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

AIMS: 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. METHOD: 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. CONCLUSION: 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.

[Dental consultations at a university hospital in Toulouse: the role for conservative treatments in oral health]. / Consultations dentaires au CHU de Toulouse: place des soins conservateurs.

A retrospective study was carried out looking at the files of 481 patients who were seen for their first consultation at a university hospital dental school clinic. Their needs for conservative treatment were evaluated and the data from their files were analysed, including the following elements: demography, general health status, the expressed reason for the consultation, and the initially planned treatment. The descriptive analysis reveals a relatively young population group with an average age of 43.8 years, for whom 32% of them had existing or past medical conditions which necessitated that certain precautions be taken when prescribing conservative treatment. The most frequently given reasons for the consultation were the need for an annual dental check-up (41%) and pain (20%). 74% of the patients were in need of conservative treatments, and a priority for an initial treatment was cited for 48.4% of them.