Clinical Oral Investigations

, Volume 22, Issue 6, pp 2381–2388 | Cite as

A web-based endodontic case difficulty assessment tool

  • P. K. Shah
  • B. S. Chong
Original Article



To develop a web-based tool to facilitate identification, evaluation and management of teeth requiring endodontic treatment.

Materials and methods

Following a literature search and thorough analysis of existing case difficulty assessment forms, the web-based tool was developed using an online survey builder (Qualtrics, Qualtrics Lab, UT, USA). Following feedback from a pilot study, it was refined and improved. A study was performed, using the updated version (EndoApp) on a cohort (n = 53) of dental professionals and dental students. The participants were e-mailed instructions detailing the assessment of five test cases using EndoApp, followed by completion of a structured feedback form. Analysis of the EndoApp responses was used to evaluate usage times, whereas the results of the feedback forms were used to assess user experience and relevance, other potential applications and comments on further improvement/s.


The average usage time was 2 min 7 s; the average times needed for the last three (Cases 3–5) were significantly less than the preceding two (Cases 1 & 2) test cases. An overwhelming majority of participants expressed favourable views on user experience and relevance of the web-based case difficulty assessment tool. Only two participants (4%) were unlikely or very unlikely to use EndoApp again. The potential application of EndoApp as an ‘educational tool’ and for ‘primary care triage’ was deemed the most popular features and of greater importance than the secondary options of ‘fee setting’ and as a ‘dento-legal justification tool’.


Within the study limitations, owing to its ability to quantify the level of difficulty and provide guidance, EndoApp was considered user-friendly and helped facilitate endodontic case difficulty assessment. From the feedback, further improvements and the development of a Smartphone App version are in progress.

Clinical relevance

EndoApp may facilitate treatment planning, improve treatment cost-effectiveness and reduce frequency of procedural errors by providing appropriate guidance on endodontic case management.


Case difficulty assessment Endodontic treatment Treatment risks Web-based tool 


Compliance with ethical standards

Conflict of interest

PK Shah declares that he has no conflict of interest.

BS Chong declares that he has no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study, formal consent is not required.

Supplementary material

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Institute of Dentistry, Barts and The London School of Medicine and DentistryQueen Mary University of LondonLondonUK

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