title: Technical outcome of root canal treatment on permanent teeth in children: a retrospective study.
abstract: OBJECTIVE
  The aim was to assess the technical quality of root canal treatment conducted in paediatric patients. No specific data is available assessing endodontic treatment quality in children. General adult populations report satisfactory technical quality between 12.8 and 55.7 %, with higher rates by endodontists (77.4-91.0 %).
  
  
  METHODS
  Radiographs of 100 chronological cases, conducted by staff (categorised as; junior staff, middle grades or consultants) in a UK teaching hospital, were evaluated retrospectively. Technical outcomes were compared to the European Society of Endodontology quality guideline consensus. A satisfactory root filling was defined as having: root filling material <2 mm from the radiographical apex; no canal space seen beyond the end of the obturation and an obturation of homogeneous density with no voids. In addition where MTA was used a plug of ≥3 mm was required. Any variation was considered unsatisfactory treatment.
  
  
  RESULTS
  61 % [95 % CI 51-70 %] of cases were deemed satisfactory. Of the remaining obturations 20.5 % were short of the apex, 28.2 % had extruded material and 56.4 % contained voids. Patients with co-operation issues, particularly anxiety, had lower technical outcomes (p = 0.001) and the use of thermoplastic obturation greatly reduced the chance of void inclusion (p = 0.004; OR 0.20 [95 % CI 0.06-0.65]). Although 'staff grade' did not show a statistically significant difference, a trend between experience and quality was suspected.
  
  
  CONCLUSIONS
  Overall technical quality of treatment was comparable to the higher rates found in the general adult population. Additionally thermal obturation may be superior to cold lateral condensation in improving obturation quality, and anxiety negatively impacts on treatment provision.
authors.affiliation: Restorative department, Liverpool University Dental Hospital, Pembroke Place, Liverpool, L3 5PS, UK. pete.t.clarke@gmail.com.
authors.forename: P
authors.initials: P
authors.lastname: Clarke
authors.affiliation: Maxillofacial Unit, Alder Hey Children's Hospital, Liverpool, UK.
authors.forename: A D C
authors.initials: AD
authors.lastname: Jones
authors.affiliation: Restorative department, Liverpool University Dental Hospital, Pembroke Place, Liverpool, L3 5PS, UK.
authors.forename: F
authors.initials: F
authors.lastname: Jarad
authors.affiliation: Paediatric Department, Liverpool University Dental Hospital, Liverpool, UK.
authors.forename: S
authors.initials: S
authors.lastname: Albadri
mesh_terms: D000293:Adolescent; D017607:Aluminum Compounds / Q000737:chemistry; D017610:Calcium Compounds / Q000737:chemistry; D002648:Child; D002652:Child Behavior; D002983:Clinical Competence; D003299:Cooperative Behavior; D016854:Dental Anxiety / Q000150:complications; D003786:Dental Pulp Cavity / Q000000981:diagnostic imaging; D003796:Dental Service, Hospital; D004338:Drug Combinations; D005547:Foreign Bodies / Q000000981:diagnostic imaging; D006801:Humans; D010087:Oxides / Q000737:chemistry; D010486:Periapical Tissue / Q000000981:diagnostic imaging; D016062:Porosity; D011859:Radiography; D012189:Retrospective Studies; D012387:Root Canal Filling Materials / Q000737:chemistry; D012389:Root Canal Obturation / Q000592:standards; D012390:Root Canal Therapy / Q000592:standards*; D017640:Silicates / Q000737:chemistry; D019227:Tooth Apex / Q000000981:diagnostic imaging; D016896:Treatment Outcome
chemical_list: D017607:Aluminum Compounds; D017610:Calcium Compounds; D004338:Drug Combinations; D010087:Oxides; D012387:Root Canal Filling Materials; D017640:Silicates; C086631:mineral trioxide aggregate
keywords: Anxiety; Endodontics; Obturation; Operator experience; Paediatrics; Permanent dentition; Quality