Trends in Endodontic Malpractice Claims and their Indemnity in Finland in the 2000s

Objectives: We hypothesized that malpractice panorama in endodontics has changed alongside of adoption of new devices. To assess such changes, we compared endodontic malpractice claims and their indemnity in Finland in 2002-2006 and 20112013. Methods: Our two cross-sectional data sets comprised the health care claims related to endodontic malpractice, handled by The Patient Insurance Centre (PIC) in Finland. Based on the law, PIC awards patients with financial compensation in cases where injury could have been avoided by following good clinical practice. In 2002-2006 and 2011-2013, a total of 1322 claims were handled and 1271 cases were eligible for analyses. Two dental advisors at the PIC scrutinized the original documents of the cases. Data included patients’ and operators’ gender and age, service sector, type of tooth, and methods of instrumentation and as types of injury, perforations and broken instruments. Indemnity was defined as dichotomy. Chisquare tests and odds ratios (OR) served for statistical evaluation. Results: From 2002-2006 to 2011-2013, mean number of cases per year increased from 134 to 201 (p=0.026). From the former to the latter period, proportion of the cases with the use of engine-driven instrumentation increased from 17% to 45% (p<0.001) and of cases with root canal perforations from 8% to 13% while cases with pulp chamber perforations decreased from 13% to 10% (p=0.016). Endodontic claims entitled to financial compensation remained nearly the same, 48% and 44%. Perforations (OR 4.4-6.6) were the most likely to receive compensation. Conclusion: Number of endodontic malpractice claims was rising rapidly and so was the adoption of new technique, enginedriven instrumentation. Our findings thus call for more attention on expanding dentists’ knowledge of tooth anatomy and training in the use of new endodontic devices