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Non-surgical Root Canal Therapy Clinical Success Rate compared between Undergraduate and Graduate Students and Reasons for Failure
Langer, Sarah
Langer, Sarah
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2025-08
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Oral Biology
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https://doi.org/10.34944/dm2j-rk79
Abstract
Non-surgical root canal therapy (NSRCT) aims to eliminate infected or necrotic pulpal tissue from the root canal system while preserving the tooth’s function within the oral environment. The definition of success in endodontic therapy varies, ranging from strict to more lenient criteria. Treatment outcomes are commonly categorized as good, questionable, poor or hopeless. The success of non-surgical root canal therapy has been widely studied, with reported success rates ranging from 70% to 95%, depending on factors such as operator experience, case complexity, tooth vitality and the presence of a restoration. Despite extensive research, few studies compare non-surgical root canal outcomes between graduate and undergraduate dental students within the same institution. This study examines success rates in both groups and key factors affecting treatment failure, such as tooth number, pulp vitality, and final restoration.
Purpose:
The purpose of this study is to compare the clinical success rates of non-surgical root canal therapy (NSRCT) performed by undergraduate dental students and graduate endodontic residents. Additionally, this research aims to assess how factors such as tooth number, pulp vitality, and the presence of a final restoration influence treatment success or failure.
Materials and Methods:
A total of 881 cases of non-surgical root canal therapy (NSRCT) performed at Temple University Kornberg School of Dentistry from 2018 to 2023 were analyzed retrospectively. Patient data were extracted from the axiUm electronic health records system using the recall code D3999RC, with recalls completed by undergraduate dental students at a minimum follow up of three months. Cases were categorized by operator level: undergraduate dental students or graduate endodontic residents. Treatment outcomes were classified into four categories based on the Strindberg Index (1956): Good (successful treatment), Questionable (uncertain prognosis), Poor (unsuccessful treatment), and Hopeless (definitive failure). For analysis, “Good” outcomes were considered successful, while the remaining categories were classified as failures. Independent variables included operator level, tooth number (anterior vs. posterior), pulp vitality (vital, non-vital, or previously initiated), and restoration status (presence of a final restoration). The primary dependent variable was treatment success or failure.
Conclusion:
Non-surgical root canal therapy performed by undergraduate dental students showed higher success rates, likely due to structured case selection, while graduate residents treated more complex cases, leading to greater variability in outcomes. Restored teeth demonstrated significantly improved success rates. Future research should explore standardized follow-up protocols and increased recall data from graduate residents to enhance success rates and ensure comprehensive data analysis.
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