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Micro-Computed Tomographic Evaluation of Shaping Ability by Novice Dental Students and Their Preference of
Akshay Keerthy1, Hae Young Hong2, Jong Ryul Kim3
1Private Practice, Boston, Massachusetts, USA.
Aim:
Nickel-titanium (NiTi) rotary instruments have helped clinicians in enhancing canal preparation, with two different kinematic systems employing either reciprocating or rotary motion. This study aimed to evaluate the influence of this kinematics on canal transportation and centering ratios when used by novice dental students and their preference after use.
Methodology:
Forty-two mesial canals of 3D-printed mandibular first molars were instrumented by 21 sophomore dental students. Students were randomly assigned to instrument both mesiobuccal (MB) and mesiolingual (ML) canals using either ProTaper Gold (PTG) or WaveOne Gold (WOG) while measuring instrumentation time. Micro-computed tomography (micro-CT) scans were taken before and after instrumentation. Canal transportation and centering ratios were calculated at apical, middle and coronal levels. A questionnaire was completed after instrumentation regarding students' perception with 5-point Likert scale: ease of use, flexibility, cutting efficiency, screwing effect, overall impression and their preferred file. Canal transportation and centering ratios were compared using paired t-tests. Data from the questionnaire were analysed using the Pearson chi-square test and independent t-tests. The statistical significance level was set at p < 0.05.
Results:
PTG showed significantly more canal transportation than WOG in both apical and middle thirds of the ML canals (p < 0.05). The centering ratios of WOG were also significantly higher at the apical and middle thirds of ML canal but lower at the apical thirds of MB canal. The time for WOG instrumentation was shorter than for PTG (218 ± 83.6 vs. 446.6 ± 231.4 s, p < 0.05). WOG had significantly higher scores in the categories of 'ease of use', 'screwing effect' and 'overall impression' (p < 0.05) than those of PTG. 19/21 students (90.48%) preferred WOG to PTG.
Conclusions:
The reciprocation system was preferred in aggregate over the rotation system by novice dental students and showed less canal transportation and better centering ability with shorter instrumentation time.
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