View - CTU

to impair the endodontic
1ay also take place when
nment. The young dentist
rd the gold standard with
treatment of the necrotic
the young dentist applies
~te
of adoption of new
·ubber dam as part of an
lar, and the endodontic
ration system) are briefly
ndatory in the university
GDPs (82%) never use it
s (Saunders et al. 1999a,
1berg 2002). Based on a
tal students to the use of
predicted that the use of
-his underlies the need to
GDPs to the need to use
the use of rubber dam is
1ulps (Study 11) the risk of
an explanatory factor for
1 (Kirkevang et al. 2001 ).
11as noted that the use or
ents made by the Dental
complaint Boards (Study VI). This could indicate that there are differences between
the Dental Complaint Board policy and that of the official guidelines (European
Society of Endodontology 2006) taught at the universities. It could be speculated that
the low focus on rubber dam application may also be related to the actual level of
knowledge of microbiology among GDPs. Interestingly, -40% of the GDPs regarded
their knowledge as not up to standard concerning microbiology (Study V).
Time spent to instrument a molar
Fifty-six per cent of the responders estimated the time to treat a mandibular molar at
-1 hour(± 15 min.). Compared to other self-reported time evaluations this is rapid. In
a Scottish sample the treatment of a single-rooted tooth was estimated to take about
70 min. (Saunders et al. 1999b). The attitude of working rapidly within endodontics
was recently associated with a low economic incentive (Basmadjian-Charles et al.
2004). The time-cost dilemma in dentistry has also been elaborated by McColl et al.
(1999), where in-depth interviews of GDPs revealed that there was a discrepancy
between the time required for molar endodontic treatment and the fee offered by the
United Kingdom National Health Insurance.
The endodontic treatment procedure
The vast majority of the GDPs (75%) used stainless steel instruments (Study IV),
which today may be considered as an inferior method for instrumenting a tooth
(Molander et al. 2007, Bergmans & Lambrechts 2010). Although the clinical outcome
studies on nickel-titanium instruments are still sparse, the available clinical trials
indicate that the use of rotary systems will lead to a reduced incidence of errors and
possibly to improved clinical outcomes (Peters & Paque 2010). The rate of adoption
was recently reported to be -65% for both nickel-titanium hand instruments and for
nickel-titanium rotary systems among GDPs in the United Kingdom (Madarati et al.
2008). In a Public Dental Service in Sweden a long-term adoption rate was reported
to be as high as 88% when hands-on training was included (Reit et al. 2007),
demonstrating the effect of educational intervention on the adoption of nickel-titanium
instruments. A similar development should be expected in Denmark in the years to
41