Prospective Evaluation of Clinical Endodontic Performance Assessment Methods

Self- Assessment of Clinical Endodontic Performance by Dental Students Using Two Distinct Rotary File Systems: A Prospective Cohort Study

This prospective cohort study evaluates dental students' self-assessment of clinical endodontic performance and compares it with independent evaluations conducted in a dental education clinical setting. Endodontic treatments are performed by undergraduate dental students using two distinct rotary file systems selected according to routine clinical practice. Students' self-assessments are prospectively collected using a structured questionnaire and compared with evaluations performed by two experienced evaluators with access to clinical and radiographic information, considered the reference standard, as well as by two different experienced evaluators using radiographic information only. Secondary analyses examine whether assessment outcomes differ according to the rotary file system used. The null hypothesis is that there is no difference between dental students' self-assessments and reference standard evaluations of endodontic treatment quality, and that assessment outcomes do not differ according to the rotary file system used.

Study Overview

• Status: Completed
• Conditions: Root Canal Therapy
• Intervention / Treatment: Other: Not applicable- observational study

Detailed Description

This prospective cohort observational study examines dental students' self-assessment of clinical endodontic performance in a dental education clinical setting and compares these assessments with independent evaluations. Endodontic treatments are performed by undergraduate dental students as part of routine clinical practice under standard supervision. Treatments are carried out using one of two distinct rotary file systems selected according to routine clinical practice, without assignment by the study protocol.

Following completion of each endodontic treatment, operators prospectively complete a structured self-assessment questionnaire evaluating the quality of their clinical performance. These self-assessments are compared with evaluations performed by experienced external evaluators. Two experienced evaluators assess each case using both clinical and radiographic information and serve as the reference standard, while two different experienced evaluators perform an assessment based on radiographic information only.

The primary objective is to evaluate the agreement between dental students' self-assessments and the reference standard evaluation of endodontic treatment quality. Secondary objectives include assessment of agreement between radiographic-only and reference standard evaluations, as well as examination of whether assessment outcomes differ according to the rotary file system used across operator self-assessments and independent evaluations.

• Study Type: Observational
• Enrollment (Actual): 201

Contacts and Locations

Study Locations

• Greece
  • Central Macedonia
    • Thessaloniki, Central Macedonia, Greece, 54124
      • School of Dentitry, Aristotle University of Thessaloniki

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

Adult patients requiring initial endodontic treatment of an upper or lower molar and deemed fit to undergo endodontic treatment performed by dental students in the undergraduate dental clinic of the Aristotle University of Thessaloniki.

Description

Inclusion Criteria:

1. Healthy patients or with a controlled systemic condition
2. 18 Years and older
3. Completion and acceptance of a patient consent form for the study
4. Patient in need of an initial endodontic treatment of an upper or lower molar

Exclusion Criteria:

1. Existence of a systemic disease or usage of drugs that makes the patient unfit to undergo endodontic treatment by students in an Undergraduate Clinic.
2. Teeth with previous endodontic treatment
3. Teeth with doubtful prognosis - unrestorable
4. Teeth with severe periodontal damage
5. Alcohol or drug use
6. Pregnancy or breastfeeding

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort	Intervention / Treatment
Endodontic Treatment Cohort; Adult patients in need of initial endodontic treatment of an upper or lower molar and deemed fit to undergo endodontic treatment performed by dental students in the undergraduate dental clinic of the Aristotle University of Thessaloniki.	Other: Not applicable- observational study; No study-defined intervention; treatments were performed as part of routine clinical care.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Agreement between dental students' self-assessment and reference standard evaluation of endodontic treatment quality	The level of agreement between dental students' self-assessment of completed endodontic treatments and evaluations performed by two experienced evaluators with access to both clinical and radiographic information, considered the reference standard.	Up to 2 weeks (at completion of endodontic treatment)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Agreement between radiographic-only evaluation and reference standard evaluation of endodontic treatment quality	The level of agreement between evaluations of endodontic treatments performed by two independent evaluators using radiographic information only and evaluations performed by two experienced evaluators with access to both clinical and radiographic information, considered the reference standard.	Up to 2 weeks (at completion of endodontic treatment)
Proportion of self-reported assessment findings by rotary file system based on dental students' self-assessment	The proportion of specific findings reported in dental students' self-assessments of completed endodontic treatments, based on a structured self-assessment questionnaire, compared between two rotary file systems used as part of routine clinical practice. Results will be reported as percentages of self-reported findings for each rotary file system.	Up to 2 weeks (at completion of endodontic treatment)
Proportion of reference standard evaluation findings by rotary file system	The proportion of specific evaluation findings identified by experienced evaluators using combined clinical and radiographic information, considered the reference standard, for completed endodontic treatments. The proportions of these evaluation findings will be compared between two rotary file systems used as part of routine clinical practice and reported as percentages for each system.	Up to 2 weeks (at completion of endodontic treatment)
Proportion of radiographic-only evaluation findings by rotary file system	The proportion of specific evaluation findings identified through radiographic-only assessment of completed endodontic treatments. The proportions of these radiographic evaluation findings will be compared between two rotary file systems used as part of routine clinical practice and reported as percentages for each system.	Up to 2 weeks (at completion of endodontic treatment)

Collaborators and Investigators

• Sponsor: Aristotle University Of Thessaloniki
• Investigators: Study Director: Nikolaos Economides, School of Dentistry, Aristotle University of Thessaloniki

Study record dates

Study Major Dates

• Study Start (Actual): January 30, 2025
• Primary Completion (Actual): April 30, 2026
• Study Completion (Actual): April 30, 2026

Study Registration Dates

• First Submitted: January 30, 2026
• First Submitted That Met QC Criteria: February 9, 2026
• First Posted (Actual): February 17, 2026

Study Record Updates

• Last Update Posted (Actual): June 2, 2026
• Last Update Submitted That Met QC Criteria: May 30, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Radiography, Dental; Self Assessment; Root Canal Therapy; Observer Variation; Education, Dental; Students, Dental
• Other Study ID Numbers: 262/10-01-2025

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No