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AlKhayer, Majd AlArab (2006): Aktueller Stand der chemo-mechanischen Wurzelkanalaufbereitung in den zahnärztlichen Praxen Bayerns. Dissertation, LMU München: Medizinische Fakultät



Standard means of endodontic therapy have changed within the last decade due to new technical developments and an increasing scientific knowledge in this field. The aim of the present study was to evaluate the current status of materials, instruments and appliances used for root canal treatment by dentists in Bavaria. A comprehensive questionnaire was performed among 6900 Bavarian dentists in the year 2004. By use of a standardized questionnaire sheet, the colleagues were asked to give written information about their individual therapeutic concepts including the materials as used to perform root canal treatment. A total of 1666 dentists were enrolled into this study returning the questionnaire within the period of time that has been scheduled. This corresponds to a 24.1% return ratio. Detailed analysis of the collected data revealed the following specific results: The dentists included into the study had an age range from 27 to 71 years. Stratifying the study sample into different categories of age showed that the majority of study subjects belonged to the subgroup of age from 35 to 49 years (53,2%). The majority of dentists were male (77.5%) and most frequently dentists were working in private practices (71%). The age- and gender distribution of the participating dentists in this study is comparable to a statistic of the federal dental association (KZBV 2005). Regarding the health care insurance of patients that are treated endodontically on average 17% of patients had a private health care insurance. Considering the individual treatment means used by the dentists for endodontic therapy the following results were achieved: On average each dentist performed 10.5 root canal treatments per week. Regarding the method used for the determination of endodontic working length (multiple answers possible) 81% of the dentists used radiographs for this purpose. A comparably high percentage of dentists (46.6%) used endometric devices for the determination of the working length. Instrumentation of root canals (multiple answers possible) was performed by 57% of dentists with machine driven devices along with Nickel-Titanium (NiTi) files. The Profile system represents the most popular machine driven endodontic treatment system among Bavarian dentists since this particular system was used by 46% of study participants followed by the ProTaper system (32%) and the Flexmaster system (31%). Machine driven endodontic treatment devices were mainly used with a suitable torque-limited motor. The various products used for this purpose were (multiple answers possible) TriAutoZX, Morita (17.5%), ATR, Dentsply (14.9%), Endostepper, SET (11.4%) and Endo IT Control, VDW (11.1%). Nevertheless, a considerable percentage of dentists (35%) used machine driven devices without torque control. For the irrigation of instrumented root canals dentists spent a mean time of 2.1 minutes and used irrigating solutions (multiple denominations possible) as follows: NaOCl (85.1%), H2O2 (62.4%), EDTA (18.1%), CHX (15.2%). Overall, there was observed an increasing use of machine driven devices along with NiTi files and of EDTA and Chlorhexidine as compared with previous studies. Moreover, comparison of present data with current studies form different European and Non-European countries revealed that the use of rotating NiTi systems was significantly higher among Bavarian dentists. Based on the present results it can be assumed that the concepts as used for endodontic treatment by Bavarian dentists represents a high therapeutic standard.