Optimization and Preclinical Perception of an Artificial Simulator for Endodontic Training: A Preliminary Study

Endodontic training requires realistic simulation tools to develop proper canal preparation skills. Traditional training methods often rely on extracted teeth or synthetic materials that may not fully replicate the clinical experience. While hydroxyapatite ceramics have been explored for their similarity to dentin, they lack the organic components found in natural teeth. This gap motivated the development of a ceramic simulator enhanced with epoxy resin infiltration to better mimic the mechanical and visual properties of real dentin. Prior research has shown that synthetic materials can influence student perception and learning outcomes, but no prior work had resolved the specific impact of resin infiltration on ceramic-based simulators. The need for a more realistic training aid is clear, as it could improve tactile feedback and radiographic visualization during practice. Current training tools remain limited in their ability to simulate the organic phase of dentin, which affects the realism of the learning environment. This limitation suggests that further refinement of ceramic simulators could enhance student performance and satisfaction. The challenge lies in balancing material properties to achieve both durability and clinical realism.

This preliminary study aimed to assess the effectiveness of a resin-infiltrated ceramic root canal simulator in endodontic training. The researchers sought to determine whether adding epoxy resin to a hydroxyapatite ceramic matrix could improve the simulator's performance compared to non-infiltrated ceramic and commercial plastic alternatives. The specific problem addressed was the lack of realistic tactile and radiographic feedback in existing simulators, which may hinder student learning. The motivation for this study stemmed from the need to develop a more accurate training aid that better mimics clinical conditions. By comparing student perceptions and canal preparation outcomes across three materials, the study aimed to identify the most suitable simulator for preclinical training. The goal was to evaluate whether resin infiltration could enhance realism without compromising usability. The study focused on student satisfaction and tactile feedback as key indicators of simulator performance. The researchers also aimed to assess whether the simulator's design influenced the quality of canal preparations on extracted teeth.

The study utilized a hydroxyapatite ceramic root canal simulator modified with epoxy resin infiltration. The ceramic matrix was vacuum infiltrated with epoxy resin to simulate the organic phase of dentin. Methylene blue staining was used to evaluate the degree of resin infiltration. Three simulator types were compared: resin-infiltrated ceramic (CR), non-infiltrated ceramic (C), and a commercial plastic bloc (P). Thirty dental students from a single French dental school participated in the study. Each student performed endodontic exercises using all three simulators. A questionnaire was administered to assess student perceptions, including satisfaction with radiographic visualization and tactile sensation. Canal preparations were also evaluated using a master cone try-in test on extracted teeth. The study was conducted in 2016, and data were collected to compare perceptions and outcomes across the three groups. The vacuum infiltration process was critical to achieving realistic material properties in the ceramic simulators.

Vacuum infiltration resulted in a high degree of epoxy resin penetration into the ceramic matrix, as confirmed by methylene blue staining. Student perceptions indicated higher satisfaction with ceramic simulators (C and CR) compared to the commercial plastic bloc (P), particularly in terms of radiographic visualization. The CR group reported greater tactile sensation than the P group, suggesting improved realism in the ceramic simulators. No significant differences were observed among the three groups in canal preparations on extracted teeth. The questionnaire revealed that the CR and C simulators were generally preferred over the P bloc in terms of usability and feedback. The resin infiltration process enhanced the performance of the ceramic simulator in perception-based tasks. Student satisfaction scores were highest for the CR and C groups, especially regarding tactile feedback and radiographic clarity. The results suggest that resin infiltration improves the ceramic simulator's ability to mimic clinical conditions during training.

The study found that resin infiltration improved the performance of the ceramic root canal simulator, particularly in terms of student perception during instrumentation. The CR simulator was rated higher than the commercial plastic bloc in tactile sensation and radiographic visualization. These findings suggest that resin-infiltrated ceramic may offer a more realistic training experience compared to non-infiltrated ceramic and plastic alternatives. The authors propose that the vacuum infiltration process effectively mimics the organic phase of dentin, enhancing simulator realism. No significant differences were observed in canal preparations across the three groups, indicating that material choice may not affect technical outcomes. The authors suggest that larger-scale investigations are needed to confirm these preliminary findings. Experienced endodontists should also be involved in future assessments to validate the model's effectiveness. The study supports the potential of resin-infiltrated ceramic as a viable preclinical training aid.