Dental Trauma Research Articles

FUNCTIONAL FEATURES OF ANATOMICAL STRUCTURES AFFECTING THE PROCESS OF ENDOTRACHEAL INTUBATION: ANALYSIS OF ANATOMICAL AND CLINICAL STUDIES

The study of morphofunctional features of various structures of the head and neck, as well as their congenital and acquired changes, allows a deeper understanding of the conditions affecting endotracheal intubation. Knowledge of the individual anatomical features of the patient allows you to carefully prepare for endotracheal intubation of the trachea and minimize the number of cases of unsuccessful intubation leading to serious consequences, including dental trauma, damage to the respiratory tract, hypoxic brain damage and even death. The article discusses various nosologies that may be the cause of difficult tracheal intubation. The generalized results of these studies can help in the development of new methods and approaches to the tracheal intubation procedure, taking into account the anatomical features of the organs of the head and neck of patients.

Prognosis of Fragment Reattachment in Anterior Crown Fractures: A Retrospective Study.

Although several studies have compared fragment attachment with resin build-ups in anterior crown fractures, none have specifically investigated the outcome of reattached fragments. This retrospective study aimed to evaluate long-term outcomes of fragment reattachment in anterior crown fractures and determine the prognostic affecting their success. We retrospectively analyzed clinical records of patients who underwent fragment reattachment for crown fractures in anterior teeth (maxillary and mandibular central and lateral incisors) between 2008 and 2023. All procedures were performed by experienced professors and residents following a standardized protocol. Kaplan-Meier survival curves and Cox proportional hazards regression analyses were performed to evaluate fragment retention outcomes and identify potential prognostic factors. Among 75 anterior crown fractures, the estimated fragment retention rates were 83.7% at 2 years, 75.2% at 5 years, and 56.4% at 10 years. Multivariate Cox regression analyses identified patient age and extent of crown fracture as significant factors affecting outcomes. The 5-year estimated fragment retention rates were 82.8% and 67.0% for uncomplicated and complicated crown fractures, respectively. Fragment reattachment remains a viable treatment option for anterior crown fractures. Treatment success decreased with patient age, and complicated crown fractures demonstrated lower retention rates than uncomplicated ones. Fragment reattachment can provide predictable outcomes in anterior crown fractures when cases are carefully selected, particularly considering the patient's age and the type of crown fracture.

Factors Associated with Dental Trauma First-Aid Knowledge of Physical Education Teachers

Factors Associated with Dental Trauma First-Aid Knowledge of Physical Education Teachers

Mouthguard types, properties and influence on performance in sport activities: a narrative review

Mouthguards are proven devices placed inside the mouth to prevent oral lacerations, dental injuries, and jaw fractures. Endorsed by the World Dental Federation, mouthguards are crucial for preventing orofacial and dental trauma. However, their adoption in sports is challenged by limited guidance, communication barriers, and cost considerations. Based on extensive literature research in PubMed/MEDLINE, this narrative review summarizes the historical development of mouthguards, elaborates on their primary classifications, and examines the factors influencing their properties. Importantly, the impact of mouthguards on sports performance is clarified in this study. Overall, using mouthguards in sports not only reduces the occurrence and severity of dental injuries but also holds promise for enhancing athletic performances such as strength, aerobic capacity, agility, balance, and flexibility. Therefore, promoting mouthguard use in the sports community should be encouraged.

Evaluation of Chatbots in the Emergency Management of Avulsion Injuries.

This study assessed the accuracy and consistency of responses provided by six Artificial Intelligence (AI) applications, ChatGPT version 3.5 (OpenAI), ChatGPT version 4 (OpenAI), ChatGPT version 4.0 (OpenAI), Perplexity (Perplexity.AI), Gemini (Google), and Copilot (Bing), to questions related to emergency management of avulsed teeth. Two pediatric dentists developed 18 true or false questions regarding dental avulsion and asked public chatbots for 3 days. The responses were recorded and compared with the correct answers. The SPSS program was used to calculate the obtained accuracies and their consistency. ChatGPT 4.0 achieved the highest accuracy rate of 95.6% over the entire time frame, while Perplexity (Perplexity.AI) had the lowest accuracy rate of 67.2%. ChatGPT version 4.0 (OpenAI) was the only AI that achieved perfect agreement with real answers, except at noon on day 1. ChatGPT version 3.5 (OpenAI) was the AI that showed the weakest agreement (6 times). With the exception of ChatGPT's paid version, 4.0, AI chatbots do not seem ready for use as the main resource in managing avulsed teeth during emergencies. It might prove beneficial to incorporate the International Association of Dental Traumatology (IADT) guidelines in chatbot databases, enhancing their accuracy and consistency.

Position statement on longitudinal cracks and fractures of teeth.

This position statement is a consensus view of an expert committee convened by the European Society of Endodontology (ESE). The statement is based on current clinical and scientific evidence as well as the collective reflective practice of the committee. The aim is to provide clinicians with evidence-based, authoritative information on the aetiology, clinical presentation, and management of cracks and fractures that typically manifest along the long axis of the crown and/or root.

Knowledge, Attitude, and Practice in Dental Trauma Management Among Schoolteachers in Taif, Saudi Arabia.

Background: In Saudi Arabia, dental trauma is regarded as one of the most important issues affecting schoolchildren. This study evaluated Saudi Arabian schoolteachers' knowledge, attitude, and practice regarding emergency dental trauma management. Methods: A cross-sectional study was conducted on 263 schoolteachers from 25 schools; 50.9% were females. A questionnaire was used to collect respondents' personal and professional data and information on managing dental injury scenarios and the respondents' attitudes toward dental injuries. A multivariate logistic regression analysis was carried out for the independent and outcome variable of inadequate knowledge regarding dental trauma management. Results: Male teachers had better knowledge than female teachers regarding emergency management of avulsed teeth. Compared to female teachers, male teachers would scrub a tooth with a toothbrush to replant it back into its socket if it fell onto the ground and was covered with dirt. Males had a significantly higher percentage of believing it is not teachers' responsibility to care for tooth injuries in schools. Teachers with teaching experience of 5-10 years had a significantly higher percentage of training in dental emergencies. Teachers with bachelor's degrees agreed on the need for teacher involvement to save the tooth in a timely manner. Compared to general teachers, physical education teachers would put the tooth back in the mouth and send the child to the dentist immediately if they were hit in the face and the upper front tooth fell out of their mouth. Teachers with a diploma level of education and teachers with a general type of teaching qualification were 2.15 times (CI = 0.98-3.11, p = 0.002) and 3.19 times (CI = 1.71-4.22, p = 0.0001) more likely to have a higher level of inadequate knowledge regarding dental trauma management. Conclusions: There is a need to raise teachers' awareness and improve their dental trauma emergency management training.

Exploring Dental Trauma Among Cattle Farmers in Vadodara, Gujarat: Prevalence and Risk Factors.

Traumatic dental injuries (TDI) are a global health concern, affecting millions of people annually. The prevalence of traumatic dental injuries (TDIs) can vary significantly with change in geographic region, occupation, and lifestyle. Animal handlers, such as cattle farmers, are at risk of experiencing TDIs due to their interactions with animals. However, there have been no previous studies investigating the prevalence of TDI among cattle farmers. To determine the prevalence and associated risk of TDI among cattle farmers in Vadodara City, Gujarat, India. A cross-sectional study was conducted among cattle farmers residing in Vadodara City. Purposive snowball sampling was used to recruit the cattle farmers. A questionnaire was used to collect data on demographic variables, animal handling practices, experience, history of trauma. Clinical examination was carried out to screen for TDI and possible risk factors. A total of 357 cattle farmers participated in the study. The prevalence of TDI among cattle farmers was 7.8%. All the respondents reported some form of soft tissue injury (100%). Luxation (60.71%) was the most frequent dental injury, followed by tooth fracture (57.14%). Maxillary incisors were the most commonly affected teeth (75.61%). Kicking (39%) and head-butting (43%) were the most frequent causes of injury. Increased overjet, inadequate lip coverage, and Class II molar relationship were associated with a higher risk of TDI. Prevalence of TDI among cattle farmers was found to be 7.8%. Since the cattle farmers are inherently at risk for TDI as occupational hazard, preventing dental trauma-related injuries in cattle farmers is crucial.

Do orthodontists consider endodontic complications in their orthodontic management of teeth with a history of dental trauma? A vignette survey

BackgroundDental trauma is a frequent injury seen commonly in young children. There is a link between malocclusion and the incidence of traumatic dental injuries. Orthodontic therapy has been suggested as a preventative measure in correcting unfavourable malocclusions and potentially avoiding traumatic dental injuries. To date, it is poorly understood if the complications reported following traumatic dental injuries are amplified during and following orthodontic treatment. The aim of this study was to evaluate whether orthodontists considered the endodontic implications associated with the orthodontic treatment of teeth with a history of dental trauma.MethodA mixed methods vignette survey was designed, piloted, and distributed online to UK registered specialist orthodontists. The survey was split into three parts and consisted of three vignette clinical scenarios with open and closed questions.ResultsA total of 76 orthodontists responded from the United Kingdom. Of the participants, 46% (n = 35) of the orthodontists felt they had insufficient training in dental trauma and 42% (n = 32) lacked confidence in the treatment of traumatic injuries. The study participants reported non-standardised pre- treatment examination, limited dental trauma experience and insufficient training. In addition, 32% (n = 24) of clinicians felt that there is a lack of guidance in the orthodontic management of traumatised teeth and pulpal sequelae.ConclusionOrthodontists are not following a standardised protocol in their examination of teeth with a history of trauma prior to orthodontic treatment. There is a need within the orthodontic specialty to create a standardised protocol to assess teeth with a history of dental trauma.

유아교육과 대학생의 응급처치 및 심폐소생술에 대한 지식, 수행자신감 및 교육 요구도

Objectives The purpose of this study was to identify the knowledge, performance confidence, and educational needs of early childhood education students regarding first aid and cardiopulmonary resuscitation, and to provide basic data necessary for developing educational programs at universities. Methods This study investigated the knowledge, performance confidence, importance, and current level of awareness of first aid and CPR among all students of the Department of Early Childhood Education at G University. The collected data were analyzed using the SPSS WIN 22.0 program to determine the educational need priority through the mean, standard deviation, t-test, Borich formula, and Locus for Focus model. Results The subjects' knowledge level of first aid and CPR was 62.8% correct, and their average performance confidence was 3.19, their average importance recognition was 4.68, and their average current level recognition was 3.14. Students with educational institution internship and first aid training experience had higher scores on knowledge and perceived importance, but there were no general characteristics that significantly differed in performance confidence. There was a need for education for all 15 emergency care items, and the results of the educational need priority check using the Borich formula and Locus for Focus model showed that the highest priority included head injury, response when discovering a person in cardiac arrest, chest compressions and artificial respiration, and AED operation, while the next highest priority included sprains, fractures, dislocations, tooth fractures, and choke. Conclusions Early childhood education students must achieve first aid and CPR competency upon graduation, so it is necessary to develop an educational program that includes practical training for the first aid items identified as having high priority in this study.

Interdisciplinary problem-based learning model for standardized dental residency training: from theory to practice in dental trauma management.

Enhancing clinical skills and quality of dental residents is critical for standardized training. Conventional standardized training falls short in exposing residents to diverse scenarios and fostering interdisciplinary collaboration, essential for dental trauma management. To address these issues, West China Hospital of Stomatology, Sichuan University introduced an interdisciplinary problem-based learning (IPBL) model to improve residents' professional quality and practical abilities. Based on the specific needs of dental residents, the hospital established a PBL framework supported by an interdisciplinary collaborative teaching team with a focus on dental trauma diagnosis and treatment. A comprehensive assessment followed the IPBL course, which informed subsequent course modifications. In a preliminary study, 134 students voluntarily chose whether to participate in the program. At the end of the study, the scores of both groups were compared. The IPBL model significantly improved the professional ability of dental residents in the diagnosis and treatment of dental trauma, and obtained positive evaluations from residents and mentors. For the quantitative analysis, the Wilcoxon signed-rank test showed an overall improvement in participants' scores after completing the course. This teaching model provides a new way for the standardized training of dental residents, and helps to cultivate dental professionals with high professional and practical abilities.

Influence of Conservative or Invasive Treatments on the Occurrence of Sequelae in Permanent Successors After Injuries in the Support Tissues of Incisors Deciduous Teeth: A Cohort Study.

To assess the influence of conservative or invasive treatments on the appearance of sequelae in permanent successor teeth (SPT) after injuries in the support tissues of anterior deciduous teeth (ISTDT). This cohort study accompanied 52 children with ISTDT up to the complete eruption of the permanent successor to investigate the presence or not of SPT. Trauma was clinically evaluated according to the International Association for Dental Traumatology. Sex, age at the time of trauma (ATT), type and severity of trauma, sequelae in anterior deciduous teeth (SDT), treatment type (conservative-without exodontia/ invasive-with exodontia), seeking care (immediate/late), and the caregiver's education level (CEL) were collected. Regression models were performed (p = 0.05). Of the children (ATT = 3.6 ± 1.5 years), boys (52/57.1%) were the majority. The teeth (n = 91) injuries were lateral luxation (26/28.6%), intrusion (22/24.1%), concussion (20/22.0%), subluxation (19/20.9%), and extrusion (4/4.4%), that affected only incisors. Most teeth (63/69.2%) received late care, presented SDT (62/68.1%) and were treated conservatively (73/80.2%). There was no association of sex (p = 0.611), SDT (p = 0.705) and seeking care (p = 0.800) with SPT. The treatment type did not influence the SPT occurrence (p = 0.923), independent of the ATT, trauma severity and the educational level of the caregiver. The lower the ATT (p = 0.026) and the more severe the trauma (p = 0.009), the higher the number of SPT. The treatment type of anterior deciduous teeth, mainly considering incisors, did not influence the appearance of SPT, which leads us to always choose the most conservative treatment, independent of the child's age, the injury severity, and the caregiver's educational level.

The influence of different types of bevels on the fracture resistance of directly restored lower anterior teeth

Background and aims. In recent years, dental trauma has been on the rise. The most common, regarding permanent dentition, are uncomplicated fractures (involving enamel or enamel and dentin) of the maxillary central incisors, followed by maxillary lateral incisors and mandibular central incisors. In anterior teeth, high impact stresses are frequently produced and because of this it is necessary that the restoration has a high fracture resistance. The aim of this study is to evaluate the influence of marginal cavity preparations (45° bevel and chamfer bevel) on the fracture resistance of teeth treated with direct composite resins. Methods. For this study, 24 extracted mandibular incisors were used. All soft tissue debris and tartar were removed. During the study, the teeth were kept in saline to prevent dehydration. The teeth were divided into three groups of 8 teeth each. Group number 1 was used as a control and named C, in group number 2, named CH, incisors were prepared with a chamfer type of bevel, and in group number 3, named B45, incisors were prepared with a 45° bevel. After preparing all mandibular incisors, they were directly restored with nano-ceramic composite (Ceram.x® Duo, Dentsply Sirona). Subsequently, all three groups were fractured to determine the maximum compressive load using the Instron 3366 universal testing machine. To ensure a standardized fracturing process, all incisors were embedded in self-polymerizing acrylic resin up to the neck to replicate the conditions in the oral cavity. Results. The Student’s T-test was employed for statistical analysis, revealing a statistically insignificant difference between the CH and B45 groups. Nonetheless, it was noted that the average values of maximum compressive loads in the chamfer bevel group were higher compared to those in the 45° bevel group, indicating its superior resistance to fracture. Additionally, the results of the fracture resistance test demonstrated that intact mandibular incisors are three times more resistant to fracture than mandibular incisors prepared and restored with dental bevels. Conclusion. Intact teeth present a superior fracture resistance compared to teeth that have been subjected to trauma or carious processes, requiring coronal restoration; dental restorations made with a chamfer bevel marginal preparation withstand higher forces with improved fracture resistance compared to those made with a 45° bevel marginal preparation.

Biomechanical Behaviors of Molars Restored with Endocrowns Composed of Different Materials.

To assess the biomechanical behaviors of endodontically treated molars (ETMs) restored with endocrowns composed of different materials, forty mandibular molars were assigned to five groups (n = 8 each). Untreated molars constituted the control group (group C); the rest of the teeth that underwent root canal therapy were restored with endocrowns composed of polycrystalline ceramics (ST zirconia®, UPCERA) in group ZR, lithium disilicate glass ceramics (UP.CAD®, UPCERA) in group LD, resin-based nanoceramics (Hyramic®, UPCERA) in group NC, and feldspathic ceramics (CEREC Blocs®, Sirona) in group FC. All teeth were axially loaded until fracture. The process was recorded using a high-speed camera system, and fractographic analysis was conducted. The results showed that fracture loads did not significantly differ among groups C, LD, and NC; the loads were significantly lower than the load in group ZR but higher than the load in group FC. The mean time from the initial crack to complete tooth fracture varied. Group C had the longest time, followed by group NC; groups ZR, LD, and FC had the shortest time. Similar failure patterns were observed in groups ZR and LD, which were more regular than the pattern in group NC; group FC exhibited the roughest fracture surfaces. Fracture resistance testing combined with a high-speed camera system and fractographic analysis provides a promising modality for studying the biomechanical behaviors of restored teeth. Endocrowns composed of lithium disilicate glass ceramics or resin-based nanoceramics offer alternative restorations for ETMs with extensive coronal loss.

Quality assessment of clinical practice guidelines and position statements on vital pulp therapy: a systematic review.

To evaluate different Clinical Practice Guidelines (CPGs) and Position Statements (PS) on Vital Pulp Therapy (VPT) using the Appraisal of Guidelines for Research and Evaluation II (AGREE II) and Appraisal of Guidelines for Research and Evaluation-Recommendation EXcellence (AGREE-REX) tools. Two authors performed the initial search using a set of keywords in six databases. Only CPGs and PS on VPT published during the past five years were included. The included CPGs were appraised independently by six appraisers. AGREE II tool was used to evaluate the methodological quality, and AGREE REX was used to evaluate the quality of recommendations. Intraclass correlation coefficient was used as a reliability indicator among assessors. Four published CPGs were shortlisted. Guidelines established by the European Society of Endodontology (ESE, 2019), German Society of Endodontology and Dental Traumatology (GSEDT, 2019), American Association of Endodontists (AAE, 2021), and Australian Dental Association (ADA, 2021) were analyzed. The ESE PS obtained the highest average score overall. Endodontists must adhere to clinical practice guidelines established by specialty associations or societies. Improving the domains "Rigour of Development" and "Applicability" is necessary to enhance the overall strength of the guidelines. It is imperative to prevent discouragement and confusion among practitioners regarding VPT procedures by ensuring cohesiveness among various endodontic associations. This assessment aids in determining the standard of CPGs among different specialized societies and associations. It also highlights the essential future actions and initiatives needed to establish robust evidence-based standards on VPT. The protocol of this systematic review was registered in PROSPERO (ID: CRD42023429673).

Emergency Management Of Dental Injury; Preparedness Among School Teachers In Swabi Khyber Pukhtunkhwa - A Cross-Sectional Study

Objective: Dental trauma poses a significant threat to the oral health and well-being of school-aged children worldwide. Prompt and appropriate management of dental trauma is crucial to prevent infection, abscess formation, and pulp necrosis. Methods: The descriptive cross-sectional study was carried out among 320 male and female teachers via cluster random sampling from October 2023 to May 2024 to assess the level of knowledge among school teachers regarding emergency management of dental injuries, to evaluate the preparedness of school teachers in handling dental injuries in the school setting and to determine the association between demographics with knowledge and preparedness regarding emergency management of dental injuries. Data was collected about socio-demographic characteristics and emergency preparedness for dental trauma. Results: Out of 320 individuals, the level of the teachers' knowledge was moderate (53.3%). Only a few teachers were found to have undergone first-aid training in TDI (19.4%) and to have encountered TDI incidents (21.9%) before. 93(50.5%) females correctly identified fracture (p-value 0.014). A significant association was observed for identifying fractured teeth and managing avulsed teeth with first aid training with a p-value of 0.017 and 0.008 respectively. A significant association was observed between the age group 41-50 years and the Importance of seeking emergency management for dental trauma (p-value 0.018) and knowledge status (p-value 0.007).52.3% of teachers correctly identified a solution for washing a re-implanted tooth(p-value 0.000).46% of teachers whose service span was more than 19 years, had better self-rated knowledge( p-value 0.002) Conclusion: A moderate number of teachers had adequate knowledge among school teachers regarding dental trauma management. While a substantial proportion of teachers exhibit a commendable understanding and readiness to address dental emergencies, there remains a notable gap between certain aspects of knowledge and preparedness. Keywords: Emergency management, Preparedness, School teachers.

Clinical and radiographic evaluation of two different apexification protocols in traumatized immature permanent incisors.

Dental trauma can cause damage to the pulp tissue in immature teeth. Revascularization therapy is a possible option in the treatment of non-vital, immature permanent teeth with a history of trauma. The aim of this prospective study was to evaluate the radiographic and clinical results of immature teeth with a history of trauma treated by regenerative endodontic procedures and mineral trioxide aggregate apexification techniques. Forty-one patients aged between 7 and 12 years with traumatized immature permanent maxillary incisors were included in the study. These patients were divided into two groups: those who had previously received endodontic treatment and those who had not. Twenty-four patients who applied directly to the university clinic and had not received endodontic treatment before were included in the regenerative endodontic protocol group (Group 1). Seventeen patients who had previously undergone endodontic intervention on their relevant teeth were included in the mineral trioxide aggregate apexification group (Group 2). The patients were followed for a period of 24 months. Clinical success rates were evaluated, and pre-treatment and control radiographs were analyzed to calculate the percentage increase in root dentin width and root length. After 24 months of follow-up, positive periapical healing was detected in the radiographic findings in the majority of cases. In Group 1, a limited increase in root length and root dentin width was observed, while a narrowing in the apical opening was evident. The radiographic evaluation of two of the cases, which could be accessed 11 years later, emphasized the importance of long-term follow-up in assessing the effectiveness of the chosen methods. The revascularization method is a treatment option that has positive results in terms of root development in teeth with necrotic pulp as a result of trauma.

Dental Trauma following Animal Attack: A Case Report

Animal attacks are a common cause of human injuries worldwide, with human-leopard encounters frequently reported in India. Animal attack injuries are increasingly common in trauma centres due to human encroachment into wildlife habitats, leading to more human-animal interactions. These attacks, especially to the face, can cause significant functional, cosmetic, and structural damage. A 40-year-old woman was attacked by a leopard, resulting in tooth mobility, pain, and orofacial lacerations. Initial treatment and primary wound closure were performed in Ratlam, Madhya Pradesh, India. On further examination, necrosis with blackish discolouration of the left ala of the nose was observed, along with scarring on the lips. Tooth 22 exhibited luxation without alveolar bone involvement, leading to proclination. A multidisciplinary treatment approach was adopted, beginning with manual manipulation and repositioning of tooth 22, followed by stabilisation and endodontic treatment. For extraoral management, plastic surgery was performed, involving a paramedian forehead flap and alar cartilage remodelling using left auricular cartilage. The patient underwent follow-ups at one, three, six months and one year. In conclusion, managing dental trauma from animal attacks requires a multidisciplinary approach and ongoing follow-up. By fostering collaboration among healthcare professionals and ensuring vigilant care, we can significantly improve patient outcomes and recovery.

Three-dimensional-printed restorations for prosthetic rehabilitation of localized tooth wear using the Dahl concept: A case report

A 26-year-old man with localized tooth wear and demand for aesthetic rehabilitation of the anterior teeth presented to our department. The patient reported excessive consumption of energy drinks. Furthermore, multiple trauma and tooth fractures have occurred in the past. In the present case, three-dimensional (3D)-printed restorations were used to restore the vertical dimensions according to the Dahl concept. An indirect build-up using noninvasive restorations has been demonstrated to be beneficial due to its pleasing aesthetic outcome and the advantage of the 3D printing process. Adhesive bonding was adapted from previous studies using direct composite materials. Thus far, whether, and to what extent, the color of these restorations changes remains unclear. Furthermore, the material wear should be evaluated in future studies. Moreover, 3D-printed, noninvasive restorations made of a computer-aided design/computer-aided manufacturing hybrid material are suitable for the application of the Dahl concept. Aesthetic improvement in combination with minimally invasive pretreatment of the teeth and subsequent noninvasive restorations led to the rehabilitation of the vertical dimension of occlusion. After a follow-up period of two years, harmonious occlusal conditions were observed in the posterior region.

Minimally invasive endodontic treatment through the labial/buccal cervical approach - protocol and case series.

Traditional access cavity preparation involves removing the roof of the pulp chamber and smoothing the dentin bulges at the root canal orifice, thereby creating straight-line access. However, this may damage more healthy dental tissue and reduce the tooth's fracture resistance. This case series presents a novel minimally invasive endodontic protocol for one maxillary canine and four mandibular premolars, which required root canal therapy due to labial/buccal cervical decay that caused pulpitis or periapical periodontitis. Our treatment protocol includes the following steps: preoperative assessment, removing decay in the labial/buccal cervical region, preparing an endodontic access cavity utilizing the affected region, establishing a working-length reference line using resin, cleansing the pulp horn with ultrasonic retro-preparation tip, root canal preparation, disinfection, obturation through the labial/buccal cervical access, and final resin restoration. Ideal root canal obsturation outcomes were achieved in all cases, while avoiding the abrasion of tooth tissue at the pulp chamber roof, caused by traditional endodontic access cavity methods. Minimally invasive endodontic treatment through the labial/buccal cervical approach offers clinicians new insights and options for endodontic access design.