Technical quality of root canal treatment performed by undergraduate students using hand instrumentation: a meta-analysis

Abstract

The technical quality of root canal treatment (RCT) may impact on the outcome. The quality of education received during undergraduate school may be linked to the quality of treatment provided in general dental practice. In this context, the aim of this systematic-review is to answer the following focused questions: 1) What is the frequency of acceptable technical quality of root fillings, assessed radiographically, performed by undergraduate students? 2) What are the most common errors assessed radiographically and reported in these treatments? For this purpose, articles that evaluated the quality of root fillings performed by undergraduate students were selected. Data was collected based on predetermined criteria. The key-features from the included studies were extracted. GRADE-tool assessed the quality of the evidence. MAStARI evaluated the methodological quality and a meta-analysis on all studies was conducted. At the end of the screening, twenty-four articles were identified. Overall frequency of acceptable technical quality of root fillings was 48%. From this total, 52% related to anterior-teeth, 49% to premolars, and 26% to molars. The main procedural errors reported were: ledge formation, furcation perforation, apical transportation, and apical perforation. The heterogeneity among the studies was high (84% to 99%). Five studies presented a high risk of bias, eight had a moderate risk, and 11 had low risk. The overall quality of evidence identified was very low. The conclusion was that technical quality of root fillings performed by undergraduate students is low, which may reveal that endodontic education has limited achievement at undergraduate level. A plan to improve the quality of root fillings, and by extrapolation the overall quality of root canal treatment, should be discussed by the staff responsible for endodontic education and training.

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