Author: Khalid Abdul-Rehman Al-Kindy

Publisher:

Published: 2003

Total Pages: 270

ISBN-13:

The objectives of this study was to investigate the attitude of general dental practitioners to endodonic techniques and treatment modalities; to investigate the attitude of patients who had received endodontic procedures; and to examine both clinically and radiographically the overall standard of endodontic treatment of patients presenting at the University Dental School and Hospital, Cork. A questionnaire form was posted to 1855 registered dental practitioner in Ireland. Two hundred and thirty six patients were surveyed using a questionnaire form; these same patients were subjected to clinical examination of the root treated tooth/teeth, and a periapical radiograph(s) were taken for each endodontically treated tooth. All the radiographs were taken using a film-holder. All the radiographs were interpreted using strict criteria. Seven hundred and forty six of the returned questionnaires were used. From these returns it was observed that: 31% of practitioners always used rubber dam during root canal treatment; 86% of practitioners always obtain preoperative periapical radiograph; 68% of respondents always use long-cone paralleling technique while taking periapical radiographs; 59% of practitioners take radiographs at each step of the endodontic treatment; periapical radiograph with an instrument in the root canal was the most common method used for establishing the working length; sodium hypochlorite was the most commonly used irrigating solution; and manual root canal preparation and obturation techniques were most commonly used by the majority of the respondents. 60% of patients stated that root canal treatment was performed on their teeth without the application of rubber dam; only 22% of patients had a complaint from the root treated tooth, 42% of the complaints were related to the coronal restoration or the surrounding tissues; 57% of the patients gave a negative response to endodontic re-treatment; clinically sinus tracts were observed in approximately 2% of cases, intra-oral swelling occurred in less than 1%, and about 5% of root treated teeth were tender to percussion. The coronal restoration was recorded good when examined clinically in 66%, while examination using radiographs was 52%; 38 (7%) of 577 root canals contained no obturation; 33% of the root treated teeth were associated with a periapical radiolucency; the overall assessment of the quality of obturation per tooth was; standard 11%, acceptable 30%, and substandard 59%; the overall assessment of complete endodontic procedure was recorded standard in 9%, acceptable in 27%, and substandard in 64% of cases; and the outcome/survival of the root treated tooth was recorded good in 94% of cases and 6% had poor outcome. From the obtained data it can be concluded that the majority of practitioners in Ireland were not familiar with or did not follow the standard quality guidelines. Radiographic examination of endodontically treated teeth demonstrated a higher prevalence of coronal restoration defect that periapical radiolucency. In the majority of teeth examined, the quality of the root canal obturations and /or endodontic procedures was considered substandard.