Radiographic Evaluation of Quality of Root Canal Treatments by Undergraduate Students

Yıl 2024, , 120 - 128, 20.08.2024

Sevda Dürüst Barış , Dilek Hançerlioğulları , Betül Sena Şahbaz , Ali Erdemir

https://doi.org/10.24938/kutfd.1389981

Öz

Objective: The aim of this study was to evaluate the quality of root canal treatments performed by 4th and 5th-year students at the Faculty of Dentistry, Kirikkale University, based on periapical radiographs.
Material and Methods: Between September 2022 and April 2023, the quality of root canal treatments performed by students in the Endodontics Department of Kirikkale University Faculty of Dentistry was examined radiographically. Radiographic images; the length of the canal filling, taper and density parameters were evaluated by taking into account iatrogenic errors such as broken instruments, perforation, step formation and transportation in the canal. Frequency distributions for all parameters were evaluated. Descriptive statistics were applied to identify categorical variables (n, %). The statistical significance level was determined as 0.05. The difference was considered significant when the p value was less than 0.05.
Results: A total of 402 treatments were examined, including 85 anterior teeth (20.74%), 156 premolars (39.25%), and 161 molars (40%). The success rate was 80% for anterior teeth, 78% for premolars, and 44% for molars. The success rate of root canal treatments performed by 4th-year students was 62%, while this rate increased to 67.4% for 5th-year students. Iatrogenic errors were identified: 3.7% broken instruments, 0.25% perforation, 6.75% ledge formation, and 1% root canal transportation. Root canal treatments on anterior teeth were found to be more successful than on posterior teeth.
Conclusion: The success rate of endodontic treatments on molar teeth may be lower due to their complex anatomical structure and difficulty in access. For this reason, it is necessary to focus on preclinical training and clinical endodontic practice, especially on molar teeth.

Anahtar Kelimeler

Root canal treatment, undergraduate students, periapical radiography

LİSANS ÖĞRENCİLERİ TARAFINDAN YAPILAN KÖK KANAL TEDAVİLERİNİN KALİTESİNİN RADYOGRAFİK OLARAK DEĞERLENDİRİLMESİ

Öz

Amaç: Bu çalışmanın amacı Kırıkkale Üniversitesi Diş Hekimliği Fakültesi’nde eğitim gören 4. ve 5. sınıf öğrencilerinin klinik eğitimleri sırasında yaptıkları kök kanal tedavilerinin kalitesini periapikal radyografiler üzerinden değerlendirmektir.
Gereç ve Yöntemler: Eylül 2022- Nisan 2023 ayları arasında Kırıkkale Üniversitesi Diş Hekimliği Fakültesi Endodonti Ana Bilim Dalı’nda 4. ve 5. sınıf öğrencileri tarafından yapılan kök kanal tedavilerinin kalitesi radyografik olarak incelendi. Radyografik görüntüler; kanal dolgusunun boyu, taper ve densite parametreleri, kırık alet, perforasyon, basamak oluşumu ve transportasyon gibi iyatrojenik hatalar göz önüne alınarak değerlendirildi. Tüm parametrelere ilişkin frekans dağılımları belirlendi. Kategorik değişkenleri tanımlamak için tanımlayıcı istatistikler uygulandı (n, %). p değeri 0.05’den küçük olduğunda aradaki fark anlamlı kabul edildi.
Bulgular: 85 anterior (%20.74), 156 premolar (%39,25), 161 molar (%40) diş olmak üzere toplam 402 kök kanal tedavisi radyografik olarak incelendi. Kök kanal tedavisinde başarı oranının; anterior dişlerde %80, premolar dişlerde %78 ve molar dişlerde %44 olduğu tespit edildi. 4.sınıf öğrencilerinin yaptıkları kök kanal tedavilerinin %62 olan başarı oranının, 5.sınıf öğrencilerinde %67.4’e yükseldiği görüldü. İyatrojenik hatalar; %3.7 kırık alet, %0.25 perforasyon, %6.75 basamak oluşumu, %1 oranında kök kanal transportasyonu olarak tespit edildi. Anterior dişlerde yapılan kanal tedavileri posterior dişlere göre daha başarılı bulundu.
Sonuç: Karmaşık bir anatomik yapı göstermesi ve ulaşım zorluğu sebebiyle molar dişlerdeki endodontik tedavilerde başarı oranı daha düşük olabilmektedir. Bu nedenle özellikle molar dişlere yönelik preklinik eğitimlere ve klinik çalışmalara ağırlık verilmesi gerekmektedir.

Anahtar Kelimeler

Kök kanal tedavisi, lisans öğrencileri, periapikal radyografi

Etik Beyan

Çalışmamız 11.10.2023 tarihli ve 2023/09 sayılı Kırıkkale Üniversitesi Girişimsel Olmayan Araştırmalar Etik Kurulu onayı ile gerçekleştirilmiştir.

Destekleyen Kurum

Çalışma için hiçbir kurum ya da kişiden finansal destek alınmamıştır.

Kaynakça

• Fransson H, Dawson V. Tooth survival after endodontic treatment. Int Endod J. 2023;56(2):140-153.
• Xie Z, Shen Z, Zhan P, et al. Functional dental pulp regeneration: Basic research and clinical translation. Int J Mol Sci. 2021;22(16):8991.
• Siqueira Junior JF, Rôças IDN, Marceliano-Alves MF, Pérez AR, Ricucci D. Unprepared root canal surface areas: Causes, clinical implications, and therapeutic strategies. Braz Oral Res. 2018;32:65.
• Ali A, Bhosale A, Pawar S, Kakti A, Bichpuriya A, Agwan MA. Current trends in root canal irrigation. Cureus. 2022;14(5):24833.
• Chubb DWR. A review of the prognostic value of irrigation on root canal treatment success. Aust Endod J. 2019;45(1):5-11.
• Ahmad MZ, Sadaf D, Merdad KA, Almohaimeed A, Onakpoya IJ. Calcium hydroxide as an intracanal medication for postoperative pain during primary root canal therapy: A systematic review and meta-analysis with trial sequential analysis of randomised controlled trials. J Evid Based Dent Pract. 2022;22(1):101680.
• Ribeiro DM, Réus JC, Felippe WT, et al. Quality of root canal treatment performed by undergraduate students using hand instrumentation: A meta-analysis. Int Endod J. 2018;51(3):269-283.
• Saatchi M, Mohammadi G, Vali Sichani A, Moshkforoush S. Technical quality of root canal treatment performed by undergraduate clinical students of Isfahan dental school. Iran Endod J. 2018;13(1):88-93.
• Barakat RM, Matoug-Elwerfelli M, Almohareb RA, Balto HA. Influence of preclinical training on root canal treatment technical quality and confidence level of undergraduate dental students. Int J Dent. 2021;13:9920280.
• Al Shehadat S, El-Kishawi M, AlMudalal A, et al. An audit of the technical quality and iatrogenic errors of root canal treatment by undergraduate dental students at the University of Sharjah. Eur J Dent. 2023;17(1):191-199.
• Ng YL, Mann V, Rahbaran S, Lewsey J, Gulabivala K. Outcome of primary root canal treatment: Systematic review of the literature – part 2. Influence of clinical factors. Int Endod J. 2008;41:6-31.
• Ng YL, Mann V, Gulabivala K. A prospective study of the factors affecting outcomes of non-surgical root canal treatment: Part 2: tooth survival. Int Endod J. 2011;44:610-625.
• Tavares PB, Bonte E, Boukpessi T, Siqueira JF Jr, Lasfargues JJ. Prevalence of apical periodontitis in root canal treated teeth from an urban French population: Influence of the quality of root canal fillings and coronal restorations. J Endod. 2009;35:810-813.
• AlRahabi MK. Evaluation of complications of root canal treatment performed by undergraduate dental students. Libyan J Med. 2017;12(1):1345582.
• Miçooğulları Kurt S, Kandemir Demirci G, Serefoglu B, Kaval ME, Güneri P. Çalışkan MK. Quality of root canal treatment performed by undergraduate students using nickel-titanium reciprocating versus hand instruments. J Dent Educ. 2022;86(12):1662-1670.
• European Society of Endodontology. Undergraduate curriculum guidelines for endodontology. Int Endod J. 2001;34(8):574-580.
• Plasschaert AJM, Holbrook WP, Delap E, Martinez C, Walmsley. AD Profile and competences for the European dentist. Eur J Dent Educ. 2005;9:98-107.
• European Society of Endodontology. Undergraduate curriculum guidelines for endodontology. Int Endod J. 2013;46:1105-1114.
• Liang YH, Li G, Wesselink PR, Wu MK. Endodontic outcome predictors identified with periapical radiographs and cone beam computed tomography scans. J Endod. 2011;37:326-331.
• Carter L, Farman AG, Geist J, et al. American Academy of Oral and Maxillofacial Radiology executive opinion statement on performing and interpreting diagnostic cone beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106(4):561-562.
• Rafeek RN, Smith WA, Mankee MS, Coldero LG. Radiographic evaluation of the technical quality of root canal fillings performed by dental students. Aust Endod J. 2012;38:64-69.
• Alsaleh I, Cousson PY, Nicolas E, Hennequin M. Is endodontic treatment performed under general anaesthesia technically acceptable? Clin Oral Investig. 2012;16(6):1599-1606.
• Fong W, Heidarifar O, Killough S, Lappin MJ, El Karim IA. An audit on technical quality of root fillings performed by undergraduate students. Int Endod J. 2018;51(3):197- 203.
• General Dental Council (2004) (erişim tarihi 10 August 2016). The first five years, 2nd Edition. http://www.gdc- uk.org/aboutus/education/documents/thefirstfiveyears.pdf
• Yavari H, Samiei M, Shahi S, et al. Radiographic evaluation of root canal fillings accomplished by undergraduate dental students. Iran Endod J. 2015;10(2):127.
• Şirin DA. Doktora eğitimindeki öğrencilerin klasik ve modern yöntem ile yaptıkları kök kanal tedavilerinin kalitesinin radyografik olarak değerlendirilmesi. Atatürk Üni Diş Hek Fak Derg. 2021;31(4):528-534.
• Duru A, Arı Aydınbelge H, Uyanik HK, Akdoğan Y. Diş hekimliği öğrencileri tarafından yapılan kök kanal tedavilerinin teknik kalitesinin değerlendirilmesi: Kesitsel Çalışma. Türkiye Klinikleri J Dent Sci. 2023;29(2):301- 309.
• Donnelly A, Coffey D, Duncan HF. A re-audit of the technical quality of undergraduate root canal treatment after the introduction of new technology and teaching practices. Int Endod J. 2016;50:941-950.
• Alsulaimani RS, Al-Manei KK, Alsubait SA, AlAqeely RS, Al-Shehri SA, Al-Madi EM. Effects of clinical training and case difficulty on the radiographic quality of root canal fillings performed by dental students in Saudi Arabia. Iran Endod J. 2015;10(4):268.
• Tekin A, Hepşenoğlu YE, Erşahan Ş. Diş hekimliği lisans öğrencileri tarafından yapılan kök kanal tedavilerinin teknik kalitesi: Radyografik bir çalışma. Selcuk Dent J. 2019;6(4):376-381.
• Abu-Tahun I, Al-Rabab'ah MA, Hammad M, Khraisat A. Technical quality of root canal treatment of posterior teeth after rotary or hand preparation by fifth year undergraduate students, The University of Jordan. Aust Endod J. 2014;40(3):123-130.
• Cheung GS, Liu CS. A retrospective study of endodontic treatment outcome between nickel-titanium rotary and stainless steel hand filing techniques. J Endod. 2009;35(7):938-943.
• Alrahabi M. Comparative study of root-canal shaping with stainless steel and rotary NiTi files performed by preclinical dental students. Technol Health Care. 2015;23(3):257-265.
• Peru M, Peru C, Mannocci F, Sherriff M, Buchanan LS, Pitt Ford TR. Hand and nickel-titanium root canal instrumentation performed by dental students: A micro- computed tomographic study. Eur J Dent Educ. 2006;10:52-59.