Slaczka Damian M, Shah Rishma, Liu Chuning, Zou Fei, Karunanayake Glen A
Endodontic Program, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Division of Craniofacial and Surgical Care, Department of Orthodontics, Indiana University School of Dentistry, Indianapolis, Indiana, USA.
Int Endod J. 2024 Nov 18. doi: 10.1111/iej.14171.
Competency in endodontic access cavity preparation requires key motor skills, good conceptual understanding, along with an appreciation of 3-dimensional pulp chamber anatomy. These are traditionally learned using natural or artificial teeth (AT) mounted within a phantom head (PH). Simodont® (Nissin Dental Products INC, JPN) is a haptic virtual reality simulator (HVRS) and offers an alternative to AT for training.
This study aimed to (1) evaluate the evolution in the performance of learners trained to prepare access cavities incorporating Simodont (test group) against learners trained on AT mounted within PH (control group), (2) determine learner acceptability of HVRS.
Forty dental students, with no prior endodontic training, were given instruction and video demonstration of access cavity preparation using a mandibular left 1st molar AT (LL6). Thereafter, they prepared an access cavity on PH mounted AT LL6. This provided a baseline record of performance. Participants were randomly assigned to the test or control groups. The test group (n = 22) trained using Simodont: preparing a virtual tooth LL6 for a period of 60 minutes with instructor feedback. The control group (n = 18) trained using AT LL6 on a PH for 60 minutes with instructor feedback. Subsequently, learners from both groups prepared an access cavity on an AT LL6 in a PH. This provided a re-evaluation record. Two calibrated examiners graded the teeth from the baseline and re-evaluation using rubric criteria; assigning scores with a grading range from 0 to 17. The examiners were blinded to which group the teeth belonged. Change in performance was determined by calculating the difference in assessment grade from baseline to re-evaluation. Scores which improved by 3 or more units were labelled improvers, all other scores were described as non-improvers.
Within the test group, the numbers of improvers were 5 (23%) versus 7 (39%) in the control group The difference failed to indicate statistical significance (p = .315). The Cohen kappa values for intra and inter-examiner agreement were 1.00 and 0.73 respectively.
The evolution of skills in learners trained using Simodont is comparable to those trained using AT. It is, therefore, reasonable to use Simodont, which was acceptable to learners, as an adjunct to AT for endodontic access cavity training.
根管治疗开髓洞形预备的能力需要关键的运动技能、良好的概念理解，以及对三维牙髓腔解剖结构的认识。传统上，这些是通过安装在模型头上的天然牙或人工牙来学习的。Simodont®（日本日进齿科产品有限公司）是一种触觉虚拟现实模拟器（HVRS），为培训提供了一种替代人工牙的选择。
本研究旨在（1）评估接受使用Simodont进行开髓洞形预备培训的学习者（试验组）与接受在模型头上安装人工牙进行培训的学习者（对照组）在操作表现上的变化，（2）确定学习者对HVRS的接受程度。
40名未曾接受过根管治疗培训的牙科学生，接受了使用下颌左第一磨牙人工牙（LL6）进行开髓洞形预备的指导和视频演示。之后，他们在模型头上安装的LL6人工牙上制备开髓洞形。这提供了操作表现的基线记录。参与者被随机分配到试验组或对照组。试验组（n = 22）使用Simodont进行培训：在教师反馈下，为一颗虚拟牙齿LL6制备洞形60分钟。对照组（n = 18）在模型头上使用LL6人工牙进行培训60分钟，并接受教师反馈。随后，两组学习者都在模型头上的一颗LL6人工牙上制备开髓洞形。这提供了重新评估记录。两名经过校准的考官根据评分标准对基线和重新评估时制备的牙齿进行评分；评分范围为0至17分。考官不知道牙齿所属的组别。通过计算从基线到重新评估的评估等级差异来确定操作表现的变化。分数提高3分或更多的被标记为进步者，所有其他分数被描述为未进步者。
试验组中进步者的数量为5名（23%），而对照组为7名（39%）。差异未显示出统计学意义（p = 0.315）。考官内部和考官之间一致性的Cohen kappa值分别为1.00和0.73。
使用Simodont培训的学习者技能的变化与使用人工牙培训的学习者相当。因此，将学习者可接受的Simodont作为人工牙的辅助工具用于根管治疗开髓洞形培训是合理的。
