EVALUATION OF THE ENDODONTICS COURSES AT FAO-UFMG IN THE POST-PANDEMIC PERIOD (2021-2024)

Ciências da Saúde, Volume 29 – Edição 150/SET 2025 / 15/09/2025

AVALIAÇÃO DAS DISCIPLINAS DE ENDODONTIA DA FAO-UFMG NO PERÍODO PÓS-PANDEMIA (2021-2024)

EVALUACIÓN DE LOS CURSOS DE ENDODONCIA FAO-UFMG EN EL PERIODO POSPANDÉMICO (2021-2024)

REGISTRO DOI: 10.69849/revistaft/ar10202509111124

Hebertt Gonzaga dos Santos Chaves¹
Luísa Lopes Duarte²
Carolina Mendes Pinheiro³
Thiago Caldeira Diniz⁴
Andreia Maria Araújo Drummond⁵

ABSTRACT

The School of Dentistry at the Federal University of Minas Gerais (FAO-UFMG) provides dental care to the community through a partnership with the Brazilian Unified Health System (SUS), encompassing emergency services, basic care, and specialized treatments, including Endodontics. This study aims to evaluate the productivity of the Endodontics I and II courses during the post-pandemic period (2021 to 2024). The analyzed data were obtained from SI-CASEU records, completed by undergraduate students enrolled in Endodontics I (ODR044) and Endodontics II (ODR048). The results revealed that, in the second semester of 2024, despite an increase in the availability of spots for Endodontics I, there was no significant growth in the number of completed treatments (fillings), as the number of filled teeth did not keep pace with the rise in the number of instrumented teeth. Between 2021 and 2022, there was an increase in the number of instrumented and filled teeth in the Endodontics I course, with a slowdown in this growth in 2024. In the Endodontics II course, a significant increase in the number of instrumented teeth was observed between 2021 and 2022, followed by a reduction in 2024. Considering that Endodontics is a highly complex discipline that requires a substantial learning period, the average number of completed treatments per semester was at most one tooth per student, a number that further decreased with the doubling of class sizes. These findings suggest potential implications for the teaching-learning process, highlighting the need to revise the pedagogical strategies employed. 

Keywords: Endodontics; Teaching; Pandemic; Teaching-learning process; Dental Education.

RESUMO

A Faculdade de Odontologia da Universidade Federal de Minas Gerais (FAOUFMG) oferece assistência odontológica à comunidade por meio de uma parceria com o Sistema Único de Saúde (SUS), abrangendo atendimentos de urgência, serviços básicos e especializados, incluindo a Endodontia. Este estudo tem como objetivo avaliar a produtividade das disciplinas de Endodontia I e II no período pós-pandemia (2021 a 2024). Os dados analisados foram obtidos a partir de registros do SI-CASEU, preenchidos por estudantes de graduação matriculados nas disciplinas Endodontia I (ODR044) e Endodontia II (ODR048). Os resultados mostraram que, no segundo semestre de 2023, apesar do aumento na oferta de vagas em Endodontia I, não houve crescimento significativo no número de tratamentos concluídos (obturados), uma vez que a quantidade de dentes obturados não acompanhou o aumento no número de dentes instrumentados. Entre 2021 e 2022, verificou-se um aumento no número de dentes instrumentados e obturados na disciplina de Endodontia I, com uma desaceleração desse crescimento em 2024. Na disciplina de Endodontia II, observou-se um aumento expressivo no número de dentes instrumentados entre 2021 e 2022, seguido por uma redução em 2024. Considerando que a Endodontia é uma disciplina de alta complexidade e demanda um período significativo de aprendizado, a média de tratamentos finalizados por semestre foi de, no máximo, um dente por aluno, valor que diminuiu ainda mais com a duplicação de turmas. Esses achados sugerem possíveis implicações no processo de ensino-aprendizagem, ressaltando a necessidade de revisão das estratégias pedagógicas empregadas.

Palavras-chave: Endodontia; Ensino; Pandemia; Processo ensinoaprendizagem; Educação em Odontologia.

RESUMEN

La Facultad de Odontología de la Universidad Federal de Minas Gerais (FAO-UFMG) ofrece asistencia odontológica a la comunidad mediante una colaboración con el Sistema Único de Salud (SUS), que incluye atención de urgencias, servicios básicos y tratamientos especializados, como la Endodoncia. Este estudio tiene como objetivo evaluar la productividad de las asignaturas de Endodoncia I y II durante el período pospandemia (2021 a 2024). Los datos analizados se obtuvieron de los registros del SI-CASEU, completados por estudiantes de grado matriculados en las asignaturas Endodoncia I (ODR044) y Endodoncia II (ODR048). Los resultados mostraron que, en el segundo semestre de 2024, a pesar del aumento en la oferta de plazas en Endodoncia I, no hubo un crecimiento significativo en el número de tratamientos completados (obturados), ya que la cantidad de dientes obturados no siguió el aumento en el número de dientes instrumentados. Entre 2021 y 2022, se observó un aumento en el número de dientes instrumentados y obturados en la asignatura Endodoncia I, con una desaceleración de este crecimiento en 2023. En la asignatura Endodoncia II, se registró un aumento significativo en el número de dientes instrumentados entre 2021 y 2022, seguido de una reducción en 2024. Considerando que la Endodoncia es una disciplina de alta complejidad que requiere un período significativo de aprendizaje, la media de tratamientos completados por semestre fue, como máximo, de un diente por estudiante, cifra que disminuyó aún más con la duplicación de grupos. Estos hallazgos sugieren posibles implicaciones en el proceso de enseñanza-aprendizaje, destacando la necesidad de revisar las estrategias pedagógicas empleadas.

Palabras clave: Endodoncia; Enseñanza; Pandemia; Proceso de enseñanzaaprendizaje; Educación en Odontología.

1 INTRODUCTION

The Unified Health System (SUS), established by the 1988 Constitution and regulated by Laws 8.080 and 8.142 of 1990, represents a significant advancement in the Brazilian Health Reform1. However, SUS still faces challenges in implementing a comprehensive healthcare model that encompasses everything from welcoming patients to the bond between social subjects2. This model is structured into three levels of care: primary, secondary, and tertiary. Primary care is the point of entry for patients3,4, while secondary and tertiary care deal with more complex cases, such as those treated at the Centers for Dental Specialties (CEO)4. 

Despite the predominance of dental services at the primary level and the backlog of demand, especially in the specialties of prosthodontics, periodontics, and endodontics, secondary care coverage remains insufficient5,6. In this context, the UFMG School of Dentistry (FAO-UFMG) integrates with SUS, providing both basic and specialized care, including in its Endodontics clinic7. 

The UFMG School of Dentistry’s undergraduate program, lasting 10 semesters, offers Endodontics courses in the 5th and 7th semesters. During this period, students perform endodontic procedures on less and more complex teeth, respectively, with continued clinical practice in the following semesters. However, the COVID-19 pandemic profoundly impacted in-person teaching, forcing the adaptation to Emergency Remote Education (ERE), which affected both student training and care for the external community. 

To evaluate the productivity and impact of remote teaching on student training, FAO-UFMG uses the CASEU Informatized System (SI-CASEU), which allows the recording of procedures performed by students, providing data on clinical production and contributing to the qualification of the care provided8. 

Analyzing the productivity of the Endodontics I and II courses between 2021 and 2023, considering the post-pandemic context, is crucial for understanding the effects of this transition on the teaching-learning process. The aim of this study is to evaluate the impact of this change on student performance and the quality of dental care provided to the population. 

2 METHODOLOGY

This study was conducted at the UFMG School of Dentistry (FAO-UFMG), covering data from the second semester of 2021 to the second semester of 2024. The data analyzed were extracted from records in the SI-CASEU, filled out by undergraduate students enrolled in the Endodontics I (ODR044) and Endodontics II (ODR048) courses. 

Authorization to use the data was granted by the course coordinators and provided by the CASEU office via email, with the response in EXCEL® format (Microsoft Excel, 2021). Data regarding the number of students per course per semester were provided by the Undergraduate Dental Program’s Department upon request by email. 

Consultations were made to the Course Pedagogical Project (PPC), among other regulations, the UFMG Endodontics Manual, and the course syllabi. 

In the analysis process, specific information was selected regarding the following procedures: “first consultation”, “radiographs”, “pulp sensitivity test”, “access to dental pulp”, “pulpectomy”, “intracanal medication”, “single-rooted tooth instrumentation”, “bi-rooted tooth instrumentation”, “three or more root tooth instrumentation”, “obturation”, “endodontic retreatment”, “clinical crown lengthening” “coronal prophylaxis and polishing” and “restorations” for both courses. 

Regarding the ethical implications associated with the use of the data, it is highlighted that, with the consent of the Department of Restorative Dentistry (ODR) and the coordinators of Endodontics I and II, this study involves an analysis of aggregated database information, which does not allow for the identification of individual participants. In this context, in accordance with Resolution No. 510 of 2016 of the National Health Council (CNS), submission to the Ethics and Research Committee is not required. 

3 RESULTS 

During the analyzed period, spanning from the second semester of 2021 to the second semester of 2024, 588 students were enrolled in the Endodontics I course and 540 in the Endodontics II course (Table 1). It is important to note that these courses were not offered in the first semester of 2021 due to restrictions imposed by the COVID-19 pandemic, which influenced the academic organization in subsequent semesters.

In addition to typical endodontic procedures such as coronal access, instrumentation, and root canal obturation, students also performed complementary procedures such as restorations, prophylaxis and coronal polishing, endodontic retreatment, and crown lengthening (Table 2). These procedures reflect the diversity of clinical experiences provided to students, broadening their practical approach and capacity to resolve various clinical cases.

Data analysis reveals a consistent increase in the number of instrumented teeth in the Endodontics I course between 2021 and 2024. The total number of instrumented teeth rose from 55 in 2021/2 to 200 in 2023/2, with a slight decrease to 126 in 2024/2 (Figure 1). Regarding obturated teeth, growth was also observed, from 30 in 2021/2 to 152 in 2023/2, declining to 100 in 2024/2 (Figure 2). This discrepancy indicates that, although clinical procedures intensified, the completion of treatments still faced limitations, possibly related to the time available in each academic semester or the complexity of the attended cases.

Figure 1. Proportion of instrumented and obturated teeth per student in Endodontics I course (2021–2024)

Figure 2. Comparison between instrumented and obturated teeth in Endodontics I course (2021–2024)

In the Endodontics II course, the trend was similar but more accentuated. The number of instrumented teeth increased from 64 in 2021/2 to a peak of 326 in 2024/1, followed by a reduction to 234 in 2024/2 (Figure 3). In parallel, the number of obturated teeth rose from 25 in 2021/2 to 202 in 2024/1, and slightly decreased to 124 in 2024/2 (Figure 3). This pattern suggests greater efficiency among students in completing treatments, despite fluctuations in the number of instrumented teeth.  

When analyzing average productivity per student, clear differences between the two courses were observed. In Endodontics I, productivity ranged from 0.50 obturated teeth per student in 2021/2, peaking at 1.95 in 2022/1, and stabilizing at 0.93 in 2024/2 (Table 1; Figure 4). In Endodontics II, productivity was higher: 0.50 in 2021/2, reaching 3.98 instrumented teeth per student in 2022/1, and stabilizing at around 2.29 instrumented and 1.22 obturated in 2024/2 (Table 1; Figure 5).

Figure 3. Comparison between instrumented and obturated teeth in Endodontics II course (2021–2024)

The doubling of the Endodontics I course offerings in 2023 had a clear impact, particularly in the second semester. While the number of instrumented teeth increased significantly, the number of obturated teeth did not grow proportionally (Figure 4; Figure 2). This disparity underscores the need for strategies to optimize clinical planning, ensuring that students can complete more treatments during the semester.

Figure 4. Temporal evolution of average productivity (teeth per student) in Endodontics I and II courses (2021–2024)

These results highlight both the progress achieved and the challenges still faced in the teaching of Endodontics at FAO-UFMG, providing evidence to support pedagogical and organizational adjustments aimed at enhancing learning and improving the quality of clinical care provided to the community.

Figure 5. Proportion of instrumented and obturated teeth per student in Endodontics II course (2021–2024).

Figure 6. Relationship between number of students and productivity (instrumented and obturated teeth) by course (2021–2024).

Figure 7. Average productivity per student in Endodontics I and II courses (2021–2024).

Figure 8. Total instrumented and obturated teeth in Endodontics I and II courses (2021–2024).

 Table 1. Number of students enrolled per semester (Sem) in the Endodontics I and II courses

Table 2 – Procedures carried out during the years 2021 to 2024 in Endodontics I and II

4 DISCUSSIONS

 The COVID-19 pandemic brought significant challenges to dental education in Brazil, particularly in the practical activities essential to academic training9,10. On March 17, 2020, the Ministry of Education implemented Emergency Remote Learning (ERL) as a response to the health crisis, temporarily suspending in-person activities, including dental clinics. Activities at FAO-UFMG resumed in January 2021, initially focusing on emergency care for students in their final semester, operating at half the clinic’s capacity in compliance with biosafety standards11.

The practical workload in Brazilian dental education represents at least 40% of the course12-14, and due to the inability to resume clinical activities and high infection rates, many classes experienced delays in graduation12. The Dentistry course was one of the most impacted by the pandemic, with studentpatient clinical practice severely affected by biosafety protocols15-17. Despite these challenges, technological adaptation in teaching, with multiple formats of interaction, helped mitigate the impacts and maintain learning during the pandemic13,17. The return of other clinical activities at FAO-UFMG occurred in the second semester of 2021, still with restrictions and adhering to biosafety norms11.

The adaptation implemented at FAO-UFMG to address the backlog of students during the pandemic resulted in the duplication of offerings for the Endodontics I course in the second semester of 2023, aiming to meet the unmet demand of students. This change led to students undertaking pre-clinical activities in an intensive week, with three practical laboratory classes maintaining the pre-established workload. Before this adaptation, the Endodontics I course had a four-week pre-clinical period, with one four-hour class per week. In the Endodontics II course, the pre-clinical phase lasted two weeks, with one class per week, totaling eight hours of workload.

The goal of pre-clinical teaching in Endodontics is to allow students to acquire and refine their technical skills before real clinical care, an essential component to ensure the quality of endodontic treatment. During this phase, faculty members and graduate students act as mentors, preparing students for the challenges of clinical practice18,19. Laboratory training is therefore crucial to consolidate technical skills and provide a solid foundation before students begin direct clinical care.

The exclusion of the year 2020 from the analysis, up to the first semester of 2021, is justified by the lack of data due to the suspension of activities and the non-offering of courses during that period. Furthermore, since the objective of the Endodontics I and II courses is to perform endodontic treatment on permanent teeth (single and multi-rooted teeth in Endodontics I and upper and lower molars in Endodontics II), data on treatments for deciduous teeth were not included in the sample.

Kamaura et al. (2003)19 compared endodontic treatments performed by undergraduate students on laboratory mannequins and on patients in the clinic. The results indicated that single-rooted teeth showed worse results in the laboratory, probably because they were the first treated by the students. On the other hand, molar teeth showed good results, due to the training and progression of the students. The study concluded that learning in laboratory activities, followed by its clinical application, improves students’ abilities.

The study by Arantes (2021)20 assessed the perceptions of final-year undergraduate students regarding the teaching-learning approach at FAO-UFMG through a questionnaire. Negative aspects identified included limited workload (28.9%) and a lack of treated cases in mandatory courses (30.1%). Positive points highlighted by students included the quality of the faculty (60.2%) and the presence of a pre-clinical laboratory phase (22.9%). Nevertheless, this study shows that the laboratory workload is still limited, and the result of the restricted time in pre-clinical training may lead to low self-confidence during clinical practice. Kappler et al. (2019)21 emphasizes the importance of pre-clinical training. Despite the increased time and emphasis on teaching Endodontics in the UK over the past two decades, students continue to face challenges. This situation encourages educators to develop new curricular alternatives aimed at creating a more conducive environment for student formation in this specific area22,23. In Brazil, despite the importance of pre-clinical training, there are no minimum criteria, such as a minimum number of hours, to guide laboratory teaching based on the new National Curricular Guidelines (DCN). Thus, it is inferred that different approaches can be proposed at existing universities in the country21,22.

With the duplication of offerings, students began to have 12 hours of laboratory activities, which were previously carried out over 4 weeks with a total of 16 hours. This reduced the pre-clinical activity time compared to the nonduplicated classes. Based on the results of the research, it can be inferred that this teaching model influenced the pre-clinical training of students, being essential for the development of manual dexterity and skills necessary for clinical practice. Intensive training contributes to the learning curve20. Given that Endodontics I students have limited clinical experience, an effective strategy would be to separate laboratory activities as an independent course before Endodontics I. This would provide more training time and an extended workload for clinical practice, allowing students to perform a greater number of endodontic procedures.

In this context, the impact of these changes on teaching and learning should be considered. Bryan and Harter (1897)23 studied the learning curve of Morse code operators, and the results showed that after ten months of experience, they became four to five times more productive. This reinforces the idea that the teaching-learning process is time-dependent18,20. The reflection proposed by Albuquerque (2010)24 on the amount of time needed for content assimilation highlights concerns about the rapid transition between Endodontics I and II courses. With the duplication of the course, one group will face these courses consecutively, with only a few months’ interval. This raises the question of whether students will be able to absorb and consolidate the knowledge of Endodontics I before advancing to the more complex concepts of Endodontics II. Therefore, it is crucial that faculty plan the time appropriately, offering additional support and opportunities for review to ensure that students can keep pace with the course and achieve effective learning.

At the end of the semester, it was observed that students had a low average number of completed endodontic treatments, which raises concerns about the learning process. Performing only one endodontic treatment per semester is not sufficient for students to gain practical experience and confidence in clinical skills. These data, also reflected in Figure 6 and Figure 7, indicate the need for a curriculum review to provide more comprehensive and effective training for future dental professionals.

Even with the duplicated offering, resulting in an increased number of students per semester, it was observed that productivity, i.e., the number of teeth instrumented and obturated, did not follow this increase. As shown in Figure 8, this may suggest that, despite having more students, it did not result in more treatments being performed and more patients treated. Instead, it could indicate that the clinic had limitations in accommodating all these students.

The completion of productivity data in the SI-CASEU system, which is responsible for managing medical records and patient flow, is a crucial step for monitoring clinical activities and for the financial transfer from the Belo Horizonte Health Department (SMSA/SUS-BH) to FAO-UFMG. However, a possible failure in data accuracy was observed, as exemplified in the Endodontics I course, where out of the 56 enrolled students, only 51 teeth were instrumented. This suggests the possibility of errors in filling out the information or even the failure to perform procedures by some students. Such failures can directly impact financial transfers, as these amounts are based on the goals and records of procedures performed according to the institution’s operational plan.

Furthermore, the results indicate that a significant number of treatments were performed on multi-rooted teeth, which require more advanced clinical skills and are more appropriate for Endodontics II students. This highlights the need for a curricular approach more aligned with the level of experience of the students, ensuring that Endodontics I students are exposed to cases that match their stage of training.

The study’s limitations related to the incorrect filling of information in the SI-CASEU system may introduce bias that compromises data interpretation. If the data on instrumented and obturated teeth were not correctly entered, this could substantially alter the analysis of the results and affect the understanding of the procedures performed. Therefore, it is essential that faculty verify the data entry to ensure the accuracy of information and, consequently, the quality of clinical and financial management.

A critical assessment of the Endodontics I and II courses, with emphasis on teaching management and adaptation to student needs, can provide valuable insights for improving educational practices in future scenarios. Additionally, this process contributes to reflecting on the impact of the pandemic and the strategies adopted to mitigate its effects on teaching and learning, offering a solid foundation for potential improvements in pedagogical approaches and administrative processes related to endodontic education.

5 CONCLUSION

FAO-UFMG plays an essential role in providing endodontic care within the SUS. The pandemic impacted the teaching of the Endodontics I and II courses, with the simultaneous offering for two classes, which reduced the students’ learning time and productivity. The duplication of the classes did not result in a proportional increase in services, highlighting the need for a pedagogical review. It is essential to discuss the changes in the teaching plan and ensure the proper recording of data in the SI-CASEU to ensure the students’ training and the allocation of resources.

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¹Master in Endodontics. Universidade Federal de Minas Gerais (UFMG). Rua Prof. Moacir Gomes de Freitas, 688, Pampulha, Belo Horizonte – MG, CEP: 31270-901. E-mail: heberttchaves_@hotmail.com;
²Bachelor in Dentistry. Universidade Federal de Minas Gerais (UFMG). Rua Prof. Moacir Gomes de Freitas, 688, Pampulha, Belo Horizonte – MG, CEP: 31270-901. E-mail: luisalopesd@gmail.com;
³Undergraduate Student in Dentistry. Universidade Federal de Minas Gerais (UFMG). Rua Prof. Moacir Gomes de Freitas, 688, Pampulha, Belo Horizonte – MG, CEP: 31270-901. E-mail: contatocarolpinheiro@hotmail.com;
⁴Master in Public Health. Universidade Federal de Minas Gerais (UFMG). Rua Prof. Moacir Gomes de Freitas, 688, Pampulha, Belo Horizonte – MG, CEP: 31270-901. E-mail: thiago.caldeira.diniz@gmail.com;
⁵PhD in Public Health. Universidade Federal de Minas Gerais (UFMG). Rua Prof. Moacir Gomes de Freitas, 688, Pampulha, Belo Horizonte – MG, CEP: 31270-901. E-mail: andreia_drummond@hotmail.com.