The results are given as absolute frequencies as well as percentages in Tables 1-6. Response rate.
From the 4545 questionnaires distributed, 1156 replies were received of which 7 were returned unopened or were unusable. Six practitioners did not perform rootcanal treatment, leaving 1143 useable responses representing 25% of the dentists in the Flemish part of Belgium. Ninety-five percent of the respondents were general dental practitioners. Demographic data.
The gender of the responding dentists were similar to the figures provided by official statistics (RIZIV 1999).Years in practice were nearly evenly distributed amongst the total respondents. Only the number of the first two age groups (0-5 and 6-10 years) were 40% lower than the other groups. Comparing these data with the data received from the government (RIZIV 1999) show the same decrease of 40%, owing to the saturation of the labour market. Data for years of activity and gender distribution were subjected to a w2-test for homogeneity. For gender, the P-value was 0.254, and thus not significant; for years of professional activity, the P-value was 0.0875, demonstrating a small but insignificant under representation of the older practitioners. For these variables, we can accept that the distribution of the present sample is representative for the total Flemish dental population (Table 1).
Table 1. Demographic and professional data of the responding dentists.Preparation technique.
A majority of respondents never used rubber dam (about 77%). Most practitioners (about 80%) aimed at achieving a working length between 0 and 1mm short of the radiographic apex. About 60% instrumented the canal with a filing technique (standard preparation), generally using a combination of different instruments. About half of the respondents used nickel-titanium instruments. A fourth canal in a maxillary molar was prepared and filled in a minority of cases (Table 2a-e).
Table 2a. Data related to preparation and instrumentation: use of rubber dam.Emergency procedure and complications.
Table 2b. Data related to preparation and instrumentation: use of nickel-titanium instruments.
Table 2c. Data related to preparation and instrumentation: number of appointments to complete root-canal treatment by number of root canals.
Table 2d. Data related to preparation and instrumentation: working length and choice of instruments.
Table 2e. Data related to preparation and instrumentation: preparation and obturation of a fourth canal in maxillary first molars.
A vast majority of the respondents (about 95%) performed a pulpectomy incases of acute pain, mostly combined with the application of intracanal medication or the prescription of analgesics. In cases of acute apical periodontitis, about 20% of the respondents only prescribed antibiotics and analgesics, the other respondents performed a pulpectomy in connection with analgesics and antibiotics. Seventy percent of the practitioners reported few complications (5%), mainly in cases of chronic apical periodontitis and in molars. Root-canal treatment was the treatment of choice (57%) for teeth presenting a large periapical lesion (Table 3a-d).
Table 3a. Management of emergencies.Root-canal irrigants and intracanal medication.
Table 3b. Occurrence of complication in general and in function of diagnosis.
Table 3c. Occurrence of complications by tooth type.
Table 3d. Management of a tooth presenting a periapical lesion with diameter of 10 mm.
The majority of the respondents (59.2%) used sodium hypochlorite, generally in a concentration of 2-3%. About 70% of the practitioners used intracanal medicaments, generally the traditional phenol or camphorated products, only 4% used calcium hydroxide (Table 4).
Table 4. Choice of root-canal irrigants and disinfectant intracanal-medication.Choice of obturation technique and temporary filling material.
The majority (61.6%) used cold lateral condensation as a filling technique. The first choice of sealer was AH26 (29%) or AH26 (15.7%), followed by the medicated ZnOE sealer, Endomethasone (15.6%). Cavit (ESPE, Seefeld, Germany) was the most popular temporary filling material (52.1%) (Table 5).
Table 5. Choice of obturation technique and temporary filling material.Attitude of practitioners towards endodontic treatment.
The majority of practitioners had a negative (23.3%) or indifferent (41.5%) attitude towards performing endodontic treatment, although they stated that they were satisfied with either preparation (57.8%) or filling technique (59%). The vast majority reported they performed re-treatments (79.8%) (Table 6a,b).
Table 6a. Attitude towards endodontic treatment and satisfaction of the practitioner.
Table 6b. Attitude towards endodontic treatment and satisfaction of the practitioner: performing of re-treatments.