Compliance of endodontic treatment with clinical guidelines for dental care in periapical diseases

Abstract

Aim. To assess compliance with clinical guidelines for periapical tissue diseases by dentists.
Materials and methods. Evaluation of medical records in non-state medical organizations for compliance with the completeness of simple medical services was performed. In the process of evaluating the completeness of clinical guidelines, the sections of the requirements for outpatient diagnosis and treatment of periapical tissue diseases in complicated clinical cases were analyzed. A total of 9 cases of patients with periapical tissue pathology were analyzed.
Results. Out of 22 simple therapeutic and diagnostic medical services (SMS) that should be performed for each patient with periapical tissue diseases, most of the mandatory PMU related to professional oral hygiene were not performed, or were performed in an insignificant number of cases. Recommendations for the selection of items and hygiene products integral to oral care education were given only to those patients (22.2%) who had a root apex resection surgery as part of the package of measures. In 100.0% of cases, dentists perform and record the following PMU: collection of anamnesis and complaints for oral pathology, visual examination for oral pathology, diagnosis of the state of the dentoalveolar system using methods and means of radiological imaging, description and interpretation of radiological images, instrumental and medicamentous treatment of root canal, root canal filling. Considering the requirements of clinical guidelines for outpatient diagnostics in periapical tissue diseases it must be noted that the following obligatory PMU are performed insufficiently: palpation of oral organs (33,3%), targeted intraoral contact radiography (33,3%), thermodiagnostics of tooth (11,1%).
Conclusions. The conducted research has shown that there are considerable deviations from requirements of acting clinical recommendations in diagnostics and treatment of periapical tissue diseases which may be connected both with continuation of the steady treatment and diagnostic approaches existing for many decades and with lack of careful attitude of dentists to the new normative legal acts regulating their labor functions.