Aktueller Stand der chemo-mechanischen Wurzelkanalaufbereitung in den zahnärztlichen Praxen Bayerns

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.