Investigating the validity of a novel paediatric pulpotomy scoring system across typodont and digital 3D preparations

Dental education has benefited to a great extent from technology in both teaching and learning fields. Implementation of technology has paved a new way for creative teaching methods and student assessments. Preclinical assessment of dental students can be affected by various factors. These factors include the type and design of assessment used and assessor calibration. Traditional visual assessment relies on the assessor's experience to evaluate the student's preparation. Computer software assessment produces consistent scores for the student's assessment but suffers from the inability to assess all the relevant criteria for the dental procedure.
Aims: The study aimed to develop and validate a standardised scoring system for a routine paediatric dental procedure (pulpotomy) on a typodont tooth mounted in a phantom head simulator to be used by staff teaching dental students, and to investigate the participants’ scoring consistency in assessing the prepared typodont tooth directly and a scanned 3D image of the same preparation.
Methods: The research design consists of two studies. The preliminary study: a questionnaire was designed and circulated to the participants to identify the need for further training on routine paediatric dental procedures and evaluate the confidence level of the participants on carrying out routine paediatric dental procedures. The main study: the principal researcher carried out the chosen dental procedure (pulpotomy) identified in the preliminary study on five typodont teeth. The typodont teeth with their preparations were scanned with an intra-oral scanner and saved as 3D images. A scoring system was designed and circulated to the participants (teachers of undergraduate students in paediatric dentistry) to assess the typodont teeth and the 3D images. The study consisted of 26 participants of consultants, specialists, and postgraduate students teaching paediatric dentistry. Two participants were selected to repeat the assessment to evaluate intra-assessor reliability. The participants assessed five typodont teeth and 3D images of the same teeth on two separate days to prevent any bias.
Results: Fleiss’ Kappa statistical analysis was used to determine the reliability of the participant assessment scores. The results showed a fair level of agreement of the typodont and the 3D image assessment scores. A mixed model analysis was used to assess the agreement level between the typodont and 3D image assessment. The results showed no significant difference between the typodont teeth and the 3D image assessment scores. Fleiss’ Kappa analysis was used to assess the intra-participant reliability of the assessment scores. The agreement was high for both methods but tended to be higher for the traditional assessment method.
Conclusion: The study results showed no statistically significant difference between the assessment scores of the typodont teeth and the 3D images. The assessment of 3D images of typodont teeth preparations can be a valid assessment method that can benefit dental students' education. The results showed high intra-participants reliability in the assessment scores.