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Balto H, Al Khalifah Sh, Al Mugairin S, Al Deeb M, Al-Madi E. Technical quality of root fillings performed by undergraduate students in Saudi Arabia. International Endodontic Journal, 43, 292–300, 2010. Aim To evaluate the technical quality of root fillings performed in the undergraduate clinic of the Dental College, King Saud University, Saudi Arabia and to compare the technical quality of root canal treatment between the 4th- and 5th-year students. Methodology A random sample of 710 records of patients who had received dental treatment by undergraduate students at the College of Dentistry (Malaz University Campus), between the years of 2005–2008, was investigated. The final sample consisted of 550 root filled teeth in 459 patients. For each root filled tooth, at least three periapical radiographs were examined: preoperative, working length determination and postoperative. The length, density and taper of root fillings, as well as the presence of procedural errors, were recorded. ‘Acceptable’ filling quality was defined as having adequate length, density and taper with the absence of any procedural error. Results were evaluated statistically using chi-square test. Results One hundred and twenty-five of 550 root filled teeth (23%) had a root filling that was classified as ‘acceptable’. There was no statistical significant association between the 4th- and 5th-year students in terms of length ( P = 0.134), density ( P = 0.081) and taper ( P = 0.590). Seventy-five (14%) treated teeth had ledges, 40 (7%) had apical transportation and 37 (7%) had apical root perforation. Ledges had significant association with the level of student ( P < 0.0001) and were greater in the cases of 4th-year students (18%) compared to the 5th-year students (8%), whilst root perforations had also significant association with level of students ( P = 0.016) and were more in the 5th-year cases (3%) compared to the 4th-year cases (0.3%). Conclusions The technical quality of root fillings placed by undergraduate dental students was classified as ‘acceptable’ in 23% of cases. There was little difference between 4th- and 5th-year students in the overall quality of root fillings. [ABSTRACT FROM AUTHOR]