歯学部生が行う根管治療中の歯内療法の災難。観察研究

Endodontic mishaps during root canal treatment performed by undergraduate dental students: An observational study.

抄録

概要:

本研究は、歯学部生が行った根管治療歯における歯内療法的誤治療の頻度と種類を評価するために行われた。サウジアラビア王国アブハにあるキング・ハリド大学歯学部の学部生が行った歯内療法的誤治療は合計404歯であった。歯内療法を行った歯のX線写真を6か月間調査し、関連する人口統計学的データを患者ファイルから収集した。最も多く確認された誤治療は、根管充填に関するもので、最大症例数（68.1%）は根管充填が不十分であった。また，教育レベル9の学生がより多くの歯内療法ミスを起こしていた．左上第2大臼歯は誤飲の頻度が高く，大臼歯はアクセスに関連した誤飲が多いことが判明した．最後に，アクセス関連と器具関連の誤飲は発生頻度が低かった．調査サンプルに認められた歯内療法の誤飲の多くは，根管閉塞に関連するものであった．また，レベル 9 の学部生は，上位レベルの学生が実施した症例と比較すると，歯内療法の誤操作が多く，RCT の実施に習熟していないことが明らかとなった．本研究は，歯学生がRCTを行う際，特に根管のオブチュレーションを行う際に適切な指導を行うことを示唆するものである．

ABSTRACT: Endodontic mishaps during root canal treatment (RCT) are considered to be one of the most commonly encountered errors, which affect the quality of treatment and may have dangerous health implications for patients.The present study was conducted to assess the frequency and types of endodontic mishaps in root canal-treated teeth performed by undergraduate dental students.A total 404 endodontically treated teeth were performed by undergraduate dental students of King Khalid University College of Dentistry, Abha, Kingdom of Saudi Arabia. The radiographs of the endodontically treated teeth were studied for a period of 6 months, and the related demographic data were collected from patient files.The most commonly identified mishaps were related to obturation, where the maximum number of cases (68.1%) had under-obturated root canals. More endodontic mishaps were performed by students in level 9 education. The upper left 2nd molar teeth had a higher frequency of mishaps, and molars were found to have more access-related mishaps. Lastly, access-related and instrument-related mishaps had a low frequency of occurrence.The majority of endodontic mishaps found in the study sample were related to root canal obturation. The undergraduate students at level 9 were less proficient in conducting RCTs with many endodontic mishaps when compared to the cases performed by students at higher levels. The study suggests relevant guidance for dental students while performing RCTs, especially during obturation of the root canals.