Evaluation of a systematic digitized training program on the effectivity of subgingival instrumentation with curettes and sonic scalers in vitro

Abstract

Objectives Whereas the key role of subgingival instrumentation in periodontal therapy is well known, the influence of operators’ experience/training with different devices on treatment results is yet uncertain. Therefore, we assessed untrained undergraduate students, working on manikins, as to how effectively they learn to use curettes (GRA) and sonic scalers (AIR); hypothesizing that AIR will result in higher relative cleaning efficacy (RCE) than GRA. Material and methods Before baseline evaluation (T0), 30 operators (9 males, 21 females) received a 2-h theoretical lesson for both instruments, followed by a 12-week period with a weekly digitized training program for 45 min. During three sessions (T1–T3), the operators had to instrument six equivalent test teeth with GRA and AIR. At T0–T3, treatment time, proportion of removed simulated biofilm (RCE-b), and hard deposits (RCE-d) were measured. Results At T0, RCE-b was in mean(SD) 64.18(25.74) % for GRA, 62.25(26.69) % for AIR; (p = 0.172) and RCE-d 85.48(12.32) %/ 65.71(15.27) % (p < 0.001). At T3, operators reached highest RCE-b in both groups (GRA/AIR 71.54(23.90) %/71.75(23.05)%; p = 0.864); RCE-d GRA/AIR: 84.68(16.84) %/77.85(13.98) %; p < 0.001). Both groups achieved shorter treatment times after training. At T3, using curettes was faster (GRA/AIR 16.67(3.31) min/19.80(4.52) min; p < 0.001). Conclusions After systematic digitized training, untrained operators were able to clean 70% of the root surfaces with curettes and sonic scalers. Clinical relevance It can be concluded that a systematic digitized and interactive training program in manikin heads is helpful in the training of root surface debridement.

Influence of motivation and a new digitized training program on undergraduate dental students during preclinical scaling training

“…However, the participants in the CTP group preferred AIR for higher effectiveness. Previously, we found that the learning curve for RCE-b was steeper with AIR than with GRA in DTP [11]. Without training, only 27% of all the students reached a cleaning performance of at least 70% when using AIRs (GRA: 40%).…”

“…After 12 weeks (end of the training period), the effectiveness of all the participants (DTP/CTP) was evaluated, and their self-assessment was determined by questionnaire. During practical evaluation, 12 comparable test teeth had to be instrumented with GRA (tooth: 11,14,16,31,37,45) and with AIR (tooth: 21,25,17,34,36,43). The sequence of both instruments was initially randomized (Microsoft Excel 16, Microsoft Corporation, One Microsoft Way Redmond, WA, USA) for each participant.…”

“…Adhering plaque was simulated with commercial varnish (A-CK, Frasaco, Tettnang, Germany), modified by the ratio of varnish to thickener to simulate the adhesion of subgingival hard deposits. Details of the reproducible and standardized procedure for coating and planimetric evaluation of cleaning efficiency have been described in detail elsewhere [11,12].…”

“…DTP concept (Graetz et al [11]) CTP concept Differences between groups of training concepts S1 Today, I think that scaling with sonic scaler is more difficult/easier to learn than the scaling with curettes (1 = very difficult to 5 = very easy)…”

“…Although artificial models do not simulate a perfect realistic situation, training is an important step in reducing treatment time and improving results [10]. In previous studies from our dental school (University of Kiel), the learning curves of scaling with Gracey curettes (GRA) and power-driven instruments using manikin heads with a conventional training program (CTP) [10] or with the help of a self-developed systematic digitized and interactive training program (DTP) [11] have been assessed. We assume that new digital interactions might have an effect on the motivation and self-assessment of the participants.…”