate the impacts of Streptococcus oligofermentans, an oral commensal, on the cariogenicity of root surface plaque biofilms, and its inhibition on root caries in a rat model. Materials and methods: Root surface plaques from root-caries patients and caries-free individuals were inoculated into a polystyrene peg model for 24 h, then cultured with or without S. oligofermentans under cariogenic pH-cycling conditions to form 72-h biofilms. Subsequently, the biofilms were subjected to biomass assay, lactate and H₂O₂ quantification, and qPCR analysis for S. oligofermentans colonization. In a root caries model, rats were received the following treatments respectively: no treatment, S. oligofermentans alone, cariogenic microbes (Streptococcus mutans, Actinomyces viscosus and Candida albicans), S. oligofermentans followed by cariogenic microbes, cariogenic microbes followed by low- or high-frequency treatment of S. oligofermentans. After 6 weeks, biosafety was assessed via organ histology, and root caries severity evaluated using Doff’s score and micro-CT. Results: S. oligofermentans successfully colonized the pre-formed root-caries and caries-free plaque biofilms, significantly reducing biomass and acid production while increasing H₂O₂ generation (p<0.05). Pretreatment and treatment with low- or high-frequency S. oligofermentans significantly reduced root caries severity in rats (p<0.0001). Additionally, S. oligofermentans treatment alone displayed no toxicity to rat organs. Conclusions: S. oligofermentans effectively colonizes root surface plaque biofilms and suppresses their cariogenicity in vitro, as well as mitigates root caries severity in vivo, suggesting its inhibition on root caries.

Calcium silicate (CS)-based bioactive materials were widely utilized to promote the therapeutic potential of bone marrow mesenchymal stem cells (BMSCs) in bone tissue engineering. The activation of numerous classic bone formation modulators, including the BMP, Wnt, and MAPK/ERK signaling pathways, contributes to the CS-induced osteogenesis of BMSCs. Mitochondrial metabolic patterns have emerged as key contributors to the osteogenic differentiation of mesenchymal stem cells. However, whether CS affects the mitochondrial metabolic profiles of BMSCs is mostly unclear. Herein, we showed that CS induced the osteogenic differentiation of human BMSCs (hBMSCs) mainly via silicon (Si) ion release. Moreover, CS-stimulated hBMSCs underwent metabolic reprogramming accompanied by increased mitochondrial oxidative phosphorylation (OXPHOS) activity. The inhibition of OXPHOS hindered the CS-induced osteogenic differentiation of hBMSCs and bone regeneration, indicating that CS-induced OXPHOS mediated the observed increase in osteogenesis. Mechanistically, CS induced mitophagy and autophagic flux by increasing the formation of autolysosomes and lysosomal degradation to eliminate dysfunctional mitochondria and mitochondrial reactive oxygen species production, leading to enhanced OXPHOS and osteogenesis in hBMSCs. Furthermore, CS promoted mitochondrial fusion in hBMSCs, which may contribute to OXPHOS activation. Our investigation reveals a previously unclear function of CS in regulating the osteogenesis of BMSCs by inducing mitophagy-mediated metabolic shifts toward OXPHOS.

Vital pulp therapy (VPT) is considered a conservative means of preserving the vitality and function of the dental pulp after injury. However, current VPT has unfavorable effects on inflamed pulp. Mesenchymal stem cell (MSC)-derived small extracellular vesicles (MSC-sEVs) show powerful immunomodulatory capacities and exert therapeutic effects on a variety of inflammatory diseases. However, whether MSC-sEVs ameliorate the inflammatory response and promote inflammatory pulp repair in pulpitis is largely unknown. In this study, we show that sEVs derived from dental follicle stem cells (typical dental MSCs, DFSC-sEVs) alleviate lipopolysaccharide-induced pulpitis in rats and enhance pulp repair by inducing M2 macrophage polarization. Mechanistically, heat shock protein 70 (HSP70) within DFSC-sEVs can be supplemented into lysosomes to directly protect lysosomal function and induce mitophagy to promote the degradation of depolarized mitochondria, thereby preprogramming inflammatory macrophages to commit to oxidative phosphorylation, which fuels M2 polarization. Furthermore, DFSC-sEVs also transfer antioxidant miRNAs, including miR-24-3p and let-7c-5p, to inhibit mitochondrial reactive oxygen species production, thereby indirectly stabilizing lysosomes to induce M2 macrophage generation. Our study reveals a promising immunotherapeutic potential of DFSC-sEVs for VPT in inflamed pulp and a novel role for DFSC-sEVs in inhibiting the macrophage inflammatory response by protecting lysosomes and inducing mitophagy-mediated metabolic shifts toward oxidative phosphorylation.

Apical microsurgery is accurate and minimally invasive, produces few complications, and has a success rate of more than 90%. However, due to the lack of awareness and understanding of apical microsurgery by dental general practitioners and even endodontists, many clinical problems remain to be overcome. The consensus has gathered well-known domestic experts to hold a series of special discussions and reached the consensus. This document specifies the indications, contraindications, preoperative preparations, operational procedures, complication prevention measures, and efficacy evaluation of apical microsurgery and is applicable to dentists who perform apical microsurgery after systematic training.

With the increasing demand for dental aesthetic outcomes, techniques for composite resin restoration intended for anterior teeth have been widely applied due to their minimally invasive and superior esthetic performance. Despite promising short-term outcomes, the long-term prognosis of anterior resin restorations remains challenging. Frequently reported complications include restoration fractures and decoloration. Material selection, operative procedures, and patient-related factors can affect the long-term outcomes of restorations. This review aims to systematically analyze the long-term clinical performance of resin restorations in anterior teeth. The key factors influencing treatment efficacy are also investigated. The findings are expected to provide a basis for optimizing clinical strategies in procedures for anterior composite resin restoration.

Enamel demineralization, the formation of white spot lesions, is a common issue in clinical orthodontic treatment. The appearance of white spot lesions not only affects the texture and health of dental hard tissues but also impacts the health and aesthetics of teeth after orthodontic treatment. The prevention, diagnosis, and treatment of white spot lesions that occur throughout the orthodontic treatment process involve multiple dental specialties. This expert consensus will focus on providing guiding opinions on the management and prevention of white spot lesions during orthodontic treatment, advocating for proactive prevention, early detection, timely treatment, scientific follow-up, and multidisciplinary management of white spot lesions throughout the orthodontic process, thereby maintaining the dental health of patients during orthodontic treatment.

With the growing emphasis on maternal and child oral health, the significance of managing oral health across preconception, pregnancy, and infancy stages has become increasingly apparent. Oral health challenges extend beyond affecting maternal well-being, exerting profound influences on fetal and neonatal oral development as well as immune system maturation. This expert consensus paper, developed using a modified Delphi method, reviews current research and provides recommendations on maternal and child oral health management. It underscores the critical role of comprehensive oral assessments prior to conception, diligent oral health management throughout pregnancy, and meticulous oral hygiene practices during infancy. Effective strategies should be seamlessly integrated across the life course, encompassing preconception oral assessments, systematic dental care during pregnancy, and routine infant oral hygiene. Collaborative efforts among pediatric dentists, maternal and child health workers, and obstetricians are crucial to improving outcomes and fostering clinical research, contributing to evidence-based health management strategies.

Human dental pulp stem cells (hDPSCs) possess multipotent properties and play a pivotal role in tissue regeneration. Elucidating the molecular mechanisms governing hDPSC pluripotency is essential for advancing their clinical application. We previously demonstrated that long noncoding RNA five prime to Xist (lncRNA FTX) suppresses the proliferation and multilineage differentiation capacity of hDPSCs by inhibiting octamer-binding transcription factor 4 (OCT4). This study aims to explore the molecular mechanisms by which FTX regulates hDPSC proliferation/differentiation via downstream miRNAs and their biological implications. Small RNA sequencing was utilized to identify differentially expressed miRNAs between the FTX-overexpressing and vector hDPSCs. Bioinformatic analysis, luciferase assay, and chromatin immunoprecipitation (ChIP) were employed to elucidate the regulatory network of the FTX/OCT4/miR-122-5p axis. Cell counting kit-8 (CCK-8) assay, quantitative real-time polymerase chain reaction (qRT-PCR), western blotting, alizarin red staining, and oil red O staining were performed to validate the functional roles of miR-122-5p and forkhead box O3 (FOXO3) in FTX-mediated proliferation and differentiation potential in hDPSCs. Furthermore, the effect of FTX/miR-122-5p on dentin formation was assessed using a subcutaneous implantation model. Sequencing revealed 115 differentially expressed miRNAs (26 upregulated and 89 downregulated; fold change ≥ 1.5, P < 0.05). miR-122-5p displayed a significant decrease in expression in FTX-overexpressing hDPSCs. Overexpression of miR-122-5p partially alleviated FTX’s inhibitory effect on hDPSC proliferation and differentiation. Cotransfection experiments demonstrated that FTX overexpression impaired the pluripotency of hDPSCs in part through miR-122-5p-mediated regulation of FOXO3 in vitro and in vivo. Mechanistically, FTX specifically suppressed OCT4 expression, which led to the transcriptional inactivation of miR-122-5p. Furthermore, upregulation of FTX resulted in enhanced expression levels of FOXO3, an effect that could be counteracted by miR-122-5p. LncRNA FTX overexpression exerts a suppressive effect on the transcriptional expression of miR-122-5p, which subsequently activates FOXO3 and thereby impedes cell proliferation as well as multilineage differentiation capacity of hDPSCs. Moreover, a novel lncRNA FTX-OCT4-miR-122-5p interaction pathway was discovered. These findings shed light on two novel regulatory mechanisms – lncRNA FTX/OCT4/miR-122-5p regulation and lncRNA FTX/miR-122-5p/FOXO3 regulation – that unravel crucial signaling pathways governing the pluripotency of hDPSCs, potentially offering promising RNA-based therapeutic strategies and gene-editing targets for dentin regeneration.

Cemental tear is a rare and indetectable condition unless obvious clinical signs present with the involvement of surrounding periodontal and periapical tissues. Due to its clinical manifestations similar to common dental issues, such as vertical root fracture, primary endodontic diseases, and periodontal diseases, as well as the low awareness of cemental tear for clinicians, misdiagnosis often occurs. The critical principle for cemental tear treatment is to remove torn fragments, and overlooking fragments leads to futile therapy, which could deteriorate the conditions of the affected teeth. Therefore, accurate diagnosis and subsequent appropriate interventions are vital for managing cemental tear. Novel diagnostic tools, including cone-beam computed tomography (CBCT), microscopes, and enamel matrix derivatives, have improved early detection and management, enhancing tooth retention. The implementation of standardized diagnostic criteria and treatment protocols, combined with improved clinical awareness among dental professionals, serves to mitigate risks of diagnostic errors and suboptimal therapeutic interventions. This expert consensus reviewed the epidemiology, pathogenesis, potential predisposing factors, clinical manifestations, diagnosis, differential diagnosis, treatment, and prognosis of cemental tear, aiming to provide a clinical guideline and facilitate clinicians to have a better understanding of cemental tear.