Micro–Computed Tomographic Evaluation of Shaping Ability by Novice Dental Students with 3 Reciprocating File Systems; WaveOne Gold, EdgeOne Fire and ESR

Abstract

According to the 2005-06 Survey of Dental Services Rendered by American Dental Association, 68% of RCTs in the United States were performed by general practitioners (GP). General practitioners in practice for 10 years or less were more likely to use rotary instruments. A recent survey of the endodontic education community among US dental schools reported that Vortex Blue is the most taught NiTi file system among both dental students and endodontic residents, while WaveOne Gold reciprocating file system is the second most taught among dental students. A previous study by Endodontic department in Temple University, Kornberg School of Dentistry reported that novice dental students preferred the reciprocating system over rotation system, which showed less canal transportation and better centering ability . This study examines if there is any difference in reciprocating files currently in the market, and if one is more superior than others to educate the dental students. Purpose This study aimed to examine the shaping ability and preference of novice sophomore dental students with 3 common reciprocation nickel-titanium file systems: WaveOne Gold ® (Dentsply, York, PA, USA), EdgeOne Fire ™ (EdgeEndo, Albuquerque, NM, USA), and ESR ™ (Brasseler, Savannah, GA, USA). Materials and MethodsMesial canals of 42 3D-printed pre-accessed mandibular first molars (TrueTooth, PlanBDental) were instrumented with ISO 25 (Primary) of WaveOne Gold (WOG) (n=14), EdgeOne Fire (EOF) (n=14), and ESR (n=14) by 14 sophomore dental students who were recruited randomly. Micro–computed tomography was used to scan teeth before and after instrumentation to compare canal transportation and centering ratio at the apical, middle, and coronal levels. Total instrumentation time was also recorded by student themselves. A questionnaire was completed after instrumentation regarding students’ perception with 5-point Likert scale: ease of use, flexibility, cutting efficiency, screwing effect and overall impression. Their preference was also asked. Statistical analysis was completed using one-way repeated measures ANOVA with Bonferroni test (p< 0.05). Results: ESR showed significantly more canal transportation and worse centering ratio than WOG and EOF at the apical thirds of mesiobuccal canal. EOF showed better centering ratio than WOG and ESR at the coronal thirds of mesiobuccal canal. EOF also showed less canal transportation than WOG and ESR, and better centering ratio than WOG at the middle thirds of mesiolingual canal. While instrumentation times were not significantly different, 9/14 students (64.3%) preferred EOF, which had significantly higher scores of “ease of use” and “flexibility” (p<0.05). Conclusion EOF produced better centering ratios and less canal transportation than other reciprocating systems and was preferred by novice dental students.Oral Biolog