Objective:This study was performed to assess the prevalence of acute periapical abscesses (PAs) in patients with psoriasis and to determine whether this relationship remains after adjusting for related systemic, behavioral, and treatment-related confounders. Methods:A retrospective hospital-based analysis of 2,108,676 patients was conducted using de-identified clinical data. Diagnoses of psoriasis and acute PA without sinus involvement were identified using standardized coding. The association between psoriasis and acute PAs was assessed using odds ratios (ORs) with 95% confidence intervals (CIs). Multivariable logistic regression analyses were performed to adjust for diabetes, nicotine dependence, alcohol related disorders, and biologic therapy use. Results:Among 16,084 patients with psoriasis, 224 were diagnosed with acute PAs. Psoriasis was associated with a significantly higher prevalence of acute PAs than in the overall hospital population (OR, 2.21; 95% CI, 1.94-2.53; p < 0.0001). This association remained statistically significant after adjustment for diabetes (OR, 1.40), nicotine dependence (OR, 1.31), alcohol related disorders (OR, 1.89), and biologic therapy use (OR, 1.77). Female patients and white patients with psoriasis exhibited a higher prevalence of acute PAs compared with other demographic groups. Conclusions:Psoriasis is independently associated with an increased risk of acute PAs, even after accounting for common medical and behavioral risk factors. Greater awareness among clinicians and closer collaboration between dermatology and oral healthcare providers can facilitate earlier diagnosis and preventive treatment.

Objectives:The aim of this study is to find out if undergraduate students could successfully shape an artificial S-shape root canal with the R25 Reciproc Blue instrument and if an existing glide path had an impact on their ability to reach full working length. Methods: A total of 60 students from two universities were given the task of shaping two training blocks (with and without a preestablished glide path) with the Reciproc Blue R25. The time needed for shaping, the number of pecking motions and the ability to reach working length were recorded and analyzed with the Wilcoxon signed-rank test for group comparison. In addition, paired within-student differences were summarized as medians [Q1-Q3], and Hodges-Lehmann (HL) estimates with 95% confidence intervals were computed to provide interpretable measures of central tendency and uncertainty. Results: Although all students needed more time and more pecking motions to reach working length in the no glide path group, no instrument separation occurred in any sample. Conclusions: With the aid of improved kinematics, metallurgic advancements, current endodontic motor technologies and the right protocol, even undergraduate students with limited experience in shaping root canals can reach working length on a double curved canal with no incidents even without a preestablished glide path

AIM:To assess the association between apical periodontitis (AP) and subclinical symptoms of anxiety, depression and disordered eating. METHODOLOGY:A total of 120 individuals were included in this case-control study. Sixty subjects were assigned to case (AP+) and 60 to control group (AP-). The periapical and dental status were assessed using radiographic images (OPT, periapical radiographs) and dental examination. The DMFT index (decayed, missing and filled teeth) and the periapical index (PAI) scores were recorded. All subjects were interviewed to compile medical history data, anxiety (Hamilton A), depression (Hamilton D) and eating disorder (EAT-26) questionnaires. Inferential and both simple and multiple logistic regression analyses were performed. RESULTS:Significant associations were observed between AP and higher scores on HAM-A, HAM-D and EAT-26. The regression model showed that higher PAI scores were significantly associated with increased odds of anxiety, depression and disordered eating. A PAI score of 3 showed increased odds of anxiety (OR = 5.57, p = 0.004) and depression (OR = 3.65, p = 0.025). A PAI score of 4 showed even greater odds for anxiety (OR = 8.68, p = 0.001), depression (OR = 14.07, p = 0.001) and disordered eating (OR = 3.98, p = 0.032). Participants with more than one periapical lesion were 3.56 times more likely to report higher levels of anxiety (p = 0.007), 3.59 times more likely to experience elevated depression (p = 0.018) and 3.08 times more likely to exhibit disordered eating behaviours (p = 0.028). Additionally, higher DMFT scores were associated with an increased likelihood of higher HAM-A scores (OR = 1.18, p = 0.001). CONCLUSIONS:The study results show a statistically significant higher prevalence of mood disorders and mental health-related conditions including anxiety, depression and eating disorders in patients with AP. Longitudinal studies are needed to determine the nature of the observed association. TRIAL REGISTRATION:ClinicalTrials.gov identifier: NCT06589076.

Background:Oral health disparities remain a significant public health concern among migrant populations, often driven by socioeconomic barriers, limited access to dental care, and challenges in health information acquisition. Objective:This study aimed to assess oral health behaviors, access to dental care, and sources of oral health information among migrants residing in Italy and to examine their association with the presence of untreated dental caries. Methods:A cross-sectional study was conducted among 427 migrants living in Italy. Data were collected using a structured online questionnaire covering sociodemographic characteristics, oral health behaviors, dental care utilization, and use of social media for oral health information. The primary outcome was the presence of at least one untreated dental caries (yes/no), assessed through self-reported data. Univariate and multivariable logistic regression analyses were performed to identify factors associated with untreated caries. Results:A total of 63.5% of participants reported having at least one untreated dental caries. Most participants reported irregular dental attendance, with a high proportion seeking care only in emergency situations. Monthly income, nationality, and frequency of dental check-ups were significantly associated with untreated caries in univariate analysis. However, in multivariable analysis, only nationality remained significantly associated with the outcome (p < 0.0001). Additionally, limited use of preventive dental services and low perceived credibility of oral health information from social media were observed. Conclusion:Untreated dental caries were highly prevalent and were associated with socioeconomic and access-related factors within the study population. These findings highlight the importance of improving access to preventive dental services and strengthening reliable oral health communication strategies in migrant populations.

PURPOSE:This study evaluated the antibacterial activity of two hydraulic calcium silicate-based sealers, NeoSealer Flo and AH Plus Bioceramic, against Enterococcus faecalis (E. faecalis) biofilm and their biocompatibility with pre-osteoblastic cells. METHODS:Thirty-one extracted human lower incisors with single canals were inoculated with E. faecalis, and their root canals were subjected to three types of filling: A) NeoSealer Flo (n = 10), B) AH Plus Bioceramic (n = 10), and C) positive control (n = 10), as well as one negative control. The teeth were embedded in resin and sectioned at their coronal, middle, and apical thirds, yielding 160 sections. Bacterial viability was assessed by confocal laser scanning microscopy using LIVE/DEAD staining. Biocompatibility was evaluated using the bicinchoninic acid protein assay and sodium dodecyl sulfate-polyacrylamide gel electrophoresis. RESULTS:NeoSealer Flo and AH Plus Bioceramic showed comparable antibacterial activity. In the coronal third of the tooth, viable bacteria were estimated at 44.1 ± 4.0% and 43.5 ± 4.0%, respectively, versus 85.7 ± 5.2% in controls. Similar results were obtained in the middle and apical thirds. Viability was significantly higher in the coronal third (P < 0.05). No significant differences in cell number or protein expression were observed between the sealers and the controls (P > 0.05). CONCLUSION:Both sealers demonstrated similar antibacterial effectiveness and biocompatibility, with greater bacterial viability in the coronal region.

ObjectiveHydraulic calcium silicate-based sealers (CSBSs) are increasingly used in endodontics, but evidence on their long-term clinical effectiveness remains limited. This retrospective study evaluated the 5-year outcomes of primary root canal treatments and retreatments performed with a CSBS in teeth with symptomatic apical periodontitis.Materials and methodsThe sample consisted of 637 teeth with symptomatic apical periodontitis treated by a single experienced operator using a premixed CSBS (CeraSeal; Meta Biomed Co., Cheongju, South Korea) with the cold hydraulic condensation technique (CHC). Data were retrospectively collected from clinical charts and radiographic archives. Preoperative variables included sex, systemic health, tooth type, arch location, lesion size, pulpal diagnosis, sinus tract, and preoperative small perforation. Intraoperative factors comprised intracanal medication, apical diameter, obturation length, and sealer extrusion. Postoperative information included the type of coronal restoration. Follow-up evaluations were based on available radiographs and clinical notes at 1, 2, 3, 4, and 5 years. Outcomes were classified according to strict criteria (absence of symptoms and complete radiographic resolution) and loose criteria (absence of symptoms with complete or partial healing). Prognostic factors were investigated using bivariate associations and multivariate logistic regression models.ResultsStrict success rates increased progressively (80.2% at 1 year, 85.7% at 2 years, 86.8% at 3 years, 88.2% at 4 years, and 87.67% at 5 years). Loose success remained consistently high (99.2% at 1 year; 90.7% at 4 years, and 87.67% at 5 years). Higher baseline periapical index (PAI) scores significantly reduced odds of strict success at 2, 3, 4 years. Other factors, including age, sex, tooth type, treatment type, extrusion, and restoration, were not significant.ConclusionsCSBSs demonstrated favorable long-term outcomes. Preoperative lesion severity was the main prognostic factor, while demographic and procedural variables showed limited influence on long-term success.Clinical relevanceThis study supports the long-term clinical reliability of CSBSs used with CHC in teeth with apical periodontitis. Preoperative lesion severity remains the primary prognostic factor influencing periapical healing over time.

Background/Objectives: This study aimed to compare the cleaning efficacy, biomechanical stress distribution under simulated occlusal loading after instrumentation, and irrigant dynamics of three NiTi rotary systems, namely ProTaper Gold, TruNatomy, and SlimShaper, using a combined experimental, finite element analysis (FEA), and computational fluid dynamics (CFD) approach. Methods: Transparent 3D replicas of mandibular mesial roots filled with a gel-like pulp tissue were instrumented with the three systems (n = 13 per group). Standardized irrigation was performed with 4% NaOCl delivered through IrriFlex® needles positioned 2 mm from the working length. Cleaning effectiveness was assessed through digital image analysis, FEA simulation of occlusal loading, and CFD evaluation of irrigation flow, wall shear stress, and dynamic pressure. Results: All systems left residual tissue, with no statistically significant differences in cleaning efficacy among them (p > 0.05). Descriptively, ProTaper Gold showed the lowest mean residual tissue (0.15 ± 0.25%), followed by SlimShaper (2.50 ± 3.81%) and TruNatomy (4.20 ± 5.12%). CFD revealed that ProTaper Gold generated the highest irrigant velocities and wall shear stresses, while SlimShaper showed the highest dynamic pressure. FEA indicated that ProTaper Gold produced the highest stress concentrations, especially in the pericervical dentin, whereas TruNatomy and SlimShaper preserved more dentin. Conclusions: Cleaning efficacy was comparable across systems. CFD/FEA from representative models illustrated patterns of irrigant dynamics and dentin preservation without supporting system superiority.

CONTEXT:Bad breath has a prevalence of 30%, which is the main cause of visits to dentists. This study focused on the efficacy of tablets added with zinc on oral volatile sulfur compounds (VSC) versus placebo over two hours. It was planned in four parallel groups, a single-centre, single-blinded randomised-controlled trial. MATERIALS AND METHODS:Eligible participants had to score VSC ≥75 parts per billion (ppb) at the basal measurement to enter. The three test tablets were different in weight and size (0.7g, 1g, 2.1g) but contained the same amount of zinc lactate (0.51 mg); the control tablet was 1 g without zinc. The OralChroma2 © device was utilised to evaluate VSC in the oral air. VSC were scored at baseline, after sucking one tablet, after 30 minutes, 1 hour and 2 hours. Data were analysed with SPSS (version 22). Comparisons within the groups were performed using a paired T-test, and among the groups with an unpaired T-test. RESULTS:120 subjects, 30 in each group, completed the trial. VSC reductions from baselines, at the end of tablet sucking, after 30 minutes, 1 hour, and 2 hours were statistically significant for the three test tablets. Comparisons between each test group and control group always showed a statistically significant difference for reductions; however, no statistical difference was reported among the test groups. CONCLUSION:Tablets containing the same amount of zinc lactate can statistically significantly reduce the VSC immediately and for over 2 hours. Moreover, the reductions with the test tablets are significantly more than those with the control tablets over time.

Background/Objectives: To evaluate whether mandibular third molar germectomy is associated with differences in neurosensory injury, postoperative complications, and patient-centred outcomes compared with delayed extraction. Methods: A systematic review and meta-analysis were conducted according to PRISMA guidelines. Electronic searches were performed in PubMed, Embase, Web of Science, Scopus, Cochrane Library, LILACS, and Google Scholar. Comparative studies including pediatric or adolescent patients undergoing mandibular third molar germectomy were included. Primary outcomes were inferior alveolar nerve (IAN) injury and overall postoperative complications; secondary outcomes included postoperative morbidity and patient-reported outcome measures (PROMs). Random-effects models were used for quantitative synthesis. Results: Ten studies met the inclusion criteria, including two randomized controlled trials and eight observational studies. Comparative evidence suggested that early removal at an immature developmental stage was associated with a lower risk of IAN injury (pooled RR = 0.05, 95% CI 0.01–0.37) and fewer overall postoperative complications (pooled RR = 0.29, 95% CI 0.20–0.42) compared with delayed extraction. However, certainty of evidence was limited due to heterogeneity, risk of bias, and potential confounding. PROMs consistently showed a short-term increase in pain and temporary quality-of-life impairment after germectomy, while delayed-onset infections were reported several weeks after surgery. Conclusions: Germectomy may reduce neurosensory risk and overall postoperative morbidity in selected developmental-age patients but entails a measurable short-term symptom burden. Decisions should therefore rely on individualized risk assessment and shared decision-making rather than routine preventive removal. Further prospective comparative studies with standardized outcome reporting are required to support definitive clinical recommendations.

AIM:To assess the adjunctive effect of periodontal therapy on psoriasis-related outcomes in a combined experimental model of ligature-induced periodontitis and Imiquimod (IMQ)-induced psoriasis. Also, this experiment aimed to study the impact of TNF-α inhibitors on the periodontium. METHODS:Fifty-six C57/BL6J mice were randomly allocated to seven experimental groups: (a) control group (P-Pso-) with no treatment; (b) periodontitis (P+Pso-) with periodontal therapy; (c) periodontitis (P+Pso-) with TNF-α inhibitor; (d) psoriasis (P-Pso+) with TNF-α inhibitor; (e) periodontitis and psoriasis (P+Pso+) with periodontal therapy; (f) P+Pso+ with TNF-α inhibitor; and (g) P+Pso+ with both periodontal therapy and TNF-α inhibitor. Samples (maxilla, dorsal skin and blood) were harvested immediately after death. Measures of periodontitis distance between the cemento-enamel junction and alveolar bone crest (CEJ-ABC) and number of osteoclasts and psoriasis (epidermal thickness and infiltrate cells (per 0.03mm2)) severity, as well as systemic inflammation (IL-6, IL-17A and TNF-α) were collected. RESULTS:In the P+Pso+ group, a significant adjunctive effect of periodontal therapy to TNF-α inhibitors was found in the reduction of epidermal thickening and inflammatory infiltrate of the dorsal skin (p < 0.05). Similarly, treatment with TNF-α inhibitor resulted in a significant adjunctive effect to periodontal therapy in the reduction of alveolar bone loss (p < 0.05). These changes were accompanied by a significant decrease in the circulating levels of IL-6 and IL-17A when both periodontal therapy and TNF-α inhibitor were administered. CONCLUSIONS:The combination of periodontal therapy and TNF-α inhibitor showed a positive synergetic effect in the treatment of comorbid experimental ligature-induced periodontitis and IMQ-induced psoriasis via the reduction of systemic inflammation.

Proper recognition along with segmentation of root canal anatomies stands essential for successful endodontic procedures. Medical imaging approaches presently rely on human-assisted interpretation because these techniques perform slowly while showing potential errors. The research investigates the utilization of AI technology for automatic identification and segmentation of root canal shapes through digital image processing. A deep learning system uses CNN which train on annotated dental images to create its operation. Performance evaluation of the methodology relies on three parameters: accuracy, Dice coefficient and processing time. The test outcomes prove that the AI model which uses deep learning achieves better accuracy as well as time savings while segmenting root canal morphology.

Lifestyle factors significantly influence the development of inflammatory diseases, and emerging evidence suggests they may also impact oral health. However, no studies have explored their role in apical periodontitis (AP) amongst adults. This study aimed to assess the association between adherence to the Mediterranean diet (MD), physical activity, perceived stress, and sleep quality with the periapical and caries status in a university-based cohort. A total of 149 periodontally healthy patients were included in the study. Clinical assessments and radiographic examinations [Orthopantomography (opt) and periapical radiographs] were conducted to evaluate the periapical status. Data on their periapical index (PAI) score and the decayed, missing and filled teeth (DMFT) index were recorded. Validated questionnaires were used to investigate patient's lifestyles. A final logistic regression model was performed for the multivariable analysis to evaluate the predictive ability of adherence to Mediterranean lifestyle on the presence of AP; other local, systemic and environmental factors were included as independent factors in the model. Significant associations were observed between AP and high/low adherence to the MD ( p  = .00), high/low-moderate physical activity ( p  = .00), high/low sleep quality ( p  = .00) and high/low perceived stress ( p  = .00). The final multivariable regression model showed that low adherence to MD (OR = 3.68; 95% confidence interval [CI]: 1.24–10.83; p  = . 01) and reduced sleep quality (OR = 3.04; 95% CI: 1.42–6.50; p  = .00) were identified as potential risk factors for AP development. On the other hand, the DMFT index showed no significant association with lifestyle factors (OR = 1.0; CI: 1.01–1.14; p  = .02) but was correlated with the development of AP (OR = 1.07; CI: 1.01–1.14; p  = .02). Results from the present study suggest a potential association between low adherence to MD and reduced sleep quality with the development of AP. Individuals with low adherence to MD and inadequate sleep quality faced respectively 4-fold and 3-fold increased odds of developing periapical lesions. Further research is essential to elucidate the causal mechanisms underlying these associations and to determine whether lifestyle adjustments could improve endodontic success rate.

This study examines how self-supervised learning may improve 3D medical imaging performance and readability by enhancing feature models and grouping. The recommended strategy combines supervised and unsupervised learning. It improves representations by combining classification problems with unsupervised feature learning. Regularization approaches reduce overfitting and increase similarity measures for better feature alignments, which is crucial for contrastive learning tasks.A grouping step reduces cluster gaps, improving feature order. By updating the proximity measure and calculating the centroid, we can improve feature correlations, which in turn helps the model distinguish data points. This boosts accuracy, precision, recall, and more complicated segmentation metrics like the Dice Similarity Coefficient and Intersection over Union.The model performs better in medical imaging segmentation and classification when optimized and grouped. It reacts immediately to fresh information, making it ideal for clinical circumstances requiring rapid and precise conclusions. This method's strong learning framework and flexibility may improve self-supervised learning algorithms in 3D medical imaging applications, resulting in improved assessments and treatment suggestions.

Interdisciplinary decision-making significantly influences both the therapeutic potential and clinical outcomes, shaping clinical attitudes and management strategies. As the integration between endodontic and restorative-prosthetic considerations becomes increasingly prevalent, it is essential to understand how different dental specialists, particularly general dental practitioners, prosthodontists and endodontists, approach clinical decision-making and collaborate to optimize patient care. Objectives: This study aims to identify practice disparities in post-endodontic crown placement to inform national policy reforms, including standardised timing protocols and interdisciplinary referral criteria. Methods: A structured questionnaire was distributed to dentists practicing in Romania, yielding 238 collected responses. Results: Substantial variability was found in clinical approaches: diagnostic imaging preferences indicated frequent use of periapical radiography (83.49%) and CBCT (53.67%). Over 70% expressed high confidence in CBCT’s diagnostic precision, significantly higher than periapical radiography (Wilcoxon Signed-Rank test, p < 0.00001). A statistically significant majority (69.3%, binomial test, p < 0.001) preferred delaying definitive crown placement until radiographic healing of periapical lesions. Logistic regression analysis showed endodontists were significantly less likely to choose invasive treatments compared to other specialists (p = 0.027). Although clinicians widely recognize the significance of prosthetic planning, its early integration into the overall treatment strategy has been inconsistent. Conclusions: This study points out the necessity for standardised guidelines that clearly integrate prosthetic planning into endodontic decision-making, enhancing predictability and tooth preservation.

Aim: The study focused to determine the microleakage of various materials using the dye penetration method. Materials and Methods: The study samples consisted of 45 healthy human mandibular premolar teeth removed for orthodontic therapy without caries. The samples were categorized into three groups of 15 each. All the samples were etched for 20 seconds with 37% phosphoric acid gel before being sealed with a glass ionomer cement (GIC) sealant (Fuji—VII GIC), light-cure glass ionomer composite cement (Prevest Fusion I), or flowable nanocomposite sealants (Prevest Fusion Flo), respectively. Every sample were thermocycled and immersed for one day in methylene blue (5%) solution to dye diffusion between the gaps present among the tooth and restoration. The teeth were sectioned and analyzed using image analysis software beneath a stereomicroscope at 10x magnification. Results: The marginal microleakage was found lowest in flowable nanocomposites (1.06 ± 0.98), then light-cure glass ionomer composite cement (2.44 ± 1.42), and GIC (4.07 ± 1.54). A statistically significant variance was noted. Conclusion: Current investigation evaluated that reduced marginal leakage was seen in flowable nanocomposites when compared to other two groups.

Objectives: The aim of this study is to investigate how Adaptive Torque Control motion influences the shaping efficiency of Neolix EDMax (Neolix SAS, Évron, France) and its ability to reach working length with or without a pre-existing glide path. Methods: A total of 90 endo training blocks with an S-shape curvature were divided into three groups based on the kinematics and preparation phase: the control group, where the Neolix EDMax (Neolix SAS, Évron, France) was used for shaping after a glide path was established; the no glide path group, where the Neolix EDMax (Neolix SAS, Évron, France) was used for shaping without a glide path; and the Adaptive Torque Control group, where the Neolix EDMax (Neolix SAS, Évron, France) was used for shaping without a glide path but in an Adaptive Torque Control motion. The time for shaping, the instrument passes, and the ability to reach working length were recorded and analyzed using a one-way Anova and Tukey’s HSD post hoc test. Results: Establishing a glide path helped the shaping file to reach working length faster and in fewer passes when compared with the no glide path group, but the Adaptive Torque Control group was able to perform even better than the control group despite not having a pre-established glide path. Conclusions: The Adaptive Torque Control motion on continuous rotation instruments does impact their performance. Combining the efficiency of continuous rotation and the safety of reciprocation, this type of motion had a significant effect on the ability to shape the simulated root canal even in the presence of a double curvature and without a pre-established glide path.

Aim: The study aims to assess and contrast the compressive strengths of three aesthetically pleasing restorative materials. Materials and Methods: Using metallic molds, 30 pellets were created, then split into 3 groups of 10, each meeting the required specifications. Glass Ionomer Cement (GIC) cylindrical specimens are in Group A; Resin Modified GIC (RMGIC) cylindrical specimens are in Group B; and Zirconomer cylindrical specimens are in Group C. A universal testing equipment was used to compress all of the samples, and the results were acquired. Tukey’s post hoc test and one-way ANOVA were used for statistical analysis. Result: Zirconomer’s compressive strength is significantly higher than that of RMGIC and GIC. Conclusion: The compressive strength of Zirconomer is the highest. As a result, Zirconomer may be the preferred material for aesthetic restorative procedures.

To evaluate the prevalence of apical periodontitis (AP) and caries in subjects with psoriasis vulgaris. In total, 152 patients with psoriasis vulgaris were included in the study. The severity and extent of psoriasis were assessed according to the Psoriasis Area Severity Index (PASI), the Body Surface Area (BSA) and the Physician's Global Assessment Scale (PGA). Periapical status was assessed through dental examination and periapical radiographs. Data regarding the Periapical Index (PAI), caries experience expressed as the Decayed, Missing, Filled Teeth Index (DMFT) and psoriasis medications were recorded. A predictive logistic regression model for the presence of AP and a linear regression model were then built to relate the severity and extent of AP to the type of drug therapy taken for psoriasis and to the severity and extent of the skin disease. Subjects with severe/moderate psoriasis showed a significantly higher prevalence of AP ( p  = .002) and a higher PAI score ( p  = .0035) than subjects with mild psoriasis. No significant correlation was found between AP and caries experience ( p  = .76). The logistic regression model showed that moderate/severe psoriasis increased the odds of having AP [odds ratio (OR) = 1.30 ± 1.088, 1.55]. A negative linear relationship between biological drug intake and PAI score value was observed (coefficient = −.54; p  = .04). The degree of severity of psoriasis is significantly associated with AP, suggesting that psoriasis may play a role in the pathogenesis of AP. However, no significant correlation was observed for caries experience. Furthermore, the immune-modulating drugs taken by these patients did not seem to have different effects on the prevalence of AP.

Background/Aim: Third molar impaction with the consequent root resorption of second molars often creates complexities in treatment planning and execution. In the past, the root canal treatment (RCT) of second molars was required in these cases to avoid pulp necrosis and infection. The aim of this paper is to report a surgical/retrograde approach for the maintenance of pulp vitality, proposed as retrograde vital pulp treatment (rVPT), in cases of asymptomatic or reversibly affected teeth with root resorptions caused by impacted adjacent teeth. Methods: A case report on the rVPT of two upper second molars with root resorption due to third molar impaction is presented. The chief complaint of the patient was a slight pain during bite involving the upper second molars. Heat and cold sensitivity tests were performed, suggesting a healthy pulp status. A cone beam computed tomography (CBCT) scan was performed to aid the diagnosis and treatment planning, showing bilateral upper third molar impaction and both distal roots of the upper second molars affected by external root resorption (ERR). In both cases, the third molar was surgically extracted, the surface of the root with ERR was smoothened and rVPT was carried out by performing a 3 mm retrograde preparation of the root canal and its retrograde sealing using a hydraulic calcium silicate-based cement (hCSCs). Results: Heat and cold sensitivity tests were performed 1 month, 3 months, 6 months and 1 year after the treatment. The patient reported no pain, and the pulp sensitivity was maintained in all follow-up periods. A CBCT scan was performed 24 months after the treatment, reporting a complete perirradicular endogenous bone apposition. Conclusions: Based on the successful clinical and radiographic outcomes observed in the present case after two years of follow-up, rVPT is proposed for the maintenance of pulp vitality in cases of asymptomatic or reversibly affected teeth with ERR caused by impacted adjacent teeth.

Background/Objectives: The objective of this study was to investigate current endodontic practice patterns and the adoption of newer technologies among dentists, endodontic specialists, and postgraduate students in Spain and Latin America. Methods: A cross-sectional survey was conducted using a structured 30-item questionnaire covering demographics, training, technology adoption (NiTi instrumentation, magnification, CBCT, irrigation adjuncts, bioceramic sealers), obturation techniques, irrigant selection, and clinical procedures. The survey was distributed through a professional Instagram account and WhatsApp groups of dentists, specialists, and postgraduate students. Participation was voluntary, anonymous, and restricted to qualified professionals. Data were collected via Google Forms, cleaned, and grouped into Spain, Mexico, Venezuela, Colombia, Southern Cone & Andes (Argentina, Chile, Peru, Ecuador, Bolivia), and other countries. Descriptive statistics were calculated, and intergroup comparisons were performed using Chi-square or Fisher's exact tests with Bonferroni correction (p < 0.05). Multiple regression analyses were performed. Results: A total of 1358 valid responses were analyzed, distributed as follows: Spain (219), Mexico (353), Venezuela (162), Colombia (108), Southern Cone & Andes (260), and other countries (256). Most respondents (62.8%) had ≤10 years of experience, and 61.2% reported postgraduate training. Loupes (55.4%) were the most frequent magnification system, followed by microscopes (18.6%). Sodium hypochlorite (98.3%) was the irrigant of choice, commonly used with EDTA (83.5%) and, to a lesser extent, chlorhexidine (33.4%). Sonic (83.2%) and ultrasonic (52.9%) activation were frequent. Bioceramic sealers were used by 18.9%, while calcium hydroxide medication was applied by 37.4%. Specialists and master-level clinicians showed greater use of rotary NiTi systems, CBCT, magnification, and bioceramic sealers, whereas general practitioners relied more on manual instrumentation and single-cone obturation. Success was mainly verified by combined clinical and radiographic evaluation (86.7%). Spain demonstrated higher adoption of microscopes, warm vertical compaction, and CBCT. Conclusions: Core practices such as sodium hypochlorite irrigation and rubber dam use were widespread, while advanced technologies and irrigant protocols varied with training level and region. Continuous education remains essential to promote evidence-based practice and reduce disparities in endodontic innovation.