Suitability of different tooth replicas for endodontic training: perceptions and detection of common errors in the performance of postgraduate students.

AIM: To compare the perceptions of students when using five different tooth replicas and to detect common errors in the performance of students that might be attributed to a specific type of tooth replica. METHODOLOGY: Five groups (n = 10 each) of artificial first maxillary molars (DEPT, DRSK, Nissin, DENTALIKE and TrueTooth) were used. All 50 teeth were mounted individually in opaque containers, distributed in 10 packages containing a sample from each with an assigned random order for students to perform root canal treatments. Ten postgraduate students each performed a root canal treatment on the five replicas, in the assigned order, and completed a satisfaction questionnaire. Three trained and calibrated endodontic educators, each with more than 15 years of experience, evaluated their performance using a grading rubric and completed a questionnaire to detect common errors attributed to a specific tooth replica. Inter-rater reliability was calculated with the interclass correlation coefficient for both consistency and absolute agreement. A two-way related measures anova was used to assess the interaction amongst evaluators and tooth groups on the average scores of students. Post hoc T3 Dunnet was used to compare groups. The perceptions of students amongst groups were compared with chi-square and linear-by-linear association tests. RESULTS: Inter-rater reliability was very high for both consistency (ICCC = 0.939; 95% confidence interval (CI) 0.902-0.964) and absolute agreement (ICCA = 0.940; 95% CI 0.904-0.965). No significant differences were found amongst the ratings of evaluators; however, students performed differently when using the various tooth replicas (P < 0.05). Overall, 60% of students preferred the DRSK replica for root canal treatment training purposes, followed by DENTALIKE (30%). The least preferred was TrueTooth (70% responses) due to its complex anatomy and poor resistance to instruments and heat pluggers. Evaluators detected several common errors in specific tooth replicas and preferred tooth replicas manufactured based on microCT scans of natural teeth. CONCLUSIONS: Tooth replicas manufactured based on microCT scans of natural teeth (TrueTooth and DENTALIKE) had much better acceptance amongst evaluators, although students rated and performed less well in TrueTooth replicas due to their greater level of difficulty.

Biofilm. Un Nuevo concepto de infección en Endodoncia / Biofilm. A new infection concept in endodintics

Distintos estudios concluyen que el porcentaje de éxito del tratamiento de conductos en dientes necróticos es menor que en dientes vitales. Hoy día, se postula que la verdadera causa de fracaso de muchos tratamientos de conductos aparentemente correctos es la entidad infecciosa conocida como biofilm. Además, se ha mostrado como un tipo de infección doble. Por un lado, conocer el papel del biofilm en Endodoncia: morfología, metabolismo, formación, evolución y localización. Por otro, actualizar los métodos que propone la Endodoncia para controlarlo y eliminarlo, poniendo especial atención EN la técnica de irrigación. Elegida por muchos autores como la clave para su tratamiento (AU)

Different studies have concluded that the success rate of root canal treatment in necreotic teeth is lower than in vita l teeth. Nowadays, the real cause of failure in many root canal treatment that have apparently been correctly carried out is considered to be the infectious matter know as biofilm. Elimination form the canal of this type of infection has proved to be very difficult and has become one of the great challenges in modern endodontics. The aim of this review article is twofold: firstly, to understand the role of bifilm in endodontics, with respect to its morphology, metabolism, formation, evolution and localization, and, secondly to update endodontic procedures for controlling and eliminating it, paying particular attention to the technique of irrigation which is the preferred key to treatment of many authors (AU)

Importancia de la irrigación en el éxito del tratamiento de conductos radiculares necróticos. Parte 2 / No disponible

La primera parte de este trabajo actualizaba el conocimiento de la necrosis pulpar y analizaba el tipo de bacterias características, así como su relación con el sistema de conductos radiculares. A continuación, se exponía el tratamiento, priorizando la acción de los irrigantes, así como distintas secuencias de irrigación y asociaciones de irrigantes recomendadas por la literatura. En esta segunda parte, nos ocuparemos de la relevancia de los instrumentos de endodoncia y de su relación con la irrigación. Además, se revisarán otros métodos de desinfección intraconducto alternativos a los instrumentos e irrigante so que los complementen y se expondrán los nuevos irrigantes que nos aporta bibliografía actual. Por último. Se expone lo más relevante conocido hasta el momento de biofilm, entidad infecciosa de reciente conocimiento en Endodoncia, y sus posibilidades de tratamiento (AU)

Part one of this article updated the knowledge about pulp necrosis and analyzed the type of bacteria as well as its relationship with the root canal system. After, the treatment was exposed, prioritizaing irrigants action as well as different irrigation sequences. We showed associations of irrigants recommended in the literature too. In part two, we will deal with relevance of endodontic instruments and its relationship with irrigation. Furthermore, other ways of canal disinfection, alternative to the instruments and irrigation, will be reviewed, and we will show the new irrigants contributed by current bibliography. Last, the most relevant aspects of biofilm, emerging infectious entity in endodontics, are exposed as well as the different treatment options (AU)

Importancia de la irrigación en el éxito del tratamiento de conductos radiculares necróticos. Parte 1 / No disponible

El objetivo del tratamiento de conductos es la limpieza y conformación de sistema de conductos radiculares. Una de las principales patología que trata es la periodontitis apical crónica, que sería la consecuencia en los tejidos periapicales de la necrosis del tejido pulpar. Diversos estudios científicos muestran un índice mayor de fracasos en dientes con esta patología que con otras. Además, muchos autores coinciden en que la irrigación es actualmente el arma terapéutica más eficaz ante esta patología. El objetivo de esta primera parte de la revisión es actualizar los conocimientos sobre la periodontitis apical crónica y su tratamiento, especialmente desde el punto de vista de la irrigación (AU)

The objective of the intracanal treatment procedures is cleaning and shaping the root canal system in such a way that the filling will be facilitated in order to seal the apical foramen. One of the most important diseases this therapy treats is apical periodontitis which is a sequel to endodontic infection and manifests as the host defense response to microbial challenge. Many studies demonstrate a higher failure rate with apical periodontitis than others pathologies. Furthermore many authors agree that irrigation is the most powerful weapon against this pathology. The aim of this first part of the review study is to update the knowledge about chronic apical periodontitis and its treatment, specially form the point of view of irrigation (AU)

[Basic techniques of root canal instrumentation]. / Técnicas básicas de instrumentación de conductos radiculares.

Many of the techniques for root canal instrumentation in endodontic treatment have been subject of great sophistication, relegating a second place the basic endodontic techniques which in our opinion can solve most of the cases that are treated by the general dental practitioner. We described each of this techniques the steps that have to be followed and the pros and cons. Finally a comparison of them is made, emphasizing the most relevant characteristics.