Sankt-Peterburg, St. Petersburg, Russian Federation
Sankt-Peterburg, St. Petersburg, Russian Federation
Sankt-Peterburg, St. Petersburg, Russian Federation
Sankt-Peterburg, Moscow, Russian Federation
Subject. One of the urgent problems of modern health care is to provide quality and effective dental care. The percentage of complications as a result of deficiencies in the provision of dental care, leading to the development of serious pathologies and deteriorating the quality of life of patients is growing every year. High rates of emergence of new technologies in dentistry, new dental materials and equipment do not always allow each practicing dentist to achieve a high professional level of assistance when working with new methods and means of treatment of caries and its complications. In this regard, endodontic care is not provided at the proper level. Goal. A retrospective analysis of medical documentation (comprehensive examinations) was conducted to identify the incidence of medical care deficiencies and adverse outcomes in endodontic dentistry. Methodology. A retrospective analysis of 19 complex forensic examinations was carried out to identify the frequency of deficiencies in medical care and adverse outcomes in endodontic treatment of teeth. Results. It was found that the most common shortcomings in the endodontic treatment of teeth are the lack of x-rays before and after endodontic treatment, removal of filling material for the apex of the tooth, non-compliance with the rules of asepsis and antiseptics in the treatment of patients, unjustified removal of dental pulp. Findings. A retrospective analysis of adverse outcomes in endodontic dentistry according to comprehensive examinations revealed significant deficiencies at the stages of diagnosis and treatment, which led to medical errors and further legal proceedings.
shortcomings of medical care, complications, errors, endodontic treatment of teeth, medical safety, medical risk, forensic medical examination
1. Butova, V. G., Gvetadze, R. Sh., Bychkov, V. I. (2016). Kriterii kachestva stomatologicheskoy pomoshchi, predostavlyayemoy v ambulatornykh usloviyakh [Quality criteria for dental care provided on an outpatient basis]. Rossiyskiy stomatologicheskiy zhurnal [Russian Dental Journal], 6, 20, 327-331. (In Russ.)
2. Khaikin, M. B., Ulanova, O. P., Belousova, L. G. (2016). Organizatsiya sistemy kontrolya i otsenki kachestva stomatologicheskoy pomoshchi [Organization of a system for monitoring and evaluating the quality of dental care]. Izvestiya Samarskogo nauchnogo tsentra Rossiyskoy akademii nauk. Sotsial'nyye, gumanitarnyye, mediko-biologicheskiye nauki [Bulletin of the Samara Scientific Center of the Russian Academy of Sciences. Social, humanitarian, biomedical sciences], 18, 1, 125-129. (In Russ.)
3. Rocha, J., Pinto, A., Batista, M., Paula, J. S., Ambrosano, G. (2017). The importance of the evaluation of expectations and perceptions to improve the dental service quality. Int J Health Care Qual Assur, 6, 30, 568-576.
4. Borisova, E. G., Yagmurov, H. O., Grieg, E. S. (2017). Posledstviya nenadlezhashchego okazaniya stomatologicheskoy pomoshchi [The consequences of improper dental care]. Vestnik nauchnykh konferentsiy [Bulletin of scientific conferences], 25, 9-1, 27-29. (In Russ.)
5. Borisova, E. G., Tolmachev, I. A., Yagmurov, H. O. (2017). Ekspertnyy analiz defektov i neblagopriyatnykh iskhodov pri okazanii stomatologicheskoy implantatsii [Expert analysis of defects and adverse outcomes in the provision of dental implantation]. Zdorov'ye i obrazovaniye v XXI veke [Health and education in the XXI century], 19, 10, 282-284. (In Russ.)
6. Klevno, V. A., Cool, V. A., Bogomolova, I. N. (2016). Opredeleniye stepeni tyazhesti vreda zdorov'yu. Primeneniye Pravil i Meditsinskikh kriteriyev. Otvety na voprosy [Determining the severity of harm to health. Application of the Rules and Medical Criteria. Answers to questions]. Moscow : GEOTAR-Media, 136. (In Russ.)
7. Gusarov, A. A., Popova, T. G., Fetisov, V. A., Kuraeva, E. Yu., Shonia, E. A. (2017). Kliniko-ekspertnaya otsenka neblagopriyatnykh posledstviy okazaniya stomatologicheskoy implantologicheskoy pomoshchi [Clinical and expert assessment of the adverse effects of dental implant care]. Sudebno-meditsinskaya ekspertiza [Forensic-medical examination], 3, 60, 34-38. (In Russ.)
8. Pigolkin, Yu. I., Murzova, T. V., Mirzoev, H. M. (2011). Metodicheskiye osnovy ekspertnoy otsenki neblagopriyatnykh iskhodov stomatologicheskogo lecheniya v ramkakh grazhdanskogo sudoproizvodstva [Methodological foundations of expert evaluation of adverse outcomes of dental treatment in the framework of civil proceedings]. Sudebno-meditsinskaya ekspertiza [Forensic medical examination], 6, 54, 38-40. (In Russ.)
9. Andreeva, S. N., Gusarov, A. A., Fetisov, V. A. (2018). Analiz sudebnoy praktiki po grazhdanskim delam, svyazannym s defektami okazaniya stomatologicheskoy pomoshchi naseleniyu Rossiyskoy Federatsii za period s 1993 po 2017 g [Analysis of judicial practice in civil cases related to defects in the provision of dental care to the population of the Russian Federation for the period from 1993 to 2017]. Sudebno-meditsinskaya ekspertiza [Forensic medical examination], 3, 61, 44-48. (In Russ.)
10. Pashkov, K. A. et al. (2009). Sudebnaya stomatologiya. Istoriya razvitiya [Forensic Dentistry. History of development]. Moscow : MGMSU : KhPI Eslan CJSC, 200. (In Russ.)
11. Snowstorm, Yu. L. (2018). Sudebno-psikhiatricheskaya ekspertiza poterpevshikh [Forensic psychiatric examination of victims]. Moscow : Legal literature, 208. (In Russ.)
12. (2015). Perelomy kostey sredney zony litsa. Sudebno-meditsinskaya ekspertiza : posobiye [Fractures of bones of the middle zone of the face. Forensic-medical examination : allowance]. Moscow : Higher School, 178. (In Russ.)
13. Roberto, L. L., Martins, A., Paula, A., Ferreira, E., Haikal, D. (2017). Dissatisfaction with the dental services and associated factors among adults. Cien Saude Colet, 5, 22, 1601-1613.
14. Patel, S., D'Cruz, L. (2016). Endodontic Risk Management : A Dento-Legal Perspective. Prim Dent J, 2, 5, 24-28.
15. Averyanova, T. V. (2018). Sudebnaya ekspertiza. Kurs obshchey teorii [Forensic examination. General theory course]. Moscow : Norma, 480. (In Russ.)
16. Alisievich, V. I. (2018). Sudebnaya meditsina [Forensic medicine]. Moscow : YOE Media, 896. (In Russ.)
17. Akopov, V. I. (2017). Sudebnaya meditsina v voprosakh i otvetakh [Forensic medicine in questions and answers]. Moscow : Phoenix, 448. (In Russ.)
18. Akopov, V. I. (2017). 445 aktual'nykh voprosov po sudebnoy meditsine [445 topical issues in forensic medicine]. Moscow : Yurayt, 416. (In Russ.)
19. Buromsky, I. V., Coolno, V. A., Pashinyan, G. A. (2016). Sudebno-meditsinskaya ekspertiza. Terminy i ponyatiya [Forensic medical examination. Terms and concepts]. Moscow : Norma, Infra-M, 256. (In Russ.)
20. Borisova, E. G., Grieg, E. S., Yagmurov, H. O., Tolmachev, I. A. (2017). Sudebno-meditsinskaya otsenka nevrologicheskikh oslozhneniy, voznikayushchikh posle stomatologicheskikh manipulyatsiy [Forensic evaluation of neurological complications arising after dental procedures]. Sb. nauch. trudov po mater. Vseross. nauch.-prakt. konf. «Aktual'nyye voprosy chelyustno-litsevoy khirurgii i stomatologii» [Sat. scientific works on mater. All-Russian. scientific-practical conf. “Actual issues of maxillofacial surgery and dentistry”], St. Petersburg, November 21-22, P. 83-84. (In Russ.)
21. Borisova, E. G., Nikitenko, V. V., Field, L. P., Field, A. V. (2018). Rezul'taty klinicheskoy otsenki primeneniya nesteroidnykh protivovospalitel'nykh preparatov pri bolevykh simptomakh, voznikayushchikh posle endodonticheskogo lecheniya zubov [The results of a clinical evaluation of the use of non-steroidal anti-inflammatory drugs for pain symptoms that occur after endodontic dentistry]. Vestnik Rossiyskoy Voyenno-meditsinskoy akademii [Bulletin of the Russian Military Medical Academy], 61, 1, 23-28. (In Russ.)
22. Borisova, E. G., Yagmurov, H. O., Griga, E. S. (2018). Vliyaniye nevrologicheskikh oslozhneniy, voznikshikh posle stomatologicheskikh vmeshatel'stv, na kachestvo zhizni patsiyentov [The effect of neurological complications arising after dental interventions on the quality of life of patients]. Vestnik Rossiyskoy Voyenno-meditsinskoy akademii [Bulletin of the Russian Military Medical Academy], 61, 1, 18-21. (In Russ.)
23. Vladychenkova, N. A. (2010). Analiz vrachebnykh oshibok i oslozhneniy pri lechenii stomatologicheskikh bol'nykh (kliniko-pravovyye aspekty problemy) : dis. … kand. med. nauk [Analysis of medical errors and complications in the treatment of dental patients (clinical and legal aspects of the problem)]. Smolensk, 153. (In Russ.)
24. Prikaz Minzdravsotsrazvitiya Rossii ot 12 maya 2010 g. № 346 n «Ob utverzhdenii poryadka organizatsii i proizvodstva sudebno-meditsinskikh ekspertiz v gosudarstvennykh sudebno-ekspertnykh uchrezhdeniyakh Rossiyskoy Federatsii» [Order of the Ministry of Health and Social Development of Russia of May 12, 2010 No. 346 n “On approval of the organization and production of forensic medical examinations in state forensic institutions of the Russian Federation”]. Registered in the Ministry of Justice of Russia No. 18111 08/10/2010
25. Romodanovsky, P. O., Barinov, E. Kh., Spiridonov, V. A. (2014). Sudebnaya meditsina : uchebnik [Forensic medicine : textbook]. Moscow : GEOTAR-Media, 2, 528p. (In Russ.)