Endodontic training in undergraduate courses: Impact of instrumentation technique and occurrence of iatrogenesis

Abstract

Dentistry programs aim to educate professionals based on knowledge and training. The objective of this study is to evaluate the main challenges of teaching endodontics in undergraduate courses, identifying the factors that influence the results of endodontic treatments performed by students, with emphasis on the occurrence of iatrogenic complications and the type of instrumentation used. This is an integrative, qualitative, and exploratory literature review. The PUBMED database was used for the years 2014 to 2024. Priority was given to free articles in English and Portuguese. Those that did not meet the established criteria were excluded, as were duplicates and those that were outside the topic addressed. A total of 213 articles were identified, and after reading the titles and abstracts, 13 articles were selected for full reading, with 10 articles ultimately selected for composition. The studies included in this review demonstrate that the type of instrumentation used by students significantly influences the occurrence of errors and the final quality of root canal filling. Manual instrumentation is frequently associated with iatrogenesis, while the use of nickel-titanium rotary files reduces errors. Among the most frequently reported errors are apical transport, zip, root perforation, obturation failures, underfilling, overfilling, step formation, instrument fracture and extrusion of obturation material. It is concluded that the main challenges in teaching endodontics to undergraduates are related to iatrogenesis in various aspects of the procedure, especially when performed by manual instrumentation. Rotary instrumentation with nickel-titanium files has obtained lower accident rates.

Keywords: Root Canal Therapy, Students, Dental, Endodontics