Frequency of endodontic complications in the clinical practice of undergraduate students. Literature review
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Published:
Jul 30, 2025
Keywords:
endodontics, complications, frequency, students, dentistry.
Main Article Content
Abstract
Introduction: Endodontic treatments aim to preserve severely compromised teeth, restoring their function and health to the stomatognathic system. However, their execution requires technical precision and a thorough knowledge of dental anatomy, which represents a constant challenge during dental training. Objective: To collect current scientific information about the frequency of endodontic complications in the clinical practice of undergraduate students. Methodology: Bibliographic and descriptive research, for the search for articles various databases were used, using DECS/MESH terms in English and Spanish, in addition to Boolean operators. Including studies published from 2014 to 2024, in English, Spanish and Portuguese. Once the studies were identified, a cross-sectional and critical reading of the selected literature was conducted, discarding duplicate records and those that did not allow free access. Results: Endodontic complications not only affect the success of the treatment but can also generate long-lasting repercussions on the patient's health. Poor instrumentation, insufficient or excessive filling of root canals and residual infections can lead to treatment failures and, in some cases, to the need for surgical treatment. Considering that the quality of endodontic treatment performed by undergraduate dental students varies significantly, it is important to improve their technical skills and anatomical understanding. Conclusions: Successful endodontic treatment requires accurate obturation and proper management of complications, including iatrogenic errors and instrumentation deficiencies. Correct evaluation and management of these complications are crucial to ensure the longevity of treated teeth and minimize long-term risks. General Area of Study: Dentistry. Specific area of study: Endodontics. Type of study: Narrative bibliographic review.
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How to Cite
Poma Carchi, L. K., & León Castro, P. A. (2025). Frequency of endodontic complications in the clinical practice of undergraduate students. Literature review. Anatomía Digital, 8(3.2), 91-108. https://doi.org/10.33262/anatomiadigital.v8i3.2.3468
Section
Articulos de revisión bibliográfica
References
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5. Rossi-Fedele G, Franciscatto GJ, Marshall G, Gomes MS, Doğramacı EJ. Endodontic complications associated with orthodontic temporary anchorage devices: a systematic review of human studies. Australian Endodontic Journal [Online]. 2020 [cited 2025 May 29]; 46(1):115-122. Available from: https://pubmed.ncbi.nlm.nih.gov/31621999/
6. Ucar F, Eren İ, Alaca HM. Solution methods of instrumentation related complications in endodontic treatment. International Journal of Contemporary Dental and Medical Reviews. [Online]. 2020 [cited 2025 May 29]; (020321):1-7. Available from: https://core.ac.uk/download/pdf/490681820.pdf
7. Miccoli G, Seracchiani M, Zanza A, Giudice AD, Testarelli L. Possible complications of endodontic treatments. The Journal of Contemporary Dental Practice [Online]. 2020 [cited 2025 May 29]; 21(5):473-474. Available from: https://pubmed.ncbi.nlm.nih.gov/32690825/
8. Dawson VS, Amjad S, Fransson H. Endodontic complications in teeth with vital pulps restored with composite resins: a systematic review. International Endodontic Journal [Online]. 2015 [cited 2025 May 29]; 48(7): 627-638. Available from: https://pubmed.ncbi.nlm.nih.gov/25100025/
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15. Mirza MB. Difficulties encountered during transition from preclinical to clinical endodontics among Salman bin Abdul Aziz university dental students. Journal of International Oral Health [Online]. 2015 [cited 2025 May 29]; 7(Suppl 1):22-27. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4516078/
16. Puryer J, Amin S, Turner M. Undergraduate confidence when undertaking root canal treatment and their perception of the quality of their endodontic education. Dentistry Journal [Online]. 2016 [cited 2025 May 29]; 5(1):1. Available from: https://pubmed.ncbi.nlm.nih.gov/29563408/
17. Grock CH, Luz LB, Oliveira VF, Ardenghi TM, Bizarro L, Cardoso Ferreira MB, Montagner F. Experiences during the execution of emergency endodontic treatment and levels of anxiety in dental students. European Journal of Dental Education [Online]. 2018 [cited 2025 May 29]; 22(4): e715-e723. Available from: https://pubmed.ncbi.nlm.nih.gov/30079613/
18. Abdulrab S, Alaajam W, Al-Sabri F, Doumani M, Maleh K, Alshehri F, Alamer H, Halboub E. Endodontic procedural errors by students in two Saudi dental schools. European Endodontic Journal [Online]. 2018 [cited 2025 May 29]; 3(3):186-191. Available from: https://pubmed.ncbi.nlm.nih.gov/32161876/
19. Hendi SS, Karkehabadi H, Eskandarloo A. Iatrogenic errors during root canal instrumentation performed by dental students. Iranian Endodontic Journal [Online]. 2018 [cited 2025 May 29]; 13(1):126-131. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5800454/
20. Al-Anesi MS, AlKhawlani MM, Alkheraif AA, Al-Basmi AA, Alhajj MN. An audit of root canal filling quality performed by undergraduate pre-clinical dental students, Yemen. BMC Medical Education [Online]. 2019 [cited 2025 May 29]; 19(1):350. Available from: https://pubmed.ncbi.nlm.nih.gov/31519180/
21. Kaplan T, Sezgin GP, Sönmez-Kaplan S. Dental students' perception of difficulties concerning root canal therapy: a survey study. Saudi Endodontic Journal [Online]. 2020 [cited 2025 May 29]; 10(1):33-38. Available from: https://journals.lww.com/senj/fulltext/2020/10010/dental_students__perception_of_difficulties.6.aspx
22. Valdez-Sosa AF, Ayma-León V, Caballero-García S. Confianza en estudiantes de 4to y 5to año de la carrera de Odontología al realizar tratamientos de conductos uniradiculares. Avances en Odontoestomatología [Internet]. 2023 [citado 15 mayo 2025]; 39(2):74-83. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0213-12852023000200004&lng=es
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24. Yadav RK, Chand S, Verma P, Chandra A, Tikku AP, Wadhwani KK. Clinical negligence or endodontic mishaps: a surgeon’s dilemma. National Journal of Maxillofacial Surgery [Online]. 2014 [cited 2025 May 29]; 3(1):87-90. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3513819/
25. Eyuboglu TF, Olcay K, Özcan M. A clinical study on single-visit root canal retreatments on 173 consecutive patients: frequency of periapical complications and clinical success rate. Clinical Oral Investigations [Online]. 2017 [cited 2025 May 29]; 21(5):1761-1768. Available from: https://pubmed.ncbi.nlm.nih.gov/27660159/
26. Hahn T, Christofzik DW, Fawzy El-Sayed K, Freitag-Wolf S, Conrad J, Graetz C, Größner-Schreiber B, Dörfer C. Effect of operators' proficiency level and patients' related factors on possible complications, using a high frequency polyamide sonic intracanal irrigation device: a prospective clinical cohort study. PLoS One [Online]. 2023 [cited 2025 May 29]; 18(5): e0285492. Available from: https://pubmed.ncbi.nlm.nih.gov/37141251/
27. Gheorghe AG, Mercut V, Popescu SM, Banica AC, Ionescu M, Gheorghița LM, et al. Frequency of endodontic treatment and prevalence of apical periodontitis in abutment teeth–a radiological study. Romanian Journal of Oral Rehabilitation [Online]. 2019 [cited 2025 May 29]; 11(1):11-20. Available from: http://www.rjor.ro/wp-content/uploads/2019/03/2.-FREQUENCY-OF-ENDODONTIC-TREATMENT-AND-PREVALENCE-OF-APICAL-PERIODONTITIS-IN-ABUTMENT-TEETH-%E2%80%93-A-RADIOLOGICAL-STUDY.pdf
28. Pontoriero DIK, Grandini S, Spagnuolo G, Discepoli N, Benedicenti S, Maccagnola V, et al. Clinical outcomes of endodontic treatments and restorations with and without posts up to 18 years. Journal of Clinical Medicine [Online]. 2021 [cited 2025 May 29]; 10(5):908. Available from: https://pubmed.ncbi.nlm.nih.gov/33669002/
29. Bjørndal L, Reit C. Endodontic malpractice claims in Denmark 1995-2004. International Endodontic Journal [Online]. 2018 [cited 2025 May 29]; 41(12):1059-1065. Available from: https://pubmed.ncbi.nlm.nih.gov/18811595/#:~:text=Results%3A%20Overall%2C%203611%20malpractice%20claims,%25)%20by%20the%20national%20DCB
30. Alrahabi M, Zafar MS, Adanir N. Aspects of clinical malpractice in endodontics. European Journal of Dentistry [Online]. 2019 [cited 2025 May 29]; 13(3):450-458. Available from: https://pubmed.ncbi.nlm.nih.gov/31795008/
31. Moreira MS, Anuar ASN, Tedesco TK, Dos Santos M, Morimoto S. Endodontic treatment in single and multiple visits: an overview of systematic reviews. Journal of Endodontics [Online]. 2017 [cited 2025 May 29]; 43(6):864-870. Available from: https://pubmed.ncbi.nlm.nih.gov/28457639/
32. Ozbay Y, Cirakoglu NY. The impact of endodontic workload and allocated treatment time of dentists in turkey on perceived stress and complication frequency and suggested solutions. Nigerian Journal of Clinical Practice [Online]. 2023 [cited 2025 May 29]; 26(2):169-176. Available from: https://pubmed.ncbi.nlm.nih.gov/36876605/
33. Madarati AA. Factors influencing incidents of complications while using nickel-titanium rotary instruments for root canal treatment. BMC Oral Health [Online]. 2019 [cited 2025 May 29]; 19(1):241. Available from: https://pubmed.ncbi.nlm.nih.gov/31711474/
34. Spili P, Parashos P, Messer HH. The impact of instrument fracture on outcome of endodontic treatment. Journal of Endodontics [Online]. 2015 [cited 2025 May 29]; 31(12):845-850. Available from: https://pubmed.ncbi.nlm.nih.gov/16306815/
35. Fonseca Tavares WL. Management of clinical complications following pulp canal obliteration: a report of two cases. Dental Press Endodontics [Online]. 2016 [cited 2025 May 29]; 6(2): 54-62. Available from: https://dpendodontics.com/artigo/393/Endodontics-2016-v06n2/11202/Management-of-clinical-complications-following-pulp-canal-obliteration:-a-report-of-two-cases
36. Kallel I, Douki N, Amaidi S, Ben Amor F. The incidence of complications of dental trauma and associated factors: a retrospective study. International Journal of Dentistry [Online]. 2020 [cited 2025 May 29]; 2020:2968174. Available from: https://pubmed.ncbi.nlm.nih.gov/32256593/
37. Malagnino VA, Pappalardo A, Plotino G, Carlesi T. The fate of overfilling in root canal treatments with long-term follow-up: a case series. Restorative Dentistry & Endodontics [Online]. 2021 [cited 2025 May 29]; 46(2): e27. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC8170384/
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2. Ba-Hattab R, Rahman I, Elsayed LK, Alasmari WF, Abidia R, Abdelgaffar S, Bahattab A. Ethical aspects concerning instrument separation and perforations during endodontic treatment: a cross-sectional study. International Journal of Dentistry [Online]. 2020 [cited 2025 May 29]; 2020:8849105. Available from: https://pubmed.ncbi.nlm.nih.gov/33014062/
3. Bhuva B, Ikram O. Complications in endodontics. Primary Dental Journal [Online]. 2020 [cited 2025 May 29]; 9(4):52-58. Available from: https://pubmed.ncbi.nlm.nih.gov/33225854/
4. De Oliveira Damasceno C, da Silveira Bueno CE, De Martin AS, Pelegrine RA, Villela AM, Ruivo LM, Shoji Kato A. Factors associated with post-endodontic treatment pain performed by students in an endodontic graduate program. Iranian Endodontic Journal. [Online]. 2020 [cited 2025 May 29]; 15(4):221-226. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9709830/
5. Rossi-Fedele G, Franciscatto GJ, Marshall G, Gomes MS, Doğramacı EJ. Endodontic complications associated with orthodontic temporary anchorage devices: a systematic review of human studies. Australian Endodontic Journal [Online]. 2020 [cited 2025 May 29]; 46(1):115-122. Available from: https://pubmed.ncbi.nlm.nih.gov/31621999/
6. Ucar F, Eren İ, Alaca HM. Solution methods of instrumentation related complications in endodontic treatment. International Journal of Contemporary Dental and Medical Reviews. [Online]. 2020 [cited 2025 May 29]; (020321):1-7. Available from: https://core.ac.uk/download/pdf/490681820.pdf
7. Miccoli G, Seracchiani M, Zanza A, Giudice AD, Testarelli L. Possible complications of endodontic treatments. The Journal of Contemporary Dental Practice [Online]. 2020 [cited 2025 May 29]; 21(5):473-474. Available from: https://pubmed.ncbi.nlm.nih.gov/32690825/
8. Dawson VS, Amjad S, Fransson H. Endodontic complications in teeth with vital pulps restored with composite resins: a systematic review. International Endodontic Journal [Online]. 2015 [cited 2025 May 29]; 48(7): 627-638. Available from: https://pubmed.ncbi.nlm.nih.gov/25100025/
9. Rajeswari K, Kandaswamy D, Karthick S. Endodontic management of patients with systemic complications. Journal of Pharmacy & Bioallied Sciences [Online]. 2016 [cited 2025 May 29];8(Suppl 1): S32-S35. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5074035/
10. Shao T, Guan R, Zhang C, Hou B. Influence of operator's experience on complications of root canal treatment using contemporary techniques: a retrospective study. BMC Oral Health. [Online]. 2024 [cited 2025 May 29]; 24(1):96. Available from: https://pubmed.ncbi.nlm.nih.gov/38233846/#:~:text=There%20were%20no%20significant%20differences,tooth%20type%20and%20treatment%20modality
11. Alshehri AA, Alshraim RA, Dawood AA, Alhawsawi AS, Ibrahim MB, Almutairi AH, et al. Endodontic flare-ups: A study of incidence and related factors. The Egyptian Journal of Hospital Medicine. [Online]. 2018 [cited 2025 May 29]; 70(2): 349-353. Available from: https://journals.ekb.eg/article_11491.html
12. Moradi S, Gharechahi M. Radiographic quality of root canal treatment performed by 6(th) year undergraduate students in Mashhad, Iran. Dental Research Journal [Online]. 2014 [cited 2025 May 29]; 11(3):364-369. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4119370/
13. Touboul V, Germa A, Lasfargues JJ, Bonte E. Outcome of endodontic treatments made by postgraduate students in the dental clinic of Bretonneau hospital. International Journal of Dentistry [Online]. 2014 [cited 2025 May 29]; 2014:684979. Available from: https://pubmed.ncbi.nlm.nih.gov/24778652/
14. Yavari H, Samiei M, Shahi S, Borna Z, Abdollahi AA, Ghiasvand N, Shariati G. Radiographic evaluation of root canal fillings accomplished by undergraduate dental students. Iranian Endodontic Journal [Online]. 2015 [cited 2025 May 29]; 10(2):127-130. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4372788/
15. Mirza MB. Difficulties encountered during transition from preclinical to clinical endodontics among Salman bin Abdul Aziz university dental students. Journal of International Oral Health [Online]. 2015 [cited 2025 May 29]; 7(Suppl 1):22-27. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC4516078/
16. Puryer J, Amin S, Turner M. Undergraduate confidence when undertaking root canal treatment and their perception of the quality of their endodontic education. Dentistry Journal [Online]. 2016 [cited 2025 May 29]; 5(1):1. Available from: https://pubmed.ncbi.nlm.nih.gov/29563408/
17. Grock CH, Luz LB, Oliveira VF, Ardenghi TM, Bizarro L, Cardoso Ferreira MB, Montagner F. Experiences during the execution of emergency endodontic treatment and levels of anxiety in dental students. European Journal of Dental Education [Online]. 2018 [cited 2025 May 29]; 22(4): e715-e723. Available from: https://pubmed.ncbi.nlm.nih.gov/30079613/
18. Abdulrab S, Alaajam W, Al-Sabri F, Doumani M, Maleh K, Alshehri F, Alamer H, Halboub E. Endodontic procedural errors by students in two Saudi dental schools. European Endodontic Journal [Online]. 2018 [cited 2025 May 29]; 3(3):186-191. Available from: https://pubmed.ncbi.nlm.nih.gov/32161876/
19. Hendi SS, Karkehabadi H, Eskandarloo A. Iatrogenic errors during root canal instrumentation performed by dental students. Iranian Endodontic Journal [Online]. 2018 [cited 2025 May 29]; 13(1):126-131. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC5800454/
20. Al-Anesi MS, AlKhawlani MM, Alkheraif AA, Al-Basmi AA, Alhajj MN. An audit of root canal filling quality performed by undergraduate pre-clinical dental students, Yemen. BMC Medical Education [Online]. 2019 [cited 2025 May 29]; 19(1):350. Available from: https://pubmed.ncbi.nlm.nih.gov/31519180/
21. Kaplan T, Sezgin GP, Sönmez-Kaplan S. Dental students' perception of difficulties concerning root canal therapy: a survey study. Saudi Endodontic Journal [Online]. 2020 [cited 2025 May 29]; 10(1):33-38. Available from: https://journals.lww.com/senj/fulltext/2020/10010/dental_students__perception_of_difficulties.6.aspx
22. Valdez-Sosa AF, Ayma-León V, Caballero-García S. Confianza en estudiantes de 4to y 5to año de la carrera de Odontología al realizar tratamientos de conductos uniradiculares. Avances en Odontoestomatología [Internet]. 2023 [citado 15 mayo 2025]; 39(2):74-83. Disponible en: http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S0213-12852023000200004&lng=es
23. Quiroz-Zubizarreta EM, Magão PH, Bramante AS, Bramante CM, Furuse AY, Quiroz-Huerta CA. Nivel de conocimiento sobre técnicas de obturación del conducto radicular en el tratamiento endodóntico de estudiantes de una facultad de odontología durante la pandemia de Covid-19. Revista de Operatoria Dental y Biomateriales [Internet]. 2023[citado 15 mayo 2025]; 12(2):7-14. Disponible en: https://www.imbiomed.com.mx/articulo.php?id=117493
24. Yadav RK, Chand S, Verma P, Chandra A, Tikku AP, Wadhwani KK. Clinical negligence or endodontic mishaps: a surgeon’s dilemma. National Journal of Maxillofacial Surgery [Online]. 2014 [cited 2025 May 29]; 3(1):87-90. Available from: https://pmc.ncbi.nlm.nih.gov/articles/PMC3513819/
25. Eyuboglu TF, Olcay K, Özcan M. A clinical study on single-visit root canal retreatments on 173 consecutive patients: frequency of periapical complications and clinical success rate. Clinical Oral Investigations [Online]. 2017 [cited 2025 May 29]; 21(5):1761-1768. Available from: https://pubmed.ncbi.nlm.nih.gov/27660159/
26. Hahn T, Christofzik DW, Fawzy El-Sayed K, Freitag-Wolf S, Conrad J, Graetz C, Größner-Schreiber B, Dörfer C. Effect of operators' proficiency level and patients' related factors on possible complications, using a high frequency polyamide sonic intracanal irrigation device: a prospective clinical cohort study. PLoS One [Online]. 2023 [cited 2025 May 29]; 18(5): e0285492. Available from: https://pubmed.ncbi.nlm.nih.gov/37141251/
27. Gheorghe AG, Mercut V, Popescu SM, Banica AC, Ionescu M, Gheorghița LM, et al. Frequency of endodontic treatment and prevalence of apical periodontitis in abutment teeth–a radiological study. Romanian Journal of Oral Rehabilitation [Online]. 2019 [cited 2025 May 29]; 11(1):11-20. Available from: http://www.rjor.ro/wp-content/uploads/2019/03/2.-FREQUENCY-OF-ENDODONTIC-TREATMENT-AND-PREVALENCE-OF-APICAL-PERIODONTITIS-IN-ABUTMENT-TEETH-%E2%80%93-A-RADIOLOGICAL-STUDY.pdf
28. Pontoriero DIK, Grandini S, Spagnuolo G, Discepoli N, Benedicenti S, Maccagnola V, et al. Clinical outcomes of endodontic treatments and restorations with and without posts up to 18 years. Journal of Clinical Medicine [Online]. 2021 [cited 2025 May 29]; 10(5):908. Available from: https://pubmed.ncbi.nlm.nih.gov/33669002/
29. Bjørndal L, Reit C. Endodontic malpractice claims in Denmark 1995-2004. International Endodontic Journal [Online]. 2018 [cited 2025 May 29]; 41(12):1059-1065. Available from: https://pubmed.ncbi.nlm.nih.gov/18811595/#:~:text=Results%3A%20Overall%2C%203611%20malpractice%20claims,%25)%20by%20the%20national%20DCB
30. Alrahabi M, Zafar MS, Adanir N. Aspects of clinical malpractice in endodontics. European Journal of Dentistry [Online]. 2019 [cited 2025 May 29]; 13(3):450-458. Available from: https://pubmed.ncbi.nlm.nih.gov/31795008/
31. Moreira MS, Anuar ASN, Tedesco TK, Dos Santos M, Morimoto S. Endodontic treatment in single and multiple visits: an overview of systematic reviews. Journal of Endodontics [Online]. 2017 [cited 2025 May 29]; 43(6):864-870. Available from: https://pubmed.ncbi.nlm.nih.gov/28457639/
32. Ozbay Y, Cirakoglu NY. The impact of endodontic workload and allocated treatment time of dentists in turkey on perceived stress and complication frequency and suggested solutions. Nigerian Journal of Clinical Practice [Online]. 2023 [cited 2025 May 29]; 26(2):169-176. Available from: https://pubmed.ncbi.nlm.nih.gov/36876605/
33. Madarati AA. Factors influencing incidents of complications while using nickel-titanium rotary instruments for root canal treatment. BMC Oral Health [Online]. 2019 [cited 2025 May 29]; 19(1):241. Available from: https://pubmed.ncbi.nlm.nih.gov/31711474/
34. Spili P, Parashos P, Messer HH. The impact of instrument fracture on outcome of endodontic treatment. Journal of Endodontics [Online]. 2015 [cited 2025 May 29]; 31(12):845-850. Available from: https://pubmed.ncbi.nlm.nih.gov/16306815/
35. Fonseca Tavares WL. Management of clinical complications following pulp canal obliteration: a report of two cases. Dental Press Endodontics [Online]. 2016 [cited 2025 May 29]; 6(2): 54-62. Available from: https://dpendodontics.com/artigo/393/Endodontics-2016-v06n2/11202/Management-of-clinical-complications-following-pulp-canal-obliteration:-a-report-of-two-cases
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