Endodontic practice amongst Nigerian dentists undergoing postgraduate training.

INTRODUCTION: this study aimed at finding out current practice of endodontics amongst Nigerian dentists undergoing postgraduate training (also referred to as dental resident doctors) in different institutions across the nation. METHODS: a questionnaire-based, cross sectional study was conducted amongst dentists undergoing postgraduate training. Questions were asked on demographics, protocol for root canal treatment (RCT), materials employed in different stages. Opinions were also sought on satisfaction with their practice and training needs in endodontics. Data were analyzed with SPSS version 20.0 and presented as tables and charts. Significance level was set at p≤0.05. RESULTS: ninety dentists undergoing postgraduate training (57 males and 33 females) with mean age of 34.81 ± 5.9 years participated in the study. Root canal treatment was mostly done in multiple visits in both single and multi-rooted teeth (p=0.01), only about 15% performed the procedure on multi rooted teeth. Sixty-five (72.2%) never used Rubber dam, stainless steel files were being used by 69%, step down technique of preparation by 53.9% and Sodium hypochlorite was the major irrigant (80%) used. Obturation was majorly with Cold lateral compaction technique (94%), 57.2% delayed definitive restoration for maximum of 1 week and amalgam was still the major material used for posterior teeth as reported by 62.9% of the participants. The majority (55.6%) were not satisfied with their current knowledge and practice and most were those that did not have good undergraduate training (p = 0.05). CONCLUSION: the practice of endodontics needs standardization across the nation as it is being advocated in other countries. There is need for hands on-training on endodontics to encourage adoption of new advances in technology, as well as improve the training of postgraduate dentists in endodontics. Also, emphasis should be placed on use of rubber dam in order to minimize the spread of infection and protect the patients from aspiration of small instruments involved in endodontic procedure.

Endodontics Program Directors', Residents', and Endodontists' Considerations About CBCT-Related Graduate Education.

Over the past decade, cone beam computed tomography (CBCT) has been increasingly used by endodontists. The aims of this study were to assess endodontic program directors', residents', and endodontists' considerations concerning CBCT-related graduate education, attitudes, and professional behavior. Survey data were collected from 31 of the 56 directors of U.S. endodontic graduate programs, 73 of 270 contacted residents, and 689 of 2,221 contacted endodontists (response rates 55%, 27%, and 31%, respectively). Ten of the 31 responding programs did not offer a CBCT-related class. Of the 21 programs that offered a CBCT class, 91% of the program directors and 85% of the residents agreed strongly that future endodontists need training to be able to use CBCT. Residents were less satisfied than directors with the way CBCT was taught (on a five-point scale with 1=most negative: 3.26 vs. 4.37; p<0.001) and the quality of their clinical CBCT-related education (3.75 vs. 4.62; p<0.001). Both groups strongly agreed that there is a need for CBCT training in endodontics (4.81 vs. 4.90). Endodontists reported being less well educated than residents about CBCT in classroom-based (2.02 vs. 2.70; p<0.001) and clinical graduate education settings (2.09 vs. 2.97; p<0.001) and wanted more CBCT-related education in endodontic programs (4.37 vs. 3.18; p<0.001). Yet, they reported being more confident than residents in interpreting CBCT scans (3.57 vs. 2.75; p<0.001) and rated themselves more positively as having sufficient clinical experience (3.76 vs. 2.92; p<0.001) to be competent in utilizing CBCT. These findings about residents' and practicing endodontists' CBCT-related considerations suggest that endodontic program directors should add more CBCT-related education.

Los retos de la endodoncia / The challenges of endodontics

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Referência e contrarreferência na especialidade de endodontia em um centro de especialidades odontológicas / Reference and counter-reference in endodontic specialty in a Center of Dental Specialties

Objetivou-se conhecer o itinerário dos pacientes atendidos na atenção primária e encaminhados para a endodontia no Centro de Especialidades Odontológicas (CEO) de Belo Horizonte, MG e o desfecho ocorrido com os dentes dos mesmos. Trata-se de um estudo transversal, cuja coleta de dados utilizou dois formulários: (1) sobre o tratamento endodôntico, preenchido pelos endodontistas, e (2) dados dos prontuários, sobre o tratamento restaurador, coletados pelos pesquisadores. Os resultados foram analisados por meio de frequência e percentis utilizando o programa SPSS 19.0. Foram finalizados 452 tratamentos endodônticos no período de maio a novembro de 2016. Os pacientes apresentaram mediana de 39 anos de idade, a maioria era do sexo feminino (69,7%) e apresentou guia de referência da atenção básica (96,2%). A maior parte dos tratamentos endodônticos realizados foi em pré-molares superiores (23,7%) seguidos de molares inferiores (22,3%), utilizando técnica mista (74,1%) e em única sessão (64,2%). O encaminhamento para o tratamento restaurador foi para o próprio CEO em 81,2% e para a Unidade Básica de Saúde (UBS) em 18,8% dos casos, e foi finalizado em 24,1% casos. Dos 452 tratamentos endodônticos finalizados, 109 (24,1%) tiveram seu tratamento restaurador finalizado (94 no CEO, 14 na UBS e 1 em consultório particular), 123 (27,2%) encontravam-se em tratamento (118 no CEO, 2 na UBS e 3 em consultório particular), e 220 (48,7%) não apresentavam informação sobre o tratamento restaurador até o período de finalização da coleta de dados. O tratamento restaurador seguiu a tendência mostrada pela referência, onde a maioria dos tratamentos finalizados e em andamento foi ou estava sendo executado no CEO (46,9%). Foi observado que a contrarreferência após o tratamento restaurador aconteceu em 58,7% dos 109 casos finalizados. O tempo de espera mediano para o paciente iniciar o tratamento endodôntico após a referência da UBS para a atenção secundária foi de 5 meses. Quando se considerou o tempo mediano para realização do tratamento endodôntico e para o encaminhamento para o tratamento restaurador este foi de 0 dia (no mesmo dia da sessão única do tratamento endodôntico). Após o encaminhamento para o tratamento restaurador o paciente esperou uma mediana de 57 dias para ser atendido, e este tratamento teve uma mediana de 17 dias de duração. É necessário um planejamento conjunto do tratamento odontológico que vise assegurar o desfecho da restauração dos dentes tratados endodonticamente e sua manutenção em função, cumprindo o princípio de integralidade

Diagnóstico diferencial da sinusite de origem odontológica por meio da tomografia computadorizada / Differential diagnosis of dental sinusitis with the aid of computed tomography

O objetivo do presente artigo é apresentar três casos clínicos com diagnóstico de sinusite de origem odontológica, ou síndrome endo-antral, um quadro inflamatório infeccioso de origem endodôntica que acomete dos tecidos e mucosa do seio maxilar adjacentes aos ápices radiculares.Os casos apresentados chamam a atenção para a dificuldade do diagnóstico apenas coma radiografia periapical e a importância da tomografia computadorizada como recurso auxiliar.

The aim of the current article is to report three clinical cases diagnosed as sinusitis of dental origin, or endo-antral syndrome, an inflammatory condition of endodontic infection origin that affects the tissues and mucosa of the adjacent maxillary sinus up to the root apex. The presented cases draw attention to the difficulty of diagnosis only with periapical radiography and the importance of computed tomography as an auxiliary resource.

Risk management in clinical practice. Part 4. Endodontics.

Endodontic procedures are challenging and technically demanding. In the UK standards of treatment have been shown to have fallen short of acceptable guidelines, laying many dentists open to litigation on questions of clinical negligence by patients who understand and know what should be considered as current best practice in this area. Failure to communicate with patients about the procedure and not obtaining consent for treatment is a key area of complaint, as is inadequate record keeping. When treatment is undertaken within the framework of accepted guidelines it would be very difficult for a patient to open a claim for clinical negligence should a failure occur. This article looks at potential dento-legal problems in endodontics and how, through compliance with best practice, they may be avoided.

Actualización en Endodoncia 2007 / 2007 Update in Endodontics

Los autores revisan los artículos publicados en las revistas científicas más significativas en el ámbito de la endodoncia durante el año 2007 comparándolos entre ellos, con otros anteriores y con los conceptos clásicos de la endodoncia (AU)

The authors review the articles published in the most relevant journals concerning endodontic during the last year 2007, making a comparison between them as well as with other older ones and with classic concepts in endodontics (AU)