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

Abstract

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).