Resources for Clinicians


Quality Guidelines

The ESE last published quality guidelines for endodontic treatment in 2006; however, there have been significant changes since not only in clinical endodontics but also in consensus and guideline development processes. In the development of the first S3-level clinical practice guidelines (CPG) in Endodontics, a comprehensive systematic and methodologically robust guideline consultation process was followed in provide evidence-based recommendations for the management of patients presenting with pulpal and apical disease. This S3-level CPG was developed by the ESE, with the assistance of independent methodological guidance provided by the Association of Scientific Medical Societies in Germany and utilizing the GRADE process. A robust, rigorous and transparent process included the analysis of relevant comparative research in 14 specifically commissioned systematic reviews, prior to evaluation of the quality and strength of evidence, the formulation of specific evidence and expert-based recommendations in a structured consensus process with leading endodontic experts and a broad base of external stakeholders. The CPG for the treatment of pulpal and apical disease describes in a series of clinical recommendations the effectiveness of diagnosing pulpitis and apical periodontitis, prior to investigating the effectiveness of endodontic treatments in managing those diseases. Therapeutic strategies include the effectiveness of deep caries management in cases with, and without, spontaneous pain and pulp exposure, vital versus non-vital teeth, the effectiveness of root canal instrumentation, irrigation, dressing, root canal filling materials and adjunct intracanal procedures in the management of AP. Prior to treatment planning, the critical importance of history and case evaluation, aseptic techniques, appropriate training and re-evaluations during and after treatment is stressed. In conclusion the inaugural S3-level CPG in endodontics informs clinical practice, health systems, policymakers, other stakeholders and patients on the available and most effective treatments to manage patients with pulpitis and AP in order to preserve teeth over a patient's lifetime, according to the best comparative evidence currently available.

Position Statements

These ESE position statements represent the consensus of expert committees, convened by the European Society of Endodontology (ESE), and summarize current best evidence in the specific topics, as well as indicating appropriate clinical management strategies. The intention of the position statements is to provide the practitioner with relevant clinical guidance. Updates will be provided periodically as further evidence emerges.