The Impact of Different Diagnostic Imaging Modalities on the Evaluation of Root Canal Anatomy and Endodontic Residents' Stress Levels: A Clinical Study.

INTRODUCTION: The purpose of this study was firstly to compare the impact of radiographs, cone-beam computed tomographic (CBCT) imaging, and 3D Endo software (Dentsply Sirona, Ballaigues, Switzerland) on the assessment of root canal anatomy and radiographic quality of endodontic treatment and secondly to assess stress levels in the same cohort of residents performing endodontic treatment. METHODS: Sixty patients requiring primary molar endodontic treatment were allocated randomly into 3 groups: group 1 (n = 20), conventional radiographs (periapical radiography [PR]) only; group 2 (n = 20), PR and CBCT imaging; and group 3 (n = 20), PR, CBCT imaging, and 3D Endo software. All treatment was performed using a standardized protocol. Residents completed a questionnaire to assess their stress levels and usefulness of the imaging modality used. The radiographic quality of completed cases was assessed by 2 experienced endodontists who were not involved in the supervision of the cases being assessed. RESULTS: Groups 2 (CBCT imaging) and 3 (PR, CBCT imaging, and 3D Endo) proved significantly better than group 1 (PR) (P < .001) for assessing the number of root canals and anatomy and estimating the working lengths. Group 3 provided a significantly more accurate determination of the working level (P = .002). There were significantly more cases with obturation short of the apex (<2 mm) and voids in group 1 compared with group 3 (P < .05) and a significantly higher number of cases with voids in group 1 compared with group 3 (P < .01). Clinicians found treatment to be moderately or very stressful in 75%, 5%, and 0% in groups 1, 2, and 3, respectively. CONCLUSIONS: 3D Endo software followed by CBCT imaging were found to be more desirable for the evaluation of root canal anatomy and working lengths and reducing the residents' stress levels.

Endodontists' Intravenous Sedation-related Attitudes and Professional Behavior: A National Survey.

INTRODUCTION: Research shows that a high percentage of endodontic patients are interested in receiving intravenous (IV) sedation. The objectives of this study were to assess endodontists' IV sedation-related education, attitudes, and professional behavior and to explore whether providing versus not offering IV sedation procedures was associated with IV-related education and attitudes and whether background characteristics and education were related with IV sedation attitudes and behavior. METHODS: Data were collected with an anonymous Web-based survey from 616 members of the American Association of Endodontists (response rate = 29%). RESULTS: Only 10% of respondents agreed/strongly agreed that they had adequate training in IV sedation. However, 48% agreed/strongly agreed that there was a need for IV sedation in their practice. Although 69% did not offer IV sedation, 26% had another professional provide it, and 4% provided it themselves. These 3 groups of providers differed in the mean quality of their IV sedation-related education (scale from 1-5 with 5 = best education: 1.50 vs 1.62/2.37, P < .001) and the positivity of their attitudes toward IV sedation (2.90 vs 3.50/4.21, P < .001). Although the quality of IV sedation education was not correlated with the graduation year, the more recently respondents had graduated, the more positive they were toward providing education about IV sedation (r = .16, P < .001). CONCLUSIONS: Most endodontists did not evaluate their IV sedation-related graduate education positively. However, nearly half acknowledged the need for IV sedation in endodontics. The more recently they graduated, the more they agreed that IV sedation-related graduate education was needed but also that staff training and maintenance of equipment would be a problem.

Should Endodontic Residents Be Educated About IV-Sedation? Endodontics Program Directors' and Endodontists' Perspectives.

The aims of the two studies reported here were to assess endodontic postgraduate program directors' educational efforts and attitudes related to educating residents about intravenous (IV) sedation (Study 1) and to assess endodontists' educational experiences and attitudes concerning IV-sedation (Study 2). Directors of all 56 U.S. endodontic residency programs and a sample of 2,173 endodontists in the U.S. were invited to participate in the surveys in 2016 and 2017; 31 directors completed the survey (response rate 55%), as did 616 endodontists (response rate 28.3%). Of the participating programs, 18 did not and 13 did offer IV-sedation education. Most directors of programs without this education agreed/strongly agreed that other programs in their institutions offered IV-sedation (83%) and that none of their faculty were trained to teach it (83%). Most directors of programs with this education were satisfied/very satisfied with their classroom-based education about IV-sedation (64%) and this education in general (54%). Directors of programs with IV-sedation education agreed more strongly than directors of programs without IV-sedation education that there is a need for IV-sedation in endodontics (on five-point scale with 1=disagree strongly: 4.08 vs. 3.39; p=0.05), that postgraduate programs should offer it (3.50 vs. 2.71; p=0.04), and that many patients inquire about it (2.75 vs.1.83; p=0.04). Most of the endodontists disagreed/disagreed strongly that they had received adequate training in IV-sedation in their postgraduate program (87%) and were not satisfied with their IV-sedation training (71%); half (51%) reported not feeling competent answering patients' questions about IV-sedation. While most of the endodontists were dissatisfied with their IV-sedation related postgraduate education, most of the program directors did not offer IV-sedation education in their programs. A discussion of the need to educate future endodontists about IV-sedation is needed.

Residents' Perceptions of the Graduate Endodontic Application Selection Process and Match.

INTRODUCTION: Anecdotal reports suggest that the application process for graduate endodontic programs in the United States and Canada is inefficient and may be perceived by applicants as being unfair. This survey examines residents' perceptions of the graduate endodontic application process and related issues. METHODS: A web-based survey consisting of 24 questions on the residents' perception of the graduate endodontic application process was developed and e-mailed to 403 graduate endodontic students in the United States and Canada. RESULTS: Of the 403 invited participants, 218 surveys were completed (53%). The responses were varied. Respondents were not overwhelmingly satisfied with the application/interview/selection process; 45% were satisfied or very satisfied, 25% were neutral, and 30% were dissatisfied or very dissatisfied. Only 39% indicated that they would have preferred a Match process. Eighty-two percent accepted the first program that offered a position, and 79% reported being satisfied or very satisfied with their choice of a program. CONCLUSIONS: Forty-five percent of endodontic residents were satisfied with the application/interview/selection process, and most would not have preferred a Match process.