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. 2022 Dec 21;20(1):90.
doi: 10.3390/ijerph20010090.

Assessment of 3D-Printed Tooth Containing Simulated Deep Caries Lesions for Practicing Selective Caries Removal: A Pilot Study

Piyaphong Panpisut  1   2 , Patchayaporn Doungkom  3 , Chawal Padunglappisit  1 , Worachate Romalee  1   4 , Nattira Suksudaj  1
Affiliations

Assessment of 3D-Printed Tooth Containing Simulated Deep Caries Lesions for Practicing Selective Caries Removal: A Pilot Study

Piyaphong Panpisut et al. Int J Environ Res Public Health. .

Abstract

A standard model for practicing caries removal skills is needed to support learners in managing deep carious lesions. The aim of the current study was to prepare 3D-printed teeth with added simulated carious layers and a pulpal structure. A first permanent mandibular containing occlusal (Class I) or proximal (Class II) cavities was printed. The teeth were then filled with wax and resin-modified glass ionomer cements mixed with a color modifier to simulate pulp and deep caries, respectively. Undergraduate dental students (n = 61) were asked to remove the caries using the selective caries removal (SCR) technique on the teeth. The students then completed a self-administered questionnaire to rate their caries removal experiences. One instructor then assessed the prepared teeth. Overall, the students provided positive feedback on the use of 3D-printed teeth; 72.1% agreed that the printed teeth provided a realistic model for practicing the SCR technique, 75.4% indicated that the new teeth were the appropriate choice for practicing the SCR technique, and 86.9% agreed that 3D-printed teeth should be used before treating real patients. More than half of the students had satisfactory outcomes in terms of the depth and caries removal aspects of the cavity preparation. These findings suggest that the developed 3D-printed teeth can potentially be adopted to practice caries removals in preclinical dental education.

Keywords: 3D printing; dental caries; dental education; dental students; operative dentistry; selective caries removal.

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Conflict of interest statement

N.S., P.P. and P.D. are the inventors of the 3D-printed teeth used in the current study. The 3D-printed teeth are a pending patent titled “Tooth with simulation caries for dental arch model” (no: 2201001101), which is under consideration for patent registration by the Department of Intellectual Property, Ministry of Commerce, Thailand. The funder had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

Figures

Figure 1
Figure 1
3D images of the permanent lower-left first molar with the occlusal cavity.
Figure 2
Figure 2
3D images of the permanent lower-left first molar with the proximal cavity.
Figure 3
Figure 3
The steps to create a Class I cavity. (A) We filled the tooth with red-colored dental wax from the bottom side to mimic the dental pulp. (B) We filled the tooth with RMGIC mixed with a color modifier for ~3 mm to mimic a caries lesion. The light-curing time was 5 s. (C) We filled the final layer with a nanofilled resin composite. We created the small opening to guide the students to the location of cavitated caries.
Figure 4
Figure 4
(A,B) Class II cavities in proximal surfaces. (C,D) We filled the cavities with RMGIC mixed with the color modifier. (E) We placed the tooth in a model. A slight dark shadow (arrows) can be observed underneath the marginal ridges, which could indicate the location of caries lesions.
Figure 5
Figure 5
Percentage of each answer for each item on the questionnaire assessing the use of the 3D-printed teeth.
Figure 6
Figure 6
Example of the task completed after cavity preparation. Class I (A) and II (B) with remaining caries over the pulp to prevent pulp exposure. The peripheral margin of the prepared cavity was in the sound tooth structure. Excessive wax appeared when the preparation was too deep (C).
Figure 7
Figure 7
Percentage of grades for each parameter evaluated for the occlusal cavity task.
Figure 8
Figure 8
Percentage of grades for each parameter evaluated for the proximal cavity task.
See this image and copyright information in PMC

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