roots C.E. - the international magazine of endodontology

I training_ 3D-printed dental replicas Recent advances in 3D-printed dental replicas for procedural training and board exams Author_L. Stephen Buchanan, DDS, FICD, FACD Fig. 1_3D-printed dental board exam replica embedded in rubber sleeve, allowing complete standardization between candidates and examiners for the first time, while it eliminates the need by the student to find acceptable extracted teeth and for examiners to check and approve candidate’s choices. This sleeve fits in commonly used typodont cavities. (Photos/Provided by Dr. L. Stephen Buchanan) Fig. 2_Radiograph of exam replica after a candidate’s finished endodontic procedure. Fig. 3_Molar exam replica in typodont cavity with apex locator leads attached. Figs. 4a, b_Practice replica with reusable rubber sleeve. This sleeve allows multiple inexpensive practice sessions without the need to buy new typodont modules, yet it delivers the same ideal apex locator function as the more expensive exam replicas. _Medical and dental procedural training has always had the severe limitation of being done on living patients in a one-on-one preceptorship basis unless cadavers are used. But cadavers are severely regulated and short in supply, thus quite expensive, as well as being biohazardous and creepy. A common alternative, of training dentists to do implant sur- gery in pig jaws, allows only the most fundamental procedures to be practiced — none of which present doctors with the case-by-case, on-the-fly treatment planning decisions that must be honed to empower predictable success when tissues have been incised and soft-tissue flaps have been reflected. In this light, 3D-printed dental replicas offer an amazing paradigm shift in dental procedural train- ing. Impossible otherwise, 3D printing authentically reproduces human anatomy in much the same way body parts are created — through additive means — rather฀than฀by฀reductive฀CAD/CAM฀milling฀of฀mate- rial blocks or by injecting material into the limited geometry of molds. Stereo-lithography offers the ability to re-create internal morphology just as hu- man bodies do, layer by layer. Multi-ink printers even allow both hard and soft tissues to be replicated in a single training jaw. It has been truly fortunate that we can train dentists to do endodontic procedures in human extracted teeth that are no longer attached to their original owners; however we are still faced with the random endodontic anatomy that presents as col- lected in extracted tooth jars. With extracted teeth, educators cannot choose the exact anatomic chal- lenge presented to their students to satisfy a given training objective, nor do they typically know what is inside all of the student’s practice teeth during a hands-on course. When we control the anatomy that is practiced in, educators can better control the students’ experience and further shorten their learn- ing curve.1,2 Beyond that, when students fail to achieve their procedural objective in an extracted tooth, there are no do-overs, thus it is a truism that it typically takes hundreds of endodontic procedural experiences in extracted teeth and patients’ root canal systems be- fore predictable competence can be achieved. Airline pilots, astronauts, musicians, police and soldiers are all taught with simulation exercises that allow itera- tive improvements in skill sets, something that has previously been impossible in dental and medical procedural training. When we consider traditional methods of train- ing health care professionals to do dangerous procedures safely in human beings, it becomes obvious that medical and dental education is dif- ferent than almost every other endeavor to create human competence in complex processes. Thus 3D-printed replication has and will continue to change everything about conventional and surgi- cal training. This article describes recent advances beyond the printing of individual teeth for endo- Fig. 1 Fig. 2 Fig. 3 12 I roots 1_ 2017 Fig. 4a Fig. 4b

roots C.E. - the international magazine of endodontology

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