Fact-checked by Grok 2 weeks ago

Root canal

A root canal, also known as root canal therapy or endodontic treatment, is a dental procedure designed to repair and preserve a tooth that has become infected or severely damaged by removing the inflamed or infected pulp tissue within the tooth, cleaning and disinfecting the root canals, and then filling and sealing them to prevent further infection. This treatment targets the pulp, which consists of nerves, blood vessels, and connective tissue housed in the tooth's inner chamber and root canals, allowing the tooth to be retained rather than extracted. More than 15 million root canal procedures are performed in the United States each year.^[1] Performed by a dentist or endodontist, the procedure addresses conditions such as deep decay, repeated dental procedures on the same tooth, faulty crowns, cracks or chips in the tooth, or trauma that leads to pulp inflammation (pulpitis) or death (necrosis).^[2] Root canal treatment is typically recommended when the pulp becomes irreversibly inflamed or infected, often due to bacterial invasion from untreated cavities, which can spread to the root tips and cause abscesses if left unaddressed. Without treatment, the infection can extend to the jawbone and surrounding tissues, potentially leading to more extensive dental issues or systemic health risks from untreated oral infections.^[1] Root canal treatments boast high success rates, often exceeding 95 percent, with many treated teeth functioning normally for a lifetime when properly restored and maintained through good oral hygiene.^[3] Post-procedure, patients may experience mild discomfort or sensitivity for a few days, managed with over-the-counter pain relievers, and should avoid chewing on the treated tooth until fully restored. Risks are low but can include incomplete healing requiring retreatment, tooth fracture if not crowned, or rare cases of reinfection, emphasizing the importance of follow-up care and professional monitoring.^[2]

Anatomy

Root canal system

The root canal system forms a continuous anatomical pathway within the tooth root, extending from the pulp chamber in the coronal portion of the tooth to the apical foramen at the root tip, serving as the conduit for neurovascular structures. This system is embedded entirely within the dentin of the root, with its walls consisting of hard dentin tissue that provides structural support. At the apical terminus, the foramen opens through a thin layer of cementum, facilitating the exit of the pathway into the surrounding periodontal ligament.^[4] The configuration of the root canal system includes a primary main canal that generally tapers from a wider coronal opening to a narrower apical end, often exhibiting slight curvatures or oval cross-sections along its course. Branching patterns add complexity, with lateral canals emerging as secondary offshoots from the main canal toward the root surface, typically occurring in the middle or apical thirds, and accessory canals representing even finer ramifications that connect the system to the exterior. These branches, while variable, are integral to the overall morphology and can number from none to several per root depending on the tooth's position.^[5] Dimensions of the root canal system vary by tooth type and location within the canal. Typical diameters range from 0.1 to 0.5 mm, with measurements often averaging around 0.3-0.4 mm near the apex in permanent teeth, reflecting the system's narrow and delicate nature. Lengths differ significantly; for instance, in molars, root canals commonly measure 10-20 mm from the pulp chamber floor to the apical foramen, accounting for the multi-rooted structure and varying root depths across maxillary and mandibular examples.^[6]^[7] In longitudinal views, the root canal system appears as an elongated, funnel-shaped channel that narrows progressively, sometimes with visible constrictions or expansions corresponding to branching points. Cross-sectional perspectives reveal the canal's internal outline as predominantly round in anterior teeth but more oval or irregular in posterior teeth, closely conforming to the surrounding dentin architecture. These morphological features underscore the system's role as a precisely organized space filled by pulp tissue.^[4]

Pulp contents

The dental pulp is a specialized soft connective tissue that fills the root canal system, consisting primarily of a loose extracellular matrix embedded with various cellular elements, blood vessels, nerves, and lymphatics. This matrix, rich in collagen fibers and ground substance, provides structural support and facilitates nutrient diffusion. The predominant cells include fibroblasts, which are the most abundant and responsible for maintaining the extracellular matrix through synthesis of collagen and elastin; odontoblasts, aligned as a single layer along the periphery adjacent to the dentin, specialized for dentin formation; and undifferentiated mesenchymal cells scattered throughout, serving as progenitors for tissue repair.^[8]^[9]^[10] Nerves within the pulp form a rich network, including myelinated and unmyelinated fibers that innervate the tissue for sensory functions, branching into the subodontoblastic plexus of Raschkow. Blood vessels, primarily capillaries and arterioles, supply oxygen and nutrients, originating from the superior alveolar arteries for maxillary teeth and inferior alveolar arteries for mandibular teeth, entering via the apical foramen and branching extensively throughout the pulp. Lymphatics, though less prominent, form a network of thin-walled vessels that drain interstitial fluid and immune cells toward regional lymph nodes, contributing to fluid balance and immune surveillance. Interstitial fluid permeates the extracellular spaces, aiding in the transport of nutrients, waste, and signaling molecules across the avascular dentin barrier.^[8]^[11]^[9] Histologically, the pulp exhibits distinct zones reflecting its functional organization. The outermost peripheral zone consists of the odontoblastic layer, followed by the cell-free zone of Weil, a narrow acellular region rich in nerve endings and capillaries located immediately subjacent to the odontoblasts, most prominent in the coronal pulp. Deeper lies the cell-rich zone, or core, densely populated with fibroblasts, immune cells, and undifferentiated mesenchymal cells, providing a reservoir for reparative processes. Adjoining this is the vascular zone, characterized by larger blood vessels and loose connective tissue, facilitating efficient circulation in the central pulp.^[8]^[10]^[12] Defensive cells, integral to the pulp's innate immunity, include macrophages, which phagocytose debris and pathogens, and plasma cells, which produce antibodies for localized humoral defense; these are distributed throughout the cell-rich core and increase in response to threats. In the apical region, the radicular pulp tapers into a narrow extension within the root, continuous with the periodontal ligament through the apical foramen, allowing vascular and neural communication between the pulp and surrounding periodontal tissues.^[13]^[14]^[15]

Anatomical variations

The root canal system exhibits significant anatomical variations across different tooth types and individuals, influencing endodontic treatment planning. In anterior teeth such as incisors, a single root canal is the predominant configuration, occurring in over 90% of cases according to Vertucci's classification type I. In contrast, premolars often feature one to two canals, with maxillary first premolars showing multiple canals (types II-V) in up to 70-80% of instances, while mandibular premolars are more likely to have a single canal (type I prevalence of 63-98%).^[16] Molars display greater complexity, with mandibular first molars typically having three to four canals, including two in the mesial root and one or two in the distal root.^[17] Incidence rates of specific configurations vary by tooth and population, as outlined in Vertucci's eight-type classification system, which categorizes canal merging and divisions from the pulp chamber to the apex. For mandibular first molars, an extra mesial canal (middle mesial) is reported in approximately 4-7% of cases globally, with variations up to 23% in some populations and higher rates (up to 32%) in younger individuals under 20 years.^[18]^[17] Vertucci type IV (two separate canals throughout) is common in the mesial root at 40-60%, while type I dominates the distal root at 70-80%. These variations underscore the need for thorough morphological assessment, as missed canals can compromise treatment outcomes. Notable anomalies include dilacerations, characterized by sharp bends in the root (often >20 degrees), with an overall prevalence of 0.3-14.5% across teeth and higher rates (up to 24%) in mandibular third molars.^[19] Taurodontism, involving an enlarged pulp chamber and shortened roots due to furcation displacement, affects 2-12% of molars, more frequently in maxillary second molars.^[20] C-shaped canals, resulting from incomplete fusion of root lobes, are a distinct anomaly with a prevalence of 30-45% in mandibular second molars among East Asian populations, compared to 4-20% in other ethnic groups.^[21] Age-related changes contribute to further variability, as secondary dentin deposition progressively narrows the pulp chamber and root canals, reducing canal diameter by up to 50% from young adulthood to senescence.^[22] This physiological response, driven by odontoblast activity, is more pronounced in the coronal portion and can obliterate accessory canals over time.^[23] Gender and ethnic differences also influence variation rates; for instance, root fusion and C-shaped configurations show higher prevalence in females (up to 53% for taurodontism) and certain populations, such as East Asians for C-shaped canals (pooled 39.6%).^[24] Mandibular premolars exhibit gender-specific patterns, with multiple canals more common in females for first premolars and in males for second premolars.^[25] These demographic factors highlight the role of genetic influences in root canal diversity.^[26]

Development and function

Embryological origins

The root canal develops as part of the overall tooth germ formation, originating from the dental papilla, a condensation of ectomesenchymal cells derived from cranial neural crest cells during the initiation of odontogenesis around the 6th to 8th weeks of human gestation.^[27]^[28] This ectomesenchyme interacts with the overlying oral epithelium to form the tooth bud, progressing through stages that establish the foundational structures of the tooth, including the precursors to the root canal system.^[29] Tooth development advances to the bell stage by approximately 8 to 12 weeks of gestation, where the enamel organ differentiates, and the cervical loop—a region at the junction of the inner and outer enamel epithelia—serves as the origin for Hertwig's epithelial root sheath (HERS).^[27] The HERS forms as a bilayered epithelial extension that proliferates apically from the cervical loop, guiding root formation by enclosing and shaping the underlying dental papilla.^[30] This sheath induces the differentiation of odontoblasts from the peripheral cells of the dental papilla, leading to the deposition of root dentin that lines the future root canal.^[29] As the HERS elongates during root development, which begins after crown formation is largely complete around 14 to 18 weeks of gestation, it invaginates into the dental papilla without fully enclosing its core, thereby delineating the lumen of the root canal through epithelial remodeling and mesenchymal organization.^[27]^[30] The central portion of the papilla remains undifferentiated, forming the pulp tissue that occupies the canal space, while the HERS fragments into epithelial rests of Malassez, contributing to ongoing root elongation.^[29] Innervation of the developing root canal arises from interactions between the neural crest-derived mesenchyme of the dental papilla and ingrowing nerve fibers from the trigeminal ganglion, with neurites reaching the tooth germ around the embryonic bud to cap stage transition and penetrating the papilla postnatally alongside vascular ingrowth, establishing sensory pathways that persist into the mature structure.^[31]^[32] Root canal formation continues postnatally, with apical elongation and canal maturation occurring after tooth eruption; for primary teeth, this process extends 1 to 2 years post-eruption, while permanent teeth complete root canal development into late adolescence or early adulthood, ensuring structural integrity and vascular-nerve continuity.^[27]

Physiological roles

The dental pulp within the root canal serves as a vital vascular and connective tissue core, delivering essential nutrients and oxygen to the surrounding odontoblasts, which are responsible for maintaining dentin integrity throughout the tooth's life. This nutritive function is facilitated by a rich network of blood vessels, including arterioles, venules, and capillaries, that permeate the pulp tissue and ensure the metabolic needs of odontoblasts are met for ongoing dentin deposition and repair.^[8]^[10] Sensory innervation of the dental pulp is provided primarily by branches of the trigeminal nerve, with A-delta fibers mediating acute, sharp pain responses to stimuli such as cold or mechanical pressure, while unmyelinated C-fibers transmit dull, throbbing pain associated with inflammatory conditions. These nerve fibers, which enter the root canal via the apical foramen, not only enable protective sensory feedback but also contribute to local neurovascular regulation by influencing blood flow during physiological stress.^[33]^[34] The pulp plays a crucial protective role through its innate immune surveillance, where resident immune cells such as macrophages and dendritic cells monitor and respond to potential bacterial ingress via dentinal tubules, preventing microbial colonization of the root canal space. Odontoblasts themselves act as sentinel cells, expressing pattern recognition receptors that detect bacterial components and initiate early defensive signaling to limit invasion.^[35]^[36] As part of the integrated dentin-pulp complex, the pulp coordinates reparative dentin formation in response to mild cariogenic challenges, where surviving odontoblasts or progenitor cells deposit tertiary dentin to seal exposed tubules and protect the pulp from further irritation. This process involves the upregulation of dentin matrix proteins and mineralization factors, ensuring the structural continuity of the tooth without compromising vitality.^[37]^[38] With advancing age, the dental pulp undergoes adaptive changes, including reduced vascularity and a progressive recession of pulp tissue into the root canal, which diminishes its regenerative capacity while enhancing resistance to certain insults through increased fibrosis and calcification. These alterations reflect a shift toward a more defensive, less proliferative state, with fewer blood vessels and cells contributing to a smaller pulp chamber volume.^[39]^[40]

Clinical aspects

Associated pathologies

Pulpitis represents the initial inflammatory response within the root canal system, primarily triggered by bacterial invasion from untreated dental caries or traumatic injury to the tooth. This condition is categorized into reversible pulpitis, characterized by hyperemia and mild inflammation that can resolve if the irritant is removed, and irreversible pulpitis, where the inflammation becomes more severe and persistent, often leading to tissue damage without intervention. Bacterial penetration through dentin tubules allows pathogens to reach the pulp, initiating an immune response that escalates from localized vasodilation in reversible cases to widespread cellular infiltration in irreversible ones. Progression from untreated pulpitis frequently results in pulp necrosis, the ischemic death of pulp tissue due to compromised vascular supply and ongoing bacterial proliferation. This necrotic state creates an environment conducive to liquefaction and gas formation within the pulp chamber, ultimately facilitating the spread of infection beyond the root apex and leading to abscess formation in the periapical region. The absence of viable pulp tissue eliminates natural host defenses, allowing anaerobic bacteria to dominate and exacerbate the ischemic process. Apical periodontitis arises as a chronic inflammatory condition at the tooth apex, driven by persistent microbial infection originating from necrotic pulp remnants. This pathology involves the recruitment of immune cells to the periapical tissues, resulting in granulomatous inflammation and potential bone resorption as the body attempts to contain the infection. The chronic nature stems from biofilms that resist immune clearance, perpetuating low-grade inflammation over time. Key risk factors for these root canal pathologies include deep caries that breach the dentin barrier, traumatic impacts disrupting pulpal blood flow, and vertical cracks in the tooth structure that permit bacterial ingress. Anatomical variations in the root canal system, such as accessory canals or irregular shapes, can predispose to pathology by hindering complete bacterial elimination during natural defense mechanisms. Additionally, systemic conditions like diabetes mellitus heighten the risk of poor healing in root canal infections, with post-2020 studies highlighting altered oral microbiomes that promote persistent inflammation and delayed resolution in hyperglycemic states.

Diagnostic and therapeutic considerations

Diagnosis of root canal issues begins with pulp vitality and sensibility testing to assess the health of the dental pulp. Electric pulp testing applies a controlled electrical stimulus to the tooth to evaluate neural response, indicating pulpal vitality if the patient reports sensation at appropriate thresholds, while thermal tests use cold or heat stimuli, such as ice or heated gutta-percha, to provoke responses that differentiate reversible from irreversible pulpitis.^[41]^[42] These tests, though primarily assessing sensory nerves rather than true blood flow, remain standard for initial endodontic evaluation due to their non-invasive nature and diagnostic reliability in most cases.^[43] Radiographic imaging is essential for confirming diagnoses and planning treatment. Periapical X-rays provide two-dimensional views of the root canal system, revealing periapical lesions or root fractures, but they often miss fine details due to superimposition.^[44] Cone-beam computed tomography (CBCT) offers three-dimensional imaging with higher sensitivity for detecting anatomical variations, such as accessory canals, and subtle pathologies like resorptions or perforations, making it particularly valuable in complex cases.^[45]^[46] Detecting accessory canals and perforations presents significant challenges in endodontic diagnosis and treatment. Accessory canals, which occur in up to 50% of teeth, can harbor persistent infection if overlooked, complicating thorough debridement and increasing failure risk.^[44] Root perforations, often iatrogenic from instrumentation errors, are difficult to identify clinically without advanced imaging like CBCT, as they may not immediately cause symptoms but lead to inflammation or breakdown if untreated.^[47]^[48] Early detection relies on careful access preparation and intraoperative radiography to minimize these complications. Therapeutic interventions in root canal treatment follow principles of access, cleaning, shaping, and obturation to eliminate infection and seal the canal system. Endodontic access involves creating a straight-line path to the canal orifices using high-speed burs, ensuring complete deroofing of the pulp chamber to facilitate instrumentation without procedural errors.^[49] Cleaning and shaping employ nickel-titanium (NiTi) rotary files for efficient removal of pulp tissue and debris, enlarging the canal while preserving dentin structure and maintaining apical patency.^[50] Obturation seals the prepared canal with gutta-percha cones and a biocompatible sealer, typically via lateral compaction or warm vertical techniques, to prevent reinfection by creating a hermetic barrier.^[51]^[52] Primary root canal treatments achieve success rates of 85-95%, with meta-analyses from the 2020s reporting weighted outcomes around 88-93% for vital and necrotic cases when assessed clinically and radiographically.^[53]^[54] Factors influencing success include timely intervention, adequate cleaning, and proper coronal restoration. Recent advances in regenerative endodontics target immature permanent teeth with necrotic pulps, using stem cell-based therapies to promote root development. Post-2023 clinical trials have demonstrated that procedures involving cell homing with scaffolds and growth factors can achieve continued root maturation and apical closure in 70-90% of cases, outperforming traditional apexification in functional outcomes.^[55]^[56] These approaches harness dental pulp stem cells to regenerate vital tissue, reducing fracture risk in young patients.^[57]

References

[1]
Root canal treatment - Mayo Clinic
Root canal is a treatment to repair and save a badly damaged or infected tooth instead of removing it. The term "root canal" comes from cleaning out the canals ...
[2]
Root Canal: Procedure & Recovery - Cleveland Clinic
Overview. A root canal treats infected tooth pulp by removing it, filling the canal and sealing the tooth with a crown.
[3]
Root Canal Explained - American Association of Endodontists
Step-by-Step Endodontic Procedure · The endodontist examines and takes a radiograph of the tooth using x-rays, then administers local anesthetic. · The ...
[4]
Myths About Root Canals - American Association of Endodontists
Endodontic treatment has a high success rate and many root canal-treated teeth last a lifetime. Replacing an extracted tooth with a bridge or implant requires ...
[5]
Endodontics, Pulp Space Anatomy and Access Cavity of Anterior ...
Sep 14, 2025 · The chamber roof, covered by dentin, runs parallel to the chamber floor, which extends into the root canal system.
[6]
Anatomical complexities affecting root canal preparation - PubMed
Nov 20, 2023 · Essentially, researches have unveiled that the root canal constitutes a complex system, comprising not only the main root canal but also lateral ...
[7]
A micro-computed tomographic (micro-CT) analysis of the root canal ...
The average external root length was 11.89 ± 1.53 mm, while root canal length was 10.18 ± 0.35 mm. The root canal diameter 1 mm from the apex was 0.37 ± 0.23 mm ...
[8]
In-depth morphological evaluation of tooth anatomic lengths with ...
This study aimed to assess the association between tooth size and root canal morphology by using CBCT analysis.Missing: diameter | Show results with:diameter
[9]
Anatomy, Head and Neck, Pulp (Tooth) - StatPearls - NCBI Bookshelf
The pulp is a mass of connective tissue that resides within the center of the tooth, directly beneath the layer of dentin.
[10]
Review on the Lymphatic Vessels in the Dental Pulp - PMC
Dec 2, 2021 · The dental pulp is a specific type of connective tissue. It contains cells, fibres, intercellular substance, nerve endings, blood and lymph ...
[11]
Dental Pulp - an overview | ScienceDirect Topics
Cell poor zone: also called the cell free zone of Weil because it is relatively free of cells. It is subadjacent to the odontoblastic layer and is traversed by ...
[12]
The Blood Vascular Supply of the Dental Pulp with Emphasis on ...
The arterial supply to the pulp has its origin from the posterior superior alveolar, infraorbital and inferior alveolar branches of the internal maxillary ...
[13]
Dental Pulp Is a Connective Tissue - Pocket Dentistry
Nov 16, 2015 · Subjacent to the odontoblast layer, a cell-free zone or zone of Weil is seen. This area consists of a rich network of mostly unmyelinated ...Missing: zones: | Show results with:zones:
[14]
Immune Defense Mechanisms of the Dental Pulp - Sage Journals
Defense reactions of the dentin/pulp complex involve a variety of biological systems, in which the immune system plays a pivotal role.<|separator|>
[15]
[PDF] CELL TYPES OF THE DENTAL PULP BEHIND THE ODONTOBLAST
Macrophages, lymphocytes, antigen presenting cells (dendritic cells), mast cells and plasma cells are involved in phagocytosis and immune defence. All these ...
[16]
Dental Pulp | Complete Anatomy - Elsevier
The dental pulp is the richly vascularized and innervated connective tissue of mesodermal origin contained in the central cavity of a tooth and delimited by ...
[17]
Prevalence of complex root canal morphology in the mandibular first ...
Sep 16, 2021 · The most common root canal configuration was Vertucci type I, with a 63.1% and 98% prevalence in the mandibular first and second premolars, respectively.
[18]
Prevalence of Root Dilaceration in Adult Patients Referred to Shiraz ...
Root dilaceration was detected in 0.3% of teeth and 7.2% of patients. It was distributed equally between the maxilla and mandible.
[19]
Comparison of root and canal anatomy of taurodont and normal ...
The occurrence rate of taurodontism was 7.78 % and 12.72 % in maxillary first and second molar teeth, respectively, and 1.99 % and 2.41 % in mandibular first ...
[20]
Prevalence of C‐shaped canal morphology using cone beam ...
Jun 18, 2019 · The pooled proportion of C-shaped anatomy in mandibular second molars in East Asian countries (39.6%; 36.0–43.1%) was significantly higher ...Introduction · Review · Results · Discussion
[21]
12: Endodontic Management of the Aging Patient | Pocket Dentistry
Jan 4, 2015 · But as individuals age and the root canal system narrows due to continued secondary or tertiary dentin formation, fewer and smaller vessels ...
[22]
Age Changes in Dentin and Dental Pulp: A Radiographic Study
There is decrease in root canal width with increasing age, which is attributed due to secondary dentin formation. In the age group of 11–60 years, the length ...
[23]
Taurodontism—Prevalence, Extent, and Clinical Challenge in ...
Jan 20, 2022 · Taurodontism was observed in 33.6% of the patients and was more prevalent among females (53% vs. 47%) and in maxillary molars compared to mandibular molars (57 ...
[24]
Gender difference and root canal morphology in mandibular premolars
In a study by Serman and Hasselgren,[30] more women had multiple roots and/or canals in MFPs, whereas more men revealed multiple roots and/or canals in MSPs.
[25]
Interrelationships in the Variability of Root Canal Anatomy among ...
In the literature, various factors such as genetics and ethnic differences, have been reported to influence root canal anatomy [1,2].
[26]
Embryology, Teeth - StatPearls - NCBI Bookshelf
The Hertwig's root sheath formed by the downward growth of the inner and outer enamel epithelium grows in the apical direction, encloses the dental papilla, and ...
[27]
The Morphogenesis, Pathogenesis, and Molecular Regulation of ...
Jun 27, 2025 · Role of Hertwig's epithelial root sheath cells in tooth root development. Dev. Dyn. 2003;228:651–663. doi: 10.1002/dvdy.10404. [DOI] [PubMed] ...Missing: canal | Show results with:canal
[28]
Cellular and molecular mechanisms of tooth root development - PMC
Hertwig's epithelial root sheath (HERS): A bilayered epithelial structure extending from the apical region of the enamel organ, growing apically, and guiding ...Missing: canal | Show results with:canal
[29]
Evolution and Development of Hertwig's Epithelial Root Sheath - NIH
The development of Hertwig's root sheath begins with the formation of a bilayered extension of the inner and outer dental epithelium from the cervical loop of ...Missing: canal | Show results with:canal
[30]
Establishment of tooth blood supply and innervation is ...
Similarly, formation of a blood vessel plexus around the bud stage tooth germ and ingrowth of vessels into dental papilla at E14 preceded ingrowth of neurites.
[31]
Integration of tooth morphogenesis and innervation by local tissue ...
Tooth innervation is tightly linked to advancing tooth development, and occurs stereotypically in a developmentally regulated manner across different species.<|control11|><|separator|>
[32]
An Insight Into Neurophysiology of Pulpal Pain: Facts and Hypotheses
Sensory nerve fibers of the dental pulp are afferent endings of the trigeminal cranial nerve. These fibers reach the root canal through the apical foramen, ...
[33]
The anatomy, neurophysiology, and cellular mechanisms of ...
Mar 24, 2024 · 2.1 Pulp. At the innermost part of the tooth lies the dental pulp, which houses living cellular components and unmineralized connective tissues.
[34]
Inflammatory Response Mechanisms of the Dentine–Pulp Complex ...
Feb 2, 2021 · This review highlights the various mechanisms of pathogen recognition and defense of dental pulp cells and periradicular tissues.
[35]
Immune System of Dental Pulp in Inflamed and Normal Tissue | DNA ...
These cells identify pathogens at an early stage and commence the immune system response. As bacteria approach the pulp, various cell types within the pulp, ...
[36]
Dentin-pulp complex responses to carious lesions - PubMed - NIH
These results suggest that carious lesions stimulate the dentin-pulp complex to actively synthesize collagen type I, PP and DSP proteins.
[37]
Dental Pulp Defence and Repair Mechanisms in Dental Caries - PMC
This paper focusses on key cellular and molecular mechanisms involved in pulp responses to bacteria and in the pulpal transition between caries-induced ...
[38]
Aging and Senescence of Dental Pulp and Hard Tissues of the Tooth
Nov 30, 2020 · This review discusses the structural alterations of hard tissues, as well as the molecular and physiological changes in dental pulp cells and dental pulp stem ...
[39]
The effects of ageing on dental pulp stem cells, the tooth longevity ...
Feb 26, 2019 · Changes that accumulate during ageing such as how reduction of pulp chamber volume, decreased vascular supply and modifications to the stem ...
[40]
Dental Pulp Testing: A Review - PMC - PubMed Central
Thermal and electric pulp tests are not sensitivity tests although they can be used as sensitivity tests when attempting to diagnose a tooth with pulpitis since ...
[41]
Review of pulp sensibility tests. Part I: general information and ...
Aug 3, 2010 · Tests such as thermal tests and electric pulp tests are sensibility tests because they are assessing whether the pulp's nerve fibres can respond ...
[42]
Determining predictability and accuracy of thermal and electrical ...
Pulp sensitivity testing, even with its limitations and shortcomings, has been and still remains a very helpful aid in endodontic diagnosis.
[43]
CBCT: The New Standard of Care?
Apr 3, 2018 · CBCT scans reveal extra anatomy, relationships of structures, traumatic fractures, missed canals, resorptions, instrumentation-related issues ...
[44]
Accuracy of Periapical Radiography and CBCT in Endodontic ... - NIH
Oct 16, 2018 · The purpose of this study was to evaluate the accuracy of CBCT in comparison with conventional intraoral radiographs used in endodontic procedures.
[45]
Cone beam computed tomography in Endodontics – a review - Patel
Feb 20, 2014 · The current evidence suggests that CBCT does have a higher sensitivity compared with periapical radiography for the detection of periapical ...
[46]
Expert consensus on difficulty assessment of endodontic therapy
Mar 1, 2024 · Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, ...<|control11|><|separator|>
[47]
Present status and future directions – Managing perforations - Clauder
Apr 11, 2022 · Root perforations may occur in any part of the root and can be divided according to the time a perforation occurs in relation to root canal ...Abstract · BACKGROUND · NONSURGICAL... · SURGICAL MANAGEMENT...
[48]
[PDF] Treatment Standards - American Association of Endodontists
Endodontic treatment is considered complete following obturation of the root canal. However, failure is inevitable in an improperly restored tooth. Coronal ...
[49]
Shaping, Disinfecting and Obturating Root Canals
Nov 2, 2016 · This concluding installment will examine the instrumentation, cleaning/disinfection and obturation phases of root canal therapy.
[50]
Root Canal Obturation - an overview | ScienceDirect Topics
Root canal obturation is defined as the three-dimensional filling of the entire root canal system, aimed at eliminating leakage and sealing irritants that ...
[51]
Cleaning and Shaping the Root Canal System - Pocket Dentistry
Apr 18, 2020 · Root canal treatment was aided by nickel-titanium rotary instruments, and obturation was done with lateral compaction of gutta-percha and AH26 ...
[52]
Outcomes of root canal treatment performed by undergraduate ...
Apr 30, 2025 · The weighted success rates from the three studies eligible for meta-analysis showed that vital teeth had a success rate of 87.8%, and necrotic ...
[53]
CBCT-Assessed Outcomes and Prognostic Factors of Primary ...
Reported success rates for primary root canal treatments are around 92.6% under “loose” criteria and 82% under “strict” criteria, while nonsurgical ...
[54]
Comparative success rates of regenerative endodontic procedures ...
Oct 3, 2025 · The combined subgroup meta-analysis compared the pooled success rates of REPs and RCT (Fig. 5), providing a direct comparison of the two ...
[55]
Establishment of a regenerative endodontic procedures model of ...
Sep 29, 2025 · Regenerative endodontics by cell homing: a review of recent clinical trials. J Endod. 2023;49(1):4–17. https://doi.org/10.1016/j.joen ...
[56]
review efficacy of stem cells in endodontic regeneration
The findings indicate that stem cell therapy holds promise for inducing dental pulp regeneration.