Private Office, Gelsenkirchen, Germany.
Department of Periodontology and Operative Dentistry, University of Münster, Münster, Germany.
Int Endod J. 2020 Jul;53(7):1007-1016. doi: 10.1111/iej.13299. Epub 2020 Apr 19.
To evaluate a modular 3D print training dental model with embedded human teeth and electronic working length determination for undergraduate endodontic education.
Cone-beam volume tomography data of a human skull were transferred into stereolithographic (STL) data, and a customizable modular 3D print model with individually removable sextants and teeth was generated for the use in commercially available phantom heads. Each of sixty-eight students performed a complete root canal treatment on an extracted human tooth. Working lengths were determined with electronic apex locators (EAL) and verified radiographically. Subsequently, an evaluation was carried out with regard to the difficulty of the working steps access cavity preparation, working length determination, root canal preparation/irrigation and canal filling, and these steps were compared to commonly used benchtop models. Additionally, the agreement of electronic and radiographic working length determination was assessed and analysed statistically with the chi-square test.
A total of 68 teeth (20 incisors, 26 premolars and 22 molars) with 127 root canals were treated. In total, 87% of the students considered the modular 3D print model considerably more demanding than the conventional benchtop model. Overall, 96% felt better prepared for the clinical situation, 92% felt markedly reduced stress levels during endodontic practice in the subsequent clinical courses, and 93% of the students suggested the model should be used in future preclinical endodontic training. The preradiographic use of EAL resulted in 85% of the cases having radiographically acceptable working length determination within 0-2 mm from the radiographic apex. Readings more than 2 mm from the apex or beyond were significantly more common in molars than in premolars and incisors (P < 0.05).
The vast majority of students rated the modular 3D print training model positively despite it being more demanding. They also recommended its use in preclinical teaching and training. The model allowed a more realistic simulation of the clinical situation with a simultaneous use of EALs and led to reduced stress levels in endodontic treatment in the subsequent clinical courses.
评估一种带有嵌入式人牙的模块化 3D 打印培训牙科模型和电子工作长度测定在本科生牙髓教育中的应用。
将人体颅骨的锥形束容积断层扫描数据转换为立体光刻（STL）数据，并生成可定制的模块化 3D 打印模型，该模型具有可单独拆卸的六分仪和牙齿，用于商业上可用的幻影头。68 名学生中的每一位都对一颗拔出的人牙进行了完整的根管治疗。使用电子根尖定位仪（EAL）确定工作长度，并进行放射学验证。随后，对工作步骤（如：制备洞型、确定工作长度、根管预备/冲洗和根管填充）的难度进行评估，并与常用的台式模型进行比较。此外，还评估了电子和放射学工作长度测定的一致性，并使用卡方检验进行了统计学分析。
共治疗了 68 颗牙齿（20 颗切牙、26 颗前磨牙和 22 颗磨牙）的 127 个根管。总的来说，87%的学生认为模块化 3D 打印模型比传统的台式模型要求更高。总的来说，96%的学生认为他们对临床情况有更好的准备，92%的学生在随后的临床课程中根管实习期间感到压力明显减轻，93%的学生建议在未来的临床前牙髓培训中使用该模型。在放射学检查前使用 EAL，85%的病例在距根尖 0-2mm 范围内放射学上可接受的工作长度确定。在磨牙中，读数超过根尖 2mm 或超过根尖的情况明显比前磨牙和切牙更常见（P<0.05）。
尽管模块化 3D 打印培训模型要求更高，但绝大多数学生对其评价积极。他们还建议在临床前教学和培训中使用该模型。该模型允许更真实地模拟临床情况，同时使用 EAL，并且在随后的临床课程中根管治疗的压力水平降低。
