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Year : 2018  |  Volume : 10  |  Issue : 6  |  Page : 303-309

A preliminary assessment of endodontic difficulty encountered at a tertiary health center in Lagos, Nigeria

1 Department of Restorative Dentistry, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
2 Department of Preventive Dentistry, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria
3 Department of Restorative Dentistry, Lagos University Teaching Hospital, Surulere, Lagos, Nigeria
4 Department of Oral Medicine/Pathology, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria

Correspondence Address:
Dr. Afolabi Oyapero
Department of Preventive Dentistry, Lagos State University College of Medicine, Ikeja, Lagos
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jioh.jioh_200_18

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Aim and Objectives: The complex anatomy of the root canal system, the challenging oral environment, and a host of patient factors can present challenges to achieving the goals of endodontic treatment. There are no clear guidelines on when a general practitioner should refer to an endodontist, and standardized forms for assessing endodontic case difficulty are rarely used in dental practices. The aim of this study was thus to assess the level of endodontic difficulty at the Restorative Dentistry Clinic at the Lagos State University Teaching Hospital, Ikeja. Materials and Methods: The participating dentists assessed the cases presenting in the clinic by reviewing the patient's history, conducting a detailed oral examination, and a radiographic review. The level of endodontic difficulty was assessed using the American Association of Endodontic Case Difficulty Assessment Form and Guidelines. Data were analyzed using the Statistical Package for the Social Sciences for Windows Version 20 (IBM Corp., Armonk, New York, USA), and the Chi-square test was used to determine the level of association between the variables. A 95% confidence interval and a 5% level of significance were adopted. Results: A total of 200 respondents were seen. Majority were females (40; 60%), aged between 21 and 40 years (110; 55%), and had a tertiary level of education (75.5%); most of them had no underlying medical problem (93%), were cooperative and compliant (88%), and had no limitation in mouth opening (95%) and no jaw swelling (87.5%). Most respondents (190; 95%) had signs and symptoms consistent with recognized pulpal and periapical conditions, with minimum radiographic difficulty (192; 96%) and normal crown morphology (89.5%). Canal was visible and not reduced in size in 89% of the study participants. The highest difficulty values were obtained under the diagnostic and treatment criteria, where fifty (25%) teeth had moderate endodontic difficulty, while 11 (5.5%) had high difficulty. Conclusion: Majority of the root canal treatment (RCT) cases seen were of minimal difficulty and could be treated by general practitioners or resident doctors. About 5.5% of the study participants, however, required specialist care. Case selection is the process of discriminating cases according to their prognosis. Clinicians must thus be able to assess and make a practical decision about the complexity of RCT and decide whether it is within their capabilities.

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