Non-Surgical Endodontic Treatment on Undergraduate Clinics:A Sustainable Future?

Aims<br/><br/>To investigate the sustainability of non-surgical endodontic treatment (NSET) carried out on undergraduate clinics (UGCs).<br/><br/>Methods<br/><br/>This project investigated the sustainability of NSET completed on UGCs by considering the resources required against the quality of the completed treatment. To be sustainable, case complexity should be appropriate for UGCs to minimise the duration and number of appointments whilst maximising likelihood of treatment success.<br/><br/>Clinical records (n=40) were reviewed following Caldicott approval. An equal number of single and multi-rooted teeth were identified. The complexity of each case was measured using the British Endodontic Society (BES) Case Assessment Tool. The quality of NSET was assessed via post-operative radiographs. Data was collected and analysed using MS Excel.<br/><br/>Results<br/><br/>Of the teeth included, 25% were of low difficulty. On average, undergraduate students used 3.5 clinical sessions to complete treatment; when considering only low complexity cases, the average was 2.7 clinical sessions. No evidence of case complexity assessment prior to allocation on UGCs was found.<br/><br/>The most common iatrogenic error was underfilling. The root canal filling was greater than 2mm from the radiographic apex of at least one canal in 17.5% of obturated teeth. Of the eight teeth where the root canal filling was greater than 2mm from the radiographic apex, seven of these teeth were in average or high difficulty cases.<br/><br/>Conclusions<br/><br/>Sustainability of treatment is related to appropriate case allocation for clinician skill to ensure efficiency of treatment whilst minimising likelihood of iatrogenic error. The BES suggests UK general dental practitioners be able to treat low and average difficulty cases.<br/><br/>Using these findings, an intervention to train staff and students to screen patients using the BES Case Assessment Tool and allocate cases appropriately. This will ensure students develop skills treating low complexity cases before progressing to average complexity.