Impact of Four-Handed Dentistry and Dental Assistant Support on Procedure Time and Treatment Quality: A Systematic Review
Dental assistant, National guard hospital.
Review Article
World Journal of Advanced Research and Reviews, 2024, 24(01), 2841-2847
Publication history:
Received on 15 September 2024; revised on 25 October 2024; accepted on 28 October 2024
Abstract:
Background: Four-handed dentistry, where a dentist works in close coordination with a trained dental assistant, is promoted as a way to improve efficiency, ergonomics and care quality. However, quantitative evidence on procedure time and treatment outcomes remains scattered. To systematically review clinical studies evaluating the impact of four-handed dentistry and structured dental-assistant support on procedure time and treatment quality in dental practice.
Methods: A systematic search of international databases identified clinical studies comparing four-handed dentistry or four-hand nursing cooperation with conventional two-handed or routine nursing approaches. Eligible studies reported procedure time and, or treatment quality indicators (complications, patient comfort, satisfaction, or cooperation). Data were extracted narratively, and risk of bias was appraised qualitatively.
Results: Seven clinical studies (all from dental clinics or hospitals, sample sizes 64–172) were included, mainly in endodontic root-canal therapy and mandibular impacted third-molar extraction. Across studies, four-handed dentistry consistently shortened key procedural steps (typically by about one-third), reduced intra- or short-term postoperative complications, and improved patient comfort, cooperation and satisfaction. One quasi-experimental study showed that structured four-hand training for oral specialty nurses reduced operation times and improved doctor and patient satisfaction. Overall study quality was moderate, with frequent lack of blinding and single centre designs.
Conclusion: Available evidence suggests that four-handed dentistry with active dental-assistant support can meaningfully reduce procedure time and improve short-term treatment quality, particularly in endodontics and minor oral surgery. Larger, multi-centre randomized trials in diverse settings are needed.
Keywords:
Four-handed dentistry; Dental assistant; Procedure time; Treatment quality; Ergonomics; Nursing cooperation
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Copyright © 2024 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0