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Effect of Training Sequence on Learning Outcomes Using a Haptic Virtual Simulator for Endodontic Access Cavities: A

Andreina Fernandes da Silva1, Thais Pereira1, Ángel Arturo López-González1

  • 1School of Dentistry, ADEMA University School, 07009 Palma, Spain.

Dentistry Journal
|February 26, 2026
PubMed
Summary

The order of haptic simulation and natural-tooth practice does not impact early endodontic skill acquisition in dental students. Both training methods offer complementary learning benefits for access cavity preparation.

Keywords:
dental educationendodonticshaptic simulationlearning curvepsychomotor skillsvirtual reality

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Area of Science:

  • Dental Education
  • Endodontics
  • Simulation-Based Training

Background:

  • Haptic virtual simulators are increasingly used in dental education.
  • The impact of training sequence (simulation-first vs. natural-tooth-first) on early endodontic skill acquisition is not well understood.

Purpose of the Study:

  • To compare the effect of two training sequences on endodontic access cavity preparation performance.
  • Investigate haptic simulation followed by natural-teeth practice versus the reverse sequence.

Main Methods:

  • Thirty-eight dental students were randomized into two groups.
  • Participants completed training attempts on a haptic simulator (Simodont®) and extracted teeth.
  • Performance was assessed using simulator metrics and blinded endodontist scoring; data analyzed with Mann-Whitney U, Wilcoxon signed-rank, and linear mixed-effects models.

Main Results:

  • No significant differences in simulator metrics or natural-tooth performance were found between the two training sequences.
  • Students showed significant improvement on the simulator between the first and second attempts, followed by a plateau.
  • Mixed-effects modeling confirmed overall learning improvement, independent of training sequence.

Conclusions:

  • The sequence of haptic simulation and natural-tooth practice does not influence learning outcomes or the quality of endodontic access preparations.
  • Early performance gains indicate a rapid familiarization effect with simulators.
  • Haptic simulation can be flexibly integrated into preclinical curricula without compromising educational effectiveness.