Search Results (134)

Background: Effective root canal disinfection is essential for successful nonsurgical root canal treatment (RCT). Although sodium hypochlorite (NaOCl) remains the standard irrigant, it carries a risk of chemical tissue injury if extruded beyond the root canal system and may have limited penetration into anatomically complex regions. Underwater discharge plasma (UDP) generates reactive oxygen and nitrogen species (RONS) through high-frequency, high-voltage electrical discharge in aqueous media, and preclinical and in vitro studies have reported broad-spectrum antimicrobial activity. This study evaluated the clinical and radiographic outcomes of nonsurgical RCT performed using physiological saline-based UDP irrigation without NaOCl in a heterogeneous real-world clinical cohort. Methods: This single-center retrospective cohort study included 186 teeth from 134 patients treated with the PLAZEN RCT^® UDP device and physiological saline irrigation, without NaOCl. The median follow-up period was 16 months. Radiographic outcomes were assessed using the Periapical Index (PAI) system, and treatment success was evaluated according to prespecified Strict and Loose criteria incorporating both radiographic and clinical findings. Stratified analysis was performed according to preoperative PAI score: Group A (PAI 1–2) and Group B (PAI 3–5). UDP-related adverse events, defined as thermal tissue injury caused by discharge heat, were ascertained through retrospective review of clinical records, operative notes, and serial periapical radiographs. Results: Among the 186 treated teeth, radiographic outcomes were classified as Healed (85.5%), Healing (3.8%), and Unhealed (10.8%). Overall Strict and Loose success rates were 79.6% and 82.3%, respectively. Initial treatment showed numerically higher success rates than retreatment. In the stratified analysis, Group A showed an 84.1% success rate with 100% tooth survival, whereas Group B demonstrated Strict and Loose success rates of 68.5% and 83.3%, respectively. Exploratory multivariable analysis showed that periodontal pocket depth > 3 mm was the most consistent factor associated with lower odds of treatment success, whereas associations involving canal obliteration and higher preoperative PAI score were less stable across sensitivity analyses and should be interpreted with caution. No UDP-related adverse events were recorded during follow-up. Attrition sensitivity analyses were performed, and the outcome estimates should be interpreted with caution, given the retrospective design and substantial loss to follow-up. Conclusions: In this preliminary observational cohort, physiological saline-based UDP irrigation without NaOCl was associated with favorable observed periapical healing outcomes and no recorded UDP-related adverse events over a median follow-up of 16 months. However, loss to follow-up was substantial; when all 116 teeth lost to follow-up were classified as treatment failures, the worst-case Strict success rate decreased to 49.0%. Therefore, these findings should be interpreted as preliminary descriptive evidence of clinical feasibility rather than as evidence of comparative efficacy or definitive clinical safety. Adequately powered randomized controlled trials with concurrent NaOCl control arms and long-term follow-up are warranted to evaluate the comparative effectiveness, safety, and reproducibility of physiological saline-based UDP irrigation protocols. Full article

Dental diseases have long been taught and treated as separate entities: cariology, operative dentistry, endodontics, and periodontology, each working within its own boundaries. However, increasing biological and clinical evidence suggests that this classified view does not fully reflect how disease progresses in the mouth. Instead, dental disease should be understood as a continuum within the interconnected tooth–pulp–periodontium complex. This review provides current evidence showing how dental caries can serve as the starting point of a process that can progress through pulpitis and apical periodontitis and eventually affect surrounding periodontal tissues. Caries is now widely known as a biofilm-driven and host-influenced condition shaped by ecological imbalance rather than specific pathogens alone. As lesions penetrate deeper into dentin, the structure becomes more permeable, permitting diffusion of microbial metabolites and signaling molecules toward the pulp. This initiates a multifaceted inflammatory reaction within the pulp tissue. At this stage, pulpitis becomes a critical turning point, where the outcome depends on microbial load, lesion activity, host response, and quality of clinical intervention. If the disease is not well controlled, it may lead to pulp necrosis, allowing infection to spread beyond the root canal and initiate periapical inflammation. Through anatomical pathways such as apical foramina and lateral canals, these processes can extend further, sometimes resembling or overlapping with periodontal disease. This overlap creates diagnostic challenges, as conventional tests may not always distinguish between conditions. A structured, pathway-based diagnostic approach is therefore essential. From a treatment perspective, this continuum model highlights early intervention, minimally invasive care, preservation of pulp vitality when possible, and maintenance of a strong coronal seal. Ultimately, stronger integration across dental disciplines can improve diagnosis, guide treatment decisions, support long-term tooth preservation, and promote unified dental education. This article presents a narrative review supported by a structured literature search and proposes a clinically actionable framework that extends established endodontic–periodontal concepts upstream to include caries initiation and restorative modulation. Full article

Background: The biological response of the periodontal ligament (PDL) following endodontic treatment remains insufficiently investigated. This systematic review aimed to evaluate the influence of endodontic treatment modalities on PDL-related healing outcomes and periapical tissue repair. Methods: A systematic review was conducted according to PRISMA 2020 guidelines. PubMed, Scopus, Web of Science, and the Cochrane Library were searched for randomized clinical trials published between 2015 and 2025. Studies evaluating the effects of endodontic interventions on clinical, radiographic, or biological outcomes associated with PDL healing. Risk of bias was assessed using the Cochrane RoB 2 tool. Results: Ten randomized clinical trials involving approximately 710 participants were included. Endodontic treatment was generally associated with favorable healing outcomes, reflected by reductions in periapical lesion size, improvement of radiographic parameters, and resolution of clinical symptoms. Single-visit and multiple-visit treatments demonstrated comparable long-term healing outcomes, although single-visit protocols were associated with increased short-term postoperative discomfort. Activated irrigation techniques appeared to enhance healing compared with conventional irrigation methods. Most studies were judged as having some concerns regarding risk of bias. Conclusions: Current evidence suggests that endodontic treatment can promote favorable healing of the periodontal ligament–periapical complex through effective infection control and resolution of inflammation. However, the certainty of evidence remains moderate because of methodological heterogeneity and the limited availability of studies directly assessing biological PDL outcomes. Further well-designed randomized clinical trials with standardized outcome measures and longer follow-up periods are required. Full article

The term “periapical lesion” refers to a pathological change in the tissues surrounding the apex of a tooth root, defined by its anatomical location rather than a distinct disease entity. Periapical lesions may be of endodontic origin, most commonly resulting from microbial infection of the root canal system following pulp necrosis due to caries, trauma, or other insults, or of non-endodontic origin, such as developmental cysts, benign and malignant odontogenic and non-odontogenic tumors, and fibro-osseous lesions. Accurate diagnosis requires a systematic approach combining patient history, clinical examination, pulp vitality testing, and radiographic assessment; histopathological evaluation is indicated when clinical and radiographic findings are inconsistent or suspicious. The pathophysiology of these lesions involves dynamic interactions between root canal microorganisms and the host immune-inflammatory response. The primary management for endodontic periapical lesions is root canal treatment, which aims to reduce or eliminate root canal microorganisms through mechanical debridement and chemical disinfection. Persistent or extensive endodontic lesions and non-endodontic lesions may require surgical intervention. Molecular and inflammatory biomarkers have been investigated as adjunctive tools for assessing disease activity and prognosis; however, these remain largely investigational and are not yet part of routine clinical practice. Future developments in artificial intelligence, advanced imaging, molecular diagnostics, and personalized therapies may enhance the diagnosis and management of periapical lesions, although further clinical validation is required. Full article

Background/Objectives: Implant explantation is often considered the standard treatment for severe peri-implant inflammatory lesions, including cases with apical involvement. However, this approach is relatively invasive and aggressive, which can lead to significant loss of bone and soft tissues, potentially compromising future prosthetic rehabilitation, particularly in the esthetic zone. This study aimed to present implant apicoectomy as a conservative alternative that would allow preservation of implant stability while effectively treating localized inflammation. Methods: This case report presents a female patient who was diagnosed with retrograde peri-implant inflammation, and an implant apicoectomy was performed as a conservative approach to implant explantation. The procedure was carried out using a minimally invasive microsurgical technique. Results: The treatment resulted in complete clinical and radiographic healing, maintenance of implant osseointegration and stability, and resolution of clinical symptoms, including fistula closure. No recurrence of periapical infection was observed during the twelve-month clinical and radiological follow-up visit. Conclusions: Implant apicoectomy may be considered a minimally invasive and effective alternative to explantation in selected cases of retrograde peri-implantitis, preserving hard and soft-tissue architecture while maintaining implant functionality. This approach may be particularly beneficial in esthetic regions where preservation of tissue architecture is critical for optimal clinical outcomes. Full article

Matrix metalloproteinases (MMPs) are zinc-dependent proteolytic enzymes involved in extracellular matrix remodelling in oral and dental tissues, including the periodontal ligament, alveolar bone, dentin, dental pulp, and periapical tissues. This narrative review summarises selected evidence on the role of MMPs and tissue inhibitors of metalloproteinases (TIMPs) in orthodontic tooth movement, dental trauma and root resorption, restorative adhesive dentistry, and pulp/periapical disease. Particular attention is given to signalling pathways that regulate MMP/TIMP activity, including nuclear factor kappa B (NF-κB), mitogen-activated protein kinase (MAPK), Wnt/β-catenin, and transforming growth factor beta (TGF-β)/Smad-related mechanisms. The review also discusses the biomarker potential and translational status of MMP-targeted strategies. Across clinical contexts, MMP activity contributes to both matrix degradation and tissue repair, and its biological effect depends on local stimuli, TIMP-mediated regulation, pathway crosstalk, and the stage of disease or treatment. Full article

Background/Objectives: Endodontic sealers can interact with periapical tissues through extrusion, yet the molecular mechanisms underlying their biological effects remain poorly defined. This study investigated how commonly used sealers influence mitogen-activated protein kinase (MAPK) signaling, cell viability, and osteogenic-associated responses in MC3T3-E1 pre-osteoblasts. Methods: Four commercial sealers, Calcium-silicate-based Bioceramic Sealer (EndoSequence^® BC Sealer, BC), Zinc oxide eugenol sealer (Kerr Pulp Canal Sealer, ZOE), Sealapex™, and AH26^®, were applied as standardized pellets, allowed to set, and cultured with MC3T3-E1 cells. Calcium deposition was assessed by Alizarin Red S (ARS) staining, and MAPK activation was evaluated by Western blotting. Due to excessive solubility (Sealapex™) or poor cell survival (AH26^®), mechanistic analyses were performed only for BC and ZOE. Osteogenic-associated gene expression was measured by qRT-PCR, and the functional role of MAPK signaling was assessed using ERK, JNK, and p38 inhibitors. Results: BC and Sealapex™ produced robust ARS staining, while ZOE and AH26^® produced minimal mineral-associated staining. Both BC and ZOE activated ERK, JNK, and p38, with ZOE inducing higher phosphorylation. However, BC maintained greater cell viability and increased Runx2 and Osx expression, whereas ZOE impaired early cell attachment and viability. MAPK inhibition in BC-treated cultures reduced osteogenic-associated gene expression and ARS staining, indicating MAPK involvement in BC-mediated responses. Conclusions: BC and ZOE elicit distinct MAPK activation patterns and cellular responses. Under the conditions tested, BC promoted a more favorable osteogenic-associated response, whereas ZOE compromised early cell viability. These mechanistic insights may help explain clinical differences in periapical tissue responses to sealer extrusion. Full article

The biological compatibility of endodontic sealers is a key determinant of periapical tissue healing. This in vitro study investigated the cytotoxic, pro-inflammatory, and redox-related effects of eight endodontic sealers on human periodontal ligament fibroblasts (HPdLFs): Biopulp (Chema-Elektromet), AH Plus (Dentsply Sirona), MTA Fillapex (Angelus), EndoSeal MTA (Maruchi), GuttaFlow (Coltène), AH Plus Bioceramic (Dentsply Sirona), TotalFill BC (FKG Dentaire SA), and BioRoot TM (Septodont). Cells were exposed for 24 h to 10-fold-diluted sealer extracts prepared in accordance with the manufacturers’ instructions, while control samples underwent identical procedures without sealer contact. Oxidative stress biomarkers, antioxidant defense parameters, protein oxidation indices, apoptotic activity (caspase-3), pro-inflammatory cytokines (IL-1, IL-6), and cell viability (MTT assay) were assessed. Under the applied conditions, all materials induced only limited global oxidative stress, with most alterations reflecting selective protein and glycoxidative modifications. Nevertheless, AH Plus, MTA Fillapex, and the calcium hydroxide-based Biopulp exhibited a less favorable redox profile and greater protein oxidation compared with calcium silicate-based sealers. AH Plus and EndoSeal MTA were associated with increased IL-6 release, whereas EndoSeal MTA moderately elevated IL-1 levels. BioRoot TM demonstrated the lowest cytokine expression, and TotalFill BC preserved high cell viability. Caspase-3 activity remained comparable across all experimental groups, indicating minimal induction of apoptosis. Full article

Background: Apical periodontitis (AP) is a common inflammatory condition of the periapical tissues, most often associated with persistent endodontic infection. Conventional two-dimensional radiography may underestimate AP because of anatomical superimposition and limited sensitivity. Cone-beam computed tomography (CBCT) allows three-dimensional visualization of periapical structures and has been increasingly used in epidemiological research. Objective: This study aimed to evaluate the prevalence and distribution of apical periodontitis, with particular emphasis on apical periodontitis associated with root canal-treated teeth (AP-RCT), in a Saudi subpopulation using CBCT imaging. Methods: This retrospective cross-sectional study analyzed CBCT scans of Saudi patients obtained for routine diagnostic purposes between 2017 and 2021. Apical periodontitis was identified using standardized radiographic criteria requiring the presence of periapical radiolucency in more than one imaging plane. Demographic and clinical variables were recorded. Descriptive statistics were used to estimate prevalence. Associations between demographic factors and AP-RCT counts were evaluated using multivariable negative binomial regression. Regional tooth distribution was analyzed using generalized estimating equation models accounting for within-participant clustering. Results: A total of 320 CBCT scans were analyzed. Apical periodontitis was detected in 231 participants (72.2%) and in 667 teeth (8.3% of examined teeth). Of the affected teeth, 457 (68.5%) were associated with root canal treatment. The mean number of AP-RCT per participant was 1.36 ± 1.81 (median: 1; IQR: 0–2). Multivariable analysis identified age as the only significant predictor of AP-RCT. Compared with individuals aged 21–30 years, higher AP-RCT rates were observed in the 31–40-year and 41–50-year age groups, while participants ≤20 years showed lower rates. Tooth-level analysis demonstrated higher AP-RCT prevalence in maxillary premolars, maxillary molars, and mandibular molars, whereas mandibular anterior teeth showed the lowest prevalence. Conclusions: Apical periodontitis, particularly AP-RCT, was frequently observed in this Saudi subpopulation when assessed using CBCT. Age and tooth location were the primary determinants of disease distribution. These findings provide population-level epidemiological data on the prevalence and anatomical distribution of apical periodontitis in root canal-treated teeth. Clinical Significance: CBCT-based epidemiological assessment enables detailed evaluation of the distribution of apical periodontitis in dentate populations and may assist in characterizing disease patterns in anatomically complex regions, without implying comparative diagnostic accuracy or treatment outcome assessment. Full article

Background: Regenerative endodontic treatment (RET) has emerged as a biologically based alternative to traditional apexification for managing immature permanent teeth with pulp necrosis. By promoting tissue ingrowth and continued root development, RET aims not only to eliminate infection but also to reinforce structurally compromised roots. Although its clinical use has expanded, evidence regarding the long-term predictability and durability of RET remains limited, as most published studies provide only short- or mid-term follow-up. Case presentation: This report describes two pediatric cases involving regenerative procedures performed on three immature permanent maxillary incisors, each followed for more than six years. The first case involved a 7-year-old girl who developed pulp necrosis in a maxillary lateral incisor after acute dental trauma. Management followed a regenerative protocol using triple antibiotic paste (ciprofloxacin, metronidazole, and minocycline) as intracanal medication and mineral trioxide aggregate as the coronal barrier. The second case concerned an 8-year-old girl presenting with chronic infection and sinus tracts affecting both maxillary central incisors. These teeth were treated using a regenerative approach with calcium hydroxide as the intracanal medicament and Biodentine as the sealing material. Clinical, radiographic, and cone beam computed tomography evaluations demonstrated complete symptom resolution and periapical healing but incomplete progressive apical closure. All treated teeth developed a calcified apical barrier, and outcomes remained stable throughout the extended follow-up period. Conclusions: While inherently limited by the nature of case reports, these findings support RET as a reliable and durable therapeutic option for necrotic immature permanent teeth, including cases in which conventional apexification has not been successful. Full article

Background: Root canal sealers may come into direct contact with periapical tissues, particularly in cases of apical extrusion, potentially influencing periapical healing and treatment outcomes. Cytotoxicity assessment represents a clinically relevant parameter when selecting endodontic sealers. However, evidence derived from in vitro studies remains heterogeneous and challenging to interpret from a clinical perspective. Therefore, the aim of this systematic review was to critically evaluate the in vitro cytotoxicity of all root canal sealers that have been commercially marketed over the years, excluding experimental materials, and to contextualize the findings in relation to clinically relevant experimental conditions. Methods: This systematic review was conducted according to PRISMA guidelines and preregistered on the Open Science Framework. PubMed, Scopus, and the Cochrane Library were searched up to 30 November 2025. In vitro studies evaluating the cytotoxicity of commercially available root canal sealers using validated cell viability or proliferation assays were included. Data extraction focused on sealer composition, setting condition, extraction protocols, exposure parameters, and cytotoxic outcomes. Due to marked methodological heterogeneity, a qualitative synthesis was performed. Results: Ninety-eight in vitro studies were included. All categories of root canal sealers demonstrated some degree of cytotoxicity, particularly when tested in freshly mixed conditions, at higher extract concentrations, or after prolonged exposure. Bioactive and calcium silicate-based sealers generally showed a more favorable cytotoxicity profile compared with conventional materials, especially after complete setting and at diluted concentrations, although cytotoxic effects were reported under specific experimental conditions. Resin-based sealers, including AH Plus, exhibited condition-dependent cytotoxicity, while zinc oxide–eugenol and glass ionomer sealers tended to display higher cytotoxic potential. Conclusions: In vitro cytotoxicity of root canal sealers varies according to material composition and experimental conditions. Bioactive sealers generally exhibit a more favorable biological profile, which may be clinically relevant in situations involving sealer extrusion or prolonged tissue contact. Standardized testing protocols and further translational studies are required to support evidence-based clinical material selection. Full article

Background/Objectives: Effective removal of organic tissue extruded beyond the apex is crucial in regenerative endodontics, particularly in teeth with immature apices; therefore, this study aims to compare the efficacy of standard needle irrigation (SNI), ultrasonic irrigation (UI), photon-induced photoacoustic streaming (PIPS), and shock wave-enhanced emission photoacoustic streaming (SWEEPS) techniques in dissolving periapical tissue in a simulated model. Methods: Sixty single-rooted human premolars and sixty bovine palatal mucosa specimens were used. A custom model was created by placing mucosal tissue in contact with the apical area. Specimens were divided into four groups (n = 15) according to the irrigation method: SNI, UI, PIPS, and SWEEPS. Each canal received 15 mL of 2% NaOCl. Tissue samples were weighed before and after treatment. One-way ANOVA and Tukey’s post hoc test were used for statistical analysis (p < 0.05). Results: UI showed significantly less tissue dissolution than the other methods (p < 0.05). SNI, PIPS, and SWEEPS showed no significant differences (p > 0.05). Conclusions: All methods led to tissue loss, but UI was significantly less effective. SNI, PIPS, and SWEEPS performed similarly. Full article

Background: Autologous platelet concentrates, including platelet-rich fibrin (PRF) matrices, have been proposed as biologically active scaffolds for vital pulp therapy. Evidence on the clinical use of different solid PRF matrices for direct pulp capping remains limited. Objective: The aim of this study is to describe and monitor two clinical cases of reversible pulpitis treated with direct pulp capping using two PRF membranes prepared by different centrifugation approaches, namely advanced platelet-rich fibrin plus (A-PRF+) and horizontal platelet-rich fibrin plus (H-PRF). Methods: In Case 1, A-PRF+ was prepared using a fixed-angle centrifugation protocol; in Case 2, H-PRF was prepared using a horizontal centrifugation protocol. In both cases, deep carious lesions with small carious pulp exposures (<1.5 mm) were managed by caries removal, ozone-assisted dentin disinfection, and direct pulp capping with the respective PRF membrane, followed by temporary calcium-silicate cement definitive coronal restoration. Clinical and radiographic follow-up, including cone-beam computed tomography, was performed for up to 12 months. Results: In Case 1 (A-PRF+), reparative dentin bridge formation was confirmed at 90 days, with a thickness of 0.2 mm. In Case 2 (H-PRF), reparative dentin was observed within 46 days, with a thickness of 0.28 mm. In both cases, pulp vitality was maintained, and no clinical symptoms or periapical changes were detected during the 12-month follow-up. Conclusions: These two cases suggest that direct pulp capping using PRF membranes (A-PRF+ or H-PRF), combined with ozone-assisted dentin disinfection and adequate coronal sealing, may be associated with maintained pulp vitality and hard-tissue repair after carious pulp exposure diagnosed as reversible pulpitis. Due to the descriptive two-case design and major confounding factors (including age and lesion characteristics), no comparative conclusions can be drawn. Prospective controlled clinical studies with standardized protocols are warranted. Full article

Background and Clinical Significance: Advanced periodontitis with severe vertical bone loss and grade III mobility is usually managed by extraction and implant placement. Digital workflows and modern regenerative techniques have opened the possibility of preserving teeth that would traditionally be considered for extraction. This report describes a digitally guided modified intentional replantation (MIR) protocol applied to a maxillary tooth with severe periodontal involvement and unfavourable prognosis. Case Presentation: A 68-year-old male, non-smoker, with a history of heart transplantation under stable medical control, presented with generalized Stage IV, Grade C periodontitis. Tooth 21 showed >75% vertical bone loss, probing depths ≥ 9 mm, bleeding on probing, and grade III mobility. After non-surgical therapy and periodontal stabilization, a CAD/CAM-assisted MIR procedure was planned. Cone-beam computed tomography (CBCT) and a 3D-printed tooth replica were used to design a surgical guide for a new recipient socket. The tooth was atraumatically extracted, stored in chilled sterile saline, and managed extraorally for approximately 10 min. Apicoectomy and retrograde sealing with Biodentine^® were performed, followed by immediate replantation into the digitally prepared socket, semi-rigid splinting, and guided tissue regeneration using autologous bone chips, xenograft (Bio-Oss^®), enamel matrix derivative (Emdogain^®), and a collagen membrane (Bio-Gide^®). A conventional orthograde root canal treatment was completed within the first month. At 12 months, tooth 21 exhibited grade 0 mobility, probing depths of 3–4 mm without bleeding on probing, and stable soft tissues. Standardized periapical radiographs and CBCT showed radiographic bone fill within the previous defect and a continuous periodontal ligament-like space, with no signs of ankylosis or root resorption. The tooth was fully functional and asymptomatic. Conclusions: In this medically complex patient, digitally guided MIR allowed preservation of a tooth with severe periodontal involvement and poor prognosis, achieving favourable short-term clinical and radiographic outcomes. While long-term data and larger series are needed, MIR may be considered a tooth-preserving option in carefully selected cases as an alternative to immediate extraction and implant placement. Full article

Background: Periapical surgery is indicated for persistent periapical lesions that do not respond to conventional endodontic therapy, yet postoperative recovery is often hindered by pain, swelling, and delayed healing. Platelet-rich fibrin (PRF) membranes are autologous biomaterials with regenerative potential, capable of modulating inflammation and promoting tissue repair. Methods: This preliminary randomized controlled trial evaluated the effectiveness of PRF membranes in improving postoperative outcomes—specifically pain, swelling, and quality of life—after apicoectomy. Twenty patients requiring periapical surgery were randomly allocated to a PRF group (n = 10) or a control group (n = 10). In the PRF group, autologous PRF membranes were applied over the resected root-end and into the osteotomy cavity before flap closure. In the control group, no PRF membranes or any additional biomaterial were applied, apart from the standard root-end filling material (MTA), which was identically used in both groups as part of the routine apicoectomy protocol. All patients were blinded to allocation, and outcomes were assessed by an independent blinded evaluator. Facial swelling was quantified by 3D facial scanning, pain was recorded daily using a visual analog scale (VAS), and quality of life was evaluated with the PROMIS-29+2 Profile. Results: The PRF group showed significantly reduced swelling (mean volume difference, 7.12 cm³; p = 0.025), lower pain scores (VAS: 1.80 ± 1.22 vs. 3.80 ± 2.44; p = 0.034), and improved quality-of-life domains, including higher Physical Function (p = 0.032) and lower Sleep Disturbance (p = 0.008) scores. Conclusions: Within the limitations of this pilot study, PRF membranes enhanced postoperative recovery after periapical surgery by reducing swelling and pain while improving patient-reported outcomes. Larger multicenter trials are needed to confirm these preliminary findings. Full article