Endodontic Education: Reflections Based on an Observational Study of Factors Associated With Root Canal Treatment Technical Quality.

PURPOSE/

OBJECTIVES

This study aimed to evaluate the prevalence of technically satisfactory root canal treatments (RCTs) performed by undergraduate dental students and to identify pre- and intraoperative factors associated with unsatisfactory outcomes.

METHODS

A cross-sectional analysis of 462 RCTs performed by third- and fourth-year students at two Brazilian dental schools was conducted. Radiographic assessments followed European Society of Endodontology (ESE) guidelines using two criteria: No sealer extrusion (NSE) and accepted sealer extrusion (ASE). Pre- and intraoperative variables, including tooth type, instrumentation method, root canal curvature, and apical root resorption, were analyzed through bivariate and multivariate logistic regression.

RESULTS

The prevalence of satisfactory RCTs was 45.9% (NSE) and 62.3% (ASE). Root canal curvature was the most significant predictor of unsatisfactory technical quality in both models (NSE: >7°, ASE: >12°, p < 0.001). Apical root resorption was also associated with failure in the NSE model (p = 0.028). Instrumentation type and tooth type were not significantly associated with technical outcome.

CONCLUSION(S): Root canal curvature strongly influences the technical quality of student-performed RCTs, regardless of instrumentation technique or tooth type. Undergraduate curriculum should optimize the development of the ability to recognize case complexity, while dental educators should continually develop strategies to improve undergraduate and supplementary professional training.