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Alshahrani AS, Alelyani AA, Al Ageel Albeaji SM, AlHarith D, Al Malwi AAA, Aldhbaan AA, Alshehri KSJ, Bakri AE, Sahli AAA, Alaajam WH, Al Moaleem MM. A Comparative Analysis of the Quality of Root Canal Fillings of In Vivo Studies Conducted in Saudi Arabia and Worldwide: A Systematic Review. Clin Cosmet Investig Dent 2024; 16:323-336. [PMID: 39291238 PMCID: PMC11407322 DOI: 10.2147/ccide.s479321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 08/30/2024] [Indexed: 09/19/2024] Open
Abstract
Aim Root canal treatment (RCT) is a common procedure practiced daily by dentists worldwide. The current systematic review aimed to evaluate and compare clinical studies on the quality of root canal fillings (RCFs) carried out by dentists with different levels of experience conducted worldwide with those conducted specifically in Saudi Arabia (SA). Materials and Methods A full literature search was conducted in Clarivate Analytics' Web of Science, Elsevier's Scopus, Embase, CINHAL, and PubMed, without a restriction to studies published before January 2015. Also, a manual search was carried out by checking papers that may have been missed during the electronic search. The following keywords were used: [(quality of root canal filling(s)) OR (quality of root canal obturation)) and dental practitioners as (general dental practitioners; final year students; endodontist; specialist) AND (root canal obturation) OR (endodontic treatment)]. Parameters of the quality of RCFs, such as length, density, and taper, were assessed and counted. Results A total of 13 worldwide and nine SA studies were included in this review, published between 2015 and 2023. Molars were the most treated teeth, at 42.3% and 40.2% for the worldwide and SA studies, respectively. Cases treated by final year students had the highest percentage, at 60.0% for both study groups. The percentages of acceptable quality, with regard to the length, density, and taper of RCFs, were 70.9%, 77.6%, and 84.3%, and 73.2%, 64.6%, and 67.8% for the worldwide and SA studies, respectively. Conclusion The overall acceptable quality of RCFs was marginally higher in worldwide studies than in SA studies. Both prevalences can be considered as good, which indicates that the quality of RCFs is moving in the right direction.
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Affiliation(s)
- Abdulmajeed Saeed Alshahrani
- Department of Restorative Dentistry, Division of Endodontics, College of Dentistry, Najran University, Najran, Saudi Arabia
| | - Ahmed Ali Alelyani
- Department of Restorative Dentistry, Division of Endodontics, College of Dentistry, Najran University, Najran, Saudi Arabia
| | | | - Dalia AlHarith
- Department of Restorative Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Ahmed Abdullah A Al Malwi
- Department of Restorative Dentistry, Division of Endodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia
| | - Abdulrahman Abdullah Aldhbaan
- Consultant of Endodontic, Endodontic Department, Aseer Specialized Dental Center, Ministry of Health, Abha, Saudi Arabia
| | - Khaled Saleh J Alshehri
- Consultant of Endodontic, Endodontic Department, Khamis Mushait Dental Center, Ministry of Health, Aseer, Saudi Arabia
| | - Alwaleed Essam Bakri
- General Practitioner, Specialized Dental Center, Ministry of Health, Jazan, Saudi Arabia
| | - Abdullah Ahmed Ali Sahli
- General Practitioner, Al-Kharish Primary Health Care Center, Ministry of Health, Jazan, Saudi Arabia
| | - Wafa Hassan Alaajam
- Department of Restorative Dental Science, Division of Endodontics, College of Dentistry, King Khalid University, Abha, Saudi Arabia
- Department of Conservative Dentistry, Faculty of Dentistry, Sana'a University, Sana'a, Yemen
| | - Mohammed M Al Moaleem
- Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, 45142, Saudi Arabia
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Almnea RA, Al-Qahtani YM, Albinali AA, Aldhbaan AA, Omar WA, Dahman RH, Almalki MM, AlMohy AA, Mohammed YHY, Mousa AYA, Al Moaleem MM. Quality of Root Canal Fillings and Procedural Errors for In Vivo Studies Prepared in Different Clinical Settings and with Rotary Systems: A Systematic Review. Med Sci Monit 2024; 30:e945225. [PMID: 39104083 PMCID: PMC11316411 DOI: 10.12659/msm.945225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 06/14/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND This systematic review of the literature aimed to identify published studies and evaluate them on the quality of root canal fillings (RCF) and procedural errors with rotary systems for in vivo studies prepared for different clinical settings. MATERIAL AND METHODS A full literature exploration was conducted in Clarivate Analytics' Web of Science, Elsevier's Scopus, Embase, and PubMed for studies published between January 2020 and March 2024. A manual search was also performed by reviewing the references of selected papers. The following keywords were used: quality of root canal filling(s) OR quality of root canal obturation, root canal obturation OR endodontic treatment, clinical setting (academic, private, governmental), AND/OR procedural errors and rotary instrumentation. RESULTS Sixteen clinical studies were included in this review. The acceptance percentages for obturation length, density, and taper were 76.3%, 74.7%, and 82.5%, respectively, indicating significantly high, good ratios. The overall RCF recorded showed that 68.2% of root canal obturations were considered acceptable. Acceptable rates remained higher than unacceptable rates in academic, hospital, and private settings, and percentages ranged from 65.2% to 93.0%. Only 5 studies reported procedural errors, namely, ledge formation, separated instruments, apical perforation, transportation, lateral perforation, and root/foramen perforation. CONCLUSIONS Using rotary instruments for different root canal treatment steps as instrumentation and obturations is highly recommended. Among different clinical setting and practice, these instruments resulted in a good and acceptable RCF, overall quality performed by those instruments, and few procedural errors.
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Affiliation(s)
- Raid Abdullah Almnea
- Division of Endodontics, Department of Restorative Dentistry, College of Dentistry, Najran University, Najran, Saudi Arabia
| | | | | | | | | | - Raed Hassan Dahman
- Dental Department, Primary Health Care Center, Ministry of Health, Abha, Saudi Arabia
| | - Mishari Mohammed Almalki
- Dental Department, Primary Health Care Center, Ministry of Health, Medina Al-Munawwarah, Saudi Arabia
| | | | | | | | - Mohammed M. Al Moaleem
- Department of Prosthetic Dental Science, College of Dentistry, Jazan University, Jazan, Saudi Arabia
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Elsayed MA, Islam MS, Saleh DR, Alnahdi AM, Padmanabhan V. Endodontic Procedural Errors and Associated Factors among Undergraduate Dental Students: A Cross-sectional Study. J Contemp Dent Pract 2023; 24:998-1007. [PMID: 38317399 DOI: 10.5005/jp-journals-10024-3614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
AIMS AND BACKGROUND To assess the procedural errors committed by undergraduate students at RAK College of Dental Sciences, during root canal treatments and the factors associated with these errors. MATERIALS AND METHODS In this cross-sectional study, 180 self-administered questionnaires were distributed, each comprising 26 questions, among 4th and 5th-year students. Participants were requested to report their endodontic mishaps based on feedback from their supervisors. The questionnaire assessed the frequency and types of procedural errors, considering patient, operator, and tooth-related factors. Data were collected tabulated and analyzed using the Chi-square test. RESULTS A total of 124 root canal-treated teeth exhibiting iatrogenic errors done by students were assessed. Out of which, 53% were performed by 5th-year students, and 69% were conducted by female operators. About 62% of errors occurred in the upper teeth and 68% in the posterior teeth. The most prevalent errors during the rubber dam isolation step were soft tissue trauma (21%) and isolation leakage (20%), significantly associated with limited mouth opening, excessive salivation, and tooth malalignment (p < 0.05). Apical blockage (15%) emerged as the most frequent error during instrumentation phase, showing a significant association with canal dimension and curvature (p < 0.05). For access cavity and obturation phases, under-extended cavity (9%), and under-extended filling (11%) were the most reported errors, respectively. CONCLUSION Tooth isolation emerges as a particularly challenging aspect for dental students, particularly when dealing with patients exhibiting limited mouth opening and excessive salivation. CLINICAL SIGNIFICANCE Clinical instructors should caution the undergraduates about the heightened risk of endodontic procedural errors when dealing with patients exhibiting limited mouth opening, excessive salivation, tooth misalignment, and narrow canals. Addressing these challenges is crucial for enhancing the proficiency of undergraduate students in performing successful root canal treatments. How to cite this article: Elsayed MA, Islam MS, Saleh DR, et al. Endodontic Procedural Errors and Associated Factors among Undergraduate Dental Students: A Cross-sectional Study. J Contemp Dent Pract 2023;24(12):998-1007.
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Affiliation(s)
- Mohamed A Elsayed
- Department of Endodontics, RAK College of Dental Sciences, RAK Medical and Health Sciences University, Ras Al-Khaimah, United Arab Emirates; Department of Endodontics, Faculty of Dentistry, Assiut University, Assiut, Egypt, Phone: +97172222593, e-mail: , Orcid: https://orcid.org/0000-0003-2058-9804
| | - Md Sofiqul Islam
- Department of Operative Dentistry, RAK College of Dental Sciences, RAK Medical and Health Sciences University, Ras Al-Khaimah, United Arab Emirates, Orcid: https://orcid.org/0000-0003-0604-9553
| | - Duaa R Saleh
- Department of Clinical Sciences, RAK College of Dental Sciences, RAK Medical and Health Sciences University, Ras Al-Khaimah, United Arab Emirates
| | - Amal M Alnahdi
- Department of Clinical Sciences, RAK College of Dental Sciences, RAK Medical and Health Sciences University, Ras Al-Khaimah, United Arab Emirates
| | - Vivek Padmanabhan
- Department of Pediatric and Preventive Dentistry, RAK College of Dental Sciences, RAK Medical and Health Sciences University, Ras Al-Khaimah, United Arab Emirates
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Dioguardi M, Stellacci C, La Femina L, Spirito F, Sovereto D, Laneve E, Manfredonia MF, D’Alessandro A, Ballini A, Cantore S, Lo Muzio L, Troiano G. Comparison of Endodontic Failures between Nonsurgical Retreatment and Endodontic Surgery: Systematic Review and Meta-Analysis with Trial Sequential Analysis. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:894. [PMID: 35888613 PMCID: PMC9324533 DOI: 10.3390/medicina58070894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 06/13/2022] [Accepted: 06/29/2022] [Indexed: 11/16/2022]
Abstract
Background and Objectives: In the presence of a persistent endodontic lesion or endodontic failure, the alternative for the recovery of the dental element is endodontic retreatment or endodontic surgery, which consists in the surgical removal of the root apices with retrograde closure of the endodontium. The objective of this systematic review and meta-analysis was to provide an updated value of the Risk Ratio between the two types of treatment in order to offer to clinicians who propose a non-surgical endodontic retreatment or an endodontic surgery a direct comparison. Materials and Methods: The revision was performed according to PRISMA indications: three databases (PubMed, Scopus and Cochrane register) were consulted through the use of keywords relevant to the revision topic: surgical endodontic retreatment, endodontic retreatment, apicoectomy. This search produced 7568 records which, after eliminating duplicates and applying the inclusion and exclusion criteria, resulted in a total of seven included articles. The meta-analyses were conducted by applying fixed-effects models, given the low percentage of heterogeneity. In addition, trial sequency analysis (TSA) was performed for the analysis of the statistical power of the results and GRADE for the quality of the evidence. Results: The results of the meta-analyses' data report an aggregate risk ratio (RR) between non-surgical endodontic retreatment and surgical endodontic retreatment of: 1.05 [0.74, 1.47] at one year of follow-up; RR 2.22 [1.45, 3.41] at two years of follow-up; an RR 1.08 [0.73 1.62] for a follow-up period of 3-4 years; and an RR 0.92 [0.53, 1.61] for a follow-up period of 8-10 years. Conclusions: The results of the present meta-analysis show that in the long term, the risk of failure is identical for the two groups, and there is only a slightly higher risk of failure for non-surgical endodontic retreatments, when only two years of follow-up are considered.
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Affiliation(s)
- Mario Dioguardi
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.S.); (L.L.F.); (F.S.); (D.S.); (E.L.); (M.F.M.); (A.D.); (L.L.M.); (G.T.)
| | - Camilla Stellacci
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.S.); (L.L.F.); (F.S.); (D.S.); (E.L.); (M.F.M.); (A.D.); (L.L.M.); (G.T.)
| | - Lucia La Femina
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.S.); (L.L.F.); (F.S.); (D.S.); (E.L.); (M.F.M.); (A.D.); (L.L.M.); (G.T.)
| | - Francesca Spirito
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.S.); (L.L.F.); (F.S.); (D.S.); (E.L.); (M.F.M.); (A.D.); (L.L.M.); (G.T.)
| | - Diego Sovereto
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.S.); (L.L.F.); (F.S.); (D.S.); (E.L.); (M.F.M.); (A.D.); (L.L.M.); (G.T.)
| | - Enrica Laneve
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.S.); (L.L.F.); (F.S.); (D.S.); (E.L.); (M.F.M.); (A.D.); (L.L.M.); (G.T.)
| | - Massimo Francesco Manfredonia
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.S.); (L.L.F.); (F.S.); (D.S.); (E.L.); (M.F.M.); (A.D.); (L.L.M.); (G.T.)
| | - Alfonso D’Alessandro
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.S.); (L.L.F.); (F.S.); (D.S.); (E.L.); (M.F.M.); (A.D.); (L.L.M.); (G.T.)
| | - Andrea Ballini
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | | | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.S.); (L.L.F.); (F.S.); (D.S.); (E.L.); (M.F.M.); (A.D.); (L.L.M.); (G.T.)
| | - Giuseppe Troiano
- Department of Clinical and Experimental Medicine, University of Foggia, Via Rovelli 50, 71122 Foggia, Italy; (C.S.); (L.L.F.); (F.S.); (D.S.); (E.L.); (M.F.M.); (A.D.); (L.L.M.); (G.T.)
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