Intern
ati
o
n
a
l
Jo
urn
a
l
o
f
P
u
b
lic Hea
l
th Science (IJ
P
HS)
V
o
l.4
,
No
.3
, Sep
t
em
b
e
r
20
15, pp
. 197
~200
I
S
SN
: 225
2-8
8
0
6
1
97
Jo
urn
a
l
h
o
me
pa
ge
: h
ttp
://iaesjo
u
r
na
l.com/
o
n
lin
e/ind
e
x.ph
p
/
IJPHS
Qualit
y of Root
Canal
Obtura
tion Performed by Senior
Undergraduate De
ntal Students
Sund
ah
nath Nagaraja
S
a
veeth
a
Den
t
al
College
and
Hos
p
itals
, Chenn
a
i
,
India
Article Info
A
B
STRAC
T
Article histo
r
y:
Received
J
u
n 25, 2015
Rev
i
sed
Au
g
20
, 20
15
Accepted Aug 30, 2015
The a
i
m
of the
pres
ent s
t
ud
y w
a
s
to
a
sse
ss the qua
lity
of
canal obturatio
n
performed b
y
u
ndergraduate denal stud
en
ts
a
t
S
a
veeth
a
Den
t
al
Coll
ege
an
d
Hospitals, Ch
en
nai. Records o
f
200 endodon
tically
treated
teeth from
patients who were v
i
sited
b
y
underg
raduate s
t
udents between
months of
November 2014 to May
2015. Periapical
ra
diogr
aphs of all
treated
teeth wer
e
assessed in terms of can
al obtur
ation
qua
lity
(
a
d
e
quate density
and leng
th).
F
o
rt
y
-fiv
e
per
c
e
n
t of te
eth fulf
il
led th
e cri
t
eri
a
of an ac
cep
tabl
e
root can
al
obturation
.
Adeq
uate length and densit
y
of root filling was found in 89% and
34% of te
eth,
res
p
ect
ivel
y.
Th
ere was
a s
i
gn
ific
ant diff
eren
c
e
betwe
e
n
m
a
xillar
y
and m
a
ndibul
ar t
eeth
r
e
garding
the
len
g
th of root
can
al
obturat
ion.
A significant dif
f
erence was observed be
tween molars and other tooth ty
p
e
s
.
The fr
equency
of root canals
with
an
acceptable filling w
a
s significantly
great
er in
the
an
terior
te
eth
com
p
ared t
o
prem
ol
ars
or m
o
lars
.
T
h
e te
chni
cal
quality
of root canal tr
eatmen
t
perform
ed b
y
un
dergraduate den
t
al students
was found to
be
less than
id
eal.
Keyword:
Dent
al
R
a
di
o
g
r
a
phy
En
do
d
ont
i
c
s
Mo
lar
Periapical radi
og
ra
ph
Ro
o
t
Can
a
l Obtu
ration
Copyright ©
201
5 Institut
e
o
f
Ad
vanced
Engin
eer
ing and S
c
i
e
nce.
All rights re
se
rve
d
.
Co
rresp
ond
i
ng
Autho
r
:
Su
nda
h
n
at
h Na
gara
ja,
Saveet
ha
De
nt
al
C
o
l
l
e
ge a
n
d
Hos
p
i
t
a
l
s
, C
h
e
nnai
,
I
n
di
a
Em
a
il: d
r
.sundah
n
a
t
h
@yah
oo.co
m
1.
INTRODUCTION
Preserv
a
tion
of th
e n
a
tural d
e
n
titio
n
h
a
s
b
eco
m
e
m
o
re p
o
p
u
l
ar in
th
e so
ciety [1
]
.
Th
erefo
r
e,
en
dod
on
tic th
er
ap
y is
becom
i
ng a
n
i
n
creasi
ngl
y
ro
ut
i
n
e p
a
rt
of ge
neral
dental practice [2]. Success
of root
canal
t
r
eatm
e
nt
has been re
p
o
r
t
e
d t
o
be 5
3
-
9
4
% [
3
]
,
[
4
]
.
Th
e
m
e
t
hods f
o
r
assessm
ent
of end
o
d
o
n
t
i
c
t
r
eatm
e
nt
out
c
o
m
e
are
most
l
y
based o
n
radi
o
g
ra
p
h
i
c
eval
uat
i
o
n o
n
l
y
[5]
-
[
7]
, com
b
i
n
at
i
on
of ra
di
o
g
ra
p
h
i
c
and cl
i
n
i
cal
ev
alu
a
tion
[8
]-[10
] or h
i
sto
l
og
ical ex
am
in
at
io
n
,
i
n
cas
e
o
f
treat
m
e
n
t
failu
res
[1
1
]
,[12
]. Th
e
q
u
a
lity of ro
o
t
can
al treatm
e
n
t
p
e
rfo
r
m
e
d
b
y
g
e
n
e
ral practitio
n
e
rs in
d
i
fferen
t
pop
ulatio
n
s
h
a
s
al
so
b
een
ex
tensiv
ely
i
nvest
i
g
at
e
d
i
n
m
a
ny
st
udi
es,
t
h
e res
u
l
t
s
of
whi
c
h ha
ve s
h
o
w
n hi
gh
pe
r
cent
a
ge
of i
n
a
d
eq
uat
e
r
o
ot
canal
t
r
eatm
e
nt
[7]
,
[
13]
-
[
15]
. The
reaso
n
s
are
com
p
lex and m
a
y be
related to
th
e d
i
fferen
t en
dod
on
tic
teach
i
ng
m
e
thods at de
ntal schools
[16]. Som
e
of the problem
s
in
endodontic teaching m
a
y
be
attributed to lim
ited
ti
m
e
allo
cated
to
en
dod
on
tics, p
oor
staf
f-
to
-stu
d
e
n
t
r
a
tio
s an
d
th
e
f
act th
at
m
a
n
y
en
d
odon
tists h
a
v
e
n
o
t
tak
e
n
the teaching skills [17]. St
udents
are ta
ught endodontics from
3
rd
year o
n
ward
s till i
n
tern
sh
i
p
, at Sav
eeth
a
Dental C
o
llege
and
Hos
p
itals, Che
n
nai are
expecte
d
t
o
pe
rform
endodontic treatm
e
nt on a
va
riety of
teeth
b
e
lon
g
i
n
g
to
t
h
e
p
a
tien
t
s d
i
ag
no
sed
to
r
e
q
u
ir
e ro
o
t
can
a
l tr
eatm
e
n
t
. Th
e
ai
m
o
f
th
is
o
b
s
er
v
a
tion
a
l study w
a
s
t
o
eval
uat
e
t
h
e
t
echni
cal
qual
i
t
y
of r
o
ot
can
al
obt
urat
i
o
n
u
s
i
ng
ra
di
o
g
ra
p
h
s
of t
eet
h t
r
e
a
t
e
d by
3
rd
year till
i
n
t
e
rns
u
n
d
er
gr
aduat
e
de
nt
al
s
t
ude
nt
s at
Sa
ve
et
ha De
nt
al
C
o
l
l
e
ge an
d
Ho
sp
i
t
a
l
s
, C
h
en
nai
.
2.
R
E
SEARC
H M
ETHOD
Records
of 200 patients, who
had r
ecei
ved endodontic treat
ment by 3
rd
year till in
tern
und
erg
r
adu
a
te
stu
d
e
n
t
s at Sav
eeth
a
Den
t
al Co
lleg
e
an
d
Ho
sp
itals
, Ch
en
n
a
i
fro
m
2
014
Nov
e
m
b
er till 2
0
1
5
May, were
Evaluation Warning : The document was created with Spire.PDF for Python.
I
S
SN
:
2
252
-88
06
I
J
PH
S Vo
l. 4
,
N
o
. 3
,
Sep
t
emb
e
r
201
5
:
1
97
–
20
0
19
8
sel
ect
ed and e
v
al
uat
e
d
.
R
eco
rds t
h
at
di
d no
t
i
n
cl
ude prea
nd
post
-
o
p
erat
i
v
e peri
a
p
i
cal
radi
og
rap
h
s o
r
t
hose
wi
t
h
p
o
o
r
ra
di
og
ra
phi
c
qual
i
t
y
besi
des t
h
e
reco
rd
s o
f
p
a
tien
t
s with
i
n
com
p
le
te en
do
don
tic treat
m
e
n
t
were
excl
u
d
ed
. The
fi
nal
sam
p
l
e
con
s
i
s
t
e
d o
f
2
00
doc
um
ent
s
o
f
en
dod
on
tically treated
t
eeth. Am
on
g t
h
e
s
e, 6
1
were a
n
t
e
ri
o
r
t
eet
h w
h
i
l
e
47 a
nd
9
2
t
eet
h we
re p
r
em
ol
ar
s an
d
m
o
lars, resp
ectiv
ely. An
asep
tic tech
n
i
q
u
e with
ru
b
b
er dam
i
s
ol
at
i
on ha
d be
en ap
pl
i
e
d i
n
al
l
t
h
e cases and
wo
rki
ng l
e
ngt
hs was d
e
t
e
rm
i
n
ed by
m
eans o
f
radi
og
rap
h
s
.
A
l
l
t
h
e t
eet
h
ha
d
been
i
n
st
ru
m
e
nt
ed
wi
t
h
p
a
ssi
ve st
e
p
-
b
ac
k t
e
c
hni
que
us
i
ng
st
ai
nl
ess st
eel
K-
files with
0
.
02
tap
e
r and
irrigated
with
2
.
5
%
so
d
i
u
m
h
y
p
o
c
h
l
orite so
lu
tio
n. Ro
o
t
fillin
g
s
h
a
d
b
een
carri
ed
ou
t
with
lateral com
p
act
io
n
techn
i
qu
e u
s
i
n
g
gutta-p
erch
a .A
ll th
e teeth
h
a
d
b
een
tem
p
o
r
ari
l
y filled
an
d
referred
for
p
e
rm
an
en
t
restoration
.
All th
e tr
eatm
e
nt steps
were
c
o
nducted
unde
r
th
e sup
e
r
v
isi
o
n of
teach
i
ng staf
f.
Ev
alu
a
tion
o
f
t
h
e techn
i
cal q
u
ality o
f
roo
t
can
al treatm
e
n
t
was b
a
sed
on
th
e immed
i
ate
p
o
s
t
o
p
e
rativ
e
RVG
of
each case. T
h
e
final RVG we
re exam
ined by two indepe
nd
ent
investigat
ors using with a
few
selected cases
wh
ich
were no
t in
clud
ed
in th
e stu
d
y
[1
6]. An
ev
al
u
a
tio
n
form
was
d
e
sign
ed
to
reco
rd
th
e informatio
n
gat
h
e
r
ed f
r
o
m
t
h
e im
m
e
di
ate post
ope
rat
i
v
e radi
o
g
ra
p
h
s.
The m
e
t
hod
of vi
e
w
i
n
g t
h
e ra
di
o
g
ra
ph
s wa
s
st
anda
rdi
z
e
d
u
s
i
ng R
V
G. T
h
e res
u
l
t
s
we
re
com
p
ared a
n
d
a fi
nal
res
u
l
t
w
a
s co
ncl
u
de
d.
Each
ro
ot
was
score
d
i
ndi
vi
dual
l
y
a
n
d t
h
e
t
o
ot
h
wa
s co
nsi
d
e
r
e
d
a
s
a
uni
t
.
I
n
m
u
lti-ro
o
t
ed
teeth, th
e
h
i
gh
est
sco
r
e of all th
e
roo
t
s
was attribu
t
ed
to
th
e t
o
o
t
h
and
u
lti
m
a
tel
y
, failu
re
o
f
on
e
ro
o
t
was
con
s
i
d
ered
t
h
e fail
ure
o
f
t
h
e too
t
h as a
w
h
o
l
e. Th
e
quality o
f
end
odon
tic treatm
e
n
t
w
a
s
d
e
term
in
ed
b
y
th
e leng
th o
f
ro
o
t
can
a
l
o
b
t
u
r
ation
i
n
relatio
n
t
o
t
h
e
ra
di
o
g
ra
phi
c
ape
x
a
n
d
al
so t
h
e
de
nsi
t
y
of
t
h
e
o
b
t
u
ra
t
i
on
base
d
on
t
h
e
prese
n
ce
o
f
v
o
i
d
s
as s
h
ow
n i
n
Tab
l
e 1
.
Meanwh
ile, Tab
l
e 2 sh
ows th
e d
i
strib
u
tion
of
teeth
in
m
a
x
illary an
d
m
a
n
d
i
b
u
l
ar arch
es.
Hen
ce,
Tab
l
e
3
p
r
o
v
i
des in
form
at
io
n
ab
ou
t
o
v
e
rall qu
ality, len
g
t
h
,
an
d d
e
n
s
ity of
roo
t
can
a
l fillin
g.
Tab
l
e
1
.
C
r
iteria fo
r assestm
e
n
t
of
rad
i
o
g
raph
ic qu
ality o
f
ro
o
t
can
a
l
fillin
g
Para
m
e
ter Criteria
Definition
density
of r
oot canal
filling quality
Adequate
No voids present in the root f
illing or between root filling and
root canal walls
Inadequate
voids present in the root filling
or between root filling and root
canal walls
Acceptable
Adequate
length and density
length of root cana
l
filling
Adequate
Root
filling ending <2
mm
f
r
o
m
radiographic apex
Over filling
Root filling
beyond the radiographic apex
Short -filling
Root filling >2mm fro
m
radiographic
apex
Tab
l
e
2
.
Distri
b
u
tion
of teeth
in
m
a
x
illary an
d
m
a
n
d
i
bu
lar arch
es
T
ooth ty
pe
N
%
Maxillary 87
44
Maxillary ante
rior
teeth
87
44
M
a
ndibular
113
56
M
a
ndibular
anter
i
or
teeth
1
0.
5
M
a
ndibular
pr
em
o
l
ar
20
10
M
a
ndibular
m
o
lar
s
92
45.
5
T
o
tal 200
100
Tab
l
e
3
.
Ov
erall q
u
a
lity, leng
th
, and
d
e
nsity o
f
ro
o
t
can
a
l
fillin
g
n
Quality Length
Density
Acceptable
Unacceptable
Adequate
Short
f
illing Over
f
illing
Acceptable
unacceptable
200
90(
45%)
110(
55%)
178(
89%)
15(
7.
5%)
7(
3.
5%)
69(
34.
5%)
131(
65.
5)
3.
RESULTS
A
N
D
DI
SC
US
S
I
ON
The teeth
were classified a
ccording t
o
t
h
eir lo
cation i
n
the a
r
c
h
es.
The
fre
quenci
es of teeth
ex
am
in
ed
in
this stu
d
y
are sho
w
n
in
Tab
l
e
2
.
Th
ere
were
8
7
m
a
x
illary an
d
11
3
m
a
n
d
i
bu
lar teeth
.
Qu
ality o
f
roo
t
can
al fillin
g
(i.e. leng
th
, an
d
d
e
n
s
ity) is sh
own
in
Tab
l
e 3
.
Ni
n
e
ty teeth
(45
%
) fu
l
f
illed
th
e criteria o
f
an
acceptable root canal filling.
Ade
q
uate lengt
h of the root
filling was found in 89%
of te
eth, while 7.5% were
u
n
d
e
rfilled
and
3
.
5
%
were ov
erfilled
.
Ad
eq
u
a
te d
e
n
s
ity
was fo
und
in
3
4
% o
f
teeth
.
Th
e frequ
e
n
c
y o
f
ro
o
t
canals with unacceptable obturation was sign
ificantly hi
gher the
n
t
h
e acc
eptable.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
J
PH
S I
S
SN
:
225
2-8
8
0
6
Q
u
a
lity o
f
Root Ca
na
l
O
b
t
u
ratio
n
Perf
o
r
m
e
d b
y
S
e
n
i
o
r
Underg
ra
dua
te D
e
n
t
a
l
.... (Su
ndah
na
th Naga
ra
j
a
)
19
9
3.
1.
Discussion
Th
is stud
y aimed
to ev
al
u
a
te
th
e qu
ality o
f
ro
o
t
can
a
l treat
men
t
carried ou
t b
y
sen
i
or
u
n
d
e
rg
radu
ate
st
ude
nt
s at
Saveet
ha
Dent
al
C
o
l
l
e
ge an
d H
o
spi
t
a
l
s
, C
h
e
n
nai
.
Po
st
o
p
erat
i
v
e R
VG
were
used f
o
r asses
s
m
e
nt
.
Th
e
q
u
a
lity o
f
roo
t
can
al
o
b
t
u
r
ation
was evalu
a
ted
[16
]
. Stu
d
i
es ev
alu
a
tin
g
t
h
e rad
i
ograp
h
i
c
q
u
ality o
f
ro
o
t
canal
t
r
eat
m
e
nt
have
m
o
st
l
y
bee
n
base
d
o
n
t
h
e
eval
uat
i
o
n
o
f
t
h
e l
e
n
g
t
h
a
n
d t
h
e
d
e
nsi
t
y
of
r
o
ot
canal
o
b
t
u
r
ation
[1
8
]
-[2
1
]
. Th
e
results o
f
th
is st
u
dy sho
w
ed
t
h
at
q
u
a
lity of
roo
t
can
al
o
b
t
u
r
ation
was less th
an id
eal
.
The reasons for this fact
are
com
p
lex and
may be related to the en
dodontic teaching strategy undertaken at
d
e
n
t
al sch
o
o
l
s [16
]
. Th
e qu
ality o
f
m
a
x
illa
ry and
m
a
n
d
i
bu
lar roo
t
fillin
g
s
was th
e same in
th
is stud
y. Th
e
fre
que
ncy of
t
eeth with
a
n
acceptable root
canal obt
ur
at
ion was
significantly lower
(45%
) c
o
m
p
ared t
o
unacce
pta
b
le (55%)
who
reporte
d
that the t
echnical
quality
was accepta
ble
m
o
re ofte
n i
n
ante
rior teet
h. This
may b
e
ex
p
l
ai
n
e
d
p
a
rtly b
y
th
e an
at
o
m
y o
f
th
ese teeth
.
Th
e p
e
rcen
tag
e
o
f
roo
t
can
a
l fillin
g
s
with
adeq
u
a
te
len
g
t
h was 89% in
th
e presen
t stud
y.Th
e
hig
h
e
r p
e
rcen
tag
e
o
f
ov
erfilli
n
g
s
repo
rted in
o
t
h
e
r stud
ies m
a
y b
e
at
t
r
i
but
ed
t
o
t
h
e
hi
g
h
er
i
n
c
i
dence
o
f
t
eet
h
wi
t
h
pree
xi
st
i
ng
peri
a
p
i
c
al
radi
ol
uce
n
c
y
i
n
t
h
ese
st
udi
es
[10
]
,[19
],[2
1
]
.
Th
ese lesio
n
s
can
resu
lt in
reso
rp
tion
and
d
e
stru
ctio
n
o
f
th
e ap
ical con
s
trictio
n
an
d th
i
s
lo
ss
m
a
y
have i
n
fl
uence
d
w
o
r
k
i
n
g l
e
n
g
t
h
c
o
nt
r
o
l
by
un
de
rg
r
a
duat
e
st
ude
nt
s. I
n
a
d
eq
uat
e
den
s
i
t
y
of
ro
o
t
canal
obt
uration m
a
y lead to failure
of ro
ot canal treatm
e
nt because of m
i
crol
eakage al
ong the
root
filling [20]. To
su
m
u
p
,
in
order to im
p
r
o
v
e
th
e tech
n
i
cal
qu
ality o
f
r
o
o
t
can
a
l treatm
e
n
t
p
e
rform
e
d
b
y
u
n
d
e
rgradu
ate
d
e
n
t
al
st
ude
nt
s, t
h
e e
n
d
o
d
o
n
t
i
c
s c
u
r
r
i
c
ul
a
have
t
o
be r
e
vi
se
d.
Th
us, t
h
e t
i
m
e of t
r
ai
ni
n
g
of
t
h
e
st
ud
ent
s
at
t
h
e
cl
i
n
i
c
has t
o
be e
x
t
e
nde
d,
an
d
su
bs
eque
nt
l
y
t
h
e cl
i
n
i
cal
req
u
i
r
em
ent
s
f
o
r e
n
d
o
d
ont
i
c
s
ha
ve t
o
be i
n
c
r
ease
d
,
s
o
t
h
at
th
e stud
en
t
will b
e
g
i
v
e
n
m
o
re ti
m
e
to
treat m
o
re cases
. The clin
ical train
i
n
g
cou
r
se
s h
a
ve to
b
e
arran
g
e
d
to
p
r
ov
id
e t
h
e stud
en
ts with prop
er sk
ills in end
odo
n
tics.
4.
CO
NCL
USI
O
N
Accord
ing
to
th
e resu
lts o
f
th
is o
b
serv
ation
a
l stu
d
y
, th
e
tech
n
i
cal qu
ality o
f
roo
t
canal treat
m
e
n
t
per
f
o
r
m
e
d by
un
de
rg
rad
u
at
e
dent
al
st
u
d
e
n
t
s
was f
o
un
d t
o
be
bet
t
e
r o
n
t
h
e ant
e
ri
o
r
t
eet
h com
p
ared t
o
t
h
e
post
e
ri
o
r
t
eet
h.
Thus
, revi
si
on
of t
r
ai
ni
n
g
co
urses
fo
r t
h
e st
ude
nt
s at
t
h
e cl
i
n
i
c
i
s
suggest
ed m
o
re t
o
be gi
ve
n
on the
posterior teeth.
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