Successful Healing of Periapical Pathology with Partial Pulpotomy in a Mature Permanent Molar: A Case Report.

BACKGROUND Vital pulp therapy approaches are preferred over non-surgical root canal treatment, giving the advantage of preserving the vitality of the dental pulp and thus maintaining its benefits. Such approaches can be performed in teeth having normal apical area; however, performing vital pulp therapy approaches in teeth associated with periapical pathology remains controversial. CASE REPORT We present a case of a mature mandibular right first permanent molar tooth in a medically fit 10-year-old female diagnosed as asymptomatic irreversible pulpitis with asymptomatic apical periodontitis with periapical radiolucency having a periapical index (PAI) score of 4. Partial pulpotomy was performed instead of non-surgical root canal treatment due to uncooperativeness of the patient. Biodentine was used as a pulp capping material. The tooth was restored with resin composite permanent restoration. Six months after the procedure, an intraoral periapical radiograph revealed normal bone features with complete periapical pathology healing and development of intact lamina dura around the mesial and distal roots. The tooth responded normal to electric pulp testing (EPT), cold, percussion, and palpation tests. CONCLUSIONS Periapical pathology involvement having large periapical radiolucency exhibiting PAI score 4 in inflamed dental pulp tooth diagnosed as irreversible pulpitis does not necessitate non-surgical root canal treatment. Partial pulpotomy should be considered as an alternative treatment to promote the return dental pulp and periapical tissue to a healthy condition. Considering a similar approach in older patients would be interesting to gain a more comprehensive understanding of its potential as a treatment method.

Endo-Perio Relationship Knowledge, Understanding, and Confidence Among Dentists.

Purpose: Proper knowledge and confidence regarding Endo-Perio relationship plays an important role in correct clinical decisions and management of these conditions. The aim of this study is to assess dentists' knowledge and understanding, in addition, their confidence regarding Endo-Perio relationship, consequently, to investigate the prevalence of misconceptions. Methods: This cross-sectional study, conducted from December 2021 to March 2022, utilized voluntary anonymous questionnaire, distributed among general dentists, graduates of King Abdulaziz University, Faculty of Dentistry, Jeddah, Saudi Arabia, year of 2021 (n = 151). The questionnaire had two parts, demographic and 13 closed ended scientific questions to assess knowledge and understanding with 4 points Likert scale after each question to assess confidence and misconceptions. Descriptive statistics and Chi-square test at a statistical significance of P-value <0.05 were conducted to analyze the data using SPSS. Results: Total of 98 participants completed the questionnaire setting a response rate of (64.9%). Only (21.4%) had sufficient overall knowledge and understanding regarding Endo-Perio relationship with no significant association found between knowledge and gender (p = 0.8). A little more than one-third of our participants (37.83%) were overly confident; false confident, thus, had misconceptions. Conclusion: Our study revealed that the majority of our participants had deficient knowledge regarding Endo-Perio relationship. Thus, to compensate for this reported deficiency, changing teaching strategies and implementing continuing education courses are suggested. More studies assessing the interaction between knowledge and confidence in different dental topics are needed.