Management of Ledge Formation and Perforations in Endodontics: A Survey of Knowledge, Attitudes, Practices, and Perceptions Among General Dental Practitioners and Endodontists

作者：Veronica AK, Dhanush K, Prakash V, Susila A · 发表于：Journal of clinical and experimental dentistry · 年份：2026 · DOI：10.4317/jced.64141

BACKGROUND: This study compared knowledge, attitudes, and perceptions of endodontists and general practitioners regarding ledge formation and root perforation. MATERIALS AND METHODS: A 15-item questionnaire assessed knowledge, attitudes, perceptions, and practices on ledge formation and root perforation. It was pilot-tested on 20 endodontists, revised for clarity and validity, and finalized for data collection. RESULTS: A total of 202 responses (65%) were analyzed, including 51% academicians and 49% private practitioners. Most participants (82%) identified stiff instruments in curved canals as the primary cause of ledge formation, while 80% recognized sudden loss of working length as a key sign; 59% identified causes of apical perforation. Mineral trioxide aggregate was preferred by 98% for perforation repair, and CBCT by 72% for diagnosis. Additionally, 95% agreed that Ni-Ti instruments help prevent ledge formation, 84% practiced pre-curving of files, and 72% prioritized sealing, while 98% supported referral of perforation cases. Despite strong knowledge, clinical gaps were evident, with only 46% consistently using apex locators and 60% adhering to recommended protocols. Significant associations by experience involved causes, Ni-Ti use, apex locator use, management goals, and tip design. By professional status, differences included causes, Ni-Ti use, pre-curving, apex locator use, techniques, and rake angle. By practice type, causes, pre-curving, and rake angle varied. The...