The Relationship Between Endodontic Case Complexity and Treatment Outcomes
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The primary goal of endodontic therapy is to prevent or heal apical periodontitis. Dental pulp has a complex internal anatomy, a thorough knowledge of both root and root canal morphology is, therefore, a fundamental prerequisite to help ensure optimal outcomes of root canal treatment.The aim of this work is to correlate between endodontic case complexities and treatment quality outcomes.A total number of 349 radiographs of patients who had received endodontic treatment during the period (2012-2015) at Hamdan Bin Mohammed College of Dental Medicine-Mohammed Bin Rashid University were selected. Unreadable radiographs due to technical errors, superimposed anatomical structures, and incomplete treatments 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 residents. All radiographs were individually evaluated following the American Association of Endodontic Case Difficulty Assessment Form. Base on this, the technical quality of the root filling which depends on two main parameters density of the root filling and the distance between the end of the root filling and radiographic apex was evaluated for each individual case.The sample evaluated consisted of 53% of high, 35% of moderate and 12% of 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. Thus 84% (0.93x0.90=0.84) of the cases were considered to have good quality endodontic work. 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).The referral pattern (53% high and 35% moderate difficulty) indicates that Hamdan Bin Mohammed College of Dental Medicine is considered a secondary/tertiary referral centre. A high percentage (84%) of the cases treated were proved to be adequate in terms of length and homogeneity. There were statistically significant differences between length of root canal filling and case difficulty but, not between homogeneity and case difficulty.