Amit Dattani, Lowri Myrddin
Introduction and Aims
The most recent published guidelines are the Royal College of Surgeons 2012 Endodontic Guidelines (currently under review). We audited surgical endodontic practice against these guidelines looking at a three year period at a single department, Cardiff University Dental Hospital.
A retrospective review of all case records of patients undergoing surgical endodontics at The Oral Surgery Department in Cardiff over a three year period (January 2010-December 2013). We assessed clinical practice against pre, peri and post-operative recommendations by the RCS Surgical Endodontic Guideline (2012) and used this as the gold standard of practice.
25 apicectomies were carried out on 20 patients during the period of review, only 8% of these resulted in extraction by one year follow up. 95% had a preoperative radiograph, 45% had no clear justification documented in the notes, 50% had no written documentation regarding other treatment options prior to apicectomy, 100% of cases had not used magnification, 65% of cases used amalgam not MTA, 80% postoperative radiographs were not reported on, 80% of specimens were not sent to histopathology.
With only 8% of apicected teeth resulting in extraction it could be said there was a 92% success rate. However there were clearly improvements needed in note keeping and awareness of the most recent guidelines. A hindrance to achieving some criteria was due to a lack of availability of equipment and materials in the outpatient department such as a microscope and MTA filling material. The department is a referral centre whereby patients referred may not have had all of their records sent to the department, this resulted in a lack of detailed record keeping. To ensure future compliance with guidelines, we designed a checklist for the clinical notes, ensured the correct dental materials were available to staff and discussed purchase of equipment.