Towards defining dental drilling competence, part 1: a study of bone drilling technique.

Technical skills are critical for dentists. Computer-based simulation offers a range of potential benefits for surgical training, but to date the development of simulators has not been characterized by a structured investigation of specific mechanisms by which trainees attain competence. This two-part study contributes to the understanding of the manner in which surgical psychomotor skills are acquired so that this knowledge can be incorporated into the design of training simulations. We studied participant groups of varying skill levels as they performed a drilling task in oral surgery. In this first part of our study, we investigated the elements of surgical technique and differences in the drilling performance of novice, competent, and expert dentists. Our results indicate that novice dentists employ a technique that differs considerably in drilling stroke length and duration from that employed by experts. Expert dentists perform faster, apply more force, lift the bur off the bone less, and produce superior results compared with novices.