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30 May 2024, Volume 17 Issue 3 Previous Issue    Next Issue

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The clinical treatment of pulpitis or apical periodontitis secondary to distal caries in mandibular second molars due to impacted mandibular third molars YANG Zi, WANG Wen-ting, ZHANG Chen 2024, 17(3): 257-264.  DOI: 10.19538/j.kq.2024.03.001 Abstract ( )   Distal caries in mandibular second molars associated with impacted mandibular third molars are hidden，often located subgingivally，which may lead to pulpitis or apical periodontitis，and accompanied by distal periodontal pathologies such as distal alveolar bone resorption. During the treatment，mandibular second molars face difficulties in rubber dam isolation，anatomical complexities of root canals，iatrogenic injury，insufficient occluso-gingival distance，and coronal restoration. Choosing appropriate dental，periodontal，and restoration treatment is of great value in preserving mandibular second molars. This article reviews the clinical characteristics，treatment difficulties，and clinical treatment strategies selection of pulpitis or apical periodontitis secondary to distal caries in mandibular second molars due to impacted third molars.

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Clinical application and prospect of vital pulp therapy in irreversible pulpitis of mature permanent teeth WANG Ming-hao, ZHU Xiao-miao, HE Wen-xi 2024, 17(3): 265-270.  DOI: 10.19538/j.kq.2024.03.002 Abstract ( )   Healthy pulp is the key to preserve natural teeth and maintain their normal function. In recent years，studies have found that vital pulp therapy has a good application prospect in the clinical treatment of irreversible pulpitis of mature permanent teeth. Compared with root canal therapy，vital pulp therapy may have a better prognosis for affected teeth. This article reviews the indications，biological basis，treatment challenges and the factors affecting the success rate of vital pulp therapy.

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Control of complications during removal of separated instruments within root canal system ZHAO Jing-wen, XIAN Hang, XUE Ming 2024, 17(3): 271-275.  DOI: 10.19538/j.kq.2024.03.003 Abstract ( )   Due to the complexity of the anatomical structure of the root canal system，limitations of the fracture resistance of endodontic instruments，and the non-standardized protocols of the operators，instruments separation remains one of the common complications in root canal therapy and may be one of the main reasons leading to the failure of root canal therapy. Removing the separated instruments helps to achieve complete cleaning，shaping，and tight filling of the root canal system，thereby achieving the goal of controlling infection. Thus，complications that occur during the removal of separated instruments have always been a key topic of clinical discussion. In this article，preoperative evaluation，method selection and control of complications of the removal of separated instruments were introduced.

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Considerations for clinical management of teeth involved in jaw bone cystic lesions LIU Xiao-yu, HUANG Zheng-wei 2024, 17(3): 276-283.  DOI: 10.19538/j.kq.2024.03.004 Abstract ( )   Jaw cystic lesions present complex challenges involving both teeth and the jawbone，predominantly encompassing jaw cysts and cystic tumors. Jaw cystic lesions often involve healthy teeth in the dentition，and the management of teeth associated with these conditions remains a subject of debate. Particularly，when teeth protrude into the cystic cavity of such lesions，especially if they maintain functional pulp，there are no universally accepted guidelines on whether to preserve the tooth or pulp. This review provides a comprehensive discussion on the etiology，diagnosis，and treatment of jaw cystic lesions. Regarding teeth involved in cysts，a treatment philosophy prioritizing "life > bone > tooth > pulp" is suggested，emphasizing the preservation of teeth with functional requirements to uphold overall oral health. Specific clinical management should be individualized based on the different pathological types of jaw cystic lesions.