Performing Root Canal Treatment Research Articles

Cross-Sectional Survey to Assess Dental Students' Perception of the Utilization of a Case Difficulty Assessment Form during Various Stages of Root Canal Therapy.

Several endodontic difficulty assessment forms are available to help dental students and general dentists estimate the difficulty of the case before initiating the endodontic treatment. This study aimed to assess if the American Association of Endodontics (AAE) case difficulty assessment form affects the dental student's perception of the difficulty encountered while performing root canal treatment (RCT). This was a cross-sectional online survey. After obtaining IRB approval, an electronic questionnaire was sent to dental students enrolled in the 4th and 5th years at King Saud University (KSU) and King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, Saudi Arabia. The questionnaire was divided into informed consent, demographic data, the use of the AAE case assessment form, RCT steps, diagnosis, local anesthesia administration, tooth isolation, and endodontic procedure. A total of 195 dental students participated in the study. There were 101 (52%) females, and 139 (71%) were from KSAU-HS. A positive association was found between students who used the AAE assessment form and who did not with their ability to reach the correct diagnosis (p=0.005), tooth isolation (p=0.03), and endodontic procedure difficulty score (p=0.018). The use of the AAE form by dental students enabled them to differentiate between complicated and uncomplicated cases, thus lowering the difficulty encountered during RCT.

The first experiences of preclinical dentistry students with rotary instruments: A pilot study

Abstract Introduction: Rotary instrumentation has been included in the undergraduate endodontic curriculum to improve the quality of endodontic treatment. The aim of this study was to compare the technical quality of root canal fillings performed by preclinical dentistry students trained with hand instrumentation (THI) or not during their initial trial with rotary instruments. Materials and Methods: Twenty-four 3rd-year students were distributed into two groups: 12 students THI group and 12 students not trained with hand instrumentation (NTHI group). Both the groups received a 50-min theoretical lecture and a demonstration about the ProTaper Universal® system before being asked to complete endodontic treatments on one extracted maxillary central incisor, premolar, and molar using rotary instrumentation and obturation with the single-cone technique. The endodontic treatment technical quality was determined by periapical radiographs. Data were statistically analyzed, and P < 0.05 was considered statistically significant. Results: A total of 144 root canals were performed by preclinical students. Although the difference in the technical quality of the canals was nonsignificant among the groups (P > 0.05), the THI group had more adequately filled root canals (45.8%) than the NTHI group (29.2%). Only maxillary central incisors had underfilled canals, whereas teeth with multirooted canals were subjected to various procedural errors in both the groups (P > 0.05). Conclusions: Intensive hand instrumentation (HI) preclinical training did not significantly improve the technical quality of root canals performed by preclinical dentistry students during their initial trial with rotary instruments. The student’s familiarity with HI did not decrease the incidence of procedural errors when performing root canal treatment with rotary instruments.

Adoption of rotary instrumentation among general practitioners in Qassim region, Saudi Arabia: A cross-sectional survey

Abstract Introduction: In contemporary dentistry, nickel–titanium (NiTi) rotary instrumentation is the standard of care. General dental practitioners (GDPs) should acquire and adopt rotary root canal instrumentation in their practices. Therefore, this study aimed to investigate the application of rotary root canal instrumentation among GDPs in the Qassim region of Saudi Arabia. Materials and Methods: This cross-sectional survey was conducted in the Qassim region of Saudi Arabia. An online survey was sent to GDPs registered in the Qassim region through the Saudi Dental Society contact list. It consisted of 15 questions about gender, demographics, sector, and the extent of rotary root canal instrumentation adoption in their daily practices. The Chi-square test was used to compare the frequency responses between the groups. Fisher’s exact test was used when the expected outcome was <5. Results: Of the 153 GDPs contacted, 81 completed the online survey. Of the 81 participants, 71.6% performed root canal treatment in their daily practice, whereas only 51.9% reported using NiTi rotary instrumentation. NiTi rotary instrumentation was adopted significantly more frequently by GDPs who graduated from non-Saudi schools, worked in the private sector, and had more than 10 years of experience. The lack of required equipment was the most commonly reported reason for not adopting NiTi rotary instrumentation. Most participants were interested in receiving training in NiTi rotary instrumentation. Conclusion: Almost half of the GDPs in the Qassim region did not use rotary files in their practices. Lack of undergraduate training and unavailability of equipment were the most commonly reported factors for not adopting rotary instrumentation. There was a significant interest in receiving additional training on NiTi rotary instrumentation.

Challenges faced by final year dental students and house officers while performing endodontic treatment.

Objective: To identify the challenges faced by final year dental students and house officers while performing endodontic treatment. Study Design: Cross sectional study. Setting: Multicenter study. Setting: Involving Dental Colleges of Twin Cities Dental Hospitals of Islamabad and Rawalpindi including Islamabad Dental Hospital, Islamic International Dental Hospital, Pakistan Institute of Medical Sciences, Armed Forces Institute of Dentistry, Rawal Institute of Health Sciences and Margalla Institute of Health Sciences. Period: June 2023 to December 2023. Material & Methods: This cross sectional descriptive study was conducted on 263 participants. The inclusion criteria was final year dental students and house officers who had completed their mandatory rotation in endodontics department and performed root canal treatment with conventional methods. A structured questionnaire consisting of five sections containing patient management, access opening, working length determination, cleaning and shaping procedure and obturation was constructed. Google forms were sent to the participants after sample size was calculated with WHO calculator. Data was analyzed through Google forms. Results: The current study shows that majority of the participants faced difficulties in the patient management and obturation procedure. The overall most common difficulty encountered was rubber dam application (44.1%) followed by accessory GP bending during obturation (42%), apex locator use (39.4%), and canal orifice location (39.8%). Conclusion: The students and house officers are facing multiple difficulties in performing root canal treatment independently. Therefore there is a need to focus more on the training of students and house officers in their endodontic department rotation.

The Incidence of Devitalization of Vital Teeth Associated with Pathologies of the Jaws Following Surgical Intervention: A Mixed-case Study.

The purpose of this mixed-case study is to explore the incidence of pulp necrosis of vital teeth after surgical treatment of adjacent lesions of the jaws. The records of 341 biopsies submitted to the institute's histopathology laboratory were reviewed to include cases that met the inclusion criteria. About 84 biopsies collected from patients during surgical enucleation of lesions in proximity to healthy vital teeth were included of which 22 patients were recalled. Adjacent teeth were examined clinically and radiographically to assess their pulpal and periapical status after at least 8 months of follow-up. There were 7 different pathological lesions diagnosed histologically. The follow-up period ranged between 8 and 72 months; 12 cases (54.6%) have developed pulpal necrosis for at least one tooth after surgical enucleation of the lesion. The other 10 cases (45.4%) showed normal responses to sensibility testing for all the teeth adjacent to the lesion. Ten out of the 12 cases (83%) that underwent pulpal necrosis were associated with odontogenic cysts, whereas the remaining 2 were associated with periapical granuloma and fibrous dysplasia. Pulp necrosis is high in vital teeth associated with lesions without pulpal involvement. These teeth may benefit from root canal treatment prior to surgical enucleation of the lesion, which may prevent impaired healing or recurrence of infection. Careful treatment planning and thorough discussion should take place between the surgeons, endodontists, and patients prior to executing the treatment. The patient should be aware that there is a possibility that they may need root canal treatment as a preventative measure to enhance the chances of healing following the surgical procedures and in case the patients opted not to perform root canal treatment beforehand, close follow-up in the future should take place to monitor the vitality of the teeth in the follow-up visits.

Evaluation of dentists’ approach to retreatment in Turkey: A survey study

Aim: This study aimed to evaluate the approaches that dentists working in Turkey take to retreatment. Methods: A questionnaire with 16 questions regarding gender, institution, specialty, experience, and root canal treatment stages was distributed to 223 dentists. The collected questionnaires were analyzed in R 4.0.0 programming language. A chi-square test analyzed the categorical variables. The statistical analyses were performed at a 5% significance level. Results: A statistically significant relationship was found between the years spent practicing dentistry and the methods of determining the length of root canal treatment (p < 0.05). The relationship between the choices of irrigation agents for canal treatment and the professional title was found to be statistically significant (p < 0.05). No significant relationship was found between gender and other parameters (p > 0.05). A statistically significant difference was found between the treatment protocol applied in molar teeth with lesions, the success rate of the patients who underwent retreatment, and the practitioners’ specializations (p < 0.05). The relationship between retreatment in unsuccessful root canal treatments and the institution studied was also statistically significant (p < 0.05). A total of 66% of dentists working in Oral and Dental Health Center, 88% of dentists working in private clinics, and 90% of dentists working at universities reported that they performed retreatment. The relationships among the frequency of endodontic treatment, the use of magnification while performing root canal treatment, the group of teeth that was most often treated, and the institutions in which dentists work were also found to be statistically significant. Conclusion: In this survey study, which was conducted to evaluate the practice of endodontic treatment, the rate of dentists performing endodontic treatments was found to have increased. Endodontists performed retreatment cases at a higher rate than general practitioners. Dentists with less professional experience had higher rates of endodontic treatment for difficult–to–treat molars than those with more professional experience. How to cite this article: Tellioğlu Avcı GR. Evaluation of dentists’ approach to retreatment in Turkey: A survey study. J Med Dent Invest 2023;4:e230314. https://doi.org/10.5577/jomdi.e230324 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Protocol on comparative evaluation of the effect of application of 38% silver diamine fluoride on sealing ability of Biodentine and MTA Angelus as a perforation repair material: a confocal laser microscopic study

Background: Perforation can occur while performing root canal treatment. Biodentine has been made utilizing MTA (mineral trioxide aggregate) as a base, and claims to improve its properties in aspects such as physical property, durability, and handling, as well as its many other applications in restorative dentistry. The chemical components of SDF (silver diamine fluoride) have been suggested to have the following benefits: fluoride aids in remineralization and prevention, silver salts induce dentin sclerosis/calcification, and exhibit germicidal actions. It works by occluding dentinal tubules thus helping in preventing microleakage. This study aims to focus on the use of SDF on Biodentine and MTA as perforation repair material using a confocal microscope. Methods: Mandibular molars will be selected for the study. The study will be divided into 4 groups: Group 1: Biodentine without application of 38% SDF; Group 2: Biodentine with the application of 38% SDF; Group 3: MTA Angelus without application of 38% SDF; and Group 4: MTA Angelus along with the application of 38% SDF. An artificial perforation 2 mm in diameter will be made directly in the middle of the pulpal floor. 38% silver diamine fluoride (FAMAGAIN) will be applied on the walls of the perforation according to the manufacturer’s instructions for the experimental groups (Groups 2 and 4). In the four groups, Biodentine will be applied in groups 1 and 2 and MTA will be applied in 3 and 4 (perforation repair material). To evaluate the sealing capacity of perforation material in this study, we will use the average values of coronal dye leakage at the perforation site and Escobar’s criteria, which are used to assess the infiltration proportions. Conclusions: It is expected that application of 38% of silver diamine fluoride on MTA Angelus and Biodentine may show better sealing ability than MTA Angelus and Biodentine alone.

Analysis of C- Shaped Root Canal Morphology in Mandibular Second Molar using Cone Beam Computed Tomography

Objective: To analyse the C-shaped canal configuration in the mandibular second molar in a Pakistani subpopulation using cone beam computed tomography (CBCT).
 Study Design: Cross-sectional study.
 Place and Duration of Study: Department of Radiology, Dow University of Health Sciences, Karachi Pakistan, from Feb to Jul 2020.
 Methodology: Cone-beam computed tomography (CBCT) scans of the mandibular second molar that were taken for some other purpose were included in the study. One hundred fifty mandibular second molar teeth were assessed for C-shaped canal morphology. The c-shaped canal was then further examined at three different levels classifying according to Fan criteria, a modification of Melton's classification. Differences between gender left and right sides, unilateral and bilateral, were determined.
 Results: Out of 150 mandibular second molars, a C-shaped canal was found in 13(8.7%) of the teeth examined, in which 9(69.2%) were in females, and 4(30.8%) were in males. Bilateral distribution was found to be 11(92.3%).
 Conclusion: A high frequency of C-shaped canal in the mandibular second molars was observed in the present study. Therefore the variations in the morphology of the root canal system of the mandibular second molars should be considered when performing root canal treatment.

Student\'s confidence level in performing root canal treatment and its correlation with encountered errors

This study aims to investigate the confidence level of undergraduate final-year dental students in performing root canal treatment (RCT) and the relationship to the problems encountered during RCT. A validated online questionnaire was distributed to final-year dental students at Universiti Teknologi MARA. The questionnaire utilized both scaled responses and closed-ended questions to gain data regarding students’ confidence levels in performing root canal treatment. : In this study, 93.4% of the students were confident in placing a rubber dam, 90.8% were confident in injecting local anesthesia and root canal irrigation. Procedures that were rated as least confident were access cavities and management of interappointment flare-ups. For the mean rate of self-confidence in performing RCT in the dentition, maxillary anterior teeth (4.24±0.63) ranked highest followed by mandibular premolars (4.11±0.72), whereas the least confidence was in treating maxillary molars (3.38±0.69). Higher scores of self-confidence were in the management of necrotic pulp (4.22±0.65), followed by vital pulp treatments (3.95±0.61). The main mishaps that students encountered were canal blockage (57.9%) and underestimation of length (52.6%). There is no statistically significant correlation between the confidence level and encountered errors. . : The mean overall confidence score of different endodontic procedures was high, which is 80%. Examining the confidence level of students is a crucial part of this study, which can help to enhance the quality of endodontic education in areas that need improvement.

Case report: Delayed autologous tooth transplantation based on objective bone healing of the extraction socket (4-year follow-up)

Autologous tooth transplantation is one of the best methods to replace a missing tooth when there is a suitable donor tooth. Tooth transplantation is mainly performed immediately after extraction because this is completed in a single surgery and donor tooth is transferred to fresh recipient site facilitated by remaining periodontal ligament. However, when transplantation is planned for severe recipient site with large bone defect surrounding the affected tooth, delayed transplantation is performed because of the mismatched size of donor tooth. When bone formation at the recipient site is gradually observed during wound healing, transplantation can be performed. However, estimated time for delayed transplantation has not been clearly determined because of the varied wound healing at recipient site. This case report demonstrates successful tooth transplantation 4 months after extraction by monitoring bone healing of the recipient site by computed tomography (CT). A male patient complained about occlusal pain in his mandibular molar. He had received the latest restoration after root canal treatment 10 years previously. Seven years later, he experienced slight spontaneous pain and consulted a private dental clinic. Radiographic examination revealed vertical root fracture and the dentist recommended tooth extraction, but he did not receive this suggestion. Several years later, he visited our hospital, and the bone resorption became much larger, and the surrounding bone was completely lost. Thus, it was decided autologous tooth transplantation several months later because of poor fit of the donor tooth using wisdom tooth. Sequential CT value was monitored during bone formation at the recipient site by multi-detector computed tomography. Four months later, CT value of the recipient site had gradually increased and tooth transplantation was performed. Fit of the donor tooth to the recipient site was still poor at the surgery, but it became better and tooth mobility decreased gradually. After performing root canal treatment, final full covered restoration was equipped. Review at 4 years after transplantation revealed the tooth showed no symptoms with no apical radiolucency. This case report suggests that delayed tooth transplantation can be performed after monitoring bone formation at the recipient site by x-ray or CT images.

Iatrogenic perforation management using calcium silicate cement: a case report

The world today is literate enough about the basics of oral health conditions and available treatment options. Due to the availability of many resources on different platforms the urge to retain natural teeth rather than have extractions has increased. Dental catastrophes are sometimes unavoidable in everyday dental practice. The prime motive should be patient benefit while the general dental practitioner (GDP) identifies the risks associated with the case, availability of equipment and enhanced operator skill when deciding to the referral of the patient to a specialist. Most failed root canal treatment cases have one or more associated endodontic errors. This case report presents stepwise management of such a case of iatrogenic perforation that occurred during the initial endodontic management. It emphasizes the significance of evidence-based treatment planning, role of magnification, selection of the appropriate armamentarium for performing root canal treatment, use of bioactive materials that collectively demonstrate peri-apical healing following the repair of endodontic mishaps. It also emphasizes on the importance of recall in such cases where adequate healing can be tracked over a period. CPD/Clinical Relevance: Knowledge of management of iatrogenic perforations is useful information for clinicians.

THE RELATIONSHIP OF MOTIVATION ON THE INTEREST OF THE COMMUNITY VISITING THE DENTIST DURING THE COVID-19 PANDEMIC IN SUNGAI MIAI VILLAGE

THE RELATIONSHIP OF MOTIVATION ON THE INTEREST OF THE COMMUNITY VISITING THE DENTIST DURING THE COVID-19 PANDEMIC IN SUNGAI MIAI VILLAGE

Dental intern’s perception of difficulties in performing root canal treatment: A cross sectional study

Introduction: Root canal treatment (RCT) is a multi-phase procedure and is the one of the most regularly practicing procedures in dentistry. This is the procedure in which many of the undergraduate dental interns face problems in one and the other step. Therefore. A questionnaire based study was done over 100 interns to determine significant procedural difficulties and challenges encountered by undergraduates during endodontic root canal treatment. Material and Methodology: It was a cross sectional study in which 100 interns with the same year of graduation and level of experience who were willing to participate were involved. All participants were given questionnaires involving 18 questions in which there were 15 close ended questions and three open ended questions. The statistical analysis was done to get the results. Results: For the first 15 close-ended questions, interns found it difficult to manage calcification in pulp chamber and root canals (89.9%), placing rubber dam (80.8%), and removing gutta percha in retreatment cases (75.8%). Interns didn't find any difficulty in irrigation procedure (92.9%), radiographic verification of master cones (92.9%), and giving local anaesthesia (89.9%). Conclusion: Assessment of major difficulties faced by interns during root canal treatment may assist in development of better and effective methods of teaching. This study will help to discover various gaps in teaching schedules which if altered correctly would be of great benefit to the quality of their performance.

Dental Students’ Self-Confidence Level in Performing Endodontic Treatment in Dentistry Faculty of Rafsanjan University of Medical

Introduction: The students’ self-confidence level is a key factor affecting the success of endodontics learning. This study aimed to determine the confidence level of dental students who performing root canal treatment at Rafsanjan University of Medical Sciences in 2021.
 Materials & Methods: In this cross-sectional study a questionnaire including demographic information, endodontic experience, attitude toward confidence in performing different stages of root canal treatment, and suggestions for improving the quality of endodontic education was distributed among 54 dentistry students from 5th and 6th -year during the last month of the academic semester. Data were analyzed using T-test, Pearson, and ANOVA tests (α = 0.05). 
 Results: According to the results, of 49 dental students, 24.5% reported the first cases of root canal treatment to be tough. The lowest confidence was reported for finding all root canals in teeth with multiple root canals, preparing access cavity and understanding and managing root canal treatment risks. According to the results of chi-square analysis test, the total confidence score between 5th and 6th year students was not significantly different (p value = 0.648). Also, the relationship between general selfconfidence and students' self-confidence level was not seen (p value = 0.372). There was no significant relationship between the Confidence level and age, academic year, the difficulty level of the first endodontic treatment, and number of endodontic treatments (p value > 0.05).
 Conclusion: Students had lower self-confidence finding all the canals in multi-canal teeth, in properly handling the treatment risks, and preparing the access cavity. Endodontics training should also be improved by increasing clinical sessions and using recent advances in endodontics.

Tingkat Keberhasilan Perawatan Saluran Akar Pada Gigi Non Vital di RSGM Universitas Jember Tahun 2016

Teeth with pulp necrosis, whether or not with periapical abnormalities, may be indicated for root canal treatment. Root canal treatment is a treatment carried out with the aim of removing infected dental pulp tissue, necrotic debris, and microorganisms. It aims to make the root canal sterile and can be filled with filling material so that a hermetic density is obtained in the apical area. Root canal treatment consists of three main stages (Triad Endodontics). The endodontic triad consists of preparation, sterilization and root canal filling. These three stages of root canal treatment are very important because not all root canal treatments end with success. The success of root canal treatment can be evaluated after a minimum of six months. Subjective, objective and radiographic examinations need to be conduct for determining the success of the treatment. Root canal treatment is said to be successful if the results of the three examinations are declared good. This type of research is descriptive research. The research method was carried out by subjective, objective and radiographic examination in the study sample who had performed root canal treatment in 2016 that met the criteria of the researcher. The results of the research are included in the table and interpreted with a percentage that is very low to very good. Based on this, it was concluded that the success rate of root canal treatment in non-vital teeth at RSGM University of Jember in 2016 was 54.54% and included in the sufficient category.

Endodontic Rotary Files, What Should an Endodontist Know?

Clinicians should be aware of all the characteristics and capacities of the instruments that are possible to use when conducting a root canal treatment. The wide variety of nickel–titanium (Ni-Ti) rotary systems on the market and the lack of standardisation of this type of instrument makes the choice in each specific case difficult. Therefore, this review is intended to summarize the characteristics that should be taken into account when choosing one instrument over another. It will be essential to know characteristics, of alloy from which the instrument is made. Moreover, the geometry of the instrument will determine its behaviour, being the mass, the one that marks its resistance to a greater extent. The movement performed by the file is another of the fundamental keys to understand rotary instruments. In conclusion, when performing root canal treatment, the characteristics of the instrument and the tooth must be taken into account, and the operator’s own limitations should be known. This paper provides the key points to keep in mind when making this type of treatment.

A survey on the perception of fear among the dental students while performing root canal treatment

Introduction: Root canal treatment is considered a procedure in endodontics that requires more focus and precision.It is a type of endodontic treatment that is mainly used to repair and save a badly injured or infected tooth. Most dental students feel that they are not prepared well enough to carry out the treatment while practising due to the presence of levels of difficulty of the root canal.Due to the gradual increase in the life expectancy among population and desire of individuals in preserving their natural teeth, an increasing demand for these endodontic treatments and are bound to increase in the years ahead. Aim: Gather information from students regarding their perception of fear of performing RCT, how they self‑evaluate their confidence level while performing in patients and difficulties faced by them. Materials and Methods: A questionnaire based survey was conducted to 100 dental students from pre-clinical second years to interns of saveetha dental college.The survey was conducted online and consisted of 15 questions based on the perception of fear among the students while performing RCT in patients after which the survey was summarised and analysed statistically using SPSS version 23.0.

Chemical neurotoxicity to the inferior alveolar nerve—A rare sequela of endodontic treatment

AbstractAimDamage to the inferior alveolar nerve (IAN) during endodontic procedures is a rare complication. However, over‐ instrumentation and over‐filling during root canal treatment can cause injury through direct trauma, pressure or neurotoxicity from intra‐canal irrigants or root canal filling materials, particularly where the roots of mandibular molars or premolars are in close proximity to the IAN. This report describes the clinical presentation and management of a severe chemical injury to the right IAN following the endodontic treatment. We also provide practical considerations to help minimise such complications.MethodsA 27‐year‐old female developed immediate onset numbness and tingling to the right mental region following endodontic treatment of tooth 47. Radiographic examination confirmed widespread extrusion of root canal sealer within the marrow spaces of the right mandibular body extending centrally within the mandibular canal and perforating the lingual cortex.ResultsUrgent surgical exploration and decompression of the right IAN were undertaken, which revealed an avascular and fibrotic nerve with virtually no normal neuronal structure. There was evidence of foreign material both in contact with the epineurium and within the nerve trunk, much of which could not be eliminated. This severe chemical insult to the nerve resulted in irreversible anaesthesia in the right IAN distribution.ConclusionThis case highlights the diligence that is required when performing root canal treatment in high‐risk mandibular molar teeth, particularly in relation to confining materials within the canal space, accurate canal measurements and comprehensive radiographic evaluation both pre‐ and post‐operatively. Urgent specialist referral for the elimination of foreign material is essential to maximise the potential for nerve regeneration.

Evaluation on the perception of final year dental students on their confidence level regarding endodontic treatments: a cross sectional analysis

Endodontics procedures are difficult and complicated that most of the practitioners would encounter. Therefore, dental students should gain their confidence and competent during their training. This research aimed to study the perception of final year students on confidence level regarding endodontic treatments from all public universities and their opinions on the quality of endodontic education. A Google Form was used to disseminate an online questionnaire to all dental students from public universities across Malaysia. The survey included both scaled answer and open-ended questions. 184 responses out of 235 students, were obtained (response rate = 78%). Perception of competence and confidence were significantly greater amongst the students from research-based universities group (P < 0.05). 93.5% (n=179) of participants agree that they were confident to do endodontic procedure on anterior tooth, whilst on posterior tooth, only 75.5% (n=139) were confident. Only 6.5 percent of participants (n = 12) did not feel confident doing root canal treatment on single-rooted teeth, but 76.1 percent (n = 140) did not feel competent performing root canal treatment on multirooted teeth. Over 90% of the students rated the quality and the amount of time spent on endodontic education were adequate at their respective university as ?5 on a Likert scale (1 = inadequate to 10 = adequate). In addition, when they were asked to give the suggestion on how to improve the quality of endodontic education, 10.9% of the students suggested to increase the number of practical session and to do regular discussion regarding endodontic cases. It is vital to improve undergraduate endodontic education in order to raise students' perceptions of their confidence and competence when doing root canal therapy.

Cone-Beam Computed Tomographic Evaluation of Canal Morphology of Mesiobuccal Root of Maxillary Molars in Saudi Subpopulation.

Introduction:The purpose of this study was to analyze the canal configuration of mesiobuccal root (MBR) of the maxillary molars in the Saudi subpopulation using cone-beam computed tomography (CBCT) and to compare if there is any gender and arch variation.Methodology:In this cross-sectional retrospective evaluation study, analysis of CBCT scans of MBRs of 400 maxillary first and second molars was done that has undergone CBCT scanning for diagnostic/treatment purposes in the private clinic of Jeddah, KSA. Statistical analysis was performed using Student's t-test and Chi-square test.Results:Type I, II, and III canal configurations have been reported to be the most common morphologies in the MBR in both first and second molars, with the incidence of 20.25% (81), 17.25% (69), and 17.25% (69), respectively. Type I canals were significantly (P < 0.001) more common in tooth #17 and #27, Type II canals were significantly (P < 0.001) more seen in tooth #26, Type 3 canals were more seen in tooth #27, but there is no statistically significant association. Supplemental canal configurations which were classified by Gulabivala as Type I, Type II, and Type IV were also seen. Furthermore, 93 additional unclassified canal configurations were also found.Conclusion:The data indicate high prevalence of MB2 canals with varying canal configurations. Preoperative CBCT imaging should always be done in tooth-like maxillary molars, to understand the complex configurations and variations and to achieve higher success while performing root canal treatment.