Pre‐clinical endodontic education outcomes between artificial versus extracted natural teeth: a systematic review

Abstract

Aim To compare the educational outcomes using artificial teeth versus extracted teeth for pre‐clinical endodontic training. Data sources Literature searches of PubMed, Scopus, Cochrane Library, Trip Database, Web of Science and Open Grey databases were conducted from their inception until November 2018 with no language restriction. Hand searching of most likely relevant journals was performed. The review followed the PRISMA guidelines. Study eligibility criteria, participants and interventions Studies that compared pre‐clinical endodontic training using extracted teeth and artificial teeth were included. Study appraisal and synthesis methods The quality of included studies was appraised by Joanna Briggs Institute Critical Appraisal tools. The findings were tabulated and summarized according to their outcomes with distinct narrative syntheses. Results Five studies were included. The component studies included 359 operators in total, mainly consisting of undergraduate students (97%, n = 349) and 10 endodontists (3%). Forty‐seven per cent (n = 170) operated on artificial teeth only, whilst 19% (n = 67) worked primarily on extracted teeth, with the final treatment outcome being evaluated by independent observers using objective criteria. Operators in two studies (34%, n = 122) used both artificial teeth and ET and compared their experiences in surveys. Regarding technical outcomes, no significant differences between training with artificial teeth and extracted teeth were found, but the performance tended to be better in artificial teeth than extracted teeth. Operators trained solely on artificial teeth appeared to be adequately educated for subsequent root canal treatment (RCT) in the clinical setting. Limitations Due to the scarcity of research on the topic overall, and the methodological variation between the studies, it was not possible to perform a quantitative analysis (meta‐analysis). Conclusions and implications of key findings Based on the available evidence, the use of artificial teeth for pre‐clinical endodontic training achieved similar educational outcomes compared to extracted teeth. However, the experiences reported by the operators diverged. Further studies assessing other artificial teeth available in the market testing other RCT procedures are necessary.

The accuracy of electronic apex locators for determining working length: An in vitro study with artificial teeth

“…The artificial teeth used in the present study were made from composite polyester resin and present similar anatomical characteristics to human teeth albeit with fewer anatomical challenges. They are routinely used for pre‐clinical endodontic training allowing students to perform and practice accessing cavities, root canal instrumentation and obturation (19,30). Artificial teeth have been proposed as a suitable alternative to extracted teeth and their use has been shown to achieve similar educational outcomes compared with extracted teeth.…”

“…Artificial teeth have been proposed as a suitable alternative to extracted teeth and their use has been shown to achieve similar educational outcomes compared with extracted teeth. (30). Both deciduous and permanent artificial teeth made from resin have also been used to evaluate the performance of EALs with similar methodology to the one used in present study, and do not interfere with the EAL results, and their anatomy enables the impedance mechanism, which is essential for EAL function (19).…”

Percepção de docentes de Odontologia sobre o uso de dentes humanos como recurso educativo em atividades pré-clínicas

“…Mais recentemente, uma revisão sistemática da literatura 15 buscou comparar os resultados educacionais que poderiam ser alcançados com o uso dentes artificiais versus dentes extraídos, especificamente para treinamento endodôntico préclínico. Foram incluídos apenas cinco estudos que totalizaram a avaliação de 359 operadores, sendo 349 (97%) estudantes de graduação e 10 (3%) endodontistas.…”

Difficulty levels of extracted human teeth used for pre‐clinical training in endodontics in an Australian dental school

“…Various artificial models to simulate root canals have been made from resin blocks, plastic, or 3D printed. No difference has been observed in regard to skill and endodontic outcomes of students after training with artificial teeth and extracted human teeth in pre‐clinical learning , though artificial teeth are perceived to be dissimilar by operators . A further option is the use of information technology, which has modernised certain aspects of education and has affected endodontic teaching .…”