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Table of Contents
ORIGINAL ARTICLE
Year : 2022  |  Volume : 9  |  Issue : 4  |  Page : 91-94

Knowledge, materials, methods, and attitudes employed during endodontic treatment by dentists to evaluate and improve the quality of practice of endodontic treatment


Reader, Department of Conservative Dentistry and Endodontics, Sri Sankara Dental College, Thiruvananthapuram, Kerala, India

Date of Submission09-Dec-2022
Date of Acceptance11-Dec-2022
Date of Web Publication29-Dec-2022

Correspondence Address:
Dr Rahul Sasidharan
Department of Conservative Dentistry and Endodontics, Sri Sankara Dental College, Thiruvananthapuram, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijpcdr.ijpcdr_24_22

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  Abstract 


Background: This procedure, known as root canal treatment, is widely used in modern dental care. Modern endodontics frequently includes the introduction of many modern devices, materials, and methods, and yet it is one of the fastest-expanding fields in everyday clinical practice. Root canal fillings, coronal restorations, and the dentist's own knowledge, attitude, and expertise all have a role in the success of endodontic therapy, which is why it is important to maintain these high standards.
Aim and Objectives: This study's objectives were similar to those of the aforementioned audit to collect data on the various approaches, specific and regular strategies, materials, and attitudes utilized by both general dental specialists and endodontists during root trench treatment, to analyze these choices in depth, and to disseminate endodontic treatment standards to evaluate the state of current practice and make adjustments as necessary.
Methodology: The materials and techniques used by general dentists during root canal treatment were the subjects of a survey. Before the research itself could begin, a questionnaire had to be created and tested in advance.
Results: The current study's findings provide light on the mindsets, strategies, supplies, and procedures used by dentists during root canal treatment. In the field of health-care evaluation, the survey questionnaire is a frequent tool. In this investigation, data were acquired by interviewing dentists in person and writing down their responses, a method that ultimately helped eliminate bias.
Conclusion: Using the tried-and-true method of positioning the apical stop 1 mm from the radiographic apex, most dentists today continue to do so. The trend toward doing root canal treatment in a single office visit applies to all patient types. As a remarkable characteristic, both types of responders made very little use of rubber dams for isolation purposes during endodontic treatment.

Keywords: Attitude, irrigant, questionnaire, root canal therapy, survey


How to cite this article:
Sasidharan R. Knowledge, materials, methods, and attitudes employed during endodontic treatment by dentists to evaluate and improve the quality of practice of endodontic treatment. Int J Prev Clin Dent Res 2022;9:91-4

How to cite this URL:
Sasidharan R. Knowledge, materials, methods, and attitudes employed during endodontic treatment by dentists to evaluate and improve the quality of practice of endodontic treatment. Int J Prev Clin Dent Res [serial online] 2022 [cited 2023 Feb 6];9:91-4. Available from: https://www.ijpcdr.org/text.asp?2022/9/4/91/366147




  Introduction Top


A root canal is a common procedure in modern dentistry. Today, root canal treatment has become a standard procedure in the field of dentistry. Contemporary endodontics frequently includes the introduction of many modern devices, materials, and procedures, and yet it is one of the fastest-expanding fields in everyday clinical practice.[1] The dentist's office setting may also play a role in how successful the root canal treatment turns out to be. The majority of the available data on the efficacy of root canal therapy comes from well-controlled clinical trials carried out at academic dentistry hospitals and specialized clinics.[2] There is a high success rate (up to 96%) for periapical health after endodontic treatment, according to the findings of such longitudinal research. Different results have been found in cross-sectional population studies of endodontic therapy provided by general dentists. The rates of apical periodontitis in endodontically treated teeth are between 20% and 60%, and they demonstrate a high incidence of insufficient root fillings.[3],[4] Many reports on the effectiveness and failure of root canal therapy have been published.[5],[6],[7],[8] The best method of debridement, cleaning, shaping, and obturation of a canal is a matter of debate. True, numerous novel ideas, methods, and tools have been developed and implemented.[6],[9] The American Association of Endodontists has also disseminated similar standards. “The impact of the general dental master's approach to endodontic therapy on the outcome of root canal treatment has only recently been the topic of a few cogent analyses, and the results are inconclusive.” It was for this reason that we conducted an audit of root canal treatment practices to collect information about the various approaches, specific and natural systems, materials, and mindsets employed by both general dental specialists and endodontists, and then to carefully analyze these options and disperse endodontic treatment standards to evaluate and improve the state of current practice.


  Materials and Methods Top


The materials and techniques used by general dentists during root canal treatment were the subjects of a survey. Before the research itself could begin, a questionnaire had to be created and tested in advance. All procedures performed in the study were conducted in accordance with the ethics standards given in 1964 Declaration of Helsinki, as revised in 2013. The study proposal was submitted for approval and clearance was obtained from the ethical committee of our institution. A written informed consent was obtained from each participant. To ensure its clarity and comprehensiveness, the questionnaire was thoroughly tested in pilot form before being released. Dentists on the dental council's roster were polled using the revised survey instrument.[7],[10],[11] Avoid any potential for bias, it is preferable to conduct interviews with endodontists in person. Prior surveys and commonplace procedures in endodontics served as inspiration for the questions.

The questions concerned:

  1. What you do for a living, your gender, how long you have been in your job, and other information about your workplace
  2. Method, instrumentation, rubber dams, appointments, and working length selection for root canal preparation
  3. Which root canal irrigant to use, how much sodium hypochlorite to put in, and whether or not to utilize an intracanal medication
  4. Obturation method and sealant of preference
  5. The outlook on endodontic therapy, the level of contentment with the results, and the frequency of retreatment.



  Results Top


The current study's questionnaire survey was done using an interview approach, which resulted in a response rate of 100%. Having face-to-face interviews with dentists to get their feedback helped keep prejudice to a minimum. Analysis of the data was performed with SPSS version 17 (SPSS Inc., Chicago, Illinois, USA). No ambiguous answers were included, and any questions that went unanswered were coded as missing values. [Table 1] and [Table 2] provide the tabulated findings for each subsection. As a root canal irrigant, Chlorhexidine was used by 45% of respondents, making it the most popular choice in this poll. Calcium hydroxide and iodoform are often used by dentists, with 60% and 40%, respectively [Table 1]. Eighty percent of dentists always place a final coronal restoration for endodontically treated patients, whereas 20% of dentists never do [Figure 1]. The vast majority of dentists (80%) reported being pleased with standard root canal therapy. However, 12% of dentists believe they could do a better job with endodontic treatment [Table 2].
Table 1: Choice of root canal irrigants and disinfection intracanal medication

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Table 2: Attitude toward endodontic treatment and satisfaction of the practitioner

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Figure 1: Dentists providing final coronal restoration

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  Discussion Top


The current study's findings provide light on the beliefs, approaches, and use of root canal treatment among general dentists and endodontists. Questionnaires are often used in surveys to assess health-care delivery and quality. The most significant drawback of surveys is that, especially when the questionnaire is posted or sent; only a small percentage of people actually fill it out. To get around this limitation, the dentists in this research were interviewed face to face, and their responses were recorded; this method not only eliminated prejudice but also the potential for social desirability bias. Root canal biofilm may be efficiently eradicated using a disinfectant irrigant. There was widespread agreement among responders that they use many types of irrigation. Chlorhexidine and salt water are the two most popular irrigants [Table 1].[7] Intervisit dressing: intracanal medicament is used to kill germs, manage discomfort and inflammation, and dry the canals after they have been cleaned and disinfected. Root canal treatment for such infected instances has been shown to have a much higher success rate with the use of a calcium hydroxide dressing placed between appointments, as shown by Sjogren et al. Calcium hydroxide's widespread use may be attributed to its reportedly beneficial effects, low toxicity rate, and injectable form.[5],[6],[7],[8],[9],[10],[11],[12],[13],[14],[15],[16],[17],[18] “In order to answer question 8, we inquired as to the anticipated number of visits required to complete root canal treatments on single-rooted (both vital and nonvital) and multi-rooted (both vital and nonvital) teeth. Obturation Technique No. 9:” Root filling quality determines the ultimate success of endodontic treatment. Root canal sealant and cold/warm lateral compaction of gutta-percha were used by the vast majority of responders. The majority of dentists who performed obturation reported preferring cold lateral compaction of gutta-percha with endomethasone (37%) sealer. Fewer than one in 10 (10%) dentists do not order a follow-up X-ray after performing a root canal. When it comes to prescribing systemic antibiotics, dentists need to have a firm grasp on the clinical justifications for doing so to avoid the potential for antibiotic abuse. During normal endodontic treatment, the majority of dentists (75%) will prescribe antibiotics for specific clinical circumstances.[11] Eighty percent of dentists always offer their endodontically treated patients with final coronal restoration, whereas 20% of dentists never provide this restoration [Figure 1].[7] Only 17% of dentists frequently monitor patients after a root canal has been finished.[12] Dentists' perspectives on endodontic care and retreatment. Most dentists (78%) are pleased with their abilities in doing regular root canal treatment [Table 2]. The majority of dentists (88%) are satisfied with their endodontic treatment; however, 16% believe it might be better. Six percent of dentists who were surveyed said they provide re-treatment services in their offices.


  Conclusion Top


According to the results of the current research, the majority of doctors continue to use the conventional technique of setting the apical stop 1 mm from the radiographic apex. The trend toward doing root canal treatment in a single office visit applies to all patient types. As a remarkable characteristic, both types of responders made very little use of rubber dams for isolation purposes during endodontic treatment. Many novel dental materials, equipment, and procedures have become available due to the field's rapid development in recent decades. The current study demonstrates the necessity to update the existing situation for root canal treatment among general dentistry practitioners, notwithstanding these innovations. The endodontics community as a whole would benefit from educational initiatives including conferences, seminars, and workshops organized by the specialty's governing organizations. Continuing education courses tailored to the specific needs of dentists may be the best way to satisfy these requirements. Therefore, ensuring the requisite expertise in clinical practice necessitates enhancing the quality of the current approach to endodontic treatment.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Mensudar R, Sukumaran VG, Julius A. Evaluation of current trends in endodontic treatment procedure among the dental practitioners. Int J Dent Health Sci 2014;1:861-8.  Back to cited text no. 1
    
2.
Kerekes K, Tronstad L. Long-term results of endodontic treatment performed with a standardized technique. J Endod 1979;5:83-90.  Back to cited text no. 2
    
3.
Friedman S. Treatment outcome and prognosis of endodontic therapy. In: Essential Endodontology. Oxford: Blackwell Science; 1998. p. 367-401.  Back to cited text no. 3
    
4.
Sundqvist G, Figdor D. Endodontic treatment of apical periodontitis. In: Orstavik D, Pitt Ford TR, editors. Essential Endodontology. London: Blackwell Science; 1998. p. 242-77.  Back to cited text no. 4
    
5.
Eriksen HM, Petersson K. Endodontic epidemiology and treatment outcome: General considerations. Endod Top 2002;2:1-9.  Back to cited text no. 5
    
6.
Whitten BH, Gardiner DL, Jeansonne BG, Lemon RR. Current trends in endodontic treatment: Report of a national survey. J Am Dent Assoc 1996;127:1333-41.  Back to cited text no. 6
    
7.
Jenkins SM, Hayes SJ, Dummer PM. A study of endodontic treatment carried out in dental practice within the UK. Int Endod J 2001;34:16-22.  Back to cited text no. 7
    
8.
Marques MD, Moreira B, Eriksen HM. Prevalence of apical periodontitis and results of endodontic treatment in an adult, Portuguese population. Int Endod J 1998;31:161-5.  Back to cited text no. 8
    
9.
Bjørndal L, Reit C. The adoption of new endodontic technology amongst Danish general dental practitioners. Int Endod J 2005;38:52-8.  Back to cited text no. 9
    
10.
Pitt Ford TR, Stock CJ, Loxley HC, Watson RM. A survey of endodontics in general practices in England. Br Dent J 1983;83:222-4.  Back to cited text no. 10
    
11.
Marshall K, Page J. The use of rubber dam in the UK. A survey. Br Dent J 1990;169:286-91.  Back to cited text no. 11
    
12.
Gergely EJ. Desmond Greer Walker Award. Rubber dam acceptance. Br Dent J 1989;167:249-52.  Back to cited text no. 12
    
13.
Christensen GJ. Using rubber dams to boost quality, quantity of restorative services. J Am Dent Assoc 1994;125:81-2.  Back to cited text no. 13
    
14.
Whitworth JM, Seccombe GV, Shoker K, Steele JG. Use of rubber dam and irrigant selection in UK general dental practice. Int Endod J 2000;33:435-41.  Back to cited text no. 14
    
15.
Weine FS. Calculation of working length. In: Weine FS, editor. Endodontic Therapy. 5th ed. St. Louis: Mosby; 1996. p. 395-422.  Back to cited text no. 15
    
16.
Olson AK, Goerig AC, Cavataio RE, Luciano J. The ability of the radiograph to determine the location of the apical foramen. Int Endod J 1991;24:28-35.  Back to cited text no. 16
    
17.
Pagavino G, Pace R, Baccetti T. A SEM study of in vivo accuracy of the Root ZX electronic apex locator. J Endod 1998;24:438-41.  Back to cited text no. 17
    
18.
De Moor RJ, Hommez GM, Martens LC, De Boever JG. Accuracy of four electronic apex locators: An in vitro evaluation. Endod Dent Traumatol 1999;15:77-82.  Back to cited text no. 18
    


    Figures

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    Tables

  [Table 1], [Table 2]



 

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