Predictor factors of root canal treatment quality in undergraduate dental clinics: a two-centered cross-sectional study

Abstract

Abstract Objectives: To evaluate the prevalence of root canal treatments (RCT) with satisfactory technical quality (TQ) and to determine the pre- and intraoperative factors associated with an unsatisfactory TQ of RCT conducted by undergraduate students. Material and Methods: This two-centred cross-sectional observational study included periapical radiographs of primary and secondary RCT conducted by undergraduate students at two dental schools (n=462). The TQ of RCT was determined using the ESE criteria, accepting (ASE) or not accepting (NSE) unintentional sealer extrusion. A calibrated examiner analysed pre- and intraoperative variables. Bivariate and multivariate analyses were conducted to identify associations between independent variables and technical outcomes (α=5%). Results: The TQ of RCT was satisfactory in 45.9% and 62.3% of the cases according to NSE and ASE criteria. Root canal curvature (RCC) (OR=0.95; 95% CI: 0.93, 0.98) and apical root resorption (OR=0.58; 95% CI: 0.35, 0.94) were associated with unsatisfactory TQ according to NSE, but only RCC (OR=0.95; 95% CI: 0.93, 0.97) affected outcomes according to the ASE criterion. Teeth with a RCC greater than 7º and 12º according to NSE and ASE criteria, respectively, were less likely to achieve a satisfactory TQ. Conclusions: The prevalence of RCT with a satisfactory TQ was comparable to that found in other dental schools and greater when sealer extrusion was accepted. A 12º RCC cutoff point seems to be satisfactory for undergraduate practice. Clinical Relevance: To accept unintentional sealer extrusion increased RCT satisfactory TQ. RCC was the main factor associated with unsatisfactory TQ and might support technical difficulty determination.