Perception and confidence levels among dental students and interns in performing various endodontic procedures / Niveles de percepción y confianza entre estudiantes de odontología y pasantes en la realización de diversos procedimientos de endodoncia

Aim: The present study aimed to collect information from senior students and new interns enrolled at the College of Dentistry, University of Science and Technology (UST), regarding their confidence levels in performing endodontic treatments. Materials and Methods: Anonymous surveys were distributed to 40 senior students and 37 new interns at UST, in Sana'a, Yemen. They were asked to indicate their self-confidence level using a Likert scoring system ranging from 1 and 5. Mann-Whitney U test and chi-squared test were used to determine statistical significance between the studied groups. Results: 37.5% of students and 35.1% of interns rated endodontic practice as difficult. Only 55% of students found that the number of treated cases were satisfactory, similar to that reported by interns (56.8%). There were no statistically significant differences between both groups regarding self-confidence levels for most endodontic procedures (p<0.05). Placing of a rubber dam, followed by managing inter-appointment flare-ups were procedures in which both groups reported the lowest confidence. On the other hand, both groups felt the lowest confidence in the treatment of maxillary followed by mandibular molars. Statistically significant differences were reported between the two groups for performing root canal treatments (RCT) (p< 0.05). Self-confidence levels on the management of most different indications showed no statistically significant differences between both groups (p>0.05) with exception to the management of irreversible pulpitis, necrotic pulp, asymptomatic apical periodontitis, chronic abscess, and traumatic cases, in which significant differences were noticed (p<0.05). Immature apices, root resorption, endodontic-periodontal (EP) lesions, trauma, symptomatic apical periodontitis and acute abscess were ranked as the cases in which both groups reported the lowest confidence. Canal blockage and ledge formation were the main mishaps encountered during practice among students and interns. Conclusion: Students and interns displayed neutral confidence in performing endodontic treatments.

Objetivo: El presente estudio tuvo como objetivo recopilar información de estudiantes de último año y nuevos pasantes inscritos en la Facultad de Odontología, Universidad de Ciencia y Tecnología (UST), con respecto a sus niveles de confianza en la realización de tratamientos de endodoncia. Materiales y métodos: se distribuyeron encuestas anónimas a 40 estudiantes de último año y 37 nuevos pasantes en UST, en Sana'a, Yemen. Se les pidió que indicaran su nivel de confianza en sí mismos utilizando un sistema de puntuación Likert que oscilaba entre 1 y 5. Se utilizaron la prueba U de Mann-Whitney y la prueba de ji al cuadrado para determinar la significación estadística entre los grupos estudiados. Resultados: el 37.5% de los estudiantes y el 35.1% de los pasantes calificaron la práctica de endodoncia como difícil. Solo el 55% de los estudiantes encontró que el número de casos tratados fue satisfactorio, similar al reportado por los pasantes (56.8%). No hubo diferencias estadísticamente significativas entre ambos grupos con respecto a los niveles de autoconfianza para la mayoría de los procedimientos de endodoncia (p<0.05). La colocación de una presa de goma, seguida de la gestión de brotes entre citas, fueron procedimientos en los que ambos grupos informaron la menor confianza. Por otro lado, ambos grupos sintieron la menor confianza en el tratamiento del maxilar seguido de los molares mandibulares. Se informaron diferencias estadísticamente significativas entre los dos grupos para realizar tratamientos de conducto radicular (ECA) (p<0.05). Los niveles de autoconfianza en el manejo de la mayoría de las indicaciones diferentes no mostraron diferencias estadísticamente significativas entre ambos grupos (p>0.05) con excepción del manejo de pulpitis irreversible, pulpa necrótica, periodontitis apical asintomática, absceso crónico y casos traumáticos, en los cuales se notaron diferencias (p<0.05). Los ápices inmaduros, la reabsorción radicular, las lesiones endodóncicas-periodontales (EP), los traumatismos, la periodontitis apical sintomática y el absceso agudo se clasificaron como los casos en que ambos grupos informaron la menor confianza. El bloqueo del canal y la formación de repisas fueron los principales percances encontrados durante la práctica entre estudiantes y pasantes. Conclusión: los estudiantes y los pasantes mostraron una confianza neutral en la realización de tratamientos de endodoncia.

Tensile stress distribution in maxillary central incisors restored with cast-made and prefabricated dental posts

AIM: To analyze and compare the tensile stress distribution in endodontically treated teeth restored with cast-made (Ni-Cr and gold) and prefabricated (titanium and glass fibre) dental posts. METHODOLOGY: Four threedimensional finite element (FE) models of a maxillary central incisor restored with Ni-Cr cast-made (Model Ni-Cr), gold cast-made (Model GO), prefabricated titanium (Model TI) and prefabricated glass fibre (Model FP) posts were constructed. An oblique loading of 100N was applied to each three-dimensional model. Tensile stress distribution within the root dentine and at the post and surrounding structure interfaces were analysed. RESULTS: In all the FE models studied, a higher magnitude of tensile stresses was observed on the palatal aspect of the cervical dentin as compared to the labial aspect and progressively decreases from the outer to the inner part of the root. The gold cast-made and glass fibre post models showed significantly less tensile stress concentration in the post-core component than the other experimental models. The maximum tensile stress was seen on the palatal aspect of the Ni-Cr compared to other posts. The higher magnitude interfacial tensile stress concentration was observed in a pulpless tooth restored with a Ni-Cr cast-made post, followed by titanium and gold castmade posts, respectively. However, the minimum interfacial tensile stress was noticed in a pulpless tooth restored with a glass fibre post. CONCLUSION: Glass fibre posts tend to transfer tensile stress more homogenously within the tooth and at interfaces than the other types of investigated posts.