Technical quality of root canal treatment in Taiwan

Aim: To evaluate the current technical quality of root canal treatment (RCT) in Taiwan. Methodology: A total of 1085 RCT cases, randomly selected from a large sample and representative of the Taiwanese population from April to September 2000, were evaluated by eight endodontic specialists. The qualitative evaluation of RCT cases was based on two variables: length of the root filling and density of the obturation. A root canal with both adequate filling length (the apical termination of the root filling within 2 mm of the radiographic apex) and complete obturation (no lateral or apical canal lumen visible in the apical one-third of the root canal) was defined as having good-quality endodontic work (GQEW). A tooth was defined as having a GOEW when all its canals were categorized as GQEW. Results: From a total of 1867 root canals, overfilling occurred in 235 (12.6%), adequate filling length in 1152 (61.7%), underfilling in 466 (25.0%) and no filling in 12 (0.6%). Of the 1867 root canals, 710 (38.0%) demonstrated complete obturation and 1157 (62%) demonstrated incomplete obturation. GQEW was found in 650 (34.8%) root canals and 329 (30.3%) teeth. The percentage of teeth with GQEW in hospital cases (38.1%) was significantly greater (P <0.001) than that in private clinic cases (24.3%). In addition, the frequency of teeth with GQEW in the anterior teeth (40.4%) or in the premolars (33%) was significantly greater (P <0.001) than that in the molars (18.4%). Conclusions: Approximately 70% of the teeth receiving RCT in Taiwan were either of inadequate filling length or sealing density.