Page 28 - Demo

Chapter 226determined with the use of an index, the Dutch Endodontic Treatment Index (DETI),24 and if applicable a classification, the Endodontic Treatment Classification (ETC).24Due to the implementation of those changes, there was an intermediate cohort comprising partly students attending the former programme and partly students attending the revised programme. This intermediate cohort of students (N=91) was included in this study. The students of this cohort were, whilst performing root canal treatment, supervised by general dental practitioners or by endodontists, but allocation of supervision was not yet based on DETI and if applicable ETC.The quality of the root filling of the first root canal treatment, in a patient, the student performed after succeeding in the summative assessment was evaluated.Two observers, who were unaware of the type of programme the student attended and the type of supervision they got evaluated the radiological quality of the root fillings separately. The observers scored all the criteria that are listed below, per root canal. In case of disagreement between the observers, they discussed the observation, also on criterion and root canal level, until they reached a consensus. When there was no consensus, a third independent observer was introduced.The quality of the root filling under investigation was, finally, determined on tooth level and was scored as “good” when all the separate root canals of the corresponding tooth met the following criteria:• Root filling follows the natural root canal and is completely within the confines of the root (no extrusion).• Root filling ending not shorter than 0-2 mm from the apex.• Root filling appears well condensed on the periapical radiograph.• No ledges, perforations, transportations or separated instruments are detectable on the periapical radiograph or reported in the chart.A couple of months after the initial evaluation, the two observers repeated the evaluation of one third of the sample to determine the intra-observer reliability. Intra- and interobserver reliabilities were determined on tooth level.As additional information to assess skills of the student, the total number of periapical radiographs taken for the treatment and the number of failed ones were recorded. A periapical radiograph was judged as “failed” if it did not reveal the information necessary for the treatment. For instance a length measurement radiograph that is not showing the apices of the tooth treated was classified as “failed.”Annemarie Baaij.indd 26 28-06-2023 12:26