Differences in clinical approaches of endodontists and general dentists when performing non-surgical root canal treatment: A prospective cohort study from the National Dental Practice-Based Research Network PREDICT Project

Aim: Information regarding differences between general dentists (GDs) and endodontists in their daily practices is limited. The aim of this prospective cohort clinical study was to compare the details of clinical approaches of GDs and endodontists when performing non-surgical root canal treatments (NSRCT). Methodology: The study was conducted among 153 practitioners (104 GDs and 49 endodontists) in the National Dental Practice-Based Research Network in the United States who performed NSRCT on at least one of 1705 patients. Practitioners completed postoperative forms to document procedural data. Bivariate and multivariable analyses were performed to adjust for the potential effect of confounders. Two different multivariable models were tested to eliminate the impact of unstable variables. Results: Overall, after adjusting for the tooth type, multivariable models showed that endodontists were significantly more likely than GDs to use magnifications >5×, rubber dam isolation, NaOCl irrigation, EDTA or H₂O₂ or chlorhexidine irrigations, ultrasonic/sonic irrigant activation, electronic apex locator and radiographs for working length determination, warm vertical condensation and lateral condensation techniques for obturation, report adequately dense obturation without voids, and to complete NSRCT in a single visit (p ≤.01). Endodontists were significantly less likely to use lubricants and to report unacceptable obturation length (≥2 mm short or extended beyond the radiographic apex) (p ≤.01). Conclusions: Based on actual clinical data, this study observed major differences between GDs and endodontists in their clinical approaches when performing NSRCTs. Further studies are needed to assess the effect of these differences on the outcome of NSRCTs.