Abstract

Endodontic pathology encompasses a wide range of diseases and conditions affecting the dental pulp and periapical tissues. Understanding its etiology, accurate diagnosis, and effective treatment are pivotal to achieving long-term oral health and preserving natural dentition. This comprehensive review explores the multifactorial causes of endodontic disease, including microbial invasion, trauma, iatrogenic factors, and systemic conditions. It delves into the complex interplay between host responses and pathogenic mechanisms that lead to pulpal inflammation, necrosis, and periapical pathology. Recent advances in diagnostic technologies such as cone-beam computed tomography (CBCT), pulp vitality tests, and molecular diagnostics have enhanced clinicians' ability to assess pulpal status and detect periapical lesions with greater precision. This review examines the clinical and radiographic signs of endodontic pathology, emphasizing the importance of integrating clinical findings with imaging and laboratory data for an accurate diagnosis. The treatment section focuses on both conventional and contemporary approaches to endodontic therapy, including non-surgical root canal treatment, regenerative endodontics, and surgical endodontics. Emphasis is placed on evidence-based protocols, the role of biocompatible materials, and strategies for managing persistent infections and complex anatomical challenges. The review also addresses the implications of untreated endodontic infections, such as systemic health effects and the risk of tooth loss. This review synthesizes the current understanding of endodontic pathology and highlights the critical role of interdisciplinary collaboration, technological innovation, and continuous professional education in optimizing patient outcomes. It serves as a valuable resource for dental professionals aiming to deepen their knowledge and enhance their clinical practice in endodontics.