Faculty of Dentistry, Oral and Maxillofacial Prosthodontics Department, King Abdulaziz University, Jeddah, Saudi Arabia.
PLoS One. 2023 Nov 9;18(11):e0294073. doi: 10.1371/journal.pone.0294073. eCollection 2023.
The success of endodontic restoration of badly compromised teeth depends on the quality of post and core placement and the extra-coronal restoration. Ensuring that students place posts to acceptable quality standards is therefore essential. The aim of this study was to radiographically evaluate post placement by final year undergraduate dental students and to identify any predictors of performance. Two hundred retrospectively and randomly selected posts placed by sixth year students were evaluated radiographically. Data on student gender; number and quality of radiographs; periapical pathology; tooth location; root canal treatment quality; amount of remaining gutta percha; gap between gutta percha and post; post-to-root width; crown-to-root ratio; and types of core material and crowns were recorded. Four criteria were used to grade post placement quality: (i) amount of remaining gutta percha; (ii) gap between gutta percha and post; (iii) post width to root ratio; and (iv) crown-to-root ratio. Assessments were scored to produce final grades. Data are presented using descriptive statistics and the chi-squared test was used to investigate whether student gender or tooth location were associated with final grade. Post and core quality was acceptable in most cases (97.5% were graded as adequate), with no differences in quality between male and female students nor according to tooth location (anterior, premolar, and molar). Just over half of radiographs were adequate quality (53.5%), while just under half were assessed as less than adequate (46.5%) due to cone cutting, overlap, shortening or elongation, although this did not affect formal assessment of post quality. General outcomes of post and core placement by undergraduate students were good, with few errors that might affect the prognosis and long-term survival of treated teeth. Providing undergraduate dental students with clear guidelines on when and how to take radiographs throughout the procedure may improve the quality of post and core treatment and reduce the risk of multiple unnecessary radiographic exposures. From the clinical perspective, although dental students generally place high quality posts and cores, it remains important to monitor the quality and performance of post placement as this determines the survival of compromised teeth.
严重受损牙齿的根管修复成功取决于桩核的位置和牙体外层修复的质量。因此,确保学生达到可接受的质量标准是至关重要的。本研究的目的是通过口腔医学专业的高年级本科生对桩的放置进行放射学评估,并确定其表现的预测因素。评估了第六年学生放置的 200 个回顾性和随机选择的桩。记录了学生的性别、放射片的数量和质量、根尖周病变、牙齿位置、根管治疗质量、剩余牙胶量、牙胶与桩之间的间隙、桩与根的宽度比、冠根比、核材料和牙冠的类型。使用四个标准对桩的位置质量进行分级:(i)剩余牙胶量;(ii)牙胶与桩之间的间隙;(iii)桩宽与根宽比;(iv)冠根比。评估结果被评分以产生最终成绩。数据采用描述性统计方法呈现,卡方检验用于研究学生性别或牙齿位置是否与最终成绩相关。在大多数情况下,桩核质量是可接受的(97.5%被评为充足),男女学生之间以及牙齿位置(前牙、前磨牙和磨牙)之间没有质量差异。只有一半以上的射线照片质量充足(53.5%),不到一半的射线照片质量不足(46.5%),原因是锥体切割、重叠、缩短或延长,尽管这并没有影响对桩质量的正式评估。本科生进行桩核放置的总体结果良好,只有少数错误可能影响治疗牙齿的预后和长期生存。为口腔医学专业的高年级本科生提供关于何时以及如何在整个过程中拍摄射线照片的明确指导,可能会提高桩核治疗的质量,并降低多次不必要的射线照射的风险。从临床角度来看,尽管牙科学生通常放置高质量的桩核,但仍需监测桩的位置质量和性能,因为这决定了受损牙齿的生存能力。