TABLE 3 - uploaded by Nikolaos Polyzos
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Objective:
To evaluate radiographically the quality of root canal fillings performed by undergraduate students between 2012 and 2015, and to investigate the impact of their quality in correlation with root type, preoperative periapical status, and type of restorative treatment on the treatment outcome.
Methods:
Six hundred seventy-seven non-surg...
Context in source publication
Context 1
... the density of root canal fillings, 251 (71.9%) roots appeared to be without voids, whereas 98 (28.1%) ap- peared with voids within the root filling material or between the root filling material and the canal walls. Table 3 shows the technical quality of root canal fillings ac- cording to the root type. Molar roots demonstrated the lowest duces a non-uniform mass of gutta-percha, and the chances of voids creation are high, especially in minimally flared root canals (4). ...
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Citations
... In another previous study in Saudi Arabia, the technical quality of root [22]. Some earlier studies revealed success rates of RCT between 3.6 and 54% [9,10,[31][32][33][34]. This observed discrepancies in the outcomes might be ascribed to the differences in educational methodologies. ...
... This observed discrepancies in the outcomes might be ascribed to the differences in educational methodologies. These discrepancies may be also attributable to the different assessment criteria employed in different studies, some of which only utilized two criteria (length and density) [30,35], the majority of which were carried out by clinical undergraduate students [31][32][33][34], and others that only examined one set of teeth [35,36]. Due to the complexity of the cases, this may have had an impact on the overall quality of the root canal filling. ...
Background
The educational process in the field of endodontics commences with preclinical exercises to enhance students’ proficiency in cleaning, shaping, and performing root canal fillings. Therefore, this study aimed to radiographically evaluate the technical quality of root canal fillings performed by preclinical students on extracted teeth at the College of Dentistry, University of Ha’il, Saudi Arabia.
Methods
A total of 788 extracted human teeth received root canal treatment by undergraduate students. The samples were then gathered and radiographically assessed using the three quality criteria of length, density, and taper. The category of root canal fillings was classified as either acceptable or unacceptable. The criteria for evaluating the acceptability of filling quality were defined based on the presence of adequate length, density, and taper. The effectiveness of root canal fillings was also evaluated in relation to the tooth type, sex, and treatment year. The agreement between the examiners was evaluated using Cohen’s kappa test, and the relationship between the research variables was determined using the chi-squared test. The significance threshold was set at 0. 05.
Results
The overall quality of root filling was determined to be satisfactory in 532 (67.5%) of 788 endodontically treated extracted teeth. The majority of the research sample (88.1%) had enough length, 89.6% had adequate density, and 86.4% had acceptable taper. The quality of anterior teeth was substantially better than that of posterior teeth (p < 0.001). Our findings showed that the quality of root canals was better in 2022 than it had been in earlier years (p = 0.001). The three RCT quality criteria differed significantly when compared between sexes (p = 0.002).
Conclusions
The quality of the root canal fillings completed by undergraduate students was rated as acceptable. The findings of the research suggest that the implementation of routine assessments to evaluate the technical competence of undergraduate dental students performing root canal treatments could provide significant insights into the efficacy of the curriculum requirements.
... Usually, a combination of gutta-percha as the core material and an endodontic sealing agent is used to fill the root canals (1). The quality of the root canal filling is evaluated according to two main technical variables: its length in relation to the radiographic apex and its density, indicating the absence of voids within the filling material (2). To adapt the filling material to anatomical variations, different techniques have been proposed, all presenting satisfactory performance repairing endodontically treated teeth when well performed (3,4). ...
Background
The purpose of this study was to assess the external root surface thermal behavior when submitted to three different obturation techniques.
Material and Methods
Forty-five single-rooted premolars were selected, prepared and randomly divided into three groups according to the studied obturation techniques: lateral condensation (LC), single cone technique (SCT) and injectable thermoplasticized technique (IT). Each tooth was placed in a customized apparatus and connected to a thermocouple. A FLIR T650sc infrared thermal camera was used to assess root temperature in a room under controlled temperature and humidity. Temperature values were recorded using the thermal camera and thermocouples before, during and 30, 60, 90, 120, 150s after obturation. Shapiro-Wilk, QQ-plot, Levene’s, ANOVA-three-way, Mauchly’s sphericity, Box’s M and Bonferroni tests were used to assess data. The significance level was set at 5%.
Results
Infrared assessment showed significant temperature changes between time intervals, obturation techniques and root thirds. Temperature increase was observed 30s after obturation for STL, LC and IT, followed by a gradual temperature decline, with temperature values similar to the initial temperature at 150s for LC and IT. SCT temperature values only returned to normal 60s after obturation in the apical third and 90s in the middle and cervical thirds. In all techniques, the temperature did not rise above the critical limit of 10°C.
Conclusions
All studied obturation techniques increased root surface temperature with IT showing the highest temperature increase. However, the temperature increase does not exceed the acceptable limits, not causing damage to the surrounding tissues.
Key words:Endodontics, changes in body temperature, root canal filling, thermography.
... Similar to previous studies, a periapical X-ray examination was performed to evaluate the quality of root canal fillings. [28][29][30] The data indicated that the root canal fillings in the face-to-face training group ended at an ideal apical distance and were significantly more homogeneous than those in the online group. The degree of taper that the two groups examined was also similar. ...
Purpose:
The aim of this study was to evaluate the competency of undergraduate students in following the principles of access cavity preparation and the radiographic quality of root canal filling in maxillary molar teeth in either online or face-to-face education courses during the novel coronavirus disease 2019 (COVID-19) pandemic.
Methods:
A total of 178 extracted maxillary molar teeth that underwent endodontic dental treatment by undergraduate students who completed the endodontic preclinical practice course online or face-to-face during the COVID-19 pandemic were retrospectively analyzed. A visual access cavity examination determined the form, width of the cavity, deroofing of the pulp chamber, and the presence of a perforation. Root canal fillings were examined radiographically on periapical radiographs for length, homogeneity, taper, and the presence of iatrogenic defects. Statistical analysis was performed using the chi-square test.
Results:
The incidence of incorrect form, wide cavities, and perforation was statistically higher in the online group than in the face-to-face group (p < 0.05). It was determined that root filling length and homogeneity were more successful in the face-to-face group (p < 0.05). When evaluated for iatrogenic errors, the presence of broken instruments was found to be significantly higher in the online group (p < 0.05). There was no significant difference between the groups in other iatrogenic errors and the taper of the root canal filling (p > 0.05).
Conclusion:
The students who underwent face-to-face education were more successful in accessing cavity preparation and root canal fillings than the students who undertook online education.
... The nRCT outcomes were classified according to Polyzo et al. [8] criteria as follows: ...
... Before, during, and after RCT, using periapical radiographs is crucial for the detection of periapical lesions, canal/s anatomy and dimensions, the quality of obturation, and records [2,3]. An appropriate RCT is characterized by a ity of RCT with respect to tooth type and location [1,14,16,22,26,33,34,36,37,40], extracting the frequency of technical errors [17,18,23,[27][28][29][30]41], identifying the academic grade of students who perform the treatment [24,35,38,39], and exploring the complications happening as a result of errors [20]. Although the studies showed significant variation in their outcomes, the overall quality of RCT performed by undergraduates was significantly high when comparing inadequate RCT (61.4% SD ± 20.2 and 38.6% SD ± 20.3, respectively). ...
... While the study for Fritz et al. showed the highest adequate RCT among dental students, 93.8% [21], the study performed by Ehsani et al. showed the lowest percentage of adequate RCT, 17.5% [38]. The maxillary anterior teeth, followed by premolar, showed higher RC quality compared to posterior teeth in most of the studies [15,16,20,22,25,26,35,37], while fewer of them showed no significant differences between anterior and premolars or anterior and posteriors [17,21]. The deficiency in the length of RCT was the highest error that happens during RCT as reported by some of the studies [16,18,21,30,34,39]. ...
... Generally, the errors were mostly associated with posterior teeth compared to anterior teeth (71.8%), with a slightly higher number in maxillary than mandibular teeth. This was consistent with several studies that expressed that the posterior teeth were more associated with accidents during RCT [15,20,29]. However, these findings contradicted some studies that showed the mandibular molars were more frequent in recording errors comparing maxillary molars [16,30], and the studies that showed no significant differences between anterior and posterior teeth [17,32]. ...
This study aimed to assess the errors that happened during root canal treatment (RCT) and compare the quality of root canal fillings (RCFs) performed by different academic grades of dental students at Jouf University. Materials and Methods: a retrospective audit study was conducted to check the errors that occurred during RCT performed by seniors and undergraduates. The quality of the RCFs were evaluated, using digital periapical radiographs depending on previously validated criteria. Data analyses were performed using Statistical Package for the Social Sciences. Descriptive statistics were used for expressing the frequencies of variables and the Chi-square test was used for comparing different variables with a 0.05 level of significance. Results: overall, 332 endodontically treated teeth (566 root canals) were finally chosen for the study. Out of these treated cases, 156 teeth (47%) had a total of 287 recorded errors, mainly in posterior teeth. From the total number of errors, short obturation was the highest error occurred (29%), followed by lack of apical seal (25.1%). Root perforation was the least reported error (2.8%), proceeded by broken instruments (5.6%). A total of 13.2% of the errors were teeth left with unfilled canals, while 7.7% were for an overextended filling. There were no significant differences between the quality of RCF performed by different academic grades. Conclusion: depending on the current study, the quality of RCTs performed by seniors and undergraduate students was 53% acceptable. A clear plan should be applied to improve the quality of treatment outcomes of undergraduate students by implementing more effective preclinical training courses, increasing the ration of supervisor-to-students, and using more advanced modalities during treatment.
... In the case of dental caries, if this deficit in access to health is not resolved in the early stage of the disease, a greater investment of resources will be required to terminate the disease, as is the case with endodontics. [1][2][3][4][5] Technological advances in health have made it possible to improve and optimize procedures that comprise the endodontic treatment; however, these advances must be constantly corroborated, in addition to proposing continuous improvements, particularly if they ensure quality and accessibility. [6] The endodontic treatment procedure begins with a combination of mechanical instrumentation and chemical debridement, after which the worked canal is filled with a biocompatible material to maintain or restore the health of the periapical tissue. ...
Objective: The aim of this article is to evaluate the quality of filling in
endodontically treated root canals using the lateral condensation technique
and modified lateral condensation technique. Materials and Methods: Thirtytwo
single-rooted teeth were divided into two groups that were assigned by
simple randomization according to the filling technique. Once the endodontic
treatment was performed, a periapical radiograph was taken to assess the quality
according to the radiographic density and tomography was taken to evaluate
the quality according to the tomographic volume of spaces, compared with the
post-preparation biomechanical tomography. Finally, we performed a statistical
analysis (Student’s t-test) to evaluate whether there were differences between
the types of filling. Results: Radiographic radiodensity was 182.89 ± 9.81 and
186.72 ± 6.97 HU for teeth treated with the lateral condensation technique and
modified lateral condensation technique, respectively. The void volume was
3.75 ± 2.35 and 2.43 ± 1.18 mm3 for teeth treated with the lateral condensation
technique and modified lateral condensation technique, respectively. Conclusion:
No significant differences were found between the techniques for both filling
quality parameters.
Keywords: Endodontics, filling techniques, in-vitro study, lateral condensation
... The root canal filling of each root was radiographically assessed in terms of the length and density of the filling materials using the criteria suggested in previous studies 15,16 . The root canal filling was classified as adequate if the root filling ended 0-2mm of the radiographic apex and there were no space/voids between root filling and root canal wall ( Table 1). ...
The aim of this study was to evaluate the quality of root canal filling performed by undergraduate students at the Federal University of Espirito Santo (UFES). A total of 368 periapical radiographs of endodontic treatment performed by undergraduate students between 2012 and 2014 was assessment. The quality of root canal filling was based on two criteria: length of root canal filling and adequate density of the obturation. Root canal fillings were considered adequate if had no voids and were located at 0-2 mm below the radiographic apex. Statistical analysis was conducted using chi-square tests, with a 5% significance level. In 93.8% of the cases the root canal filling was considered adequate. The density of the obturation was considered inadequate in 3% of the cases. When the length of root canal filling was observed, 1.2% of cases were considered as over-filled and 2.2% were considered under-filled. Non-significant differences were observed among the tooth type (incisive, canines and pre-molars) and the quality of root canal filling. Most of root canal filling performed by undergraduate students at the UFES were considered adequate, regardless of tooth type.
... Several studies point out that the quality of root canal treatments performed by undergraduate students is often poor [1][2][3][4][5] thereby questioning the quality of teaching endodontics [6]. The traditional preclinical training involved practicing the procedure on extracted natural teeth. ...
Abstract Background The quality of root canal treatments performed by undergraduate students is often unsatisfactory questioning the current methods of teaching. Based on treatment errors made by students participating the endodontic courses at RWTH Aachen University (Germany), new radiopaque artificial root canal treatment models (DRSK RCT; incisor, premolar, molar) were designed and developed. The aim of the study was to evaluate these models by groups of students and demonstrators. Methods A total number of 60 students and seven demonstrators from a single institution (RWTH Aachen) participated in this study. They performed endodontic treatments on either initial versions of the DRSK RCT or modified versions. The initial versions were evaluated by students (n = 25) and demonstrators (n = 7). The obtained questionnaire was conducted as 7-point Likert-Scale covering the topics material properties, feeling while performing exercises and perception of its closeness to reality via 19 items (students) and 21 items (demonstrators). According to the evaluations several alterations were applied to the DRSK RCT, the whole study was repeated and evaluated by different students (n = 35) and the same demonstrators (n = 7). Additionally, the demonstrators blindly evaluated the quality of root canal treatments performed by the students (n = 35) on the modified DRSK RCT. Comparisons between the initial versions and the modified versions were calculated using Chi-squared tests. Results Students as well as demonstrators positively evaluated both variants of the DRSK RCT with especially high ratings in the overall evaluation. Students’ rating of the pulp anatomy significantly increased from 5.4 ± 1.1 (mean ± SD) to 5.9 ± 0.9 (mean ± SD; p
... Among errors, voids showed the second highest frequency following underfilling. Our finding is consistent with the finding of Polyzos, Sarris (19), where voids appeared in 28.1 % of filling placed by undergraduate dental students using the cold lateral condensation technique. Overall, the technical quality of root canal filling at preclinical stage was poor. ...
Root canal treatment (RCT) errors such as ledges, perforations, blockages, broken instruments or overfilling could lead to bad prognosis and treatment failure. The assessment of such errors at preclinical stages of dental students could highlight aspects that require improvement in endodontic teaching. This study analysed dental radiographs to determine the error types that could occur during RCT performed by 4th year dental students at preclinical stages. Different types of endodontic errors were investigated in root canal-treated teeth (n = 1320 extracted teeth). The treatment was previously performed with approximately consistent preparation using step-back hand instrumentation and obturation with cold lateral compaction. Two examiners assessed the radiographs following achieving intra-and inter-examiner agreements. The data were analysed statistically using SPSS software. The results showed significant differences in the occurrence of different types of errors during RCT (P≤0.05). The errors were less likely to occur during the phases of opening access and instrumentation than during the phase of obturation. In this final phase, errors such as underfilling and voids were most frequent. In conclusion, the quality of RCT was poor, especially at the phase of obturation. Improving pre-clinical teaching methods, such as increasing training sessions and the number of supervisors, seems to be mandatory to reduce such technical errors. Keywords-Root canal treatment, Endodontic errors, periapical radiograph. 1. Introduction RCT refers to a chemo-mechanical preparation followed by three-dimensional obturation of the root canal system. The primary aim is to remove diseased pulp and control infection in the pulp cavity and periapical tissue [1]. Successful RCT relies on; the identification of all root canals in the tooth structure, the extirpation of pulp tissues inside these canals, and the correct instrumentation and irrigation of these canals along three-dimensional filling with an inert filling material [2]. The application of proper techniques during root canal procedure can improve treatment outcome. For instance, the correct chemo-mechanical preparation and filling of the root canal system revealed a good prognosis with high success rates from 90-95% [2]. Technical errors by operators, such as perforations, blockages, broken instruments can increase the likelihood of treatment failure and the development of periapical diseases [3]. Also, the chances of success rate could be affected by the distance that remains unfilled between the end of the filling material and the radiographic apex. It has been shown that healing rates are higher (87%-94%) in underfilled (0-2 mm) root canal fillings but lower (68-77%) in overfilled (2 mm) fillings. The success rate was even lower (75-76%) where root canal overfilling extended 2 mm beyond the radiographic apex [4].
Background The COVID-19 pandemic massively impacts endodontic teaching and a dramatically reduced number of patients is registered in clinical courses. This could be countered with suitable training aids. Based on treatment errors made by students in the last five years of endodontic courses at RWTH Aachen University (Germany), a new artificial root canal treatment model (DRSK RCT) was developed. The model was aimed to be radiopaque and to simulate the tactile feel during instrumentation in a realistic manner. Unlike already existing 3D-printed tooth replicas, the RCT has anatomical root canals with a narrow lumen with its width matching an ISO size 6 endodontic file.
Methodology 35 fourth-year students and seven dental demonstrators performed endodontic treatments on both the DRSK RCT and extracted teeth. Students and demonstrators answered a questionnaire on a scale ranging from 1 to 7 (poor to high) for different items (part 1). After the first study, changes in the materials and root canal anatomy were applied to the model. Then, the whole study was repeated and evaluated (part 2). Finally, it was evaluated whether the models could replace patient treatment during the Covid-19 pandemic.
Results Ratings by students and dental instructors (5.1 ± 0.4 and 5.3 ± 1.5 [mean ± SD], respectively) in the first study increased after modifications of the DRSK RCT (5.5 ± 0.5 and 6.2 ± 0.8, respectively). Radiographs of the models were excellently assessable. The properties of the DRSK RCT were found to be realistic, thus allowing students to perform a satisfactory simulation of root canal treatment and being rated sufficient in substituting patient treatment during COVID-19 pandemic.
Conclusion The analysis suggests that the DRSK RCT has the ability to improve endodontic technique and education. Visible root canals enable students to observe the treatment process. All steps of a regular root canal treatment can be simulated. Further studies are needed to investigate the outcome of treating the first patient after practicing on the DRSK RCT.
