An assessment of endodontic treatment completion rate in a University-based student clinic and the factors associated with incomplete treatment

Incidence of interappointment emergencies in multiple-visit root canal treatments performed with or without intracanal medicament by undergraduate students

Objectives

This retrospective cohort study examined the incidence of interappointment emergencies during multiple-visit molar root canal treatments conducted by undergraduate students. Treatments performed without the use of intracanal medicament were compared to treatments that incorporated calcium hydroxide as an intracanal medicament.

Materials and Methods

Interappointment emergencies, defined as instances of pain or swelling that required the patient to make an unscheduled follow-up visit, were recorded for up to 2 months after the intervention. To avoid the influence of obturation on the observed incidence of emergency visits, only unscheduled visits occurring between the start and end of the root canal treatment were included.

Results

Of the 719 patients included in this study, 77 (10.7%) were recorded as experiencing interappointment emergencies. Of these emergencies, 62% occurred within 2 weeks following the most recent intervention. In the group of patients who did not receive intracanal medicament, the incidence of interappointment emergencies was 11.9% (46 of 385 patients). In comparison, this rate was 9.3% (31 of 334 patients) among those who received calcium hydroxide as an intracanal medicament (odds ratio, 1.33; 95% confidence interval, 0.82-2.15; p = 0.249).

Conclusions

Interappointment emergencies may arise at any point during root canal treatment, but they most commonly occur within the first 2 weeks following intervention. The omission of intracanal medicament in multiple-visit molar root canal treatments, performed by undergraduate students, did not significantly increase the incidence of these emergencies.

Factors Associated with Incomplete Endodontic Care

INTRODUCTION

Incomplete endodontic treatment has been associated with detrimental health outcomes.

METHODS

This retrospective study reviewed charts of patients receiving endodontic care over a 1-year period at the Postgraduate Endodontic Clinic at Rutgers School of Dental Medicine, Newark, NJ, to assess whether factors such as receipt of palliative endodontic care and demographic factors were associated with completion, or noncompletion, of initial nonsurgical root canal therapy (RCT).

RESULTS

A total of 1806 patient charts met the study inclusion criteria. With descriptive statistics and bivariate analysis, the variables of palliative care, Medicaid recipient, age group, and distance from the clinic were significantly associated with RCT completion (P < .05). In the binary logistic regression with all independent variables, palliative care and age group variables were the significant factors (P < .05). Patients who had no palliative care had 8.5 times the odds of completing RCT than patients who had received palliative care. The age group of 18-35 years had 0.59 times the odds of complete RCT than the age group <18 years.

CONCLUSIONS

Incomplete nonsurgical endodontic treatment is highly associated with the receipt of prior palliative care. Further research is indicated to investigate additional factors that may influence patient completion of endodontic care and opportunities to improve public health care program design to obtain optimal patient-centered outcomes.

Undergraduate endodontic clinical training in Malaysia: A National survey

AIM

Online survey was conducted to investigate the state of undergraduate endodontic clinical training in Malaysian dental schools.

METHODS

An online questionnaire and a cover letter were emailed to the deans of 13 Malaysian dental schools. The questionnaire covers various aspects of endodontic clinical training including teaching methods, endodontic clinical procedures, minimum requirements, clinical sessions and teaching staff.

RESULTS

The response rate was 69%. Similarities in teaching methods were observed in all responding schools. All schools taught contemporary root canal treatment procedures, including the utilisation of radiograph and electronic apex locator for working length determination, the crown-down approach for canal preparation and the cold lateral compaction for obturation. Sodium hypochlorite solution and non-setting calcium hydroxide medicament were used in most dental schools. Variations were observed in terms of the number of clinical requirements, supervisor: student ratio, and availability of endodontic specialists. The use of engine-driven instruments was observed mainly in government-funded dental schools.

CONCLUSIONS

The majority of dental schools in Malaysia are adopting the European Society Endodontology recommendation for undergraduate endodontic training, particularly in relation to the surveyed aspects. Most of the government-funded dental schools have progressed towards engaging contemporary endodontics with their increasing application of engine-driven Ni-Ti instruments and 3D imaging techniques. Appointments of full-time endodontic specialists would further enhance the quality of endodontic teaching and permit the utilisation of contemporary endodontic materials.