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去除发炎或坏死的牙髓组织并用古塔胶替代。然而，根管治疗（RCT）后清创根管系统并防止根管系统细菌再感染对于牙髓治疗来说非常重要。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的复杂性和 RCT 的技术敏感性。随机对照试验的成功取决于患者、感染严重程度、根管解剖结构和治疗技术等因素。因此，加强疾病管理是防治牙髓病、治愈根尖周病变的关键问题。RCT的临床难度评估体系是根据患者情况、牙齿情况、根管形态、需要复治的根管情况建立的，强调治疗前的风险评估，以获得最佳结果。研究结果表明，风险因素的存在可能与实现随机对照试验所需高标准的挑战相关。这些见解不仅有助于改善教育，还可以帮助从业者制定牙髓病学领域的治疗计划和转诊决策。