Impact of Instrumentation Technique on Endodontic Treatment Quality in Curved Molars: A Retrospective Analysis

TL;DR

This study found that manual instrumentation techniques in curved molars lead to more technical failures in root canal treatments compared to reciprocating techniques.

Contribution

The study identifies specific technical failures linked to manual instrumentation in curved molars, offering insights into improving endodontic training.

Findings

Manual instrumentation is associated with higher risks of ledge/zip formation, inadequate density, and underfilling.

Reciprocating techniques result in more overfilling but fewer other complications.

Root curvature did not significantly influence failure rates.

Abstract

This cross‐sectional study evaluated technical failures in root canal treatments (RCTs) of curved molars (> 10°) performed by undergraduate students and their association with instrumentation techniques. Evaluations included filling extension, density, taper and ledge/zip formation. Bivariate analysis (chi‐square, 5% significance) calculated odds ratios (OR) and 95% confidence intervals (CI). Among 188 RCTs, manual instrumentation had higher risks of ledge/zip formation, inadequate density, taper and underfilling, while reciprocating techniques showed more overfilling. Root curvature did not influence failure rates. The study showed 100% power for detecting underfilling, inadequate density and taper; 97.98% for overfilling and 71.11% for ledge/zip formation. Instrumentation technique significantly impacted failure frequency, with manual techniques associated with more complications.

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