Division of Restorative Dentistry and Periodontology, Dublin Dental University Hospital, Trinity College Dublin, Dublin, Ireland.
Int Endod J. 2017 Oct;50(10):941-950. doi: 10.1111/iej.12727. Epub 2016 Dec 30.
To revaluate through re-audit the technical quality of undergraduate nonsurgical root canal treatment (RCTx) in a dental teaching hospital as a result of recommended changes to teaching practices.
The technical quality of undergraduate RCTx was evaluated radiographically after educational changes and the mandatory introduction of new technologies (nickel-titanium files, apex locators, greater taper gutta-percha points) in 182 root canals. Evaluation was based on four criteria: presence of voids, root canal filling termination (0-2 mm of radiographic apex), all roots filled and the prepared canal contained the original anatomy. Chi-squared analysis was used to determine statistically significant improvements in quality between the respective audits (P < 0.05).
Twenty-three of the 40 canals in single-rooted teeth (57.5%) and 68 of the 129 (52.7%) canals in multirooted teeth analysed had an acceptable root filling. This compared with 48% of canals in single-rooted teeth and 38% of canals in multirooted teeth in the original audit. Specifically, the frequency of root canal voids and unsatisfactory apical root filling termination were reduced in multirooted teeth by 23% and 14% and in single-rooted teeth by 11% and 12%, respectively, compared with the original audit. When multirooted teeth were taken as one unit, 45.2% were considered to be acceptable, significantly better than the 18.8% multirooted teeth in the original audit (P = 0.042). Deviations from the canal anatomy on radiographic examination were rare findings in both audits.
Changes to endodontic teaching practices significantly improved the technical standards of undergraduate root filling in multirooted teeth. The regular auditing of undergraduate teaching practice is necessary to inform current teaching, instigate change and improve standards.
通过对教学实践中推荐的变化进行再审核,重新评估牙科学院本科生非手术根管治疗(RCTx)的技术质量。
在教育改革和强制性引入新技术(镍钛锉、根尖定位仪、更大锥度牙胶尖)后,对 182 根管的本科生 RCTx 技术质量进行放射学评估。评估基于四个标准:是否有空隙、根管充填终点(根尖 0-2mm 射线影像)、所有根管均充填以及预备后的根管包含原始解剖结构。使用卡方分析确定质量在各自审核之间是否存在统计学显著提高(P<0.05)。
在分析的单根牙 40 个根管中有 23 个(57.5%)和多根牙 129 个根管中有 68 个(52.7%)的根管充填可接受。这与原始审核中单根牙的 48%和多根牙的 38%的根管相比有所提高。具体而言,多根牙的根管空隙和根尖未充填终止的频率分别减少了 23%和 14%,单根牙分别减少了 11%和 12%,与原始审核相比。当多根牙作为一个整体时,45.2%被认为是可接受的,显著优于原始审核中多根牙的 18.8%(P=0.042)。在两次审核中,根管解剖结构在射线影像上的偏差都是罕见的发现。
根管治疗教学实践的改变显著提高了多根牙本科生根管充填的技术标准。定期审核本科生教学实践对于了解当前教学、推动变革和提高标准是必要的。