Technical outcome of root canal treatment on permanent teeth in children: a retrospective study

The aim was to assess the technical quality of root canal treatment conducted in paediatric patients. No specific data is available assessing endodontic treatment quality in children. General adult populations report satisfactory technical quality between 12.8 and 55.7 %, with higher rates by endodontists (77.4-91.0 %).

Radiographs of 100 chronological cases, conducted by staff (categorised as; junior staff, middle grades or consultants) in a UK teaching hospital, were evaluated retrospectively. Technical outcomes were compared to the European Society of Endodontology quality guideline consensus. A satisfactory root filling was defined as having: root filling material <2 mm from the radiographical apex; no canal space seen beyond the end of the obturation and an obturation of homogeneous density with no voids. In addition where MTA was used a plug of ≥3 mm was required. Any variation was considered unsatisfactory treatment.

61 % [95 % CI 51-70 %] of cases were deemed satisfactory. Of the remaining obturations 20.5 % were short of the apex, 28.2 % had extruded material and 56.4 % contained voids. Patients with co-operation issues, particularly anxiety, had lower technical outcomes (p = 0.001) and the use of thermoplastic obturation greatly reduced the chance of void inclusion (p = 0.004; OR 0.20 [95 % CI 0.06-0.65]). Although 'staff grade' did not show a statistically significant difference, a trend between experience and quality was suspected.

Overall technical quality of treatment was comparable to the higher rates found in the general adult population. Additionally thermal obturation may be superior to cold lateral condensation in improving obturation quality, and anxiety negatively impacts on treatment provision.