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 Table of Contents  
SHORT COMMUNICATION
Year : 2022  |  Volume : 14  |  Issue : 6  |  Page : 646-648

Novel endodontic simulation trainer for dental pulpotomy and pulp capping


1 Department of Prosthodontics and Crown and Bridge, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth, Puducherry, India
2 Department of Pediatric and Preventive Dentistry, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth, Puducherry, India

Date of Submission24-Jun-2022
Date of Acceptance13-Oct-2022
Date of Web Publication30-Dec-2022

Correspondence Address:
Dr. Prathima G Shivashankarappa
Department of Pediatric and Preventive Dentistry, Indira Gandhi Institute of Dental Sciences, Sri Balaji Vidyapeeth, Pondi-Cuddalore Road, Pillaiyarkuppam, Puducherry 607402
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jioh.jioh_137_22

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  Abstract 

Pulp exposures are the common problems encountered during the management of deep carious lesions in children and adolescents. The clinical skill plays an important role to achieve cooperation, reduced chair side time, and total patient care. This article describes a novel endodontic simulation trainer for dental pulpotomy and pulp capping. The simulator described in the article provides advantages such as life size design, easy to use, and cheaper to fabricate with good functional fidelity. This invention has the advantage that the pellet is replaceable, and so the procedure can be done multiple times simply by replacing it with a new pellet.

Keywords: Deep Caries Management, Preclinical Training, Simulation


How to cite this article:
Livingstone D, Manivasakan S, Shivashankarappa PG. Novel endodontic simulation trainer for dental pulpotomy and pulp capping. J Int Oral Health 2022;14:646-8

How to cite this URL:
Livingstone D, Manivasakan S, Shivashankarappa PG. Novel endodontic simulation trainer for dental pulpotomy and pulp capping. J Int Oral Health [serial online] 2022 [cited 2023 Feb 1];14:646-8. Available from: https://www.jioh.org/text.asp?2022/14/6/646/366429




  Introduction Top


Dentistry being a skill-based profession, skills are the core abilities and credentials needed to perform independently, for the safety of the patient and integrity of the profession. Pulp therapies are commonly performed procedures in children and adolescents in the management of deep carious lesions. As there is no consensus in the management of deep carious lesions, it is difficult to decide whether to stop the carious removal, or when to stop, or without exposing the pulp.[1] The morphological differences between primary and permanent teeth, high pulp horns in primary teeth, fear of pulp exposure during a procedure, anxious child, small mouth, and excessive salivation are some of the key factors to be kept in mind for a dental practitioner while performing these procedures in children.

Pediatric dentists and general dental practitioners incorporate pulpectomy procedures rather than indirect pulp capping/pulpotomy procedures in their clinical practice, which could be attributed to a lack of training on indirect pulp therapy during their undergraduate and postgraduate programs. The acquisition of these clinical skills depends on repetitive tasks performed in the preclinical laboratory (an integral part of dental curriculum) ensuring that they achieve the necessary level of clinical competency in order to treat patients. The clinical skill plays an important role in achieving patient cooperation, reduced chair side time, and total patient care. Therefore, there is a need to undergo endodontic simulation training prior to treating the pediatric patients.[2] Simulators are experiential learning tools to mimic real-life situations and dental simulators as those practices that reproduce or imitate clinical scenarios in dentistry,[3] conventionally the preclinical skills, are performed on the extracted teeth, or on plastic or plaster teeth models. But the extracted teeth and plaster models are unsuitable for the tactile feel of dentin and in the practice of minimal intervention dentistry. Similarly manikin exercises are often inappropriate for case-based/problem-based learning.

There is no simulator that teaches or trains pulp therapy procedures to the best of our knowledge as reviewed from the literature. Our simulator device enables both teaching and learning more effectively and efficiently compared with the available simulators. This will fill existing curricular gaps with conservation of resources, and it facilitates skill transfer from the preclinic to the clinical situation. Dental educators can combine case-based scenarios with this device to create simulations, which can be addressed by students in the simulator using clinically appropriate instrumentation and equipment.

Currently, in India, not many dental institutions use virtual reality simulators in training dental students during their preclinical training. In endodontics, this issue is more severe, because of the complete absence of simulators capable of mimicking dentin or pulp. The usage of such simulators can reduce the impact of the insufficiency of natural teeth and provide uniform training for all students. The authors who are also the inventors hereby describe a very innovative simulator device called the “dental pulpotomy and pulp capping simulator” that helps students practice the required skills (i.e., indirect pulp capping and pulpotomy) needed for the management of deep carious lesions in patients.

Dental pulpotomy and pulp capping simulator

Description

The dental pulpotomy and pulp capping simulator consists of a model of a molar crown, on a holding base, made of clear acrylic [Figure 1]. The crown has a hole that accommodates the simulator pellet. The holding base has a channel to facilitate the removal of the pellet after use. The simulator pellet is a transparent plastic cylinder 8 mm in length. The base of this pellet has a hard acrylic plate over which red-colored (pulp tissue) sponge is present [Figure 2]. Above the sponge layer, there is a cuttlefish bone disc simulating normal healthy tooth structure (affected dentin and infected dentin). The layers are glued together with room temperature-vulcanizing silicone to prevent the displacement of the various components within the pellet. The simulator pellet can be loaded and removed from the model whenever it is needed [Figure 3]. The simulator is a replaceable cartridge that would fit inside the phantom tooth. The design discussed here is the functional prototype. During commercialization, design considerations would be taken care of.
Figure 1: Images of the various components of the device

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Figure 2: Removal of pulp tissue layer

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Figure 3: The completed procedure can be evaluated after the removal of the pellet (removable)

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Advantages

This simulator pellet has life size design, is easy to use, and provides consistent hands-on or psychomotor experience. It is made of inert nontoxic materials and is cheaper to fabricate. The simulator pellet is replaceable, and so the procedure can be done multiple times simply by replacing it with a new pellet. It possesses good functional fidelity and gives the perception of penetration into dentin and pulp tissue. The device can be used standalone and do not require a typodont or phantom head as the focus is only the pulp; adjacent and/or opposing teeth contact is not needed.


  Application of the Invention Top


  • A valuable simulation tool for teaching, learning, and assessment in undergraduate and continuing professional education courses;


  • To practice pulpotomy and pulp capping procedures for undergraduate and postgraduate scholars before performing it on pediatric patients;


  • To train general dental practitioners on pulp therapies.



  •   Conclusions Top


  • The device can be used standalone and do not require a typodont or phantom head as the focus is only the pulp; adjacent and/or opposing teeth contact is not needed;


  • The device serves as a valuable simulation tool for students to learn/train pulpotomy and pulp capping procedure before performing it on patients;


  • The device is made of inert nontoxic materials and is cheaper to fabricate, life size design, and easy to use;


  • The simulator pellet is replaceable, and so procedure can be done multiple times simply by replacing with a new pellet;


  • Good functional fidelity gives the perception of penetration into dentin and pulp tissue.


  • The usage of haptic simulators in dentistry has been improving in recent years; however, high cost, critical feedback, a lack of human contact (mandatory while dealing with children), and technical hardware issues experienced with the computer-supported simulators are some of the disadvantages of the new technology. This article is the first in the series describing the product. A study is being conducted with similar prototypes to know the degree of functional fidelity, results of which will be published in the forthcoming articles in the series.

    Acknowledgement

    Not applicable.

    Financial support and sponsorship

    Nil.

    Conflicts of interest

    The authors have no conflicts of interest

    Authors contributions

    Not applicable.

    Ethical policy and institutional review board statement

    Not applicable.

    Patient declaration of consent

    Not applicable.

    Data availability statement

    Not applicable.



     
      References Top

    1.
    Nayak UA, Wadhwa S, Kashyap N, Prajapati D, Mahuli AV, Sharma R Knowledge and practice of, and attitudes toward, pulp therapy in deciduous teeth among pediatric dentists in India. J Invest Clin Dent2018;9:12284.  Back to cited text no. 1
        
    2.
    Kabra P, Choudhary E, Bindal N Impact of pre clinical training on students clinical performance: A cross sectional analysis. Biosc Biotech Res Comm 2020;13:200-3.  Back to cited text no. 2
        
    3.
    Suvinen TI, Messer LB, Franco E Clinical simulation in teaching preclinical dentistry. Eur J Dent Educ 1998;2:25-32.  Back to cited text no. 3
        


        Figures

      [Figure 1], [Figure 2], [Figure 3]



     

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