School of Dentistry, College of Biomedical and Lifesciences, Cardiff University, Cardiff, UK.
Int Endod J. 2022 Nov;55(11):1190-1201. doi: 10.1111/iej.13815. Epub 2022 Aug 26.
To evaluate the complexity of root canal treatments accepted for treatment by postgraduate training grades at Cardiff University Dental Hospital (CUDH) using the English Commissioning Standard for Restorative Dentistry (ECS) in comparison with the American Association of Endodontists case complexity form (AAE) and the Restorative Index of Treatment Need (RIOTN).
Two hundred case records were evaluated using the AAE, RIOTN and ECS scoring systems. Each case received a score from minimal to high complexity (1-3). Examiners were calibrated and inter-examiner reliability calculated using the percentage agreement. Frequency of scores were then compared.
Most cases were at level 3 and assessment varied amongst the criteria used (AAE: 99.5%, RIOTN: 65.5% and ECS: 55.5%). The AAE factor 'endodontic treatment history' was largely responsible for differing scores when compared with the RIOTN (78%) and ECS (64%). The RIOTN factor regarding post treatment disease ('endodontic retreatment') was responsible for increased complexity compared with ECS in most cases (74%). The ECS factor 'quality of root filling' was the most common reason (85%) for an increase in complexity compared with RIOTN.
Within the limitations of this service evaluation, it was possible to conclude that a high proportion of cases treated by training grades at CUDH were of a high complexity level (level 3) using the three guidelines (ECS, AAE and RIOTN). These cases were appropriate for postgraduate training under various levels of supervision and substantiated by the findings reported here. The factors responsible for a large part of difference in allocation of scores amongst the systems were 'endodontic treatment history', 'root canal retreatment' and 'quality of root filling'.
使用英国修复牙科学委托标准（ECS）评估卡迪夫大学牙科医院（CUDH）研究生培训级别接受治疗的根管治疗复杂性，与美国牙髓病协会病例复杂性表（AAE）和治疗需求修复指数（RIOTN）进行比较。
使用 AAE、RIOTN 和 ECS 评分系统评估 200 例病历。每个病例的评分从最低到最高（1-3 分）。对检查者进行校准，并使用百分率一致来计算检查者间的可靠性。然后比较评分的频率。
大多数病例处于 3 级，使用的标准评估各不相同（AAE：99.5%、RIOTN：65.5%和 ECS：55.5%）。AAE 因素“牙髓治疗史”与 RIOTN（78%）和 ECS（64%）相比，导致评分差异较大。在大多数情况下，RIOTN 中关于治疗后疾病的因素（“牙髓再治疗”）与 ECS 相比，增加了复杂性（74%）。在大多数情况下，ECS 因素“根管充填质量”是导致复杂性增加的最常见原因（85%），与 RIOTN 相比。
在这项服务评估的限制范围内，可以得出结论，CUDH 培训级别治疗的高比例病例（3 级）使用三种指南（ECS、AAE 和 RIOTN）具有较高的复杂性水平。这些病例适合在各种监督水平下进行研究生培训，并得到这里报告的结果的证实。导致系统之间评分分配差异的大部分因素是“牙髓治疗史”、“根管再治疗”和“根管充填质量”。
