Root canal treatment outcomes at the University of Pretoria Oral Health Centre

Abstract

Aim: The University of Pretoria Oral Health Centre (UPOHC) is inundated by patients who demand emergency pulpectomies. The demand for service however exceeds the capacity to treat, which may be problematic in terms of treatment outcomes. The aim of this study is therefore to measure the outcome of emergency pulpectomies at the UPOHC. Method: The electronic and paper records of 498 randomly selected teeth that received an emergency pulpectomy at the UPOHC from 1July 2012 until 30 June 2013 were examined to determine the outcome of the treatment. The completion rate over time was calculated in combination with the percentage of teeth that was eventually extracted or referred for extraction. In the case where the root canal treatment (RCT) reached the obturation phase, the post-operative radiographs were analysed in terms of the technical quality of the obturation. Results: Forty-five percent of the sample size of 498 teeth for which an emergency pulpectomy was performed returned to have the RCT completed. Of these, 43% were inadequately obturated. Eight percent of teeth observed referred for extraction. Seven percent of teeth had the initial phase of treatment repeated while 40% were never seen again after the initial pulpectomy. A total of 46.96% of the teeth were still incomplete after 16.56 months. Conclusion: The results of the study indicate that the UPOHC has a limited capacity to complete RCTs. A strategy is needed to expand the region’s resources and to incorporate a preventative dental focus. However, this will require an intervention in the functioning of the dental health system with regard to government funding in order to achieve success in both service delivery and education. An audit of the current undergraduate endodontic curriculum is perhaps necessary to improve students’ skills and efficiency in the service learning environment.