Assessment of Technical Quality of 9562 Endodontic Cases Treated by Undergraduate Students and Endodontics Specialists

Authors

DOI:

https://doi.org/10.14295/bds.2020.v23i4.2240

Abstract

Objective: The aim of the study was to assessment of technical quality of 9562 endodontic cases treated by heterogeneous groups with different clinical experience. Material and methods: This retrospective study reviewed the dental records of 8590 patients (9562 endodontic cases and 13203 root canals including 3340 retreatment root canals) treated by fourth-year undergraduates, fifth-year undergraduates, endodontic program students, and endodontic specialists between December 2017 and December 2018 at the Department of Endodontics of Necmettin Erbakan University Faculty of Dentistry in Konya. The length, density, and taper of root fillings, the acceptable technical quality of the root filling criteria, and the presence of procedural errors, were recorded. Chi-square tests with a significance level at p=0.05 were used for statistical analysis. Results: Acceptable root fillings were found in 71.5% of endodontic cases. Clinical experience showed statistical differences in the root filling quality among fourth-year undergraduates, fifth-year undergraduates, endodontic program students, and specialists (52, 63.1, 77.9 and 86.5% respectively). Fractured instruments and missed canals were noted in 9.8% and 0.57% of cases treated by endodontic program students significantly more than the other clinical experiences. No statistical differences were found among the clinical experiences in other procedural errors. No statistically significant differences were found between age range and gender in additional root canals. Statistically significant differences were observed between the number of root canal retreatments in terms of age range and gender. Conclusions: Clinical experience affects the technical quality of root canal treatments. Fractured instruments and missed canals, especially by endodontic program students, should be given more attention.

KEYWORDS

Dental radiography; Education; Undergraduate.

Author Biographies

Durmuş Alperen Bozkurt, University of Necmettin Erbakan, Faculty of Dentistry, Department of Endodontics, Konya, Turkey

Department of Endodontics, Faculty of Dentistry

Arslan Terlemez, University of Necmettin Erbakan, Faculty of Dentistry, Department of Endodontics, Konya, Turkey

Department of Endodontics, Faculty of Dentistry

Mutlu Özcan, University of Zurich, Center for Dental and Oral Medicine, Dental Materials Unit, Clinic for Fixed and Removable Prosthodontics and Dental Materials Science, Zürich, Switzerland.

Clinic for Fixed and Removable Prosthodontics and Dental Materials Science, Dental Materials Unit

References

Schilder H. Filling root canals in three dimensions. 1967. J Endod. 2006;32(4):281-90. doi:10.1016/j.joen.2006.02.007

Zeng C, Meghil MM, Miller M, Gou Y, Cutler CW, Bergeron BE, et al. Antimicrobial efficacy of an apical negative pressure root canal irrigation system against intracanal microorganisms. J Dent. 2018;72(5):71-5. doi:10.1016/j.jdent.2018.03.008

De Moor RJ, Hommez GM, De Boever JG, Delmé KI, Martens GE. Periapical health related to the quality of root canal treatment in a Belgian population. Int Endod J. 2000;33(2):113-20. doi:10.1046/j.1365-2591.2000.00295.x

Kabak Y, Abbott PV. Prevalence of apical periodontitis and the quality of endodontic treatment in an adult Belarusian population. Int Endod J. 2005;38(4):238-45. doi:10.1111/j.1365-2591.2005.00942.x

Lin LM, Pascon EA, Skribner J, Gängler P, Langeland K. Clinical, radiographic, and histologic study of endodontic treatment failures. Oral Surg Oral Med Oral Pathol. 1991;71(5):603-11. doi:10.1016/0030-4220(91)90371-i

European Society of Endodontology. Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J. 2006;39(12):921-30. doi:10.1111/j.1365-2591.2006.01180.x

AlRahabi MK. Evaluation of complications of root canal treatment performed by undergraduate dental students. Libyan J Med. 2017;12(1):1345582. doi:10.1080/19932820.2017.1345582

Ilgüy D, Ilgüy M, Fisekçioglu E, Ersan N, Tanalp J, Dölekoglu S. Assessment of root canal treatment outcomes performed by Turkish dental students: results after two years. J Dent Educ. 2013;77(4):502-9.

Saunders WP, Saunders EM, Sadiq J, Cruickshank E. Technical standard of root canal treatment in an adult Scottish sub-population. Br Dent J. 1997;182(10):382-6. doi:10.1038/sj.bdj.4809394

Weiger R, Hitzler S, Hermle G, Löst C. Periapical status, quality of root canal fillings and estimated endodontic treatment needs in an urban German population. Endod Dent Traumatol. 1997;13(2):69-74. doi:10.1111/j.1600-9657.1997.tb00013.x

Balto H, Al Khalifah Sh, Al Mugairin S, Al Deeb M, Al-Madi E. Technical quality of root fillings performed by undergraduate students in Saudi Arabia. Int Endod J. 2010;43(4):292-300. doi:10.1111/j.1365-2591.2009.01679.x

Barrieshi-Nusair KM, Al-Omari MA, Al-Hiyasat AS. Radiographic technical quality of root canal treatment performed by dental students at the Dental Teaching Center in Jordan. J Dent. 2004;32(4):301-7. doi:10.1016/j.jdent.2004.01.002

Eleftheriadis GI, Lambrianidis TP. Technical quality of root canal treatment and detection of iatrogenic errors in an undergraduate dental clinic. Int Endod J. 2005;38(10):725-34. doi:10.1111/j.1365-2591.2005.01008.x

Hayes SJ, Gibson M, Hammond M, Bryant ST, Dummer PM. An audit of root canal treatment performed by undergraduate students. Int Endod J. 2001;34(7):501-5. doi:10.1046/j.1365-2591.2001.00421.x

Alamoudi RA, Alharbi AH, Farie GA, Fahim O. The value of assessing case difficulty and its effect on endodontic iatrogenic errors: a retrospective cross-sectional study. Libyan J Med. 2020;15(1):1688916. doi:10.1080/19932820.2019.1688916

Fezai H, Al-Salehi S. The relationship between endodontic case complexity and treatment outcomes. J Dent. 2019;85:88-92. doi:10.1016/j.jdent.2019.05.019

Haug SR, Solfjeld AF, Ranheim LE, Bårdsen A. Impact of case difficulty on endodontic mishaps in an undergraduate student clinic. J Endod. 2018;44(7):1088-95. doi:10.1016/j.joen.2018.03.012

Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. Int J Surg. 2014;12(12):1495-9. doi:10.1016/j.ijsu.2014.07.013

Er O, Sagsen B, Maden M, Cinar S, Kahraman Y. Radiographic technical quality of root fillings performed by dental students in Turkey. Int Endod J. 2006;39(11):867-72. doi:10.1111/j.1365-2591.2006.01158.x

Gound TG, Sather JP, Kong TS, Makkawy HA, Marx DB. Graduating dental students' ability to produce quality root canal fillings using single- or multiple-cone obturation techniques. J Dent Educ. 2009;73(6):696-705.

Dummer PM. Comparison of undergraduate endodontic teaching programmes in the United Kingdom and in some dental schools in Europe and the United States. Int Endod J. 1991;24(4):169-77. doi:10.1111/j.1365-2591.1991.tb00127.x

Burke FM, Lynch CD, Ní Ríordáin R, Hannigan A. Technical quality of root canal fillings performed in a dental school and the associated retention of root-filled teeth: a clinical follow-up study over a 5-year period. J Oral Rehabil. 2009;36(7):508-15. doi:10.1111/j.1365-2842.2009.01966.x

Moussa-Badran S, Roy B, Bessart du Parc AS, Bruyant M, Lefevre B, Maurin JC. Technical quality of root fillings performed by dental students at the dental teaching centre in Reims, France. Int Endod J. 2008;41(8):679-84. doi:10.1111/j.1365-2591.2008.01417.x

Elsayed RO, Abu-Bakr NH, Ibrahim YE. Quality of root canal treatment performed by undergraduate dental students at the University of Khartoum, Sudan. Aust Endod J. 2011;37(2):56-60. doi:10.1111/j.1747-4477.2010.00273.x

Unal GC, Kececi AD, Kaya BU, Tac AG. Quality of root canal fillings performed by undergraduate dental students. Eur J Dent. 2011;5(3):324-30.

Bierenkrant DE, Parashos P, Messer HH. The technical quality of nonsurgical root canal treatment performed by a selected cohort of Australian endodontists. Int Endod J. 2008;41(7):561-70. doi:10.1111/j.1365-2591.2008.01398.x

Tronstad L, Asbjørnsen K, Døving L, Pedersen I, Eriksen HM. Influence of coronal restorations on the periapical health of endodontically treated teeth. Endod Dent Traumatol. 2000;16(5):218-21. doi:10.1034/j.1600-9657.2000.016005218.x

Buckley M, Spångberg LS. The prevalence and technical quality of endodontic treatment in an American subpopulation. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995;79(1):92-100. doi:10.1016/s1079-2104(05)80081-2

Dugas NN, Lawrence HP, Teplitsky PE, Pharoah MJ, Friedman S. Periapical health and treatment quality assessment of root-filled teeth in two Canadian populations. Int Endod J. 2003;36(3):181-92. doi:10.1046/j.1365-2591.2003.00640.x

Marques MD, Moreira B, Eriksen HM. Prevalence of apical periodontitis and results of endodontic treatment in an adult, Portuguese population. Int Endod J. 1998;31(3):161-5. doi:10.1046/j.1365-2591.1998.00136.x

Sidaravicius B, Aleksejuniene J, Eriksen HM. Endodontic treatment and prevalence of apical periodontitis in an adult population of Vilnius, Lithuania. Endod Dent Traumatol. 1999;15(5):210-5. doi:10.1111/j.1600-9657.1999.tb00776.x

Schäfer E, Schulz-Bongert U, Tulus G. Comparison of hand stainless steel and nickel titanium rotary instrumentation: a clinical study. J Endod. 2004;30(6):432-5. doi:10.1097/00004770-200406000-00014

Di Fiore PM, Genov KA, Komaroff E, Li Y, Lin L. Nickel-titanium rotary instrument fracture: a clinical practice assessment. Int Endod J. 2006;39(9):700-8. doi:10.1111/j.1365-2591.2006.01137.x

Tzanetakis GN, Kontakiotis EG, Maurikou DV, Marzelou MP. Prevalence and management of instrument fracture in the postgraduate endodontic program at the Dental School of Athens: a five-year retrospective clinical study. J Endod. 2008;34(6):675-8. doi:10.1016/j.joen.2008.02.039

Sert S, Bayirli GS. Evaluation of the root canal configurations of the mandibular and maxillary permanent teeth by gender in the Turkish population. J Endod. 2004;30(6):391-8. doi:10.1097/00004770-200406000-00004

Pekiner FN, Borahan MO, Dumlu A. Evaluation of distolingual canal/roots in mandibular molars and mesiobuccal canals in maxillary molars by CBCT. Open Dent J. 2017;11:360-6. Published 2017 Jun 30. doi:10.2174/1874210601711010360

Zheng QH, Wang Y, Zhou XD, Wang Q, Zheng GN, Huang DM. A cone-beam computed tomography study of maxillary first permanent molar root and canal morphology in a Chinese population. J Endod. 2010;36(9):1480-4. doi:10.1016/j.joen.2010.06.018

Ng YL, Mann V, Gulabivala K. Outcome of secondary root canal treatment: a systematic review of the literature. Int Endod J. 2008;41(12):1026-46. doi:10.1111/j.1365-2591.2008.01484.x

Olcay K, Eyüboglu TF, Özcan M. Clinical outcomes of non-surgical multiple-visit root canal retreatment: a retrospective cohort study. Odontology. 2019;107(4):536-45. doi:10.1007/s10266-019-00426-6

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Published

2020-12-22

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Clinical or Laboratorial Research Manuscript