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Measuring the impact of simulation practice on the spatial representation ability of dentists by means of Impacted Mandibular Third Molar (IMTM) Surgery on 3D printed models.

INTRODUCTION
The ability of spatial representation is one of the most important competences of an oral surgeon, but also a challenging competence to assess in educational settings. The aim of this pilot study was to investigate the impact of a hands-on simulation practice on the development of the Dental Anatomy Spatial Representation Ability (DASRA) of recent dental graduates, using a novel assessment instrument based on CBCT radiographic data.


MATERIALS AND METHODS
A novel instrument for the measurement of DASRA for oral surgery was developed, utilising panoramic, sagittal and horizontal slices from 3D radiographic imaging of impacted wisdom teeth. Twenty-one young dentists (nine males and 12 females) were enrolled in this study. After measurement of dentists' perceptual ability (PA), all dentists completed a DASRA drawing test and thereafter practiced surgical extraction on 3D printed models, which were based on actual patients' anatomy. A second DASRA was administered after the hands-on exercise, followed by a feedback survey.


RESULTS
A slight increase in DASRA scores was revealed after practicing on models, which however did not reach statistical significance. However, statistically significant decrease in drawing time was observed after hands-on experiences (P < 0.001), while important qualitative improvements were noted, such as dentists' ability to position the mandibular nerve. Dentists perceived 3D printed model as a very effective and efficient manner in planning and practicing of surgical interventions.


CONCLUSIONS
An instrument for the measurement of DASRA based on 3D radiographic imaging might support educators in the assessment of spatial skills of novice surgeons. Practice on 3D printed, anatomically precise models can benefit dentists on pre-clinical surgical training and has the potential of improving their dental anatomy spatial representation ability.