Assessment of procedural errors and student satisfaction in preclinical root canal treatment: a cross-sectional study

Root canal treatment (RCT) is a key dental procedure that removes inflamed or infected pulp tissue through a series of critical steps. Undergraduate students learn RCT in preclinical and clinical settings, where procedural errors may occur and affect treatment quality. Such errors can also influence students' confidence and satisfaction with their performance. This study aims to evaluate the frequency and types of procedural errors in a preclinical setting, their effect on radiographic quality, and their influence on student satisfaction.

A cross-sectional study was conducted in May 2023 among third-year pre-clinical dental students. Participants performed RCT on extracted premolars using the step-back technique for preparation and cold lateral condensation for obturation. Radiographic evaluation was conducted at: pre-operative, working length (WL), master cone fit (MC), and obturation. Data collection included radiographic assessments and structured feedback forms, with a 100% response rate. Statistical analysis involved descriptive statistics and Chi-square testing.

Among 307 students (3:1 female-to-male ratio), most treated lower premolars with single canals (67%). Optimal working length and master cone fit were achieved in 84% and 74% of cases, respectively. Procedural errors occurred in 23.5%, ledges being the most common (14%). Radiographically, optimal obturation length was seen in 72%, taper in 47%, and density in only 6%; coronal extension was optimal in 29%. Students with procedural errors had significantly poorer obturation length and density (p < 0.05). Gender, tooth type, and repeated radiographs did not affect obturation quality (p > 0.05). Satisfaction was significantly lower among students with compromised obturation length or taper (p < 0.05) but not affected by coronal extension or minor voids (p > 0.05). Overall, satisfaction was higher among those without procedural errors or repeated radiographs (p < 0.05) and was not influenced by gender or tooth type.

This study demonstrates a clear association between procedural errors, radiographic quality of RCT, and student satisfaction. While errors are an expected part of the preclinical learning process, it offers an important learning opportunity. A balanced approach that encourages technical skills while allowing reflection on mistakes is essential for improving student performance and clinical outcomes in endodontic training.