Root canal shaping using rotary nickel-titanium files in preclinical teaching. 2008

M Georgelin-Gurgel, and R Devillard, and M E Lauret, and F Diemer, and P Calas, and M Hennequin
Université Paul Sabatier, CH Purpan, Toulouse, France.

OBJECTIVE This study set out to evaluate the prevalence of iatrogenic events during preclinical teaching of endodontics, comparing manual stainless steel versus nickel-titanium (Ni-Ti) rotary techniques for shaping natural root canals. METHODS Two groups of 13 inexperienced dental students were randomly made up and asked to shape 104 canals in natural teeth. Group R used Ni-Ti rotary files for shaping while Group M used a sequence of five manual stainless steel files. Occurrence of file breakage, loss of work length, and iatrogenic instrumentation on apical foramina were evaluated. RESULTS Overall occurrence of adverse events during shaping did not differ between the groups, being 58% in Group R and 51% in Group M. Inter-group distribution of type of event differed significantly, however. File breakage (7.7%) and loss of working length of > 2 mm (6.7%) occurred only in Group R. Iatrogenic shaping on apical foramina showed the same frequency in each group. CONCLUSIONS Manual instrumentation is safer than rotary instrumentation in the hands of inexperienced students. Acquiring skill in the use of Ni-Ti rotary instrumentation requires specific preclinical training to avert file breakage. These findings argue for the rethinking of theoretical and practical coursework in endodontics teaching, especially in dentistry schools where students are required to treat patients during their training.

UI MeSH Term Description Entries
D007049 Iatrogenic Disease Any adverse condition in a patient occurring as the result of treatment by a physician, surgeon, or other health professional, especially infections acquired by a patient during the course of treatment. Hospital-Acquired Condition,Condition, Hospital-Acquired,Conditions, Hospital-Acquired,Disease, Iatrogenic,Diseases, Iatrogenic,Hospital Acquired Condition,Hospital-Acquired Conditions,Iatrogenic Diseases
D009532 Nickel A trace element with the atomic symbol Ni, atomic number 28, and atomic weight 58.69. It is a cofactor of the enzyme UREASE.
D002983 Clinical Competence The capability to perform acceptably those duties directly related to patient care. Clinical Skills,Competence, Clinical,Clinical Competency,Clinical Skill,Competency, Clinical,Skill, Clinical,Skills, Clinical,Clinical Competencies,Competencies, Clinical
D003722 Dental Alloys A mixture of metallic elements or compounds with other metallic or metalloid elements in varying proportions for use in restorative or prosthetic dentistry. Alloy, Dental,Alloys, Dental,Dental Alloy
D003762 Dental Instruments Hand-held tools or implements especially used by dental professionals for the performance of clinical tasks. Instrument, Dental,Dental Instrument,Instruments, Dental
D004708 Endodontics A dental specialty concerned with the maintenance of the dental pulp in a state of health and the treatment of the pulp cavity (pulp chamber and pulp canal). Endodontology
D004868 Equipment Failure Failure of equipment to perform to standard. The failure may be due to defects or improper use. Defects, Equipment,Device Failure,Failure, Equipment,Malfunction, Equipment,Medical Device Failure,Misuse, Equipment,Device Failure, Medical,Device Failures, Medical,Failure, Medical Device,Failures, Medical Device,Defect, Equipment,Device Failures,Equipment Defect,Equipment Defects,Equipment Failures,Equipment Malfunction,Equipment Malfunctions,Equipment Misuse,Equipment Misuses,Failure, Device,Failures, Device,Failures, Equipment,Malfunctions, Equipment,Misuses, Equipment
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D013193 Stainless Steel Stainless steel. A steel containing Ni, Cr, or both. It does not tarnish on exposure and is used in corrosive environments. (Grant & Hack's Chemical Dictionary, 5th ed) Stainless Steels,Steel, Stainless,Steels, Stainless
D013335 Students, Dental Individuals enrolled a school of dentistry or a formal educational program in leading to a degree in dentistry. Dental Student,Dental Students,Student, Dental

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