The relationship between endodontic case complexity and treatment outcomes

The aim of this work is to correlate between endodontic case complexities and treatment quality outcomes.

Three hundred and forty nine radiographs of patients who had received endodontic treatment at a postgraduate dental institute in Dubai were retrieved from the Institute's data base. The majority of the cases were referred by in house general dental practitioners (GDPs). Unreadable radiographs were all excluded. From the original sample of 349,in total 51 radiographs were discarded. The final sample thus consisted of 298 root canal fillings of 211 patients treated by the endodontic postgraduate students. All radiographs were individually evaluated following the American Association of Endodontic Case Difficulty Assessment Form. Based on this, the technical quality of the root filling was evaluated for each individual case.

The sample consisted of 53% high,35% moderate and 12% minimal difficulty cases. Adequate homogeneity of root canal fillings were found in 93% of the cases. This compared with 90% of cases with adequate length of root fillings. There were statistically significant differences between the length of root canal filling and level of difficulty (p = 0.016) but, no statistically significant difference between homogeneity of root canal filling and case difficulty (p = 0.794).

Eighty four percent (0.93 × 0.90 = 0.84) of the cases treated proved to be adequate in terms of length and homogeneity which is in line with published work of Endodontic treatment carried out by specialists.

GDPs require robust guidelines to help with appropriate referral of patients to Endodontic specialists.