Expert consensus on difficulty assessment of endodontic therapy

doi:10.1038/s41368-024-00285-0

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International Journal of Oral Science ›› 2024, Vol. 16 ›› Issue (0) : 22. DOI: 10.1038/s41368-024-00285-0

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Expert consensus on difficulty assessment of endodontic therapy

Dingming Huang¹, Xiaoyan Wang², Jingping Liang³, Junqi Ling⁴, Zhuan Bian⁵, Qing Yu⁶, Benxiang Hou⁷, Xinmei Chen¹, Jiyao Li¹, Ling Ye¹, Lei Cheng¹, Xin Xu¹, Tao Hu⁸, Hongkun Wu⁹, Bin Guo¹⁰, Qin Su¹, Zhi Chen⁵, Lihong Qiu¹¹, Wenxia Chen¹², Xi Wei⁴, Zhengwei Huang³, Jinhua Yu¹³, Zhengmei Lin⁴, Qi Zhang¹⁴, Deqin Yang¹⁵, Jin Zhao¹⁶, Shuang Pan¹⁷, Jian Yang¹⁸, Jiayuan Wu¹⁹, Yihuai Pan²⁰, Xiaoli Xie²¹, Shuli Deng²², Xiaojing Huang²³, Lan Zhang¹, Lin Yue², Xuedong Zhou¹

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1. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Operative Dentistry and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu, China;
2. Department of Cariology and Endodontology, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology & Research Center of Engineering and Technology for Computerized Dentistry Ministry of Health & NMPA Key Laboratory for Dental Materials, Beijing, China;
3. Department of Endodontics, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Clinical Research Center for Oral Diseases, National Center for Stomatology, Shanghai Key Laboratory of Stomatology, Shanghai, China;
4. Department of Operative Dentistry and Endodontics, Hospital of Stomatology, Guanghua, School of Stomatology, Sun Yat-Sen University & Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China;
5. The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) & Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, China;
6. Department of Operative Dentistry & Endodontics, School of Stomatology, The Fourth Military Medical University, Xi’an, China;
7. Department of Endodontics, Beijing Stomatological Hospital, School of Stomatology, Capital Medical University, Beijing, China;
8. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China;
9. State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Geriatric dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, China;
10. Department of Stomatology, First Medical Center, Chinese PLA General Hospital, Beijing, China;
11. Department of Endodontics, School of Stomatology, China Medical University, Shenyang, China;
12. College of Stomatology, Hospital of Stomatology, Guangxi Medical University, Nanning, China;
13. Department of Endodontics, School and Hospital of Stomatology, Nanjing Medical University, Nanjing, China;
14. Department of Endodontics, Stomatological Hospital and Dental School of Tongji University, Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai, China;
15. Department of Endodontics, Stomatological Hospital of Chongqing Medical University, Chongqing, China;
16. Department of Endodontics, First Affiliated Hospital of Xinjiang Medical University, and College of Stomatology of Xinjiang Medical University, Urumqi, China;
17. Department of Endodontics, Schoolof Stomatology, First Affiliated Hospital of Harbin Medical University, Harbin, China;
18. Department of Endodontics, The Affiliated Stomatological Hospital of Nanchang University, Nanchang, China;
19. Key Laboratory of Oral Disease Research, School of Stomatology, Zunyi Medical University, Zunyi, China;
20. Department of Endodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, China;
21. Department of Cariology and Endodontics, Xiangya Stomatological School, Central South University, Changsha, China;
22. Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Hangzhou, China;
23. School and Hospital of Stomatology, Fujian Medical University, Fuzhou, China

Corresponding author: 2024-03-01

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Abstract

Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy (RCT). Recent research, encompassing bacterial etiology and advanced imaging techniques, contributes to our understanding of the root canal system’s anatomy intricacies and the technique sensitivity of RCT. Success in RCT hinges on factors like patients, infection severity, root canal anatomy, and treatment techniques. Therefore, improving disease management is a key issue to combat endodontic diseases and cure periapical lesions. The clinical difficulty assessment system of RCT is established based on patient conditions, tooth conditions, root canal configuration, and root canal needing retreatment, and emphasizes pre-treatment risk assessment for optimal outcomes. The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT. These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.

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Dingming Huang, Xiaoyan Wang, Jingping Liang, Junqi Ling, Zhuan Bian, Qing Yu, Benxiang Hou, Xinmei Chen, Jiyao Li, Ling Ye, Lei Cheng, Xin Xu, Tao Hu, Hongkun Wu, Bin Guo, Qin Su, Zhi Chen, Lihong Qiu, Wenxia Chen, Xi Wei, Zhengwei Huang, Jinhua Yu, Zhengmei Lin, Qi Zhang, Deqin Yang, Jin Zhao, Shuang Pan, Jian Yang, Jiayuan Wu, Yihuai Pan, Xiaoli Xie, Shuli Deng, Xiaojing Huang, Lan Zhang, Lin Yue, …Xuedong Zhou. Expert consensus on difficulty assessment of endodontic therapy. International Journal of Oral Science, 2024, 16(0): 22 https://doi.org/10.1038/s41368-024-00285-0

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