Technical Quality Of Root Fillings Research Articles

An Audit of the Technical Quality and Iatrogenic Errors of Root Canal Treatment by Undergraduate Dental Students at the University of Sharjah.

The aim of this study was to determine the technical quality of root canal fillings and the presence of iatrogenic errors in the cases treated by undergraduate dental students using radiographic images. This study included 480 root-filled teeth, which were evaluated using intraoral periapical radiographic images. The technical quality of obturation was assessed by observing the length, density, and taperness of the root filling. Ledges, apical transportation, fractured instruments, zipping, and root perforation were recorded as iatrogenic errors. Teeth were classified as acceptable if the technical parameters were adequate and there were no iatrogenic errors. Data were statistically analyzed using Pearson's chi-squared test. The quality of root filling was acceptable in 183 of the 480 teeth. The rate of acceptable quality was higher for the teeth treated by 4th-year students (41.9%) than for those treated by 5th-year students (27.4%; p = 0.004). Length and taperness were adequate in more of the patients treated by the 4th-year students (p<0.05). There was a significant difference in the incidence of ledge formation and apical transportation in relation to the student's level (p<0.05). The technical quality of root fillings performed without iatrogenic errors by undergraduate dental students was declared acceptable in 38.1% of the assessed teeth. There was a noticeable difference in the quality of root canal treatment between the 4th- and 5th-year students. The findings demonstrate that periodic assessment of the technical quality of root filling performed by undergraduate dental students provides feedback on curriculum standards.

Effects of an individualized training course on technical quality and periapical status of teeth treated endodontically by dentists in the Public Dental Service in Norway: An observational intervention study.

To investigate the effect of a continuing education course on technical quality and treatment outcome for root filled permanent teeth in Møre and Romsdal County, Norway. Fifty-two dentists employed in the Public Dental Service in Møre and Romsdal county, Norway, completed a two-day continuing education course in root canal treatment. Periapical radiographs of root filled teeth treated before and after the course, with at least one-year follow-up were identified and scored for technical quality and periapical status. Technical root filling quality was assessed by density and length and the treatment outcome by PAI scores. Treatment information was achieved from the county's electronic dental record system. Information regarding the dental practitioners' background and treatment procedure routines was collected by a questionnaire. Descriptive statistics analyses and mixed-effect logistic regression analyses were performed to evaluate the effect of the course. Radiographs were available for 224 teeth root filled before and for 221 teeth after the course. The proportion of teeth with adequate root filling quality was significantly lower after the course (p=.006), associated mainly with short root fillings (p<.001). No significant differences were observed in treatment outcome. There were, however, large differences in treatment outcome amongst subgroups of dentists. Further, there was evidence of effect modification by the continuing education course on periapical outcome by patient's age (pinteraction =.0023) suggesting that teeth in patients ≤18years healed relatively better post-course compared to patients >18years. A two-day continuing education course in root canal treatment attended by Public Dental Service dentists in Norway did not improve the technical quality of root fillings or periapical status associated with root filled teeth.

Comparison of Endodontic Treatment Qualities of Molar Teeth Performed by Endodontists and Practitioners: A Radiographic Analysis

Background: The aim of this study was to evaluate the radiographic technical quality of root fillings and the incidence of iatrogenic errors in treatments performed by endodontists and dentists.Methods: 1135 radiographic records of endodontic treatments performed by endodontists and dentists were qualified to be further investigated. Radiographs were assessed by two independent endodontists. The length and the density of the obturations and iatrogenic errors were investigated. Chi-square tests were used for statistics.Results: According to iatrogenic errors; the presence of instrument fractures was significantly higher in the endodontists, and likewise, in the mesiobuccal canals of the mandibular teeth (p&amp;lt;0.05). dentists were found more likely to treat the root canal in poor radio-opacity and short filling-overfilling (p&amp;lt;0.05). no significant difference was found between the groups in other iatrogenic errors (p&amp;gt;0.05).Conclusion: The results of this retrospective study show that the canal treatment performed by endodontists were better in terms of the quality of the root canal filling than dentists.

Is the technical quality of root fillings associated with socioeconomic status?

Abstract Background Socioeconomically better-off tend to receive better care, and to benefit more from care they receive, than the less well-off. The technical quality of root fillings can be assessed radiographically. Our aim was to investigate differences in the technical quality of root fillings according to socioeconomic status not studied before. Methods In the Finnish Health 2000 Survey, a sample of 8 028 over 29-year-old adults was selected by a stratified two-staged cluster sampling. Of these, 6 115 (76%) underwent panoramic radiography. A total of 7 986 endodontically treated teeth were detected among 3 905 participants. The criterion for a technically inadequate root filling was a distance from the root filling to the root apex of over 3 mm or material over the apex. Education, employment status and household income were used as measures of socioeconomic status. Differences in the quality of root fillings according to socioeconomic status were investigated using the Multiple Additive Regression Tree mediation analysis, taking into account age, gender and tooth type of the root filled tooth. Results Almost half (47%) of the root fillings were inadequate. Root filling quality was associated particularly with age of the participant and type of tooth. Mediation analysis showed that among the over 64-year-olds, higher education or income were associated with a slightly higher probability of inadequate root filling quality (ORs 1.15-1.20, p &amp;lt; 0.05). Among the under 65-year-olds, age of the participant and type of tooth explained the observed variations in root filling quality according to socieconomic status, and socioeconomic status had no influence (ORs 0.99-1.02, p &amp;gt; 0.05). Conclusions Those in a lower socioeconomic status had not received poorer endodontic treatment quality. It seems that those in a lower socioeconomic status are not prone to receive poorer quality care in endodontic setting, that they tend to receive in longer and more socially complex treatments. Key messages Variations in the technical quality of root fillings by socioeconomic status has not been studied. Lower socioeconomic status was not associated with poorer technical quality of root fillings.

Is the technical quality of root fillings associated with socioeconomic status? A cross-sectional study among Finnish adults.

We investigated differences in the technical quality of root fillings according to socioeconomic status. In the Finnish Health 2000 Survey, which comprised a sample of 8,028 adults aged over 29yr, 6,115 underwent panoramic radiography. A total of 7,986 endodontically treated teeth were detected among 3,095 participants. The criterion for a technically inadequate root filling was a distance from the root filling to the root apex of over 3mm or a filling extruding beyond the apex. Educational level, employment status, and income were the measures of socioeconomic status. Differences in the frequency of inadequate root fillings according to socioeconomic status were investigated using a multilevel logistic mixed-effects model taking into account age, gender, number of teeth, and type of root filled tooth. Almost half (46%) of the root fillings were inadequate. Among the over 64-yr-olds, higher education and higher income were associated with a higher probability of having an inadequate root filling. Among the under 65-yr-olds, socioeconomic status was not associated with root filling quality. Contrary to expectation, lower socioeconomic status was not associated with poorer endodontic treatment quality; however, higher income and higher education was associated with higher odds for inadequate root fillings among the over 64-yr-olds.

Prevalence of Apical Periodontitis in patients with Multiple Myeloma.

Background Aim Previous reports have been analyzed the prevalence/association of apical periodontitis (AP) with systemic diseases. The present study aims to analyze the prevalence of healthy/diseased periapex and endodontic treatments in patients with Multiple Myeloma (MM) and compare the results with those of control subjects. Material and Methods Methodology Panoramic radiographs of 50 individuals with MM were evaluated and compared with 50 controls that were sex and age matched exactly with the diseased group. Radiographic analysis was performed by 2 two experienced endodontists under standardized conditions. The periapical status (presence or not of AP) was assessed using the periapical index (PAI). Data included systemic health, technical quality of root fillings, total number of teeth, quality of restoration, and periapical status. Statistical evaluation of differences between groups included used chi-squared tests and Fisher’s exact tests. Results The prevalence of root canal-treated teeth was 10.11% in the MM group and 12.05% in the control group (p=0.90). The average root canal-treated teeth in the test group was 2,34 and 2.48 in the control group, where the difference was statistically significant (p=0.05). AP in 1 or more teeth was found in 86 % and in 78% of the patients in the MM and the control groups, respectively. When analyzed by subject, there was no statistically significant difference in the prevalence of AP (p>0.72). Similarly there was also no statistically significant difference in the prevalence of PA (p=0.85), when analyzed by tooth, AP was found in 63.2% and 62.9% in MM and control groups. Conclusions The presence of AP and endodontic treatment was not significantly different in individuals with MM compared with control subjects. Future studies are needed to elucidate and confirm the association between MM and AP. Key words:Apical periodontitis, multiple myeloma, endodontics, root canal treatment, systemic disease.

Posttreatment endodontic disease among patients seeking treatment at a referral dental hospital in Kenya

Background: The incidence of postendodontic treatment disease has equally increased in prevalence among patients with previous root-treated teeth. Objective: This study aimed at determining the characteristics of post-treatment disease following endodontic treatment. Materials and Methods: This was a descriptive cross-sectional study. Convenience sampling was used to select periapical radiographs of patients who needed treatment of teeth with previous root canal treatment. Data were analysed using SPSS. Study Benefits: This research will aid in the development of realistic, evidence-based oral health care policies that could be integrated into general health care within the region. Results: A total of 42 patients participated in the study with 54 teeth presenting with posttreatment endodontic disease (PTEDx). The ages of most patients were distributed in the range of 31–40 years with maxillary molars (25.9%) being the most commonly affected teeth. Thirty-nine (72.2%) teeth were asymptomatic, whereas 15 (27.8%) were associated with pain of varying severity. Well-defined radiolucent lesions were present in 59.3% of the cases, whereas 74.1% of the teeth presented with voids. Inadequate root-filling length (79.6%) appeared to be the most common characteristic of PTEDx. Conclusion: Posttreatment disease in this sample presented with the comparatively high substandard technical quality of root fillings and restorations. Recommendations: Academic institutions teaching dentistry and related authorities should collaborate managing this problem of posttreatment disease judiciously. Technical skills, technology, and performance of root canal filling procedures should be emphasized, and suitable methods should be developed in order to achieve better treatment outcomes. Further studies should be done to establish the challenges that lead to substandard root canal treatment.

Impact of systemic diseases and tooth-based factors on outcome of root canal treatment.

To investigate the impact of systemic health and tooth-based factors on the outcome of root canal treatment (RCT). The target population consisted of all patients receiving RCT at the Helsinki University Clinic in 2008-2011. The inclusion criteria were diagnosable pre- and postoperative (minimum 6months after root filling) radiographs and adequate patient records of RCT available. Teeth extracted for nonendodontic reasons were excluded. Patient documents including digital radiographs of 640 permanent teeth in 504 patients were scrutinized. The radiographs were assessed by two examiners under standardized conditions. The Periapical Index was used to define radiographically 'healthy' and 'healing' cases as successful. Data included systemic health, technical quality of root fillings, type of restoration and level of alveolar bone loss. Statistical evaluation of differences between groups included chi-squared tests and Fisher's exact tests. Logistic regression modelling utilizing robust standard errors to allow for clustering within patients was applied to analyse factors related to the outcome of RCT. The mean age of patients was 51.5years (standard deviation (SD) 15.0; range 10-83), and 49% were female. In 41 cases (6%), the patient had diabetes mellitus (DM), in 132 (21%) cardiovascular disease and in 284 (44%) no systemic disease. The follow-up period was 6-71months (mean 22.7). In the primary analyses, the success rate of RCT was 73.2% in DM patients and 85.6% in patients with no systemic disease (P=0.043); other systemic diseases had no impact on success. In the multifactorial analysis, the impact of DM became nonsignificant and RCTs were more likely to succeed in the absence of apical periodontitis (AP; odds ratio (OR)=4.4; P<0.001), in teeth with optimal root filling quality (OR=2.5; P<0.001), in teeth restored with indirect restorations (OR=3.7; P=0.002) and in teeth with none/mild alveolar bone loss (OR=2.4; P=0.003). DM diminished the success of RCT, especially in teeth with apical periodontitis. However, tooth-based factors had a more profound impact on the outcome of RCT. This should be considered in clinical decision-making and in assessment of RCT prognosis.

Post-treatment apical periodontitis related to the technical quality of root fillings and restorations in Thai population.

The aim of this study was to investigate the post-treatment apical periodontitis in endodontically treated teeth related to the technical quality of root fillings and restorations in Thai population. Full-mouth periapical radiographs from Thai patients attending the Faculty of Dentistry, Mahidol University, Thailand were examined. The periapical status, quality of root fillings and coronal restorations, existence of intraradicular post and its relationship to the root fillings were evaluated. Among 1586 patients, 37.4% presented endodontically treated teeth. The total number of endodontically treated teeth was 1511, and 35% presented apical periodontitis. Combined data for root filling and coronal restoration qualities revealed significantly better outcome in teeth with adequate qualities of both parameters than the other combinations (P < 0.001). The prevalence of post-treatment apical periodontitis among Thai population was relatively high and significantly associated with substandard technical quality of root fillings and restorations.

Technical quality of root canal treatment performed by undergraduate students using hand instrumentation: a meta-analysis.

The technical quality of root canal treatment (RCT) may impact on the outcome. The quality of education received during undergraduate school may be linked to the quality of treatment provided in general dental practice. In this context, the aim of this systematic review was to answer the following focused questions: (i) What is the frequency of acceptable technical quality of root fillings, assessed radiographically, performed by undergraduate students? (ii) What are the most common errors assessed radiographically and reported in these treatments? For this purpose, articles that evaluated the quality of root fillings performed by undergraduate students were selected. Data were collected based on predetermined criteria. The key features from the included studies were extracted. GRADE-tool assessed the quality of the evidence. MAStARI evaluated the methodological quality, and a meta-analysis on all studies was conducted. At the end of the screening, 24 articles were identified. Overall frequency of acceptable technical quality of root fillings was 48%. From this total, 52% related to anterior teeth, 49% to premolars and 26% to molars. The main procedural errors reported were ledge formation, furcation perforation, apical transportation and apical perforation. The heterogeneity amongst the studies was high (84-99%). Five studies had a high risk of bias, eight had a moderate risk, and 11 had low risk. The overall quality of evidence identified was very low. The conclusion was that technical quality of root fillings performed by undergraduate students is low, which may reveal that endodontic education has limited achievement at undergraduate level. A plan to improve the quality of root fillings, and by extrapolation the overall quality of root canal treatment, should be discussed by the staff responsible for endodontic education and training.

An audit on technical quality of root fillings performed by undergraduate students.

To evaluate radiographically the technical quality of root fillings performed by undergraduate dental students and to assess whether students were exposed to an appropriate endodontic case mix during their clinical training. A retrospective audit was undertaken evaluating the clinical records of patients who underwent endodontic procedures during the period from September 2015 to June 2016 in the Dental School at Queen's University Belfast, UK. Two final-year dental students were trained and calibrated to evaluate postoperative intra-oral periapical radiographs of completed root canal treatments using specific assessment criteria. Data were presented as frequencies, percentage and mean±standard deviation (SD). Comparisons of treatment outcomes between groups (posterior and anterior teeth) were calculated using Fisher's exact test, and the level of significance was set at P<0.05. Intra- and interexaminer reproducibility was assessed by Kappa statistics. A total of 222 teeth and 381 canals were assessed, and of those, 253 (66%) of the root fillings were found to be acceptable in all the assessment parameters, namely taper, length and lateral adaptation of the root filling. Subanalysis of individual root filling parameters revealed that 372 canals (97%) exhibited good taper, and 275 canals (72%) were considered to be of an appropriate length, with 89 canals (23%) found to be underfilled and 17 canals (5%) overfilled. Overall 346 (91%) of canals had good lateral condensation. Students treated both single and multirooted teeth, and there was no significant association between tooth type and the quality of root filling provided (P>0.05). In the majority of the teeth treated by undergraduate students at Queen's University Belfast, the technical quality of the root filling was acceptable and students were exposed to an appropriate case mix for endodontic training.

Radiographic technical quality of root canal treatment performed by a new rotary single-file system

The aim of the present study was to evaluate radiographically the technical quality of root canal filling performed by postgraduate students with a new single-file Nickel-Titanium System (F6 Skytaper Komet) in clinical practice. Records of 74 patients who had received endodontic treatment by postgraduate students at the School of Dentistry, Faculty of Medicine, University of Pavia in the period between September 2015 and April 2016 were collected and examined: the final sample consisted 114 teeth and 204 root canals. The quality of endodontic treatment was evaluated by examining the length of the filling in relation to the radiographic apex, the density of the obturation according to the presence of voids and the taper of root canal filling. Chi-squared analysis was used to determine statistically significant differences between the technical quality of root fillings according to tooth's type, position and curvature. The results showed that 75,49%, 82,84% and 90,69% of root filled canals had adequate length, density and taper respectively. Overall, the technical quality of root canal fillings performed by postgraduates students was acceptable in 60,78% of the cases.

A Radiographic Study of the Association between Apical Periodontitis and Technical Quality of Intraradicular Posts and Root Canal Fillings: A Cross-sectional Study in Qassim Region, Saudi Arabia.

Objectives:This study evaluates the association between the apical periodontitis (AP) and quality of intraradicular posts and the quality of root fillings assessed radiographically in Qassim region, Saudi Arabia.Materials and Methods:Digital periapical radiographs of 327 teeth with post-retained restoration were retrieved randomly from the Qassim University screening clinic's digital archives and evaluated. The quality of the intraradicular post and root filling was evaluated according to the optimum criteria. The presence of AP was assessed based on the periapical index scoring system. The relation between the post technical quality, the quality of root filling, and AP was determined. The data were analyzed using Chi-square test and logistic regression.Results:AP was found in 22% of the investigated teeth. Adequate root fillings were found in 69% of roots, and 14% of these cases were associated with AP. In roots with root filling classified as inadequate, 38% had AP with a statistically significant association between the root filling length and the presence of AP (P < 0.001). The most frequently used posts were prefabricated metallic posts (57%). Teeth restored with cast posts and prefabricated metallic posts exhibited AP with a frequency of 42.3% and 25.4%, respectively, and teeth with nonmetallic posts had significantly fewer cases of AP (12.0%) with a statistically significant association between the post type and the presence of AP (P = 0.016).Conclusion:Both the quality of the root filling and the intraradicular post type were correlated significantly with the presence of AP. The technical quality of root fillings and intraradicular posts was adequate. Nevertheless, the use of threaded posts is still a common practice in this study population.

Evaluation of the Quality of Root Canal Treatments Performed by Dental Undergraduates: Is There a Need to Review Preclinical Endodontic Courses?

Aim: To evaluate the quality of root canal treatment (RCT) performed by undergraduate (UG) dental students at the Jordan University Dental Hospital (JUDH) using radiographic records. Methods: All RCTs performed by UG students in the period between November 2013 and May 2014 were included in this study (213 teeth). ‘Adequate’ filling quality was defined as having adequate length, density and taper with the absence of any procedural error. Statistical analysis of the resulting data was carried out using the Chi-square test (χ2). Results: 61.5% of treated teeth were adequate in length, 50.5% were adequate in density and 56.1% were adequate in taper; only 29.2 % fulfilled these criteria at the same time, the relationship between the technical quality of root filling and tooth type was statistically significant (P< 0.01); the most adequate found in maxillary anterior teeth (47.1%), the least adequate found in maxillary molar teeth (5.9%). Conclusions: The technical quality of root fillings performed by undergraduate dental students using cold lateral compaction was poor. This suggests that the undergraduate endodontic training at the JUDH needs to be improved.

Assessment of the periapical health of abutment teeth: A retrospective radiological study.

The aim was to examine the technical quality of root fillings and periapical status of root-filled and nonroot-filled teeth restored with crowns and bridge retainers through a retrospective analysis of orthopantomographs (OPTGs) in an adult Turkish subpopulation. In this study, the digital OPTGs of adult patients between the ages of 20 and 70 who appealed to the Endodontics Endodontics Department of the Dentistry Faculty at Marmara University (Istanbul, Turkey) for the first time to have their endodontic treatment needs met were used. The periapical health of all teeth restored with crowns and bridge retainers, and the technical quality of the root fillings on abutment teeth were evaluated by radiographic criteria. The survey was carried out using the OPTGs of 1000 adult patients composed of 590 (59.0%) women and 410 (41.0%) men. 4656 (20.9%) of the totally examined 22280 teeth were with crowns and bridge retainers. 986 of the total abutment teeth were root-filled and 458 (46.5%) of them had apical periodontitis (AP) while 3670 of the total abutment teeth were nonroot-filled and 930 (25.3%) of them were with AP. The most commonly treated teeth were premolars (33.8%), followed by molars (26.2%), incisors (23.3%) and canines (16.7%). Technical quality was proved to be adequate in 27.5% of the root fillings. A higher frequency of AP was related to inadequate root fillings (P<0.01). The frequency of root-filled abutment teeth with AP, nonroot-filled abutment teeth with AP, and technically inadequate root-fillings among teeth with crowns and bridge retainers was high in the selected adult population.

Effect of education intervention on the quality and long-term outcomes of root canal treatment in general practice.

To compare the technical quality and long-term outcomes of root canal treatment by general practitioners of a Swedish Public Dental Service, before and after an endodontic education including Ni-Ti rotary technique (NiTiR). A random sample was compiled, comprising one root filled tooth from each of 830 patients, treated by 69 general practitioners participating in the education: 414 teeth root filled in 2002, pre-education, using primarily stainless steel instrumentation and filling by lateral compaction, and 416 teeth root filled post-education (2005), using mainly NiTiR and single-cone obturation. Follow-up radiographs taken in 2009 were evaluated alongside immediate post-filling radiographs from 2002 to 2005. The density and length of the root fillings were registered. Periapical status was assessed by the Periapical Index (PAI), using two definitions of disease: apical periodontitis (AP) (PAI 3 + 4 + 5) and definite AP (PAI 4 + 5). Tooth survival was registered. Root fillings pre- and post-education were compared using chi-square and Fisher's exact tests. Crude extraction rates per 100 years were calculated for comparison of tooth survival. Explanatory variables (type of tooth, root filling quality, periapical status, marginal bone loss, type and quality of coronal restoration) in relation to the dependent variable (AP at follow-up) were analysed by multivariable logistic regression. Follow-up data were available for 229 (55%) of teeth treated pre- and 288 (69%) treated post-education: both tooth survival (P < 0.001) and root filling quality were significantly higher (P < 0.001) in the latter. However, there was no corresponding improvement in periapical status. Both pre- and post-education, root fillings with definite AP on completion of treatment had significantly higher odds of AP or definite AP at follow-up. For teeth treated post-education, inadequate root filling quality was significantly associated with AP at follow-up. Despite a higher tooth survival rate and a significant improvement in technical quality of root fillings after the education, there was no corresponding improvement in periapical status.

Technical Quality of Root Fillings Performed by Dental Students in Babol Dental School

Introduction: There is substantial evidence that the technical quality of root canal filling has a significant effect on the outcome of root canal treatment. The aim of this study was to evaluate the technical quality of root canal fillings performed by dental students. Methods: The records of 325 teeth radiographs, treated by dental students in 2008-2009 in Babol Dental School, were selected and evaluated. For each tooth, three periapical radiographs (before treatment, during operation and at the end of treatment) were examined. Filling length, density and taper, and presence or absence of void was evaluated. Obturations that have proper length, density and taper, without any void are classified as acceptable root canal fillings. The SPSS statistical software and Chi-Square test were used for analysis. Results: Of the 325 radiographs, 72% had good length and 75% had acceptable taper. There were 14.2% low densities, whereas, only 3.32% of teeth have no void. At least 17.8% of teeth had underfilling and 10.2% overfilling. Finally, only 17.5% of teeth showed acceptable filling length, taper and density without any void. There was no significant difference between the 4 th and 5 th year students and oral hygienist (who studied oral hygiene and now continuing it to dentistry) in root canal filling quality (P> 0.05). Conclusion: Technical quality of root fillings performed by dental students was found to be less than 20%. .It should be revised in the endodontic curriculum requirement to improve their performance.

Technical Quality of Root Fillings Performed by Undergraduate Students: A Radiographic Study

Aim. The aim of this study was to evaluate the radiographic technical quality of endodontic treatment performed by undergraduate students at the School of Dentistry, Faculty of Medicine, University of Novi Sad, Serbia. Materials and Methods. Electronic records of 220 patients treated by final-year undergraduate students during the school year 2011/2012 were examined, and the final sample consisted of 212 patients, 322 teeth, and 565 root canals. The criteria for overall radiographic adequacy of root canal fillings were defined as the presence of adequate length and density and absence of iatrogenic errors (ledge, fractured instrument, untreated canal, and apical transportation). Chi-square test was used to determine statistical significance between different parameters. Results. Adequate root canal fillings were found in 74.22% of the teeth. The percentage of root fillings with adequate length and density was 89.73% and 92.6%, respectively. Fractured instruments and ledges were present in 16 root canals (2.8%), while the presence of missed canal and apical transportation was observed in 2 cases, each (0.3%). Conclusions. Overall, the technical quality of root canal fillings performed by undergraduate students was satisfactory.

Radiographic Assessment of the Technical Quality and Periapical Health of Root‐Filled Teeth Performed by General Practitioners in a Turkish Subpopulation

Aim. The aim of this study was to evaluate by means of radiographs the technical quality of root fillings performed by dental practitioners. Methods and Material. Standardized periapical radiographs were made on 484 patients who received endodontic treatment in private practice. A total of 831 endodontically treated teeth with 1448 roots were evaluated for technical quality of the root canal filling and the periapical status of the teeth. Also, the apical status of each root-filled tooth was assessed according to the length, density, and taper of root fillings, and the presence of apical transportation, broken root instruments, and overfilled sealer or gutta-percha material was recorded for each root canal. Results. Of the endodontically treated teeth 26.6% had healthy periapical tissues, while technically good endodontic treatment constituted 12.8%. Based on the treatment success, there was no significant difference between the tooth groups. Statistical analysis of the data did not demonstrate statistically significant differences between the various parameters that were evaluated (P < 0.05). Conclusions. Technical quality of root fillings in a population who received treatment in private practice was poor and was consistent with a low prevalence of apical health. The probable reasons for this failure are multifactorial and may be improved if the operators improve their skills with continuing postgraduate education programs.

Endodontically related lesions on panoramic radiographs in a Turkish subpopulation

Objective: The purpose of this study was to evaluate the prevalence of detectable endodontically related lesions as determined from the reports of panoramic radiographs in a Turkish subpopulation. Materials and Methods: There were 19,625 reports of panoramic radiographs that were evaluated. Four investigators assessed the radiographs and reports that had been written. For each tooth of the subjects, the following items were surveyed: presence of periapical lesion, inadequate root canal treatment, external and internal root resorption. Results: The patients who had panoramic radiography reports were between the ages of 3 and 91 years (mean age 29,43 ± 18,83 years). 10,941 (56%) were female and 8684 (44%) were male patients. Inadequate root canal treatment was recorded in 588 (3%) radiography reports and it was more frequent in mandibular molar teeth. 2287 (11.7%) of the patients had periapical lesions and it was more frequent in maxillary incisor teeth and mandibular molar teeth. External resorption was observed in 61 (0.3%) patient records, while internal root resorption was reported in 14 (0.1%) reports. 81 inadequate root-filled teeth presented a periapical lesion. A positive strong linear correlation was found between the presence of inadequate root canal treatment and a periapical lesion among the patients (r = 0.098, P = 0.000). Conclusions: The results of this study suggest that external and internal root resorption were not frequent clinical conditions. The high frequency of periapical lesions and inadequate canal treatment in molar teeth indicate the need to improve the technical quality of root fillings, especially in molar teeth.