Perceived Realism of 3D-Printed Teeth, Extracted Human Teeth and Clinical Patient Cases in Endodontic Training: A Within-Subject Study
This study found that while extracted human teeth offer the highest perceived realism compared to clinical cases for endodontic training, current 3D-printed models serve as valuable standardized and ethical adjuncts despite their lower fidelity, particularly in procedures requiring tactile feedback.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
Learning to treat a tooth that has a damaged nerve requires a delicate touch and a steady hand. Before a student ever works on a living patient, they must practice on models that mimic the inside of a real mouth. For decades, the standard for this practice has been teeth pulled from people who have lost them. These natural teeth offer a perfect map of the complex, winding tunnels inside a root, but they are becoming harder to find, and using them raises questions about ethics and safety. In recent years, technology has offered a new path: three-dimensional printed models. These artificial teeth are created by machines that layer material to build a replica of a tooth, complete with the tiny channels where a dentist must work. They promise a solution that is always available, perfectly identical from one to the next, and free from biological risks. But the crucial question remains: do these plastic replicas feel and act like the real thing, or is there a gap between the simulation and the reality a student will face in a clinic?
A team of researchers at Heinrich Heine University in Düsseldorf set out to answer this question by asking recent dental graduates to compare the different ways they learned to clean out tooth roots. They gathered twenty new dentists who had just finished their final exams and asked them to rate how realistic three different training tools felt. The first tool was the gold standard: actual teeth extracted from patients. The second and third were two different brands of 3D-printed teeth, known as TrainyDent and Frasaco, which are widely used in German dental schools. To make the comparison fair, the researchers also used the students' own experiences treating real patients as the ultimate benchmark for what "real" feels like. The students performed the same eight steps of a root canal treatment on each type of model, from drilling the opening to sealing the final filling, and then rated how closely each step matched the feeling of working on a live human tooth.
The results were clear and consistent across every stage of the procedure. When the students rated the realism of the training tools on a scale from zero to ten, with ten being identical to a real patient, the extracted human teeth scored the highest, averaging a score of 7.51. The 3D-printed models scored lower, with the TrainyDent brand averaging 6.07 and the Frasaco brand averaging 5.55. This difference was not a matter of opinion on a single step; it held true for every part of the treatment, including finding the tiny openings of the canals, shaping the inside, and filling the space. The researchers found that the artificial models felt noticeably different from natural teeth, particularly when it came to the physical sensation of cutting and moving instruments inside the root. The natural teeth provided a tactile feedback that the plastic models could not fully reproduce, likely because the materials used to print the teeth are harder and behave differently than the complex structure of a real tooth.
Despite the lower scores for realism, the study does not suggest that 3D-printed teeth are useless. The researchers emphasize that these models offer something that natural teeth cannot: a standardized, repeatable, and ethical way to practice. Because every printed tooth is made to the exact same specifications, every student faces the same challenge, which is vital for fair testing and consistent learning. The study suggests that while these artificial tools may not yet feel exactly like a real tooth, they serve as valuable practice partners that help students build confidence and skill before they ever touch a patient. The findings indicate that the future of dental training will likely involve a mix of both approaches, using the consistency of printed models to build a foundation and the unpredictability of real teeth to refine the final skills needed for clinical care.
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