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Background This study aimed to assess the effect of a virtual reality (VR) simulator for instruction of restorative dentistry on the level of competence of undergraduate dental students. Methods This case-control study was conducted on 55 third-year dental students, who were randomly assigned to the intervention ( n  = 30) and control ( n  = 25) groups. Both groups received the same theoretical instruction for preparation of a Class I cavity in a mandibular first molar. The control group then practiced cavity preparation on acrylic teeth for 8 h. The intervention group practiced by using a VR simulator for 4 h and practicing on acrylic teeth for 4 h. Both groups participated in a pretest on acrylic teeth. The intervention group had one posttest after using the VR simulator and another posttest after practicing on acrylic teeth. The control group also had two posttests after the first and second phases of practice. The performance of the two groups was scored blindly by three examiners. Data were analyzed by independent and paired t-test, Chi-square test, Fisher’s exact test, and Mann-Whitney U test (alpha = 0.05). Results The improvement in overall performance was significantly greater in the intervention group than the control group ( P  < 0.05). Progression in the first step (pretest-posttest 1) was significantly greater in 5 out of 9 criteria in the intervention group than the control group ( P  < 0.05). Progression in the second step (posttest 1-posttest 2) was significantly greater in the intervention group than the control group in 6 out of 9 criteria ( P  < 0.05). The reduction in catastrophic errors in the first posttest compared to pretest was significantly greater in the intervention group than the control group ( P  = 0.000 for the VR group and P  = 0.006 for the control group). Conclusions VR simulation can improve the quality of learning of preclinical restorative dentistry, and may be used as an educational supplement in dental curricula.

Mastering complex psychomotor skills is essential in undergraduate dental education; however, traditional live demonstrations (LDs) face limitations such as high instructor-to-student ratios and restricted viewing angles. Prerecorded video demonstrations (VDs) offer scalable, repeatable instructions and the ability to integrate multimedia cues but may lack real-time interaction and immediate feedback. There is limited evidence comparing these teaching modalities, particularly regarding gender differences, in the acquisition of restorative dentistry skills. This study aimed to (1) compare first-year dental students' knowledge acquisition and procedural performance following a LD versus a prerecorded VD of a class II amalgam restoration and (2) evaluate whether gender influences outcomes within each demonstration method. A total of 51 students enrolled in an Introduction to Operative Dentistry course (2024-2025) participated in this cohort study. The students were randomized into 2 groups: LD (26/51, 51%) or VD (25/51, 49%). Both groups received identical lectures and demonstrations of a standardized class II cavity preparation and amalgam restoration. Knowledge was assessed via preprocedural and postprocedural multiple-choice questionnaires, and the procedural performance was graded by 2 blinded raters using a 10-point rubric. Student perceptions were measured with an 8-item Likert survey. Mixed ANOVA and independent and paired 2-tailed t tests evaluated between-group and within-group differences, while gender analyses used factorial ANOVA. Interrater reliability (interclass correlation coefficient=0.991) was confirmed. The baseline knowledge scores did not differ between the 2 groups. After the demonstration, knowledge was significantly higher with LD (mean 71.22, SD 17.3) than VD (mean 58.4, SD 21.7; P=.02; Cohen d=0.65). The LD method demonstrated significant within-group improvement (P<.001; Cohen d=0.83). Procedural grading favored LD (mean 8.3, SD 0.9 vs mean 7.9, SD 1.0); however, results were not statistically significant (P=.08; Cohen d=0.50). No significant differences were found in the student perception survey. Gender analysis revealed that male students in the LD group achieved higher postknowledge scores (mean 74.0, SD 12.3 vs mean 55.0, SD 24.3; P=.03), greater score improvements (P=.03), and higher grading scores (mean 8.5, SD 0.6 vs mean 7.6, SD 1.3; P=.03) compared to those in the VD group. No significant differences were observed among female students. LDs yielded superior knowledge acquisition and better performance compared to VDs, particularly for male students. VDs remain a viable alternative when supplemented with interactive elements and instructor feedback. Blended teaching models integrating live and video methods may optimize the demonstration experience for the students, thus enhancing the learning outcomes.

Objectives The advent of artificial intelligence (AI) and large language model (LLM)-based AI applications (LLMAs) has tremendous implications for our society. This study analyzed the performance of LLMAs on solving restorative dentistry and endodontics (RDE) student assessment questions. Materials and methods 151 questions from a RDE question pool were prepared for prompting using LLMAs from OpenAI (ChatGPT-3.5,-4.0 and -4.0o) and Google (Gemini 1.0). Multiple-choice questions were sorted into four question subcategories, entered into LLMAs and answers recorded for analysis. P-value and chi-square statistical analyses were performed using Python 3.9.16. Results The total answer accuracy of ChatGPT-4.0o was the highest, followed by ChatGPT-4.0, Gemini 1.0 and ChatGPT-3.5 (72%, 62%, 44% and 25%, respectively) with significant differences between all LLMAs except GPT-4.0 models. The performance on subcategories direct restorations and caries was the highest, followed by indirect restorations and endodontics. Conclusions Overall, there are large performance differences among LLMAs. Only the ChatGPT-4 models achieved a success ratio that could be used with caution to support the dental academic curriculum. Clinical relevance While LLMAs could support clinicians to answer dental field-related questions, this capacity depends strongly on the employed model. The most performant model ChatGPT-4.0o achieved acceptable accuracy rates in some subject sub-categories analyzed.

To test and evaluate the second installment of DENTIFY, a virtual reality haptic simulator for Operative Dentistry (OD), on preclinical dental students, by focusing on user performance and self-assessment. Twenty voluntary unpaid preclinical dental students, with different background experience, were enrolled for this study. After the completion of an informed consent, a demographic questionnaire, and being introduced to the prototype (on the first testing session), three testing sessions followed (S1, S2, S3). Each session involved the following steps: (I) free experimentation; (II) task execution; S3 also included (III) completion of questionnaires associated with the experiment (total of 8 Self-Assessment Questions (SAQ)); and (IV) guided interview. As expected, drill time decreased steadily for all tasks when increasing prototype use, verified by RM ANOVA. Regarding performance metrics (Comparisons by Student’s t-test and ANOVA) recorded at S3, in overall, a higher performance was verified for participants with the following characteristics: female, non-gamer, no previous VR experience and with over 2 semesters of previous experience of working on phantom models. The correlation between the participants’ performance (drill time), for the four tasks, and user self-assessment evaluation, verified by Spearman’s rho analysis, allowed to conclude that a higher performance was observed in students who responded that DENTIFY improved their self perception of manual force applied. Regarding the questionnaires, Spearman’s rho analysis showed a positive correlation between the improvement DENTIFY inputs on conventional teaching sensed by students, also enhancing their interest in learning OD, their desire to have more simulator hours and the improvement sensed on manual dexterity. All participating students adhered well to the DENTIFY experimentation. DENTIFY allows for student self-assessment and contributes to improving student performance. Simulators with VR and haptic pens for teaching in OD should be designed as a consistent and gradual teaching strategy, allowing multiplicity of simulated scenarios, bimanual manipulation, and the possibility of real-time feedback to allow for the student’s immediate self-assessment. Additionally, they should create performance reports per student to ensure self-perception/criticism of their evolution over longer periods of learning time.

Background The integration of artificial intelligence (AI) in healthcare and medical education has advanced rapidly, with conversational AI systems gaining attention for their potential in academic assessment and clinical reasoning. This study aimed to evaluate AI chatbots’ performance on restorative dentistry questions from the Turkish Dental Specialty Examination (DUS), a high-stakes national exam assessing theoretical and clinical knowledge. Methods An in silico, cross-sectional, comparative design was employed. A total of 190 multiple-choice questions (MCQs) from 19 DUS sessions between 2012 and 2025 were obtained from the Assessment, Selection, and Placement Center (ÖSYM) website. After excluding annulled items, 188 questions were analyzed. Eight AI chatbots (ChatGPT-3.5, ChatGPT-4o Free, ChatGPT-4o Plus, Claude Sonnet 4, Microsoft Copilot, DeepSeek, Gemini 1.5, and Gemini Advanced) were tested using a standardized single-attempt protocol in Turkish. Performance measures included accuracy, response length, and response time. Questions were categorized by year, content domain, and length for subgroup analyses. Statistical analyses were conducted in Python using standard libraries. Descriptive statistics and Pearson’s correlation were calculated, while comparisons involved the Shapiro-Wilk test, Levene’s test, Kruskal-Wallis test, and Dunn’s post hoc test, with significance set at p  < 0.05. Results No significant difference was found in overall accuracy ( p  = 0.18). However, response time and word count differed significantly ( p  < 0.001). Gemini Advanced showed the highest accuracy (96.28%), followed by ChatGPT-4o Plus (93.62%). Gemini 1.5 produced the longest yet fastest responses, while DeepSeek had the lowest accuracy and slowest responses. Accuracy remained stable across years but varied by topic, with lower performance in complex areas such as cavity preparation. In case-based questions, Gemini Advanced, Gemini 1.5, and ChatGPT-4o Plus achieved 100% accuracy. Performance in image-based questions was inconsistent, underscoring limitations in visual reasoning. Conclusions AI chatbots demonstrated high accuracy in answering restorative dentistry exam questions, with Gemini Advanced, ChatGPT-4o Plus, and Gemini 1.5 showing superior performance. Despite differences in response time and content length, their potential as supplementary tools in dental education is evident, warranting further validation across specialties and contexts. Trial registration Not applicable.

Purpose In the realm of restorative dentistry, the integration of virtual reality haptic simulation (VRHS) for learning operative skills has garnered varied perceptions among dental students. Therefore, the aim of this study was to delve deep into undergraduates dental students’ perceptions related to the impact of VRHS in pre-clinical restorative dentistry. Methods A homogeneous purposive sampling method was utilized to gather data from third-year undergraduate dental students ( n  = 23) at the College of Dental Medicine, Qatar University, to thoroughly investigate their views on the impact of VRHS on their learning experience in preparing a standard class I cavity. An explorative qualitative method using face-to-face focus group sessions were conducted in English during 2023. Focus group sessions were recorded and transcribed using Microsoft Teams. Two authors independently read the transcripts, coded the text, and manually analyzed text using an inductive thematic approach. Results A total of 21 (91.3%) students participated in this study. Analysis of 3 focus group interviews revealed five primary themes summarized with the term “MASTR” (M = manual dexterity, A = assessment, S = sequence, T = training, and R = realism). Based on frequency of reported themes, students perceived realism/ lifelike nature of VRHS requiring further enhancement to achieve the desired learning objective. Conclusion Although, VRHS play a crucial role in modern dental education, offering innovative solutions for training, evaluation, and feedback, the need to enhance their ability to simulate real-life dental procedures and learning environment (realism), coupled with interactive and immersive learning experiences were the most frequently raised theme by students. In terms of curriculum design and learning pedagogies, dental educators should consider the appropriate sequence when integrating VRHS within the undergraduate curricula.

Background Minimally invasive dentistry (MID) is a conservative approach focusing on early diagnosis and minimally invasive procedures to prevent the progression of carious lesions.The aim of the study was to assess the knowledge of minimally invasive dentistry among dental students and interns and encourage them to improve their attitudes towards minimally invasive pediatric dentistry (MIPD). Methods A validated questionnaire used to test the knowledge level of 4th, 5th years dental students and interns was distributed prior to an interventional lecture, followed by an educational lecture on the minimally invasive techniques used in pediatric dentistry and later a post-intervention questionnaire distributed to the dental students and interns. Results Almost 74% from the 183 study participants reported that they were aware of the term MIPD,73.8% of them had responded positively, and a higher proportion 65.6% of them knew about this through lectures.The study subject’s knowledge about MIPD was assessed before they attended the lecture on this topic and after the lecture in multiple responses, where the proportion for different procedures had increased from pre-intervention to post-intervention. Conclusion It can be concluded that the dental students and interns have an acceptable amount of knowledge on MIPD. However, there is a lack of knowledge on when to use these techniques and how to apply them.

Background Acquiring competency in restorative dentistry (RD) and fixed prosthodontics (FP) is challenging for undergraduate dental students due to the presence of threshold concepts and tacit knowledge. The aim of this study was to identify the threshold concepts (knowledge barriers) and tacit knowledge (skill development barriers) necessary for achieving competencies in RD and FP using quantitative and qualitative approaches. The strategies for attaining these competencies were also proposed. Methods The present study adopted a critical-theorist mixed-method study design, using quantitative and qualitative approaches. The participants were third- to sixth-year dental students, and recent graduates. An online questionnaire was used to investigate the knowledge and skill required for achieving competency and barriers in RD and FP. Four focus group interviews were conducted to gather in-depth information. The data was analyzed using descriptive statistics and thematic analysis. Results A total of 275 dental students and recent graduates completed online questionnaires (56.8% response rate), and 28 of them participated in focus group interviews. The threshold concepts for RD comprised restorative techniques, covering cavity preparation design and restorative material selection. The tacit knowledge for RD was caries removal. Threshold concepts for FP focused on resin cement and treatment planning, including crown and bridge design and restorative material selection. The tacit knowledge for FP encompassed tooth or cavity preparation and material handling. Observing the actual work situations and the educators’ ability to articulate and clarify are crucial to overcome these barriers. Furthermore, working and practicing in real clinical situations was the most important factor for enhancing practical skill. Conclusions Developing competency in RD and FP requires integrating knowledge and skill. Barriers to competency development were identified based on threshold concepts and tacit knowledge. To enhance learning and competency development, focus should be placed on three components, including learners, teaching materials, and educators.

Objective In many dental schools worldwide, theoretical knowledge is prioritized over comprehensive training in essential clinical procedures. This leads to graduates with insufficient hands-on experience who are not fully “ready to practice”, thereby failing to meet the demands of the job market and community needs. This study aimed to address this critical gap by developing and validating a set of core Entrustable Professional Activities (EPAs) specifically for operative dentistry clerkships to enhance the practical competencies and readiness of dental graduates for effective and independent practice. Methodology A multi-method research approach was employed using a five-stage process to develop EPAs for an operative dentistry clerkship program. First, a literature review was conducted to select the EPA topics. Second, the Nominal Group Technique (NGT) was used with nine faculty members to build consensus and create a list of EPAs based on the literature review and faculty input. Third, feedback on the drafted EPAs was solicited using the Delphi method, which involved 24 faculty members to refine and validate the EPAs. Fourth, rigorous validation was performed using Queen’s EQual Rubric with further refinement by a panel of five medical educationists. Finally, the EPAs were finalised for incorporation into the operative dentistry curriculum. Results Ten EPAs ranging from entrustment levels 1 to 4 were identified and validated through consensus among dental education experts. These EPAs encompass a range of competencies, including medical expertise, communication, professionalism, and patient care. Each EPA was scrutinised for its relevance, clarity, and applicability within the dental curriculum. The validation process, encompassing the Nominal Group Technique (NGT), Delphi, and EQual Rubric, ensured that the EPAs were aligned with the competencies required for dental graduates. Conclusion This study successfully developed and validated ten EPAs for use in operative dentistry. These EPAs focus on key clinical competencies, ranging from patient history taking to complex surgical procedures, representing a significant advancement in enhancing dental graduates’ practical skills and readiness for independent practice. This study highlights the need for a continuous curriculum assessment and adaptation to meet the evolving demands of dental education and practice.

Objective To explore the feasibility of applying the digital evaluation system in the homogeneous training and qualification evaluation of teaching faculty in the preclinical simulation teaching of G.V. Black Class II cavity tooth preparation in operative dentistry. Methods Eighteen clinicians who graduated with Ph.D. and were about to participate in the operative dentistry preclinical teaching at the Hospital of Stomatology, Sun Yat-sen University, were selected to practice the G.V. Black Class II cavity tooth preparation of the left mandibular first molar by using the Aizhixing Digital Dental Virtual Teaching Evaluation System DHC210. Through continuous practice and assessment, we evaluated whether there were changes in their examination scores and operation time after practicing with multiple teeth. Meanwhile, we evaluated the condition of Class II cavity tooth preparation before and after practices using Fair Grader 2000, a Dental Digital Teaching Practice Evaluation System, and combined it with questionnaires to examine the teaching effectiveness of this training. Results As the number of exercises increased, there was a tendency for the result scores of the four tests of Aizhixing to increase ( P  > 0.05), and the operating time was progressively less ( P  < 0.05). The results of Fair Grader 2000 showed that dental clinicians who had completed their standardized residency training had higher and more stable scores than those who were ongoing ( P  < 0.05). The questionnaire survey results showed that it was necessary to apply Aizhixing to Class II cavity tooth preparation teaching activities, which can effectively improve students' theoretical knowledge and the level of cavity preparation skills. Conclusion The application of the digital real-time evaluation system of Aizhixing and the digital evaluation system help to improve the efficiency and objective assessment of Class II cavity tooth preparation, which provides a certain reference basis for achieving high-quality and homogeneous teaching and reform of oral endodontics.