Umfrage zum Stand der endodontischen Behandlung in Deutschland
Survey on the state of endodontic treatment in Germany
by Kimberly Anthea Geraldine Goepel
Date of Examination:2016-10-11
Date of issue:2016-10-10
Advisor:Prof. Dr. Michael Hülsmann
Referee:Prof. Dr. Michael Hülsmann
Referee:PD Dr. Matthias Rödiger
Referee:Prof. Dr. Dr. Franz-Josef Kramer
Persistent Address:
http://dx.doi.org/10.53846/goediss-5888
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Abstract
English
Endodontics has developed considerably over the last years, but there are only few studies on the materials and methods preferred by German dentists for root canal treatment and respective developments over the years. The present study was undertaken in order to enable a national and international comparison of standard and developments in endodontics in Germany. A questionnaire was developed comprising 27 questions, many of these already previously used in comparable national and international studies. Of 2,000 randomly selected German dentists who were notified by e-mail, 339 (17%) returned the questionnaire. The programs SurveyMonkey and Excel were used to collect and analyze the data. Many German dentists claim to have a main focus on endodontics (42%). The majority of respondents conduct more than 10 root canal treatments per month (72%). Advanced devices such as loupes (73%), microscopes (20%) and NiTi systems (92%) are used by a large percentage of dentists. There is also a high interest in continuing education (90%). Many dentists determine the working length electrically and radiographically (66%). The most commonly used irrigation solution is NaOCl (73%). Only half of the dentists activate the irrigation solution to increase the disinfection of the canal system. The German dentists prefer multiple-visit treatment of endodontic cases (74%), with calcium hydroxide being favored as intracanal medicament (46%). A clear deficit was shown in the prescription of antibiotics, the application of rubber dam (application: 33% never, 29% sometimes) and the obturation technique used (31% single-cone technique). The three most common problems during root canal treatment were loss of working length, overfilling, and insufficient anesthesia, but most dentists never refer patients to an endodontic specialist (78%). Most dentists (48%) perform the restoration of endodontically treated teeth within 6 months, and only less than half of the dentists have introduced a systematic recall system (49%). Some dentists (n = 55) indicated that they could increase the success rate of their root canal treatment if they were to take more time for the treatment, but this is only possible by an increase in remuneration by the health insurance funds. Probably responding dentists are a positive selection with a slightly over-representative proportion of dentists interested in endodontics as indicated by a surprisingly high proportion of microscope users (20%). The study reveals a number of deficits as well as some positive developments over the years. Such deficits were found concerning the application of the rubber dam, the prescription pattern of antibiotics, the use of single-cone obturation techniques and the frequently delayed restoration of endodontically treated teeth. Improvements are obvious for the use of loupes and microscopes, the electrical determination of the working length, the use of rotary NiTi instruments and the quality of root canal disinfection. In the national longitudinal comparison, there are some major improvements, but also still a number clear deficits. In the international longitudinal and horizontal comparison, German dentists are positioned in the top field despite the shortcomings mentioned.
Keywords: endodontic
Schlagwörter: Endodontie