Endodontic root canal treatment performed by undergraduate dental students: Identification of technical standard and post-endodontic restorations


  • Norazlina Mohammad Universiti Sains Islam Malaysia
  • Faizah Abd Fatah Universiti Sains Islam Malaysia
  • Norzalina Ghazali Universiti Sains Islam Malaysia
  • Ahmad Zaim Muhamad Dental Division Ministry of Health
  • Nurhidayah Hamir Dental Division Ministry of Health




Root canal treatment, undergraduate students Malaysia, technical standard, obturation quality, post-endodontic restoration


Root canal treatment (RCT) is a procedure to eliminate pulpal diseases with the aim to promote healing of the periradicular tissue. The RCT conducted must be of high technical standard and achieve a good quality endodontic work (GQEW) to ensure successful outcome and prolonged retention of the teeth in oral cavity. Previous studies reported poor outcome of RCT conducted by the undergraduate dental students. There is limited report documented on the quality of RCT performed by the dental students in Malaysia. The aim of this study was to identify the technical standards of the RCT and types of post-endodontic restoration placed by USIM undergraduate dental students. The radiographic obturation quality from 274 root filled teeth were evaluated against several indices. The data were analyzed using SPSS version 21. Post treatment radiographs indicated that 84.62% of the RCT have adequate density indicating good apical seal. Meanwhile, for obturation level, the root canal filling that ends 0-2mm (optimal), >2mm away (inadequate), and beyond apex (extrusion) were 84.59%, 5%, and 10.77%, respectively. Teeth with GQEW, having both adequate root filling length and complete obturation were found in 194 (74.6%) teeth. McNemar’s test revealed significant reduction in post-treatment periapical index (p<0.001) indicating good periapical healing. Permanent restoration was only placed in 48% of the teeth. In conclusion, the RCT conducted by USIM undergraduate dental students have a good technical standard. Placements of post-endodontic permanent restoration need to be emphasized in the curricular to ensure long-term success of the endodontically treated teeth.

Author Biographies

Norazlina Mohammad, Universiti Sains Islam Malaysia

Department of Conservative Dentistry and Prosthodontic

Faizah Abd Fatah, Universiti Sains Islam Malaysia

Department of Conservative Dentistry and Prosthodontic

Norzalina Ghazali, Universiti Sains Islam Malaysia

Department of Paediatric Dentistry and Orthodontics

Ahmad Zaim Muhamad, Dental Division Ministry of Health

Dental Division Ministry of Health

Nurhidayah Hamir, Dental Division Ministry of Health

Dental Division Ministry of Health


Ashley, M., Harris I. (2001). The assessment of the endodontically treated tooth. Dent Update. 28(5):247-252.

Consensus report of the European Society of Endodontology on quality guidelines for endodontic treatment. (1994). Int Endod J. 27(3):115-124.

De Moor, R., Hülsmann, M., Kirkevang, L. L., Tanalp, J., Whitworth, J. (2013). Undergraduate curriculum guidelines for endodontology. Int Endod J. 46(12):1105-1114.

Estrela, C., Holland, R., Estrela, C. R., Alencar, A. H., Sousa-Neto, M. D., Pécora, J. D. (2014). Characterization of successful root canal treatment. Braz Dent J. 25(1):3-11.

European Society of Endodontology. (2006). Quality guidelines for endodontic treatment: consensus report of the

European society of endodontology. Int Endod J. 39:921-930.

Hossein, L., Gita, R., Shahriar, S., Hadi, A., Fatemeh, M. M. (2014). Retrospective evaluation of endodontic procedural errors by under and post-graduate dental students using two radiographic systems. J Islam Den. Assoc Iran. 26(4):245-54.

Hui, K. C., Chen, N. N., Koh, E. T., Lam, E. C., Lim, K. C., Sum, C. P. (2004). Guidelines for root canal treatment. Singapore Dent J. 26(1):60-62.

Imura, N., Pinheiro, E. T., Gomes, B. P., Zaia, A. A., Ferraz, C. C., Souza-Filho, F. J. (2007). The outcome of endodontic treatment: a retrospective study of 2000 cases performed by a specialist. J Endod. 33(11):1278-1282.

Kirkevang, L. L., Ørstavik, D., Bahrami, G., Wenzel, A., Vaeth, M. (2017). Prediction of periapical status and tooth extraction. Int Endod J. 50(1):5-14.

Kirkevang, L. L., Ørstavik, D., Hörsted-Bindslev, P., Wenzel, A. (2000). Periapical status and quality of root fillings and coronal restorations in a Danish population. Int Endod J. 33(6):509-515.

Kumar, M., Duncan, H. F. (2012). Radiographic evaluation of the technical quality of undergraduate endodontic 'competence' cases in the Dublin Dental University Hospital: An audit. J Ir Dent Assoc. 58(3):162-166.

Lin, L. M., Rosenberg, P. A., Lin, J. (2005). Do procedural errors cause endodontic treatment failure? J Am Dent Assoc. 136(2):187-193.

Ørstavik, D., Kerekes, K., Eriksen, H. M. (1986). The periapical index: A scoring system for radiographic assessment of apical periodontitis. Endod Dent Traumatol. 2(1):20-34.

Ray, H. A., Trope, M. (1995). Periapical status of endodontically treated teeth in relation to the technical quality of the root filling and the coronal restoration. Int Endod J. 28(1):12-18.

Saunders, W. P., Saunders, E. M., Sadiq, J., Cruickshank, E. (1997). Technical standard of root canal treatment in an adult Scottish sub-population. Br Dent J. 182(10):382-386.

Saunders, W. P., Saunders, E. M. (1994). Coronal leakage as a cause of failure in root-canal therapy: A review. Endod Dent Traumatol. 10(3):105-8. Review.

Segura-Egea, J. J., Jiménez-Pinzón, A., Poyato-Ferrera, M., Velasco-Ortega, E., Ríos-Santos, J. V. (2004). Periapical status and quality of root fillings and coronal restorations in an adult Spanish population. Int Endod J. 37(8):525-530.

Siqueira, J. F. Jr., Rôças, I. N., Abad, E. C., Castro, A. J., Gahyva, S. M., Favier,i A. (2001). Ability of three root-end filling materials to prevent bacterial leakage. J Endod. 27(11):673-675.

Siqueira, J. F. Jr., Rôças, I. N., Lopes, H. P., de Uzeda, M. (1999). Coronal leakage of two root canal sealers containing calcium hydroxide after exposure to human saliva. J Endod. 25(1):14-16.

Siqueira, J. F. Jr. (2001). Aetiology of root canal treatment failure: why well-treated teeth can fail. Int Endod J. 34(1):1-10.

Smadi, L., Hammad, M., El-Ma’aita, A. M. (2015). Evaluation of the quality of root canal treatments performed by dental undergraduates: is there a need to review preclinical endodontic courses? Am. J. Educ. Res. 3(12):1554-1558.

Yousuf, W., Khan, M., Mehdi, H. (2015). Endodontic procedural errors: Frequency, type of error, and the most frequently treated tooth. Int J Dent. 2015:673914.