Patterns of Root Canal Instrumentation in a Nigerian Teaching Hospital: A Retrospective Cross-sectional Study
DOI:
https://doi.org/10.61172/hpaxeg74Keywords:
Root canal treatment, rotary instrumentation; nickel–titanium; manual instrumentation; caregiver designation; endodontics; NigeriaAbstract
Background: Root canal treatment (RCT) is a cornerstone of restorative dental practice, and the choice of instrumentation system may influence clinical outcomes. Despite global advances in rotary nickel-titanium (NiTi) technology, manual instrumentation persists in many resource-constrained teaching environments. This study evaluated the types of instrumentation and techniques used in RCT across different caregiver designations at a tertiary teaching hospital in Nigeria.
Methods: A retrospective cross-sectional study was conducted involving 357 RCT cases performed at University College Hospital, Ibadan, from January 2020 to December 2022. Data were extracted from standardized endodontic records using a structured form. Variables included caregiver designation (resident, house officer, consultant, student), instrumentation type (manual, rotary, combined), and technique (step-back or crown-down). The association between caregiver designation and instrumentation type was assessed using chi-square analysis, with significance set at p ≤ 0.05.
Results: Residents performed the majority of procedures (88.2%). Manual instrumentation was used in 353 cases (98.9%), while rotary and combined techniques were each used in 2 cases (0.6%). The step-back technique predominated (97.8%). A statistically significant association was found between caregiver designation and instrumentation type (p < 0.001).
Conclusion: Manual instrumentation remains overwhelmingly dominant at this teaching hospital, with rotary NiTi systems confined to more experienced clinicians. Targeted strategies to integrate rotary instrumentation into undergraduate and postgraduate curricula are urgently needed.
Keywords: Root canal treatment; rotary instrumentation; nickel titanium; manual instrumentation; caregiver designation; endodontics; Nigeria
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1. Peters OA. Current challenges and concepts in the preparation of root canal systems: a review. J Endod. 2004;30(8):559–67.
2. Ruddle CJ, Machtou P, West JD. The shaping movement: fifth-generation technology. Dent Today. 2013;32(4):94–6, 98–101.
3. Parashos P, Messer HH. Rotary NiTi instrument fracture and its consequences. J Endod. 2006;32(11):1031–43.
4. Raftu G, Pușcașu CG, Șachir EE, Bartok-Nicolae C, Sin CE, Buștiuc SG, Caraiane A. Comparative assessment of root canal instrumentation: manual versus rotary techniques. Romanian Journal of Medical and Dental Education. 2025 May;14(3).
5. Makanjuola JO, Umesi DC, Oderinu OH. Treatment outcome of manual versus rotary techniques in single-visit endodontics for patients in a Nigerian teaching hospital: A randomized clinical trial. Journal of the West African College of Surgeons. 2018 Apr;8(2):44.
6. Goker Kamali S, Kutlu Basmaci G, Altinova YT, Sazak Ovecoglu H. Impact of holistic versus step‐by‐step curriculum on technical competency and self‐confidence in preclinical endodontic training. Journal of Dental Education. 2026.
7. Piñas-Alonzo R, Pérez AR, Aranguren J, Vieira GCS, Paz JC, Saavedra J, Guerrero Ferreccio J, Grandini S, Malvicini G. Patterns of endodontic practice and technological uptake across training levels in Spain and Latin America: results from a multicountry survey of 1358 clinicians. Dent J (Basel). 2025 Nov 27;13(12):558.
8. Alshahrani AS. Knowledge, awareness, and clinical practice of digital technologies in endodontics among dental professionals in southern Saudi Arabia: cross-sectional survey study. The Journal of Contemporary Dental Practice. 2026 Jan 14;26(12):1206-14.
9. Von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370(9596):1453–7.
10. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159–74.
11. Cohen J. Statistical Power Analysis for the Behavioral Sciences. 2nd ed. Hillsdale (NJ): Lawrence Erlbaum Associates; 1988.
12. World Medical Association. World Medical Association Declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 2013;310(20):2191–4.
13. Plotino G, Grande NM, Melo MC, Bahia MG, Testarelli L, Gambarini G. Cyclic fatigue of NiTi rotary instruments in a simulated apical abrupt curvature. Int Endod J. 2010 Mar;43(3):226-30.
14. Tanalp J, Güngör T. Apical extrusion of debris: a literature review of an inherent occurrence during root canal treatment. Int Endod J. 2014 Mar;47(3):211-21.
15. Zupanc J, Vahdat-Pajouh N, Schäfer E. New thermomechanically treated NiTi alloys: a review. Int Endod J. 2018;51(10):1088–103.
16. Silva EJNL, Vieira VTL, Hecksher F, Dos Santos Antunes HS, De-Deus G, Moreira EJL. Cyclic fatigue using realistic simulated curved canals and torsional resistance of five thermally treated reciprocating instruments. Clin Oral Investig. 2020;24(2):1007–13.
17. European Society of Endodontology. Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology. Int Endod J. 2019;52(9):1195–209.
18. Kandaswamy D, Venkateshbabu N. Root canal irrigants. J Conserv Dent. 2010;13(4):256–64.
19. Saraki TO. Strengthening medical training: NPMCN receives critical clinical training equipment under the Global Health Workforce Programme (GHWP). Lagos: Wellbeing Foundation Africa; 2025 May 30 [cited 2026 May 27]. Available from: https://toyinsaraki.org/blog/npmch-ghwp-equipment-handover-ceremony-lstm-wbfa/
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