Khawlah Rashed AlDhanhani^1* and Khawlah Rashed AlDhanhani²

¹Department of Dental, Khorfakkan Specialized Dental Center (Emirates Health Services), United Arab Emirates
²Department of Restorative Dental Sciences, College of Dentistry, Gulf Medical University, United Arab Emirates

*Corresponding Author: Khawlah Rashed AlDhanhani, Department of Dental, Khorfakkan Specialized dental Center (Emirates Health Services), United Arab Emirates.

Received: July 13, 2026; Published: July 20, 2026

Background: This clinical audit assessed the radiographic technical quality of root canal treatments performed by endodontists at Khorfakkan Specialized Dental Center (CSDK) between 2022 and 2024, against predefined technical criteria.

Methods: In this retrospective cross-sectional audit conducted at Khorfakkan Specialized Dental Center, 400 randomly selected postoperative intraoral periapical radiographs from treatments completed between 2022 and 2024 were assessed for length, density, taper, and absence of iatrogenic errors using standardized European Society of Endodontology (ESE) criteria against a predefined institutional quality target benchmark of 70% overall acceptability. Inter-examiner agreement was high, with Cohen’s kappa = 0.90 (p < 0.001). Frequency comparisons were performed using the Chi-square test, with significance set at p ≤ 0.05.

Results: Adequate length was achieved in 79.0%, density in 85.3%, taper in 88.5%, and absence of iatrogenic errors in 77.5% of cases. Overall, 67.3% of treatments met all four predefined technical quality criteria, falling slightly below the 70% institutional benchmark. Univariable analysis showed significant associations between overall technical acceptability and number of root canals and number of visits.

Conclusions: This clinical audit found that root canal treatments performed at CSDK fell slightly short of the predefined 70% institutional benchmark, with an overall radiographic technical acceptability rate of 67.3%. Because this audit evaluated only radiographic parameters, these findings are strictly limited to technical performance and do not imply long-term clinical success or healing prognosis.

Keywords: Audit; Endodontics; Periapical Radiography; Quality Assurance; Root Canal Filling; Technical Quality

References

1. Segura‐Egea JJ., et al. “Evaluation of undergraduate endodontic teaching in dental schools within Spain”. International Endodontic Journal3 (2021): 454-463.
2. Tajonar RGSY., et al. “Periapical healing of endodontically treated teeth filled only in the apical third: a randomized controlled trial”. European Endodontic Journal1 (2017): 24-30.
3. Moradi S and Gharechahi M. “Quality of root canal obturation performed by senior undergraduate dental students”. Iranian Endodontic Journal1 (2014): 66-70.
4. Arenas R., et al. “Factors influencing the technical quality of root canal fillings: a comprehensive review”. Journal of Endodontics4 (2021): 522-530.
5. Almutairi M., et al. “Challenges assessment in endodontics among undergraduate students”. Cureus 8 (2023): e43215.
6. AlRahabi MK and AlKady AM. “Current trends in practice of residents in the Saudi Board of endodontics program”. European Journal of Dentistry4 (2019): 619-624.
7. Iandolo A., et al. “Special issue “The state of the art in endodontics”. Journal of Clinical Medicine9 (2022): 2329.
8. Al-Dhanhani KR., et al. “Evaluating root canal treatment quality by undergraduate dental students at Gulf Medical University”. Journal of International Dental and Medical Research1 (2024): 310-318.
9. Bajawi A., et al. “Radiographic assessment of the quality of root canal treatments performed by practitioners with different levels of experience”. Biomed Pharmacology Journal 11 (2018): 1609-1616.
10. Almnea RA. “Radiographic assessment of the quality of root canal filling of mandibular first molars performed by endodontists in Asir Region, Saudi Arabia”. Journal of Contemporary Dental Practice7 (2024): 624-630.
11. Abdulrhman Hatiwsh and Abubaker Deeb. “Radiographic assessment of root canal filling for undergraduate, graduate students, and endodontic specialist”. Scholars Journal of Dental Sciences 7 (2022): 147-154.
12. Al-Obaida MI., et al. “Radiographic evaluation of the technical quality of root canal filling in Riyadh government and private hospitals”. Saudi Endodontic Journal 10 (2020): 194-198.
13. Pietrzycka K., et al. “The assessment of quality of the root canal filling and the number of visits needed for completing primary root canal treatment by operators with different experience”. Bioengineering 9 (2022): 468.
14. Ng YL., et al. “A prospective study of the factors affecting outcomes of non‐surgical root canal treatment: part 2: tooth survival”. International Endodontic Journal7 (2011): 610-625.
15. Ng YL., et al. “Outcome of primary root canal treatment: systematic review of the literature--Part 2. Influence of clinical factors”. International Endodontic Journal1 (2008): 6-31.
16. Burry Jacob C., et al. “Outcomes of primary endodontic therapy provided by endodontic specialists compared with other providers”. Journal of Endodontics5 (2016): 702-705.
17. Ajayi DM., et al. “Evaluation of radiographic quality of root canal obturation performed by undergraduate and postgraduate clinical dental students in a Nigerian hospital”. Pan African Medical Journal 47 (2024): 166.
18. Mustafa M. “Evaluating the quality of root canal obturation performed by undergraduate dental students: a retrospective clinical study”. World Journal of Dentistry2 (2022): 133-137.
19. Al Shehadat S., et al. “An audit of the technical quality and iatrogenic errors of root canal treatment by undergraduate dental students at the University of Sharjah”. European Journal of Dentistry 13 (2022).
20. Javed MQ., et al. “Retrospective audit for quality assessment of root fillings performed by undergraduate dental students in clinics”. Journal of Taibah University Medical Sciences2 (2022): 297-303.
21. Ng Jia Min., et al. “Effect of quality of radiographs taken during root canal treatment on technical quality of root canal fillings and endodontic outcome”. Restorative Dentistry & Endodontics1 (2025): rde-2025.
22. Cochran WG. “Sampling techniques”. 3^rd New York: John Wiley & Sons; (1977).
23. European Society of Endodontology. “Quality guidelines for endodontic treatment: consensus report of the European Society of Endodontology”. International Endodontic Journal12 (2006): 921-930.
24. Al-Manei KK., et al. “Radiographic quality of single vs. multiple-visit root canal treatment performed by dental students: a case control study”. Journal of Applied Oral Science 26 (2018): e20170507.
25. Eskandarloo A., et al. “Radiographic quality of root canal obturation performed by fifth year students of hamadan dental school”. Iranian Endodontic Journal2 (2017): 236.
26. Yusufoglu Sİ and Sarıçam E. “Comparison of endodontic treatment qualities of molar teeth performed by endodontists and practitioners: a radiographic analysis”. Selcuk Dental Journal 8 (2021): 127-132.
27. DE Bierenkrant., et al. “The technical quality of nonsurgical root canal treatment performed by a selected cohort of Australian endodontists”. International Endodontic Journal7 (2008): 561-570.
28. R Stoll., et al. “The influence of different factors on the survival of root canal fillings: a 10-year retrospective study”. Journal of Endodontics11 (2005): 783-790.
29. K Kerekes and L Tronstad. “Long-term results of endodontic treatment performed with a standardized technique”. Journal of Endodontics3 (1979): 83-90.
30. Wong CY., et al. “Factors associated with the technical quality of root canal fillings performed by undergraduate dental students in a Malaysian Dental School”. Brazilian Journal of Oral Sciences1 (2016): 45-50.
31. Abraham SB and Abdullah N. “Quality of root canal fillings performed by undergraduate students at the College of Dental Medicine, University of Sharjah, UAE”. Journal of Dental Science2 (2016): 1-7.
32. Donnelly A., et al. “A re‐audit of the technical quality of undergraduate root canal treatment after the introduction of new technology and teaching practices”. International Endodontic Journal 10 (2017): 941-950.
33. Ingle J., et al. “Modern endodontic therapy”. In: Ingle J, Bakland L, Eds. Endodontics. Baltimore, Md, USA: Williams & Wilkins; (1994): 27-53.
34. Saeed HM., et al. “Quality of root canal fillings performed by undergraduate dental students in the School of Dentistry, University of Sulaimani”. Journal of Dental and Medical Sciences 14 (2015): 105-109.
35. Fong W., et al. “An audit on technical quality of root fillings performed by undergraduate students”. International Endodontic Journal 51 (2018): e197-203.
36. Patel S., et al. “European Society of Endodontology position statement: use of cone beam computed tomography in Endodontics: European Society of Endodontology (ESE) developed by”. International Endodontic Journal 12 (2019): 1675-1678.
37. Duncan HF and El-Karim I. “Endodontic S3-level clinical practice guidelines: the European Society of Endodontology process and recommendations”. British Dental Journal7 (2025): 580-586.

Citation

Citation: Khawlah Rashed AlDhanhani and Ranya Farag Elemam. “Radiographic Quality of Root Canal Treatments at Khorfakkan Specialized Dental Center: A Retrospective Cross-Sectional Audit". Acta Scientific Dental Sciences 10.8 (2026): 27-34.

Copyright

Copyright: © 2026 Khawlah Rashed AlDhanhani and Ranya Farag Elemam. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.