Factors Associated with the quality of RCT by Dental Undergraduates

Objective: To evaluate the technical quality of root canal treatments (RCT) performed by dental undergraduates and determine the factors associated. Methods: A total of 140 records of patients who had received RCT by undergraduates were investigated. For each root canal filling, periapical radiographs were examined by two examiners Kappa value for inter-examiner agreement was 0.74. The quality of root canal fillings was evaluated according to its extension, condensation and presence of procedural mishap. These were graded as ‘acceptable’, where the root canal filling was within 2mm of the radiographic apex and ‘unacceptable’, where filling was short (>2mm) or extruded beyond the radiographic apex. The presence of void in root canal filling and procedural mishap was considered unacceptable. Possible factors associated with technical quality such as: tooth type, canal curvature, student level and quality of record keeping were also evaluated. Data were statistically analyzed using chi-square test and significance level was set at p<0.05. Results: Of the 140 root-filled teeth, acceptable extension, condensation and no-mishap were observed in 101 (72.1%), 93 (66.4%), and 109 (77.9%) cases respectively. Overall, the technical quality of 68 (48.6%) root-filled teeth was considered acceptable. Among different tooth types, overall non-acceptable root canal fillings were statistically significantly more likely to be observed in molars (69.2%) compared to other tooth types (p<0.01). Overall non-acceptable root canal fillings were significantly more in moderately and severely curved canals (71.4%) compared to straight canals (47.9%, p<0.05).  According to student seniority, non-acceptable root canal fillings were significantly associated with junior (61.5%) compared to senior students (42.7%, p<0.05). No association was detected in between acceptable root canal fillings and quality of record keeping. Conclusion: The technical quality of root canal fillings performed by undergraduates was acceptable in 48.6% cases and it was associated with tooth type, degree of canal curvature and student seniority.