Clinical Efficiency (Reliability) of Using a Barbed Broach for the Purpose of Pulp Extirpation among Undergraduate Dental Students

Abstract

Introduction: A barbed broach is considered to be a primitive hand instrument (root canal) and considered by many as outdated, especially in the modern world of rotary instruments. However, its efficiency in terms of pulp removal is unmatched and therefore is considered necessary to teach its use at the level of undergraduate dental curriculum. This study aims to evaluate the clinical reliability and efficiency of barbed broach as pulp removal instrument, and indirectly determine the need of modifying undergraduate students' curriculum. Materials and methods: Patients suffering from pain due to pulpal/periapical involvement, which was referred from diagnostic department to ongoing fifth year clinical courses and recommended for root canal treatment were included in the study. Reliability was measured by determining the procedure each student used to remove the pulp (barbed broach versus other instruments), while efficiency was determined by determining the pain score (visual analog scale with a score of 1 to 10) for three consecutive days after pulp extirpation. A questionnaire was distributed among all students who had to enter all details of the treatment in the questionnaire. Results: The average preoperative pain score for females (n+35) was 9.09±1.22 which decreased significantly to 4.49±2.88 after pulpectomy only with bb in the 1st day then to 3.00±2.8 in the 3rd day. After working length determination and initial instrumentation, the mean pain scores decreased to 0.94±1.9. In the males (n=25), the average preoperative pain score was 6.56±1.4 which decreased significantly to 3.60±2.67 after pulpectomy only with bb in the 1st day then to 2.60±2.06 in the 3rd day. After working length determination and initial instrumentation, the mean pain scores decreased to 1.16±1.67. Patients whose pulp were removed using files (n=11 students), revealed an increase in pain (n=2), same level (n=5) and little decrease (n=4). No statistical tests were employed since the number of cases in the groups was not equal. Conclusion: Within the limitations of this study, it was observed that the method of pulp extirpation done by using a barbed broach was more effective in reducing pulpal pain clinically as compared to other instrument among the studied sample.