Radiographic Evaluation of Root Canal Fillings Performed by Dental Students

Objectives: To evaluate radiographically the technical quality of root canal fillings performed by dental students at the School of Dentistry, University of the West Indies. Methods: The dental school's database of student clinical activity between the period 2000-2004 was investigated for patients who completed root canal treatment. For each root filled tooth, at least four periapical radiographs were examined: preoperative, working length determination, try in GP point and postoperative. The final sample consisted of 198 patients with 288 root filled teeth and 460 canals. The length, presence of voids, taper, curvature of canal and fractured instruments were recorded and scored. Chi-squared analysis was used to determine statistically significant differences between the technical quality of root fillings and tooth type. Results: Sixty-three percent, 27.6% and 72.2% of root filled canals had adequate length, density and taper respectively. Fractured instruments were found in only 7 of the root canals (1.5%).The acceptability for both length and taper was found in 31.5% of canals. A significantly greater proportion of root fillings of adequate length and taper were observed in straight canals compared to curved canals (P<0.05). However no significant difference was observed for the presence of voids in straight or curved canals. The percentage of root fillings with adequate length was significantly greater in maxillary teeth than in mandibular teeth (P <0.05) and in anterior teeth compared to posterior teeth (P< 0.001).The overall acceptability of root fillings having adequate length and taper, absence of voids and no fractured instruments was found in 10.9% of canals. The mandibular incisors had the greatest level of acceptability for all observed parameters (27.3%). Conclusion: The overall acceptability of root fillings performed by dental undergraduate students was only 10.9%. Changes in teaching methods may be required to improve the quality of root canal treatment among dental students.

Management of teeth requiring root canal treatment and views on continuing professional education in endodontics by dental practitioners in Trinidad and Tobago [abstract]

Many of the new materials and techniques used in endodontics (root canal treatment) require considerable practice to master and many require continuing education courses to allow formal instruction. Nothing is known regarding techniques employed and views on continuing professional education (CPE) in endodotics by dentists in Trinidad and Tobago. With the shift toward evidence-based dentistry and rising patient expectation of quality oral health care, a survey was conducted to describe these issues. A self-administered postal questionnaire was sent to all registered dentists in Trinidad and Tobago. Seventy dentists responded after two mailings. Most respondents worked primarily in private practice (85.5 percent). Years since qualification ranged from 2 to 45 years and 54.3 percent were qualified for more than 10 years. Most frequent treatment of an acute dental abcess involved opening, preparing the canal(s), dressing and prescribing antibiotics (40 percent). Forty-one respondents (58.6 percent) ocassionally completed root canal treatment in a single visit. Isolation of the tooth for molar root treatment always caused difficulty for thirty-five respondents (50 percent) and rubber dam isolation was used routinely by only nine respondents (12.9 percent). Most respondents either filed (20 percent) or reamed (18 .6 percent) for canal preparation usually using K files. Thirty-three respondents (47 percent) used sodium hypochlorite to irrigate the tooth and thirty-one (44.3 percent) used cold lateral condensation of gutta percha to obturate. Thirty-four respondents (48.6 percent) subscribed to professional journals and sixty-seven (95.7 percent) had attended some form of Continuing Professional Education. Sixty-seven (95.7 percent) of respondents would attend CPE in endodontics if available in Trinidad and Tobago, with most (72.9 percent) preferring a lecture/seminar format addressing problem-solving and new techniques. Respondents to this survey showed use of a wide range of techniques and materials but still expressed considerable interest in developing their skills in endodontics through formal CPE. (AU)