Technical Quality and Associated Iatrogenic Errors of Endodontic Treatments Performed in Extracted Anterior Single-Rooted Teeth by Preclinical Undergraduate Students

Download Article

1 / Andreas Koutroulis2 / Georgios Chatzopoulos3 / Vasileios Kapralos2

1Aristotle University of Thessaloniki, School of Dentistry, Department of Endodontology, Greece
2Aristotle University of Thessaloniki, School of Dentistry, Greece
3University of Minnesota, Division of Periodontology, Minneapolis, United States

Summary

Aim: To evaluate technical quality of root canal treatments performed in extracted anterior single-rooted teeth in an undergraduate dental clinic, and to record the associated iatrogenic errors.

Material and Method: 287 root canal treatments performed by 114 preclinical undergraduate students in extracted anterior teeth at the Department of Endodontology were radiographically evaluated, based on the following parameters: access cavity dimensions and direction, root canal instrumentation, and root canal filling quality.

Results: The access cavity was found of adequate dimensions in 28.9% and straight in direction in 71.1% of the material. Erroneous position, overextension of the access cavity and non-straight access were noted in 39.7 %, 21.6% and 28.9% of the cases, respectively. The frequency of ledged root canals was 10.1%, while 84.7% of the teeth had no instrumentation related iatrogenic errors. Regarding root canal filling, incomplete density apically and technical inadequacies in the middle and cervical thirds were observed in 76.3% and 82.3% of the cases. The percentage of flawless endodontic treatments was 3.1%.

Conclusions: Most of the endodontic treatments evaluated were classified unacceptable. Inadequate root canal filling density in the middle and cervical third and ledge formation were the most common faults.

Keywords: Dental Education; Dental Students; Endodontics; Medical Errors

References

  1. Boucher Y, Matossian L, Rilliard F, Machtou P. Radiographic evaluation of the prevalence and technical quality of root canal treatment in a French subpopulation. Int Endod J, 2002; 35(3):229-238. [Crossref]
  2. Eleftheriadis G, Lambrianidis T. Technical quality of root canal treatment and detection of iatrogenic errors in an undergraduate dental clinic. Int Endod J, 2005; 38(10):725-734. [Crossref]
  3. Hunt R. Percent agreement, Pearson’s correlation, and kappa as measures of inter-examiner reliability. J Dent Res, 1986; 65(2):128-130. [PubMed][Crossref]
  4. Ingle JI, Bakland LK, Baumgartner JC. Ingle’s Endodontics 6: PMPH-USA; 2008.
  5. Kersten H, Wesselink P, Thoden van Velzen S. The diagnostic reliability of the buccal radiograph after root canal filling. Int Endod J, 1987; 20(1):20-24.[Crossref]
  6. Lambrianidis T. Observer variations in radiographic evaluation of endodontic therapy. Dent Traumatol, 1985; 1(6):235-241. [Crossref]
  7. Lambrianidis TP. Risk Management in Root Canal Treatment: University Studio Press; 2001.
  8. Moor R, Hülsmann M, Kirkevang LL, Tanalp J, Whitworth J. Undergraduate Curriculum Guidelines for Endodontology. Int Endod J, 2013; 46(12):1105-1114. [Web of Science] [Crossref] [PubMed]
  9. Reit C, Hollender L. Radiographic evaluation of endodontic therapy and the influence of observer variation. Scand J Dent Res, 1983; 91(3):205-212.[PubMed]
  10. Román-Richon S, Faus-Matoses V, Alegre-Domingo T, Faus-Llácer VJ. Radiographic technical quality of root canal treatment performed ex vivo by dental students at Valencia University Medical and Dental School, Spain. Med Oral Pathol Oral Cir Bucal, 2014; 19(1):e93.
  11. Schaeffer MA, White RR, Walton RE. Determining the optimal obturation length: a meta-analysis of literature. J Endod, 2005;31(4):271-4. [PubMed]
  12. Tchorz JP, Brandl M, Ganter PA, Karygianni L, Polydorou O, Vach K, et al. Preclinical endodontic training with artificial instead of extracted human teeth: Does the type of exercise have an influence on clinical endodontic outcomes? Int Endod J, 2014; n/a-n/a.
  13. Torabinejad M. Endodontic mishaps: etiology, prevention, and management. Alpha Omegan, 1989; 83(4):42-48.
  14. Valachovic R, Douglass C, Berkey C, McNeil B, Chauncey H. Examiner reliability in dental radiography. J Dent Res, 1986; 65(3):432-436. [PubMed][Crossref]
Citation Information: Balkan Journal of Dental Medicine. Volume 19, Issue 2, Pages 96–100, ISSN (Online) 2335-0245, DOI: https://doi.org/10.1515/bjdm-2015-0042, July 2015

COMMENTS