Three‐dimensional printed model of impacted third molar for surgical extraction training

Abstract

Objectives: Extraction of impacted mandibular third molars is one of the most common surgical procedures performed at dental clinics; however effective training models for teaching oral surgery to dental students are limited. This study aimed to use three-dimension (3D) printing technology to develop an effective training model for impacted third molar extraction. Methods: The data for the 3D model were digitally processed using highresolution computed tomography, and two common, but different patterns of impacted third molars were simulated using computer-aided design. Thereafter, the model was printed using the 3D-printing technology, and the efficiency of the 3D-printed model and an animal model (pig mandible) were compared using a five-point Likert scale by 35 oral surgeons in the oral surgery department and 208 students of stomatology in the internship stage. Results:The 3D-printed model consisted of three parts: a non-replaceable part (i.e., the body of the mandible and the teeth from the left first molar to the right first molar) and two replaceable parts (i.e., the part of the ascending ramus of the mandible, as well as the second and third molars). It was covered with a layer of rubber-like material to simulate the gingiva. For the comparison between the 3D-printed and animal models, a total of 205 questionnaires were collected. Both oral surgeons and students agreed that the 3D-printed model was better than the animal model in terms of total value and the anatomy of the bone and teeth, simulating the surgical procedure (p < 0.05), while the two models achieved similar results for haptic feedback of the soft tissue (p > 0.05). Conclusions:The 3D-printed model is realistic and effective for learning impacted third molar extraction and received positive feedback from students and oral surgeons. This model can significantly improve the pre-clinical skill training of dental students.

3D‐printed model for gingival flap surgery simulation: Development and pilot test

“…In consideration of the ethics central to medical practice, the use of 3D-printed models is an alternative to cadaveric and animal models. 10,18 Thus, the current trend is to reproduce pathological situations based on 3D images of patients, which are then reconstructed in STL format and 3D printed. 10,32,35 Our model provides reproducibility and printability on a large scale, which is interesting in the context of surgical training and improvement.…”

“…Cadaveric models remain the gold standard for oral surgery simulation. In consideration of the ethics central to medical practice, the use of 3D‐printed models is an alternative to cadaveric and animal models 10,18 . Thus, the current trend is to reproduce pathological situations based on 3D images of patients, which are then reconstructed in STL format and 3D printed 10,32,35 .…”

“…Meanwhile, there are various limitations to the use of oral surgery simulators. A fundamental disadvantage is the absence of bleeding on incision, which is required to make the training more realistic 18,21 . In this context, it is important to incorporate anatomical elements, such as nerves, arteries and veins, and highlight them to make the simulation more realistic.…”

“…10,18,19 This is because mucosal flap surgery is mostly taught on cadavers or theoretically, previous studies have reported difficulties in reproducing soft tissues and the cost of 3D printing remains very high. 20 In addition, various materials have been used to replicate the gingiva, 18,[21][22][23][24] but they lack accurate anatomical reproduction and resistance to tearing during surgical procedures. 10,18 The present study aimed to develop and evaluate a computeraided design (CAD)-based surgical simulator for intraoral mucosal flaps.…”

“…Although promising, the use of simulators for oral flap surgery remains limited. 10,18,19 This is because mucosal flap surgery is mostly taught on cadavers or theoretically, previous studies have reported difficulties in reproducing soft tissues and the cost of 3D printing remains very high. 20 In addition, various materials have been used to replicate the gingiva, 18,[21][22][23][24] but they lack accurate anatomical reproduction and resistance to tearing during surgical procedures.…”