CBCT-Based 3D-Printed Simulation Model for Pediatric Dental Trauma Training

Abstract

Pediatric traumatic dental injuries require immediate, evidence-based treatment to avoid long-term consequences such as pulp necrosis, root resorption, ankyloses, and loss of teeth. Despite their clinical relevance for the early management of traumatic events, many dental students do not receive sufficient practical experience of managing these high-risk situations, resulting in a wide gap between academic knowledge and clinical competence. This study aimed at developing and testing a high-fidelity, CBCT-based, 3D printed simulation model for teaching dental students dental trauma management. A CBCT scan from an 11-year-old- pediatric patient was digitized, segmented, and modified to create a three-dimensional digital model of a pediatric maxilla. The model incorporated an avulsed permanent incisor, a complicated crown fracture and built-in channels that allowed simulated bleeding from both the socket and pulp exposure. During the simulation, students performed tooth replantation, Cvek pulpotomy, and flexible splinting. Twenty-five third- and fourth-year dental students participated in a one-time group-based pre-test-post-test educational intervention. Students completed pre-and post-simulation evaluations assessing their trauma-related knowledge, confidence and preparedness. Objective knowledge proficiency was determined through case-based questions and procedural accuracy was evaluated before the simulation using a competency rubric. After completing the simulation, students provided ratings on the realism, educational value, stress level and fidelity of the model. Students demonstrated statistically significant gains in all knowledge and confidence domains after participating in the simulation. Statistically significant improvement included protocol knowledge (by 5.2 points [95% CI: 4.4–6.0; p < 0.001]), trauma management confidence (by 5.0 points [95% CI: 4.1–5.8; p < 0.001]) and bleeding control (by 4.5 points [95% CI: 3.6–5.3; p < 0.001]). Statistically significant objective gains occurred primarily in areas where they had shown deficits in pre-simulation knowledge. Additionally, the students rated the model highly in terms of realism, recommendation, engagement, and preference to lecture-based learning (with several median scores being 10). In addition, the students rated simulated bleeding, replantation, splinting, and Cvek pulpotomy elements very highly, supporting the model’s procedural and technical fidelity. Prior to structured instruction or repetitive practice, baseline procedural accuracy was found to be moderate with a mean score of 67.2% ± 8.4%. This indicates that students did not possess full procedural competence prior to receiving instructional or practicing repeatedly. This study demonstrated that a CBCT-based, 3D-printed pediatric dental trauma simulation model can enhance students' knowledge and confidence regarding managing pediatric dental trauma. Furthermore, the study identified significant baseline deficiencies in students applied procedural skills. The model received positive perceptions in terms of its realism, engagement, and value as an educational tool, which supports its use as a teaching tool and an evaluation instrument.