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Under the conditions of this study, pulpotomy offered a viable alternative to root canal treatment for teeth with vital pulps in the short term. However, there is insufficient clinical evidence to consider this technique for the treatment of every permanent tooth. Nevertheless, it should be considered as a potential alternative approach to be further developed for future applications.

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Introduction Orstavik's periapical index is widely used for radiographic assessment of periapical status. This study analyses the reliability and reproducibility of a modified guide for the interpretation of the periapical index (PAI) scores recorded by undergraduate students. Materials and Method Two groups of 4th‐year students were asked to assess the PAI scores of 100 X‐rays two or three times depending on the group. The reliability of their judgment was evaluated by comparing the students' assessments to those of a standard, based on the evaluations made by three teachers. Short‐term stability was evaluated for two lengths of interval separating the Test and Retest phases, respectively, 1 week for Group 1 and 2 weeks for Group 2. Long‐term stability was evaluated by having Group 1 repeat the Retest phase after 15 months. Results Overall mean success rates ranged from 61% to 65% according to the student group and the study phase. Intergroup comparisons showed no statistical difference. The reliability of the PAI score evaluation by students was excellent in both groups. Short‐term and long‐term stability were also excellent regardless of the duration of the interval between the study's phases. Discussion The image misinterpretations are discussed according to the study phases and the PAI score values. Conclusion Undergraduate students can be trained to use the modified guide for scoring PAI for self‐evaluation of the outcomes of the root canal treatments and re‐treatments they are asked to perform during their clinical sessions.

INTRODUCTION: Coronal sealing, quality of root canal treatment, and periapical status have been widely investigated. However, which of two practitioner-dependent determinants (endodontic treatment or coronal restoration) is the most important to the periapical status remains scientifically debated. OBJECTIVES: This study investigated the relative importance of the technical qualities of root canal filling and marginal sealing of the coronal restoration on the periapical status and screened previously published data. METHODS: A retrospective study collected and analyzed clinical and radiological data on 246 endodontically-treated teeth. Six paired comparisons were carried out between groups combining good or poor endodontic treatment (G/P E) with good or poor coronal restoration G/P R). Results are displayed through forest plots of odds ratios for each comparison.RESULTS: In the retrospective study, the endodontic determinant seems to be more important than the restorative one (37.5% of diseased periapical status with GE versus 41.2% with PE). In the systematic review, odds ratio analyses showed that group GE+GR had 1.7 less periapical lesions than group PE+GR and 2.7 less lesions that group PE+PR. Belonging to group PE+PR was found significantly associated with ‘diseased’ periapical status. CONCLUSION: The retrospective study and the systematic review agreed that endodontic treatment (precisely, root canal filling) was found more important than coronal restoration (precisely, marginal sealing) for healthy periapical tissue.