Peyton’s Approach in Teaching Access Cavity Creation and Root Canal Location: A Report from one Institution

Abstract

Objective: Access cavity preparation and location of the
root canals are important stages in root canal therapy.
The traditional see one-do one method of clinical
instruction has been used in teaching these skills.
However, newer methods of instruction in surgical skill
acquisition have been advocated. The Peyton’s four steps
of instruction approach promotes active participation in
the learning process by the learner. It represents a lowtechnology
alternative to the traditional see one-do one
approach for teaching surgical skills in a developing
country like Nigeria. The study sought to compare access
cavity preparation and root canal location among a group
of junior residents using the traditional see-one-do-one
approach; and the Peyton’s four steps of instruction
approach.
Methods: Ten consenting participants were randomly
selected and divided into two groups A and B
representing the see one-do one and Peyton’s approach
groups. The participants crossed over after a 6-week
washout period. The participants created access cavities
and located root canals in plaster mounted lower first
molars. The time taken for the task and the angle of flare
of the mesio-axial wall from the long axis of the mesiobuccal
canal were recorded.
Results: The mean time for the traditional method was
547seconds ± 204, while that for the Peyton’s technique
was 425 seconds ± 138. The mean angulation for the
traditional technique was 430 ± 14.9, while the mean
angulation for the Peyton’s technique was 300 ± 13.3.
Paired t-tests showed that the mean angulation recorded
with the Peyton’s technique was significantly less than
that recorded with the traditional technique (p=0.04),
while the difference in times did not attain significance
(p=0,08)
Conclusion: The outcomes with the Peyton’s approach
were significantly better than the outcomes with the
traditional methods in this study