Yes, practicing is worth it! We live in the era of digital orthodontics, in which some beginners can be dazzled by the technologies offered to move teeth. There are even those who celebrate the supposed lack of need to bend wires in current orthodontics.
Without going into the merit of this strange celebration (after all, every dentist should like to develop their manual skills, shouldn't they?), This post aims to clarify those students who are FEAR of bending wires, claiming a lack of innate ability for this type of task.
The good news is that: yes, you can! You can learn to bend wires relatively easily. Just like any other motor activity that requires training, the first movements (and results) are difficult and discouraging. But with practice and a little persistence, your manual dexterity changes significantly. This is what a recent study conducted at the University of Pécs in Hungary has showed. (1)
Freshmen dental students were divided into two groups (n = 15). The “trained group” was submitted to a 10-week course (1 hour / week) to improve manual dexterity. Activities included free drawing, wax sculpture of geometric shapes and teeth, soft wax modelling and wire bending. The control group did not participate in the training. Before and after the course, the volunteers underwent manual dexterity tests (semi-subjective and objective evaluation-Fig 1) and functional magnetic resonance (MRI) imaging of the cerebellum.
The wire bending HAM-Man test (Hamburg Assessment Test for Medicine-Manual Dexterity) was first assessed with the Likert scale. The objective evaluation included the comparison of pixel numbers related to the areas of specific bends performed in chromium wires (150 mm length and 0.8 mm diameter). The first shape was an equilateral triangle, the second one was a three-dimensional bent shape and the third one was a two-dimensional shape that contained three waveforms. Image from Siman, B., Janszky, J., Perlaki, G. et al. Sci Rep 11, 6188; 2021 (1).
The results of manual dexterity tests of the trained group showed significant elevation, while there was no notable increase in the control group. The results of MRI measurements demonstrate a significant increase in the grey matter volume in both sides of the cerebellum of the trained group, indicating that these neuroanatomical changes were due to the training of manual skills.
RELEVANCE AND FUTURE PERSPECTIVES
Although the study has some limitations (the group of participants was small, and the length of the training course was a quite short), the results show that the training of manual skills, for a relatively short period of time, can significantly stimulate the development of dexterity in dental students. Moreover, this post-training improvement is measurable with MRI and HAM-Man dexterity tests.
The effects on the volume of cerebellar gray matter are remarkable. Most neurons in the brain are located in the cerebellum, and its functions on balance, speech, eye and limb movements are well established. The cerebellum is essential for processing visual feedback during visually controlled movements and predicting the sensory interpretation of motoric events. It is also involved in mental skills such as learning, cognition, and language. (2,3) The mechanisms responsible for the gray volume changes were not explained in the mentioned study. However, several related studies revealed that volumetric changes as measured by morphometric MRI methods correlate strongly with the presence of axon growth and synaptic reorganization.
To conclude, I found the optimistic message extracted from this study very interesting: manual skills can (and should) be improved! Let's use this high cerebellar plasticity to our advantage. You don't have to be a “Michelângelo of the archwires”, but yes, you can improve. Especially for students with greater difficulties, specific training courses can play a fundamental role in their preparation for clinical practice.
I end this post with a gift to motivate you to practice the art of bending wires. Download our manual of rectangular loops and learn more about one of the most versatile and efficient tools of the orthodontic clinic. Enjoy!
1- Siman, B., Janszky, J., Perlaki, G. et al. Course induced dexterity development and cerebellar grey matter growth of dentistry students: a randomised trial. Sci Rep 11, 6188 (2021).
2- Jung, KI., Park, MH., Park, B. et al. Cerebellar Gray Matter Volume, Executive Function, and Insomnia: Gender Differences in Adolescents. Sci Rep 9, 855 (2019).
3- Koppelmans V, Hirsiger S, Mérillat S, Jäncke L, Seidler RD. Cerebellar gray and white matter volume and their relation with age and manual motor performance in healthy older adults. Hum Brain Mapp. 2015;36(6):2352-2363.