A 3D-Printed Tooth Simulation Model for Electronic Apex Locator Training: A Feasibility Study

In current pre-clinical endodontic education, extracted human teeth are the primary resource for students, and Commission on Dental Accreditation (CODA) has no requirements mandating usage of electronic apex locators (EALs). The introduction of digital dentistry has improved the ability to create simulation models for pre-clinical education. While previous studies have confirmed the accuracy of EALs and explored the usage of EALs in simulation models, no study has documented the exposure and importance of pre-clinical education using EALs. The primary objective of this study is to assess the feasibility and educational value of integrating Cone-Beam Computed Tomography (CBCT)-derived 3D-printed tooth replicas into a conductive simulation model for EAL training. By capturing a CBCT of an extracted human tooth, a 3D-printed tooth replica was created and integrated into a simulation model. The model included a conductive circuit that allowed the use of an EAL. Twenty-three pre-doctoral dental students each recorded the working length at five identically configured stations (115 measurements in total) and completed pre- and post-activity surveys. Overall, 59.1% of all measurements achieved clinical accuracy within ±0.5 mm of the actual working length. Self-reported confidence in EAL use increased significantly (from 3.14 to 4.09 on a five-point scale; p = 0.015), whereas the increase in self-rated theoretical understanding (p = 0.106) and the decrease in anxiety (p = 0.349) were not statistically significant. The CBCT-derived conductive simulation model was a feasible, functional platform for preclinical EAL training and was associated with improved self-reported confidence; whether these gains translate into improved clinical performance remains to be determined.