title: The impact of a continuing education programme on the adoption of nickel-titanium rotary instrumentation and root-filling quality amongst a group of Swedish general dental practitioners.
abstract: BACKGROUND
  The aim of the study was to test the hypothesis that a further education programme relating to nickel-titanium rotary instrumentation (NTRI), with the concurrent activation of social/professional networks amongst all general dental practitioners (GDPs) in a public dental service in Sweden, would increase the adoption rate and improve root-filling quality.
  
  
  METHODS
  To activate the networks, the GDPs at the 25 clinics elected training coaches from amongst themselves. The coaches were educated by a specialist and were then free to organise and conduct the training of the local GDPs. However, collective hands-on training and discussions were mandatory. Lectures were held by an endodontist. The rate of adoption and root-filling quality was evaluated just before and 6 months after the education. Statistical tests were performed with chi-square using a 95% confidence interval.
  
  
  RESULTS
  Nickel-titanium rotary instrumentation was adopted by 88%. Excellent root fillings (score 1) increased from 45% to 59% (P = 0.003). The rate of poor-quality root fillings (score 4 and score 5) was not affected. The quality ratio (score 1/score 5) increased from 5.36 (118/22) to 9.5 (133/14). Eleven dentists (17%) at nine different clinics produced 49% of the poor-quality root fillings (score 4 and score 5). Seventy-three per cent of these dentists stated that they had adopted NTRI.
  
  
  CONCLUSIONS
  The introduction of NTRI will increase the adoption rate and the frequency of good-quality root fillings. However, it will not overcome the problems associated with dentists producing a low-quality level, even if a local professional network is activated.
authors.affiliation: Department of Endodontology, Institute of Odontology, The Sahlgrenska Academy at the University of Gothenburg and Public Dental Service, Region Västra Götaland, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Dahlström
authors.forename: A
authors.initials: A
authors.lastname: Molander
authors.forename: C
authors.initials: C
authors.lastname: Reit
mesh_terms: D000328:Adult; D003762:Dental Instruments; D004498:Education, Dental, Continuing; D004708:Endodontics / Q000193:education*; D005260:Female; D005792:General Practice, Dental / Q000193:education*; D006801:Humans; D008297:Male; D009532:Nickel; D019239:Practice Patterns, Dentists' / Q000706:statistics & numerical data*; D011636:Public Health Dentistry / Q000193:education*; D011861:Radiography, Dental; D011795:Surveys and Questionnaires; D013548:Sweden; D014025:Titanium
chemical_list: C040654:titanium nickelide; D009532:Nickel; D014025:Titanium
keywords: adoption; continuing education programme; endodontics; general dental practitioner; local network; nickel-titanium rotary instrumentation; root-filling quality; substandard performance