High-Standard Non-Surgical Endodontic Treatment and Outcome: A Retrospective Follow-Up Study on Self-Assessment of Grading and Case Difficulty in an Academic Setting

<b>Background/Objectives:</b> Endodontic treatment quality can be graded from A to D according to international standards. This study aimed to evaluate radiographic treatment success of high-standard endodontic treatments (Grade A). A secondary aim was to assess the students' self-perceived assessment of case difficulty. <b>Methods:</b> A retrospective analysis was conducted on root canal treatments (RCTs) performed by undergraduate students at the University of Bergen between January 2012 and December 2014. Data related to endodontic treatments graded as A, along with a postoperative self-perceived assessment of case difficulty, were extracted from patient records. Statistical analysis was performed with a significance level set at <i>p</i> ≤ 0.05. <b>Results:</b> Out of 1149 RCTs, 462 (40.2%) were classified as Grade A. Among these, 350 teeth had at least one recall after one year. Out of the 350 teeth, 312 were successful (89.2%), 6 (1.7%) were failures and 32 (9.1%) were extracted due to factors unrelated to endodontic infection. After exclusion or inclusion of extracted teeth, the success rate was 98.1% and tooth survival 90.9%. Patients under 56 years of age, and teeth with indirect coronal restorations, had significantly better tooth survival. Students significantly underestimated case difficulty (<i>p</i> < 0.01). <b>Conclusions:</b> High-standard endodontic treatments can achieve a high success rate. Self-assessment of endodontic treatment and accurate assessment of case difficulty using relevant tools serves as an important educational aid, potentially contributing to enhanced knowledge and improved clinical decision-making.