View - CTU

SETTING THE STAGE
Endodontics may be regarded as a set of procedures to either prevent or treat apical
periodontitis (0rstavik & Pitt Ford 2008). Although technically complicated, such
measures, when carried out meticulously, have been found to produce successful
results, in terms of apical healing, in 85% to 95% of treated teeth (Kerekes &
Tronstad 1979, Petersson et al. 1982, Sjogren et al. 1990). On the other hand,
epidemiologists have observed high frequencies of substandard root filling quality
and radiographic signs of apical periodontitis in root-filled teeth. In Denmark, for
example, Kirkevang et al. (2000) found that 59% of the root-filled teeth showed
inadequate lateral seal and 40% displayed inadequate length. Furthermore, 52% of
the treated teeth were associated with signs of apical periodontitis. Obviously there is
a great discrepancy between healing rates that can be achieved with root canal
treatment and those observed in many populations. This 'gap' was the starting point
for the present dissertation and the overall aim was to reveal factors that influence
the incidence and quality of root canal treatment in general dental practice.
Some of th
years have
For exampl
nickel-titan it
and make p
IV). Studiei
important f<
knowledge i
V) and neit~
final part of
and the pat
that importa
cases (Stuc
Pulpal disease has mainly been regarded as a sequel to caries and therefore it might
be expected that when caries prevalence decreases, as in Denmark, the demand for
endodontic treatment also decreases. However, there is a lack of knowledge
concerning the incidence over time (Study I) as well as the contemporary reasons for
root canal treatment (Study II). Furthermore, the acceptance of modern strategies for
treatment of deep caries lesions and exposed pulps among general dental
practitioners (GDPs) may decrease the future need for root canal treatment (Study
Ill).
Factors that influence the endodontic treatment quality in general dental practice are
not very well known. Quality is shaped by the interplay between the knowledge,
attitude and skill of the dentist and the demand and satisfaction of the patient, framed
in a societal context of available resources, insurance and remuneration systems and
ethical codes (Fig. 1 ).
I.­
The annu•
frequency
root filling
di
Fig. 1. In the
result. Within
determine the
8