Perceptual Evaluation of 3D-Printed Typodont Teeth with Comparable Cutting Forces.

Background

Pre-clinical training in endodontics relies heavily on typodont teeth to develop operative skills before patient care, but conventional polymer-based typodonts differ from human teeth in their cutting response, requiring greater force and producing an unrealistic cutting experience that often dissatisfies students.

Methods

This study evaluated four alternative 3D-printed typodont materials-15 wt.% carbonated hydroxyapatite, 15 wt.% Puraflake® (glass flake filler), 15 wt.% zinc oxide, and a urethane/triethylene glycol dimethacrylate resin composite-based on their cutting force, post-cut surface roughness, and perceived cutting feel relative to extracted enamel, assessed via a five-point Likert scale questionnaire completed by 46 (n = 46) fourth- and fifth-year dental students.

Results

No statistically significant differences in cutting force were detected between the four printed materials and extracted enamel, a finding confirmed using formal two one-sided equivalence testing (TOST); larger confirmatory studies would allow this equivalence to be established with greater statistical precision. Perception scores differed significantly between materials, and fifth-year students rated the dental resin composite significantly more favourably than fourth-year students, with only the composite effect surviving stringent Bonferroni correction across all four material comparisons, underscoring the reliability of this specific finding. Post-cut surface roughness showed a strong, statistically robust monotonic association with perception scores at the individual-respondent level (Page's L trend test, n = 46, p < 0.001), suggesting that surface behaviour during material removal may contribute to perceived haptic similarity.

Conclusions

Matching cutting force alone does not guarantee perceptual equivalence. Among the materials tested, the dental resin composite most closely approximated extracted-enamel surface roughness, received the most favourable and consistent perception scores, and is recommended as the preferred material for pre-clinical typodont fabrication where accessible. These 3D-printed typodonts offer a standardised, openly documented alternative to commercial typodonts for pre-clinical training, with digital models and manufacturing workflows openly available via an institutional platform (TactiTooth).