PDF: Procedural errors during root canal preparation using rotary NiTi instruments detected by periapical radiography and cone beam computed tomography

Endodontic teaching requires scientific knowledge and appropriate methodological strategies to optimize the use of materials and techniques.

Several challenges are present during undergraduate teaching, in particular, the recent conceptual changes in terms of the shaping of curved root canals.

This study detected procedural errors created by rotary nickel-titanium (NiTi) instruments during root canal preparation by two imaging methods. 

Forty extracted human maxillary and mandibular molars were divided randomly into two groups and treated by two endodontists (n=10) and two undergraduate dental students (n=10). 

The ProTaper Universal™ Rotary System was used to shape the canals and then they were filled using AH PlusTM sealer and gutta-percha. Periapical radiographs (PR) and cone beam computed tomography (CBCT) images were obtained and two examiners, who evaluated them to verify the occurrence of procedural errors (fractured instruments, perforations, and canal transportation).

The Chi-square test at 0.05 level of significance was used for statistical analyses. There were no significant differences (p>0.05) between the imaging methods. In the analysis of procedural errors, there was no significant difference (p>0.05) between the groups of operators (endodontists vs. students) nor between tooth groups (maxillary molars vs. mandibular molars). 

In view of the low incidence of procedural errors during root canal preparation performed by students the introduction of rotary NiTi instruments has potential in undergraduate teaching.

PR and CBCT permitted the detection of procedural errors, but the CBCT images offer more recourse for diagnosis.