Modalities of using endodontic nickel-titanium rotary instruments and factors influencing their implementation in dental practice

Assessment of the Current Endodontic Practices among General Dental Practitioners in the Kingdom of Saudi Arabia

A contemporary knowledge of root canal treatment (RCT) is a prerequisite for a successful outcome. Studies observed that General Dental Practitioners (GDPs) were not abreast of current endodontic knowledge due to a lack of continuing dental education, not following the treatment protocols that they had learned in their undergraduate program, and overlooking the evidence-based current endodontic practices. Therefore, this study was intended to assess the awareness, attitude, and clinical endodontic practices among General Dental Practitioners in Saudi Arabia. This cross-sectional questionnaire-based study was conducted among all 312 GDPs working in Saudi Arabia. The questionnaire consisted of socio-demographic details and 23 questions regarding current endodontic practices. The collected data was analyzed using the SPSS Version 21 (Chicago, IL, USA). The chi-square test was applied to explore the influence of gender, workplace, and the years of professional activity on the materials and techniques employed in the RCT procedure. The study results showed that of all respondents, 159 (51.0%) were males, 153 (49.0%) were females, and 286 (91.7%) were Saudi nationals. Most of the GDPs, i.e., 204 (65.4%) practiced in private hospitals or clinics whereas 108 (34.6%) practiced in Government hospitals. Root canal treatment on all teeth had been performed by 196 (62%) of the practitioners. Association of gender with demographic details and endodontic practices revealed a statistically significant difference between both genders with respect to region, nationality, type of RCT treated on the tooth, and the technique used to measure the working length (p < 0.05). Furthermore, years of professional experience and workplace significantly affect endodontic practices (p < 0.05). This study concluded that most of the general dental practitioners complied with quality standard guidelines showing a positive attitude toward endodontic practices. Furthermore, irrespective of gender, most of the steps in endodontic procedures revealed a significant association with years of professional experience and the workplace.

The impact of technological endodontic resources on the training of the general dentist

INTRODUCTION

Technological resources are considered important for the practice and training in endodontics. It is not yet clear the extent of the insertion of these resources in predoctoral dental programmes and the effect of such resources to the general dentist training.

AIM

To evaluate the faculty perception regarding the insertion of technological resources, particularly rotary instruments, and the impact of such resources to the student's learning process graded at the end of predoctoral dental programmes in Brazil by the National Students Performance Exam (ENADE).

METHODS

The endodontic department faculties in all 205 programmes that participated in the 2016 ENADE received a questionnaire by email. The institution, faculty credentials, and insertion of technologies in each programme were described, and an association between these data and the ENADE score was tested.

RESULTS

149 educators (72.7%) answered the form. From this total, 73.2% of them were from private institutions and 26.8% from public ones. Educators mix manual and rotary instrumentation to treat selected patients in 47.7% of the programmes. Most educators (89.9%) consider the utilisation of technology in endodontics as positive. Whilst there was not a significant association between the use of rotary instrumentation and better performance in ENADE, there was a significant association between the performance and the supply of special instruments by the institutions.

CONCLUSION

These results show that even though most faculties consider the insertion of technologies as positive, the factor that caused a significant impact to the training of the general dentist is the general infrastructure of the institutions.

Implementation of Digital Radiography during Root Canal Treatments in Saudi Endodontic and General Dental Practice

Objective:

To report usage of full-digital-radiography (FDR) during root-canal-treatments (RCTs) in Saudi dental-practice and to explore factors and measures that obstacle/contribute to better implementation.

Methods:

Following a pilot study, questions on demography, types of radiographic systems used during RCTs, advantages and disadvantages of FDR, reasons of not using it and measures that increase its implementation were included. The sample size was calculated considering the total number of general dentists (GDs) in Saudi Arabia and a 50-60% expected response rate. The questionnaire was emailed to 550 GDs and all endodontists in Saudi Arabia (185). A solo a reminder was emailed two months later. Data were analyzed by the Chi-square test at P=0.05.

Results:

Most participants (64.9%) used FDR for RCTs (P<0.001); with all endodontists (100%) and 52% of GDs (P<0.001). While all who were working in governmental-academia (100%) used FDR, 69.2% in private-academia did so (P<0.001); with no difference between private and governmental-clinics (60.6 and 69.2%). As the weekly-performed RCTs increased and participants’ experience decreased, FDR usage increased (P<0.05). While high-cost was the main FDR disadvantage, faster-workflow, better image-quality and less-radiation were the main advantages (P<0.001). The majority (76.1%) of FDR none-users were doing so because of unavailability. Participants reported lower-cost and better undergraduate-education as most effective measures that increase FDR implementation in dental-practice.

Conclusion:

FDR was adopted to good extent in Saudi dental-practice. Financial aspects were the main concern that should be addressed to increase FDR implementation in private practice. Endodontists showed better perception towards FDR and suggested more attention to educational aspects.