Influence of specialty training and experience on endodontic decision making.

INTRODUCTION: The purpose of this study was to compare decision-making choices among dentists with different levels of training. METHODS: Scanned periapical radiographs and a leaflet with relevant information of 17 endodontically treated teeth were mailed to 40 undergraduate students, 25 general practitioners, 20 postgraduate students, and 40 endodontists. All teeth were symptom-free. The hypothetical scenario referred to patients who sought treatment for first time and had noncontributory medical history. Five treatment options were given for each situation: (1) Extraction, (2) Surgical Retreatment, (3) Nonsurgical Retreatment, (4) Wait and See, and (5) No Therapy. Statistical analysis was performed by using multinomial logistic regression models. RESULTS: The overall response rate was 70.4%, with endodontists exhibiting the lowest response. The undergraduates gave 4 or 5 treatment solutions for all cases, in contrast to endodontists, who gave 2 or 3 treatment solutions in a percentage of 82%. Nonsurgical Retreatment predominated among the participants' choices. Significant differences were detected in (1) Extraction for postgraduate students (P = .008) and endodontists (P = .001), (2) Surgical Retreatment for general practitioners (P = .002), postgraduate students (P = .002), and endodontists (P = .001), and (3) Wait and See for postgraduate students (P = .023). CONCLUSIONS: Differences in specialty training and experience strongly influence endodontic decision making. Endodontists showed the most consistent agreement among the groups.

Periapical status and quality of root canal fillings and coronal restorations in a Greek population.

OBJECTIVE: To investigate the quality of root canal fillings and coronal restorations in relation to periapical status in a Greek population. METHOD AND MATERIALS: A total of 320 patients who required full-mouth radiographic examination were included. The quality of root canal fillings and the periapical status, as well as the quality of coronal restorations, were assessed by radiographic criteria. Results were analyzed using random effects logistic regression models. RESULTS: Root canals with adequate filling length had a lower incidence of apical periodontitis than root canals with inadequate filling length (51.7% versus 63.4%, P ;= .002). Root-filled canals with adequate coronal restorations showed a lower incidence of apical periodontitis than those with inadequate restorations (47.3% versus 67.4%, P; < .001). When both root filling and coronal restoration were assessed, the incidence of apical periodontitis ranged from 39.2% to 67.6%. CONCLUSION: Quality of root canal treatment, as well as quality of coronal restoration, are strongly associated with the incidence of apical periodontitis.