Effects of an individualized training course on technical quality and periapical status of teeth treated endodontically by dentists in the Public Dental Service in Norway: An observational intervention study

Abstract

Aim: To investigate the effect of a continuing education course on technical quality and treatment outcome for root filled permanent teeth in Møre and Romsdal County, Norway. Methodology: Fifty-two dentists employed in the Public Dental Service in Møre and Romsdal county, Norway, completed a two-day continuing education course in root canal treatment. Periapical radiographs of root filled teeth treated before and after the course, with at least one-year follow-up were identified and scored for technical quality and periapical status. Technical root filling quality was assessed by density and length and the treatment outcome by PAI scores. Treatment information was achieved from the county's electronic dental record system. Information regarding the dental practitioners' background and treatment procedure routines was collected by a questionnaire. Descriptive statistics analyses and mixed-effect logistic regression analyses were performed to evaluate the effect of the course. Results: Radiographs were available for 224 teeth root filled before and for 221 teeth after the course. The proportion of teeth with adequate root filling quality was significantly lower after the course (p = .006), associated mainly with short root fillings (p < .001). No significant differences were observed in treatment outcome. There were, however, large differences in treatment outcome amongst subgroups of dentists. Further, there was evidence of effect modification by the continuing education course on periapical outcome by patient's age (p interaction = .0023) suggesting that teeth in patients ≤18 years healed relatively better post-course compared to patients >18 years. Conclusions: A two-day continuing education course in root canal treatment attended by Public Dental Service dentists in Norway did not improve the technical quality of root fillings or periapical status associated with root filled teeth.

A comparison of radiographically determined periapical healing and tooth survival outcomes of root canal (re)treatment performed in two care pathways within the United Kingdom Armed Forces

“…However, a systematic review of root canal retreatment (Ng, Mann, & Gulabivala, 2008), where the majority of included studies had been conducted in hospital and specialist practice settings, found clinical outcomes were not influenced by level of operator experience. Short endodontic technique courses, likely to have been undertaken by many of the General Dental Practitioners, have been reported not to influence PAH outcomes (Jordal et al., 2022; Koch et al., 2015), even though technical aspects of treatment delivery, and TS may be improved (Koch et al., 2015). Given that the Referred cohort PAH outcomes were aligned with those achieved by specialty trainees or specialists (Ng et al., 2011a; Ng, Mann, Rahbaran, et al., 2008), it would suggest that higher level training plays an important role in intra‐operative decision‐making.…”

Radiographic outcome of endodontic treatment and retreatment of teeth with apical periodontitis using two different root canal irrigants. A prospective cohort study

“…The radiographs taken on admission, on completion of treatment and at control were analysed in the ImageJ program (Schneider et al., 2012). A plug‐in addition (Preus et al., 2015) modified for registrations of endodontic parameters (Jordal et al., 2022) was used for recording radiographic features of interest (see Table S1). The radiographs were anonymized and randomly mixed and the observers were blinded for all clinical data, including the type of irrigation that was used.…”

PROBE 2023 guidelines for reporting observational studies in endodontics: Explanation and elaboration

“…From Jordal et al (2022)—‘The project was presented to the Regional Ethics Committee (REC South‐East Norway) without objections (ref no. 2015/265 B) and was approved by the Norwegian Center for Research Data, NSD (Ref no 39991).…”