Endodontic Teaching Research Articles

Academic performance and dental student satisfaction with emergency remote teaching of endodontics during COVID-19 pandemic: A retrospective cohort study

Introduction: The study aimed to evaluate the consequences of introducing online modalities for emergency remote teaching during the coronavirus disease 2019 pandemic, on students' learning satisfaction in the endodontic preclinical course and their performance in the summative examination. Materials and Methods: On completion of the preclinical endodontic course, 39 students were E-mailed an online questionnaire investigating their overall satisfaction with online modalities used for emergency remote teaching. They were requested to evaluate their satisfaction with three methods of lecture delivery: conventional face to face, online synchronized and online asynchronized, in terms of comprehension and retention of knowledge, communication with the lecturer, time convenience, Internet or technical support, transportation for face-to-face lectures, and stress-free learning. Students' scores were compared to scores of students who took the course before the pandemic and received only conventional face-to-face teaching. Data were statistically analyzed. Results: A response rate of 100% showed that 87% of the students were satisfied with the online modalities used for emergency remote teaching. Students were significantly less satisfied with online-asynchronized lectures in terms of communication with the lecturer (P Conclusion: Dental students were satisfied with online modalities used for emergency remote teaching in the preclinical endodontic course and their academic performance was not adversely affected.

Confidence in Performing Endodontic Treatment and Perception of the Quality of Endodontic Education

Confidence in Performing Endodontic Treatment and Perception of the Quality of Endodontic Education

Frequently affected teeth by different types of iatrogenic perforations made during dental training in Bulgaria

Background: One of the reasons for endodontic treatment failure is iatrogenic perforation. That is why it is important to provide adequate endodontic education for graduating young practitioners. Aim: The aim of this study is to determine the most common locations of the iatrogenic perforations made by last year students in the Dental Faculty in Sofia, Bulgaria, to note the association of particular errors with particular teeth and to determine how this information can improve their education. Methods: All patient records of last-year students for 2015 and 2016 were examined. Perforations were diagnosed by radiography, and also confirmed clinically. Results: From all 778 teeth 30 incidents of root perforations were found: 10 in 2015 and 20 in 2016. More perforations were found in upper posterior teeth- 80% of all the perforations made in 2015, and 45% of all registered perforations in 2016. For the entire period of the research perforation frequency in upper molars, and in upper anterior teeth were found to be significantly higher than in other group of teeth. In academic 2015 year, 8 of the perforations (80%) were furcal. In 2016 year, 11 (55%) of all perforations were apical. Conclusions: More in-depth knowledge of endodontic anatomy , and also more strict supervision on students’ tasks are needed, especially regarding standard root canal treatment on molar teeth.

An investigation into security, self-confidence and gender differences related to undergraduate education in Endodontics.

To analyse responses from dental practitioners (DPs) on how secure they felt as a newly graduated dentist, level of confidence or self-efficacy when performing root canal treatment (RCT), and if undergraduate (UG) education in Endodontics adequately met their needs in a dental practice. An electronic questionnaire was sent to 459 dentists who graduated from the University of Bergen, Bergen, Norway, between 2008 and 2018. The survey consisted of questions with closed-end options and Likert scale (1-5). An open-ended free text option was always provided. A total of 314 (68.4%) DPs answered the questionnaire. Of these, 87 (27.8%) were men and 224 (71.3%) were women. Three respondents did not disclose their gender. As a newly graduated dentist, 37.3% of the respondents felt secure when performing RCT, 30.7% felt indifferent, and 32.0% felt insecure. The majority (72.4%) of respondents were either confident or very confident when performing RCT, 21.3% were indifferent, and 6.3% had little or no confidence. A majority of DPs (84.4%) self-evaluated the quality of their root fillings as good or very good, and 15.2% were indifferent. Only one DP selected 'not good' and none selected 'bad'. There were significant gender differences where male DPs felt more secure than female DPs when performing RCT (P<0.001). A significantly larger number of men were very confident compared to women (P<0.001). A logistic regression analysis using confidence as a dependent variable to predict self-efficacy revealed that DPs who felt secure when performing RCT as a newly graduated dentist had about 8 times more self-efficacy (odds ratio=8.49) than those who were insecure or indifferent. Respondents who rated their quality of root fillings as good or very good had forty times more self-efficacy (odds ratio=40.06) when performing RCT. UG education in endodontics was considered inadequate by 71.3% of the respondents where a significantly larger number of DPs (70%) wanted more clinical training (P<0.05). About half the DPs (47.7%) stated that there was a need for lifelong learning with majority preferring hands-on courses and continuing dental education organized by dental associations. The results of this study suggest that there is a need to promote self-efficacy during UG education in Endodontics. Hands-on training is the preferred form of lifelong learning for DPs.

Evaluation of undergraduate Endodontic teaching in dental schools within Spain.

To evaluate the current situation of undergraduate endodontic teaching in Spanish dental schools. An online version, translated into Spanish, of a survey conducted in the UK (Int Endod J 52, 2019, 1077) was sent via email to the undergraduate endodontic programme leads in all 23 Spanish dental schools. The response rate was 96%. In 95% of dental schools, endodontics is taught in the fourth year. Students treat simple root canal treatment cases in 100% of schools and only in 40% treat moderate cases. In 65% of schools, students are supervised by full-time professors who are specialists in Endodontics, significantly more frequently in private dental schools (P=0.002). Spanish dental schools use both rotary and reciprocating instrumentation systems during endodontic training, with consistency on methods of working length determination, use of silicate-based endodontic cements, irrigating solutions, inter-visit medicaments and canal filling techniques. No type of magnification is used in 90% of dental schools, and only 25% use ultrasonic instruments. Private dental schools have a significantly better staff: student ratio during clinical practice (P=0.041), spend significantly more hours in clinical training (P=0.04) and have significantly greater number of clinical areas specifically dedicated to Endodontics (P=0.010). Undergraduate endodontic teaching in Spanish dental schools follows the key recommendations of the ESE Undergraduate Curriculum Guidelines (Int Endod J 46, 2013, 1105), being, in most respects, comparable to that carried out in the UK (Int Endod J 52, 2019, 1077). The use of magnification and ultrasonic instruments needs to be increased. Private schools reported better results than public schools in some of the variables that were analysed.

Making use of three-dimensional models of teeth, manufactured by stereolithographic technology, in practical teaching of endodontics.

Making use of 3D printed teeth models in teaching students offers an innovative approach. The mistakes made by the students at the access cavity stage were assessed with the aid of 3D models, and their overall, hands-on learning progress was evaluated. Ninety 3D models of teeth were constructed using stereolithographic technology and then randomly divided into 9 groups. One dentistry student was randomly assigned to each group and then performed primary access cavity in 10 identical 3D models. Then the teeth were evaluated in the order of their preparation, relative to the model tooth. The material of 14 (15.5%) out of 90 teeth models sustained significant damage during the preparation. As regards the remaining 76 (84.5%) 3D models, the students committed the greatest number of mistakes on the incisors, and fewer on the molars and the least in the premolars. The difference in the number of errors between particular groups of teeth was statistically significant (P=.0001). The number of errors committed in subsequent repetitions amongst all students was significantly different for the incisors (P=.00215) and premolars (P=.00383), whereas insignificant in the case of molars (P=.77116). Thanks to perfect representation of teeth anatomy; making use of 3D models in the teaching of endodontics may well be recommended as holding substantial potential in improving overall quality of training at the pre-clinical stage, with a view to appreciably reducing overall risk of encountering complications during the actual clinical work.

Undergraduate endodontic clinical training in Malaysia: A National survey.

Online survey was conducted to investigate the state of undergraduate endodontic clinical training in Malaysian dental schools. An online questionnaire and a cover letter were emailed to the deans of 13 Malaysian dental schools. The questionnaire covers various aspects of endodontic clinical training including teaching methods, endodontic clinical procedures, minimum requirements, clinical sessions and teaching staff. The response rate was 69%. Similarities in teaching methods were observed in all responding schools. All schools taught contemporary root canal treatment procedures, including the utilisation of radiograph and electronic apex locator for working length determination, the crown-down approach for canal preparation and the cold lateral compaction for obturation. Sodium hypochlorite solution and non-setting calcium hydroxide medicament were used in most dental schools. Variations were observed in terms of the number of clinical requirements, supervisor: student ratio, and availability of endodontic specialists. The use of engine-driven instruments was observed mainly in government-funded dental schools. The majority of dental schools in Malaysia are adopting the European Society Endodontology recommendation for undergraduate endodontic training, particularly in relation to the surveyed aspects. Most of the government-funded dental schools have progressed towards engaging contemporary endodontics with their increasing application of engine-driven Ni-Ti instruments and 3D imaging techniques. Appointments of full-time endodontic specialists would further enhance the quality of endodontic teaching and permit the utilisation of contemporary endodontic materials.

Continuing endodontic education and COVID‐19: before, during and after?

In all likelihood, the COVID-19 pandemic will continue to have a major impact on the practice of dentistry, not only in clinical practice but also in education. Certainly both dental schools and continuing education providers will be impacted, and particularly with respect to hand skill teaching for example in endodontic procedures.

What happened to our former students five to six years after graduation? An endodontic teacher's perspective.

Endodontic teaching follows common concepts in the four Swiss dental schools. The aim of this survey was to ask former Swiss dental students how they adopted these endodontic concepts in clinical practice. All the graduates of the years 2012 and 2013 (n = 196) were targeted in 2018 using an internet-based anonymous questionnaire, which was based on five initial questions. One hundred forty-one individuals (participants) filled in these questions on their work situation and referral concepts (72% response rate). Those 111 participants who performed root canal treatments themselves were the focus group. They answered an additional 11 questions. Their affinity towards performing endodontic treatments was investigated. The use of rubber dam isolation served as a surrogate to see if biological principles were respected. Furthermore, it was asked which instrumentation systems they used in daily practice, and how they perceived the impact of their superior/employer on these choices. Of the 141 survey participants 55 were men and 86 women. Thirty-eight of these (27%) reported to refer difficult endodontic cases. Individuals in the focus group had an overall positive attitude towards endodontics. There was very little variance in the responses between the four Swiss dental schools. The vast majority (86.5%) reported to use rubber dam routinely. More than half in the focus group used reciprocating systems, and only a few (22.5%) would still use the rotary system they were taught at university. There was a significantly (p < 0.05) higher perceived impact of the employer on choice of instrumenting system versus the use of rubber dam.

What happened to our former students five to six years after graduation? An endodontic teacher's perspective.

Endodontic teaching follows common concepts in the four Swiss dental schools. The aim of this survey was to ask former Swiss dental students how they adopted these endodontic concepts in clinical practice. All the graduates of the years 2012 and 2013 (n = 196) were targeted in 2018 using an internet-based anonymous questionnaire, which was based on five initial questions. One hundred forty-one individuals (participants) filled in these questions on their work situation and referral concepts (72% response rate). Those 111 participants who performed root canal treatments themselves were the focus group. They answered an additional 11 questions. Their affinity towards performing endodontic treatments was investigated. The use of rubber dam isolation served as a surrogate to see if biological principles were respected. Furthermore, it was asked which instrumentation systems they used in daily practice, and how they perceived the impact of their superior/employer on these choices. Of the 141 survey participants 55 were men and 86 women. Thirty-eight of these (27%) reported to refer difficult endodontic cases. Individuals in the focus group had an overall positive attitude towards endodontics. There was very little variance in the responses between the four Swiss dental schools. The vast majority (86.5%) reported to use rubber dam routinely. More than half in the focus group used reciprocating systems, and only a few (22.5%) would still use the rotary system they were taught at university. There was a significantly (p < 0.05) higher perceived impact of the employer on choice of instrumenting system versus the use of rubber dam.

How is paediatric dentistry taught? A survey to evaluate undergraduate dental teaching in dental schools in the United Kingdom.

The quality assurance of undergraduate dental education in the UK is regulated by the General Dental Council who describe the competencies expected of the newly qualified dentist or "safe beginner." Whilst the literature has explored the level of undergraduate training in a number of dental specialties within the UK, there is a paucity of information on the UK curriculum for undergraduate paediatric dental teaching. This study aimed to assess the undergraduate teaching of paediatric dentistry within dental schools in the UK. An anonymous questionnaire was distributed to all 16 UK dental schools via email. Twelve questionnaires were completed, giving a response rate of 75%. First exposure to both academic teaching and clinical teaching in paediatric dentistry ranged from years 1-4. Whilst there were broad similarities between units with regard to core components of the curricula, there were notable differences including the teaching of regenerative endodontics (75%) and the use of the titanium trauma splint (58%). Silver diamine fluoride was only used clinically in one unit (8%), and non-vital pulpotomy was taught by two units (16%). There was also considerable heterogeneity in assessment methods between universities. The undergraduate paediatric dental curriculum is broadly similar between UK dental schools. However, there are discrepancies in assessment methods and the teaching of new advances.

Conception of an endodontics questionnaire in undergraduate dental education

The purpose of this study was to create a valid assessing instrument using a set of questions to examine preclinical dental education in endodontics. For this reason, we constructed the “German Endodontology Questionnaire” (GEndoQ), which assesses preclinical dental education in endodontics. In recent years and decades, various curricula in preclinical and clinical endodontic education have been evaluated at both national and international levels and the results published. However, the conception of the questionnaires that have been used have never been discussed or published.

Endodontic follow-up practices, sources of knowledge, and self-assessed treatment outcome among general dental practitioners in Sweden and Norway

Objective: To reduce the gap between what can be achieved in endodontic treatments and the observed treatment outcome among general dental practitioners, the present study set out to assess the status of the endodontic practices as regards to knowledge and self-assessed skills among general dental practitioners in Sweden and Norway.Material and method: The questionnaire was sent to 1384 general dental practitioners. It contained questions regarding access to continuing education in endodontics, sources of knowledge for clinical management of patients, post-operative follow-ups, self-assessed success-rate, and the initial diagnosis impact on the outcome of endodontic treatments.Results: The response rate was 61.4%. Almost half estimated their endodontic success-rate to be 90%. About two-thirds of the respondents did not know, or did not believe, that the initial diagnosis could affect the outcome of their endodontic treatments. Respondents who did not believe the diagnosis could impact the outcome were more likely to estimate their success rate as the highest (p<.001). Less than half performed post-operative follow-ups a year after treatment. A third of the respondents had not attended any continuing endodontic education.Conclusion: Dentists who do not receive regular feedback on their treatments may lack insight into their own shortcomings. If this is combined with insufficient knowledge and understanding it may result in sub-par endodontic treatments being performed. It is important to have reliable ways to communicate current endodontic knowledge and to establish robust methods that may help dentists accurately assess their own performance in endodontics.

Perception of a modular 3D print model in undergraduate endodontic education.

To evaluate a modular 3D print training dental model with embedded human teeth and electronic working length determination for undergraduate endodontic education. Cone-beam volume tomography data of a human skull were transferred into stereolithographic (STL) data, and a customizable modular 3D print model with individually removable sextants and teeth was generated for the use in commercially available phantom heads. Each of sixty-eight students performed a complete root canal treatment on an extracted human tooth. Working lengths were determined with electronic apex locators (EAL) and verified radiographically. Subsequently, an evaluation was carried out with regard to the difficulty of the working steps access cavity preparation, working length determination, root canal preparation/irrigation and canal filling, and these steps were compared to commonly used benchtop models. Additionally, the agreement of electronic and radiographic working length determination was assessed and analysed statistically with the chi-square test. A total of 68 teeth (20 incisors, 26 premolars and 22 molars) with 127 root canals were treated. In total, 87% of the students considered the modular 3D print model considerably more demanding than the conventional benchtop model. Overall, 96% felt better prepared for the clinical situation, 92% felt markedly reduced stress levels during endodontic practice in the subsequent clinical courses, and 93% of the students suggested the model should be used in future preclinical endodontic training. The preradiographic use of EAL resulted in 85% of the cases having radiographically acceptable working length determination within 0-2mm from the radiographic apex. Readings more than 2mm from the apex or beyond were significantly more common in molars than in premolars and incisors (P<0.05). The vast majority of students rated the modular 3D print training model positively despite it being more demanding. They also recommended its use in preclinical teaching and training. The model allowed a more realistic simulation of the clinical situation with a simultaneous use of EALs and led to reduced stress levels in endodontic treatment in the subsequent clinical courses.

Perception of Undergraduate Students at the Faculty of Medicine in Hradec Králové Regarding Their Endodontic Education and Suggested Improvements.

The aim of this study was to assess the perception of undergraduate dentistry students at Charles University, Faculty of Medicine in Hradec Králové, the Czech Republic regarding their endodontic education within the context of the Undergraduate Curriculum Guidelines for Endodontology by the European Society of Endodontology (ESE). The secondary aim was to compare this perception among students in the Czech and English groups. A questionnaire survey was conducted among fifth year students at the very end of their studies. The students returned 60 filled questionnaires, making the response rate of 75.9%. More than two thirds of the respondents declared that they were competent at or had knowledge of most of the major competencies defined by the ESE. Eighty seven percent of respondents felt competent to perform a root canal treatment on anterior teeth; 86.7% on premolars; and 48.3% on molars. Nearly all respondents (98.3%) recommended more opportunities to practice on patients. The overall perception of the students was that their endodontic education was sufficient and largely conformed to the guidelines. Insufficient exposure to endodontic practice on patients was identified as a deficiency. There were no significant differences in perceptions between the two study groups.

Role-play in Endodontic Teaching: a Case Study.

Objective: To investigate the role of the application of role-play in endodontic study in improving the communication skills of Chinese dental undergraduates prior to their direct interactions with patients at the Fourth Military Medical University’s School of Stomatology, China. Methods: Students were recruited from the 5-year bachelor’s programme (n = 36) and randomly divided into six groups, and from the 8-year DDS programme (n = 10) and randomly divided into two groups to participate in the role-play training. Cases selected randomly from the case pool were distributed to the groups. The teacher gave an outline of the roles in the simulation. Each member of each group randomly selected their own role for the role-play. Four types of surveys were distributed to students and faculty members at different points after the role-plays had taken place, to evaluate their attitude towards the use of role-plays in endodontic study. Frequency analysis and a one sample t test were used to describe and analyse students’ acceptance of role-play as a teaching technique. The level of statistical significance was set at P < 0.05. Results: Students’ performance and satisfaction as well as the supporting faculty responses were very favourable towards role-playing. In total, 93.5% of students responded favourably to the role-play, answering ‘strongly agree’ or ‘agree’ to the positive statements about their role-play performance. A total of 95.1% of students stated that they had benefited psychologically and technically from the role-play (‘strongly agree’ or ‘agree’) after their 1-year rotating internship. Conclusion: The application of role-play in endodontic study is an effective way of educating Chinese dental undergraduates and can be beneficial for their transition from students to dentists.

Dental schools and clinical endodontics in Brazilian Dental education institutions

Este estudo transversal do tipo censo avaliou características dos cursos e os modelos de ensino de endodontia clínica nos cursos de Odontologia no Brasil. Realizou-se acesso a sítios eletrônicos de 452 cursos registrados no Cadastro Nacional de Cursos e Instituições de Educação Superior do Ministério da Educação. As variáveis de interesse foram: dados da instituição; presença de matriz curricular e projeto pedagógico do curso: dados do curso (número de semestres, turno de realização), dados referentes à área de endodontia clínica. Os dados foram inseridos em banco de dados e foi realizada análise estatística descritiva. A graduação em Odontologia ocorre majoritariamente em instituições privadas (86,3%) e na região sudeste (37,8%), sendo os cursos em sua maioria diurnos (73,8%). A matriz curricular e os projetos pedagógicos estavam disponíveis em 76,5% e 23,4%, respectivamente, sendo predominantemente encontrados nos sítios eletrônicos de instituições públicas. O ensino de endodontia clínica tem início em diferentes momentos, conforme o curso, iniciando no terceiro semestre e pode ocorrer de forma isolada ou em clínica integrada. Conclui-se que há um predomínio de oferta de ensino de graduação em Odontologia em instituições privadas. Há um número restrito de vagas em cursos noturnos. Há uma tendência que o ensino de endodontia clínica ocorra de forma integrada com as demais áreas da Odontologia. A coleta de informações é dificultada pelo número restrito de projetos pedagógicos disponíveis para consulta. O total acesso a estar informações permitiria que o aluno, ao ingressar na instituição, conheça como ocorrerá o processo de ensino-aprendizagem.

Magnification in undergraduate endodontic teaching in the UK and Ireland: a survey of teaching leads in Endodontology.

To investigate the use of magnification in undergraduate endodontic teaching in dental schools within the UK and Ireland and identify factors that may impact on levels of adoption. An electronic questionnaire was distributed to teaching leads in undergraduate endodontics in all UK and Ireland dental schools. Completed questionnaires were received from 15 of 18 course leads. The study revealed magnification is not universally embedded within the undergraduate curricula, and the majority of schools had no expectation for students to use magnification, although it was encouraged. The study provided insight into teaching staff factors, student factors and institutional factors that impact upon the adoption of magnification in undergraduate endodontic teaching. Although course leads utilized magnification in their own practice, this did not translate into institutional expectation for students to use magnification. Barriers to adoption of such an institutional expectation included cost and lack of staff training. Magnification has become viewed as an essential part of endodontic practice. The dental operating microscope has the most significant impact on endodontic visualization; however, the use of dental loupes in nonsurgical endodontics could be considered the minimum standard. The pedagogical dilemma faced by dental educators training undergraduates to behave in a manner that they themselves would not, cannot be rationalized on the basis of cost and lack of staff training. It is proposed that although significant, these barriers are not insurmountable and the use ofdental loupe should become an expectation in undergraduate training in the UK and Ireland.

Self-efficacy of undergraduate dental students in Endodontics within Aarhus and Amsterdam.

AimTo understand whether the self‐efficacy of undergraduates is associated with the extent of the endodontic education they received.MethodologyData were obtained from three undergraduate endodontic programmes in two universities: Aarhus University (AU), Denmark and the Academic Centre for Dentistry Amsterdam (ACTA), the Netherlands. Just before their graduations in 2016 or 2017, students completed a questionnaire that contained the Endodontic General Self‐Efficacy Scale and questions on how they valued the education they received in Endodontics. The information on the number and type of root canal treatments participants had performed on patients was collected from dental clinic management systems. Data were ana‐lysed using non‐parametric tests and multiple regression analyses.ResultsThe median number of treated root canals on patients per student was 5 in the standard programme at ACTA, 10 in AU, and 14.5 in the extended programme at ACTA. Students’ self‐efficacy increased with the number of treated root canals; however, retreatments and root canal treatments in molars were negatively associated with self‐efficacy. All students wanted more experience in performing root canal treatment on patients.ConclusionsThe endodontic self‐efficacy of students from the standard programmes of the two participating universities was comparable. Students’ self‐efficacy was influenced mostly by their clinical experience when performing root canal treatment. It seems that the more root canal treatments students perform on patients, the greater their self‐efficacy is at graduation. However, treating difficult cases (molars and retreatments) might reduce their self‐efficacy.

O ensino de Endodontia pré-clínica nos cursos de Odontolologia brasileiros

O objetivo desse estudo foi obter informações quanto ao ensino de Endodontia em atividades pré-clínicas nos diferentes cursos de graduação em Odontologia no Brasil, além de avaliar o perfil e a distribuição por regiões do país dessas instituições. Foi realizado um estudo observacional transversal do tipo censo, envolvendo 246 instituições de ensino, por meio do acesso aos sítios eletrônicos das respectivas instituições, obtendo-se dados de domínio público. As informações relacionadas às instituições de ensino foram obtidas em base de dados pública, em sítio eletrônico do Conselho Federal de Odontologia (CFO). Foram registradas as seguintes variáveis de interesse: dados sobre a instituição de ensino, a distribuição das disciplinas relacionadas ao ensino de pré-clínica na área de Endodontia, e a carga horária e relacionada com o ensino de Endodontia. Foi realizada análise estatística descritiva dos dados obtidos. A maioria dos cursos ocorrem em instituições privadas, localizadas no Sudeste do país, com maior número de cursos diurnos e apresentando duração mínima de 10 semestres. Em relação à presença de informações relativas à estrutura curricular dos Cursos de Odontologia nas instituições avaliadas, verificou-se que foi possível acesso direto em sítios eletrônicos de 190 instituições (77,2%). O Projeto Pedagógico está disponível no sítio eletrônico de 57 cursos (23,2%). Observou-se grande diversidade de organização das disciplinas nas diferentes instituições. Constatou-se que há informações limitadas disponíveis para acesso na forma de domínio público, o que dificulta uma análise mais criteriosa acerca dos modelos didáticos e conteúdos abordados pelas instituições. Ainda, observou-se que as informações disponibilizadas sugerem que há abordagens heterogêneas para o ensino da endodontia pré-clínica.