Endodontic diseases are a kind of chronic infectious oral disease. Common endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by gutta-percha. However, it is very essential for endodontic treatment to debride the root canal system and prevent the root canal system from bacterial reinfection after root canal therapy (RCT). Recent research, encompassing bacterial etiology and advanced imaging techniques, contributes to our understanding of the root canal system’s anatomy intricacies and the technique sensitivity of RCT. Success in RCT hinges on factors like patients, infection severity, root canal anatomy, and treatment techniques. Therefore, improving disease management is a key issue to combat endodontic diseases and cure periapical lesions. The clinical difficulty assessment system of RCT is established based on patient conditions, tooth conditions, root canal configuration, and root canal needing retreatment, and emphasizes pre-treatment risk assessment for optimal outcomes. The findings suggest that the presence of risk factors may correlate with the challenge of achieving the high standard required for RCT. These insights contribute not only to improve education but also aid practitioners in treatment planning and referral decision-making within the field of endodontics.

牙髓病是一种慢性感染性口腔疾病。常见的牙髓治疗概念是基于去除发炎或坏死的牙髓组织并用牙胶代替。然而，根管治疗对根管系统进行清创并防止根管治疗 （RCT） 后根管系统再次感染是非常重要的。最近的研究，包括细菌病因学和先进的成像技术，有助于我们了解根管系统的解剖结构复杂性和 RCT 的技术敏感性。RCT 的成功取决于患者、感染严重程度、根管解剖结构和治疗技术等因素。因此，改善疾病管理是对抗牙髓病和治愈根尖周病变的关键问题。RCT 的临床难度评估系统是根据患者情况、牙齿状况、根管结构和需要再治疗的根管建立的，并强调治疗前风险评估以获得最佳结果。研究结果表明，危险因素的存在可能与达到 RCT 所需的高标准的挑战相关。这些见解不仅有助于改善教育，还有助于从业者在牙髓病学领域内制定治疗计划和转诊决策。