Mandel E, Adib-Yazdi M, Benhamou L M, Lachkar T, Mesgouez C, Sobel M
University of Paris 7, School of Dentistry, Endodontic Department, France.
Int Endod J. 1999 Nov;32(6):436-43. doi: 10.1046/j.1365-2591.1999.00239.x.
The aim of this study was to determine the incidence of fracture of ProFile 0.4 and 0.6 taper Series 29 nickel-titanium instruments with respect to operator experience.
A total of 125 simulated root canals in resin blocks with the same geometrical shape in terms of angle and radius of curvature and coronal and apical orifice diameter were used. Five operators prepared all the specimens using an identical step-down instrument sequence, each one preparing 25 canals. The operators included two endodontists and three general practitioners. Statistical data concerning the incidence of instrument failure was compiled using Statlab and Fisher's partial least square difference analysis of variance.
A total of 21 (16.8%) instruments fractured, all had 0.04 tapers. Nine size 25 instruments failed, 9 size 20 instruments failed and 3 size 15. During the study, the Binary Tree analysis of instrument failure revealed two operator populations belonging to two different study periods. The first period, which represented the first 13 root canal preparations, was called the 'learning period', and the second period, which represented the next 12 sample preparations, was called the 'application period'. A greater number of instruments failed during the first period than during the second. In the 'learning period', both groups of operators learned the same way. In the 'application period', two groups could be distinguished; the first group consisted of a general practitioner who produced worse results, and the second group consisted of the other four operators.
The results indicate the necessity of mastering this rotary canal preparation technique, and the importance of improving competence through learning and experience.
