Journal of Health and Medical Sciences

Tooth carving is done to develop the psychomotor skills necessary for dental technician practice and teach tooth morphology. This study aimed to determine the effect of tooth carving as a teaching method for tooth morphology and assessment. 116 students trained in teeth carving at Istanbul Aydın University Dental Technician Department were subjected to 2 different teeth carving exams with soap and wax. Instructors evaluated tooth carvings according to a standard checklist. At the end of this study, a student satisfaction survey was carried out to get feedback on tooth carving as a teaching methodology. The scores given by the instructors did not differ by material and gender (p >0.05). Overall, student feedback on teeth carving was equally positive. The vast majority found the tooth they carved to be confirmed (75.86%). They believed that carving exercises would help develop laboratory skills (76.03%). They found the training method and materials applied sufficient. Dental carving applications develop dexterity and psychomotor skills for dental prosthesis technician applications. Before laboratory applications, it should be an integral component of the dental prosthesis technician curriculum to develop cognitive and psychomotor skills related to clinical applications. Based on this study, live representation of teeth carving skills and different educational materials (plaster models, videos, slides, etc.) should be the preferred teaching method. this study. A soap and wax block (50x25x25mm) were given to the students. The teeth were collected anonymously without disturbing the group's integrity. Both groups were asked to carve a right maxillary molar tooth from wax and soap blocks. Ninety

The Asian Institute of Research

Introduction
The dentist needs to have comprehensive knowledge of morphology and function of teeth in the construction of aesthetic restorations (Nance et al., 2009;Obrez et al., 2011).Along with theoretical knowledge of tooth structure and function, it is essential to have technical skills, dexterity, and more for proper restoration.It makes purely artistic sense (Rubinstein & Nidetz, 2007).A clinician can only reproduce anatomical details to make a dental restoration look natural (Capote et al., 2018).
Dental students' psychomotor skills in carving need to be developed early to acquire the dexterity to reconstruct fine-tooth forms for restorative clinical procedures and functional purposes (Giuliani et al., 2007).In the preclinical years, dental anatomy and dental morphology is the first course that introduces dental students to the structure and function of human teeth (Schroeter, 1959).Knowledge of tooth morphology, alignment, and occlusion is critical for identifying teeth and relating morphology.It is vital to develop psychomotor skills as it helps students later identify the details of the tooth surface and the changes that may occur (A.Kilistoff, 2011).Oral anatomy and dental morphology are traditionally taught through didactic lectures, books, manuals, artificial tooth models, and extracted teeth.Wheeler's first introduced tooth carving in wax blocks.10 In many dental schools worldwide, dental carving is an integral part of the curriculum.Students carry out carving teeth from wax or soap molds (Capote et al., 2018).

., 2007).In t
e preclinical years, dental anatomy and dental morphology is the first course that introduces dental students to the structure and function of human teeth (Schroeter, 1959).Knowledge of tooth morphology, alignment, and occlusion is critical for identifying teeth and relating morphology.It is vital to develop psychomotor skills as it helps students later identify the details of the tooth surface and the changes that may occur (A.Kilistoff, 2011).Oral anatomy and dental morphology are traditionall taught through didactic lectures, books, manuals, artificial tooth models, and extracted teeth.Wheeler's first introduced tooth carving in wax blocks.10 In many dental schools worldwide, dental carving is an integral part of the curriculum.Students carry out carving teeth from wax or soap molds (Capote et al., 2018).

The purpose of tooth carving is to reconstruct different positive and negative anatomical features, such as tubercles, cingulum, ridges, fossae, and grooves, close to the dimensions of natural teeth.Each tooth has six surfaces, and each surface of the tooth has its characteristics.Dental wax carving is an exercise for learning the contours, convexities, and concavities specific to tooth type and location.Dental wax carving skills introduce dental students to hand tool techniques.Provides improvements in-hand manipulation.

Today, many experts think that the examination of tooth morphology is an age-old exercise that serves no purpose, even though it has been practiced for many years (Baskar, 2009;Rao, 2010;Sivapathasun The purpose of tooth carving is to reconstruct different positive and negative anatomical features, such as tubercles, cingulum, ridges, fossae, and grooves, close to the dimensions of natural teeth.Each tooth has six surfaces, and each surface of the tooth has its characteristics.Dental wax carving is an exercise for learning the contours, convexities, and concavities specific to tooth type and location.Dental wax carving skills introduce dental students to hand tool techniques.Provides improvements in-hand manipulation. Today, many experts think that the examination of tooth morphology is an age-old exercise that serves no purpose, even though it has been practiced for many years (Baskar, 2009;Rao, 2010;Sivapathasundharam, 2008).Teaching dental morphology is exhausting as it requires expertise and manual dexterity.Although it is an education that is also applied in the education of dental students, several reasons can be given that dental morphology education is not necessary.First, learning dental morphology can prepare a student to be a good technician rather than a clinician (Baskar, 2009).Second, since most restorative work is done by dental technicians, they may not need dental morphology and carving training to perform surgery and learn anatomy (Sivapathasundharam, 2008).
haram, 2008).Teaching dental morphology is exhausting as it requires expertise and manual dexterity.Although it is an education that is also applied in the education of dental students, several reasons can be given that dental morphology education is not necessary.First, learning dental morphology can prepare a student to be a good technician rather than a clinician (Baskar, 2009).Second, since most restorative work is done by dental technicians, they may not need dental morphology and carving training to perform surgery and l arn anatomy (Sivapathasundharam, 2008).

These assumptions are a precious argument against not including dental morphology in education for dental students (undergraduate and graduate students).Dental technicians can benefit from pre-carved dental materials and earn this title without school.(Some of the current technicians have never been enrolled in dental schools or colleges in Turkey).In addition, dental technicians do not need more information about tooth morphology other than the exact determination of the tooth to be replaced.Dental students or technicians do not necessarily need to learn dental morphology at the curriculum level, which takes a lot of time and effort.Even if they learn all the tricks of tooth morphology, there is no guarantee that they will pa These assumptions are a precious argument against not including dental morphology in education for dental students (undergraduate and graduate students).Dental technicians can benefit from pre-carved dental materials and earn this title without school.(Some of the current technicians have never been enrolled in dental schools or colleges in Turkey).In addition, dental technicians do not need more information about tooth morphology other than the exact determination of the tooth to be replaced.Dental students or technicians do not necessarily need to learn dental morphology at the curriculum level, which takes a lot of time and effort.Even if they learn all the tricks of tooth morphology, there is no guarantee that they will pass the exam successfully (Ponniah, 2010).
s the exam successfully (Ponniah, 2010).

Since dental anatomy is one of the first lessons directly related to teeth and mouth function, it presents particular challenges for students and teachers (Mitov et al., 2010).In most schools, the didactic part of dental morphology is usually taught in the traditional course format, and written exams test students' knowledge (Maggio et al., 2012).These conventional teaching methods have revealed some weak points that cause frustration for both students and faculty (Nayak et al., 2014).The student's perception of the education received is valuable information for curriculum planners and should include advice from dental carving students and educators (Nayak et al., 2014).Therefore, the study evaluates dental technician students' kno Since dental anatomy is one of the first lessons directly related to teeth and mouth function, it presents particular challenges for students and teachers (Mitov et al., 2010).In most schools, the didactic part of dental morphology is usually taught in the traditional course format, and written exams test students' knowledge (Maggio et al., 2012).These conventional teaching methods have revealed some weak points that cause frustration for both students and faculty (Nayak et al., 2014).The student's perception of the education received is valuable information for curriculum planners and should include advice from dental carving students and educators (Nayak et al., 2014).Therefore, the study evaluates dental technician students' knowledge, perception, and attitudes about tooth carving.
ledge, perception, and attitudes about tooth carving.


Method

The research was conducted on 116 students studying in the first year of dental prosthesis technology (man=58, woman=58) at Istanbul Aydın University.The study was carried out with the permission of the ethics committee of Istanbul Aydın University, numbered 2022/44.All participants signed consent forms.

Tooth morphology was taught to both groups (woman and man) with handouts, plaster models, slides, videos, and demonstrations.The demonstrations included a step-by-step application of the notes given in the laboratory environment.The demonstrations were recorded as videos and regularly watched during the training.Carving training was given for the same tooth from the wax and soap block in equal time (6 hours), and carving oper

Method
The research was conducted on 116 students studying in the first year of dental prosthesis technology (man=58, woman=58) at Istanbul Aydın University.The study was carried out with the permission of the ethics committee of Istanbul Aydın University, numbered 2022/44.All participants signed consent forms.
Tooth morphology was taught to both groups (woman and man) with handouts, plaster models, slides, videos, and demonstrations.The demonstrations included a step-by-step application of the notes given in the laboratory environment.The demonstrations were recorded as videos and regularly watched during the training.Carving training was given for the same tooth from the wax and soap block in equal time (6 hours), and carving operations were carried out in the laboratory studies.The maxillary first molar was selected for this study.A soap and wax block (50x25x25mm) were given to the students.The teeth were collected anonymously without disturbing the group's integrity.Both groups were asked to carve a right maxillary molar tooth from wax and soap blocks.Ninety minutes were given for carving from each block. 2 prosthodontists and two dental technicians evaluated carved teeth.

ions we
e carried out in the laboratory studies.The maxillary first molar was selected for this study.A soap and wax block (50x25x25mm) were given to the students.The teeth were collected anonymously without disturbing the group's integrity.Both groups were asked to carve a right maxillary molar tooth from wax and oap blocks.Ninety minutes were given for carving from each block. 2 prosthodontists and two dental technicians evaluated carved teeth.

The examiners evaluated the teeth against the same grading chart.A grading chart was formulated based on work by Kilistoff et al. (Table 1) to standardize the grading of the teeth (A.J. Kilistoff et al., 2013).This standardized chart scored different morphological features of the maxillary first molar.(2 marks for each completed feature, 1 mark for a full feature, and 0 points for a missing feature.)2) (Eid et al., 2013).Descriptive tests were applied for the gender and exam results of the students.An independent sample t-test was used to compare the average results of scores given by students and examiners.A P value less than 0.005 was retained as significant.The frequency of the answers to the questionnaire was calculated by applying descripti The examiners evaluated the teeth against the same grading chart.A grading chart was formulated based on work by Kilistoff et al. (Table 1) to standardize the grading of the teeth (A.J. Kilistoff et al., 2013).This standardized chart scored different morphological features of the maxillary first molar.(2 marks for each completed feature, 1 mark for a full feature, and 0 points for a missing feature.)2) (Eid et al., 2013).Descriptive tests were applied for the gender and exam results of the students.An independent sample t-test was used to compare the average results of scores given by students and examiners.A P value less than 0.005 was retained as significant.The frequency of the answers to the questionnaire was calculated by applying descriptive tests (Table 2).
e tests (Table 2).


Results

The answers to the survey questions are shown in Table 2.The scores obtained from the answers given in the questions graded according to the Likert scale were converted into percentages.The percentages of the responses given give information about the perceptions and thoughts of the students.The majority state that they are successful while they think that the training provided helps to improve their laboratory skills.The usefulness and accuracy of the materials used during the training are confirmed by the results obtained.It was found that the material and gender did not affect success in the teeth carving process.The difficulty of carving specified for materials affects time but not success.Although 72% of participants stated that they lik

Results
The answers to the survey questions are shown in Table 2.The scores obtained from the answers given in the questions graded according to the Likert scale were converted into percentages.The percentages of the responses given give information about the perceptions and thoughts of the students.The majority state that they are successful while they think that the training provided helps to improve their laboratory skills.The usefulness and accuracy of the materials used during the training are confirmed by the results obtained.It was found that the material and gender did not affect success in the teeth carving process.The difficulty of carving specified for materials affects time but not success.Although 72% of participants stated that they liked tooth carving, 53.62% viewed carving as an unnecessary waste of time.It was found that 3D plaster models were more useful in the materials used during training.

tooth c
rving, 53.62% viewed carving as an unnecessary waste of time.It was found that 3D plaster models were more useful in the materials used during training.


Discussion

The demographic information of the students and grades given by faculty members are shown in Table 2.The morphological features on the plaster model teeth given to the students during the scoring were taken as a basis.Therefore, plaster models can also help reproduce the same features on the surface of the carved tooth.88.79% of the students responded positively to whether plaster models were good teeth.This demonstrates that magnified dental plaster models provide a three-dimensional teaching method for tooth morphology that surpasses videos and other resources.So it can be used as a reference for tooth carving practice.

When students were asked if they found the crown or root part difficult when carving, 80.2% of the participants stated that the

Discussion
The demographic information of the students and grades given by faculty members are shown in Table 2.The morphological features on the plaster model teeth given to the students during the scoring were taken as a basis.Therefore, plaster models can also help reproduce the same features on the surface of the carved tooth.88.79% of the students responded positively to whether plaster models were good teeth.This demonstrates that magnified dental plaster models provide a three-dimensional teaching method for tooth morphology that surpasses videos and other resources.So it can be used as a reference for tooth carving practice.
When students were asked if they found the crown or root part difficult when carving, 80.2% of the participants stated that the crown part was more complex than the root.This contrasts with the results of the study by Azevedo RA et al., who reported that the root is thinner than the crown and, therefore more difficult to carve and manage because it can easily break during the carving (de Azevedo et al., 2018).

own part wa
more complex than the root.This contrasts with the results of the study by Azevedo RA et al., who reported that the root is thinner than the crown and, therefore more difficult to carve and manage because it can easily break during the carving (de Azevedo et al., 2018).

The majority of students in this study agreed that tooth carving should be taught in the first year of education (88.96%).Regarding the usefulness of the teaching methodology used, 78.62% of the group's students agreed that it helped improve their skills.76.86% of students of both groups agreed that the marking criteria for dental carving were realistic, robus The majority of students in this study agreed that tooth carving should be taught in the first year of education (88.96%).Regarding the usefulness of the teaching methodology used, 78.62% of the group's students agreed that it helped improve their skills.76.86% of students of both groups agreed that the marking criteria for dental carving were realistic, robust, and comprehensive.The marking criteria included a detailed analysis of all the anatomical features of a maxillary rıght upper molar.Similar surveys previously conducted on dental students reported similar results.They also emphasized that dental carving is important to clinical skills and should be an integral part (Eid et al., 2013;Nayak et al., 2014).They find it challenging to carve from wax while they need about 1.5-2 hours.This difficulty and duration can be attributed to the material's physical properties being harder than soap.applications such as 3D tooth anatomy have been and should be implemented by authors (Chowdhry & Sircar, 2020).Since the morphology of restoration is determined by the morphology and location of neighboring and opposing teeth, meticulous carving exercises can be helpful to some extent in crown carving.However, the logic behind root carving remains unclear.Although the knowledge of the shape, the number of roots, and several canals within the root are significant in endodontic and exodontic applications, this is not needed in laboratory applications, and it makes root carving exercises in dental techniques unnecessary.
, and comprehensive.The marking criteria included a detailed analysis of all the anatomical features of a maxillary rıght upper molar.Similar surveys previously conducted on dental students reported similar results.They also emphasized that dental carving is important to clinical skills and should be an integral part (Eid et al., 2013;Nayak et al., 2014).They find it challenging to carve from wax while they need about 1.5-2 hours.This difficulty and duration can be attributed to the material's physical properties being harder than soap.applications such as 3D tooth anatomy have been and should be implemented by authors (Chowdhry & Sircar, 2020).Since the morphology of restoration is determined by the morphology and location of neighboring and opposing teeth, meticulous carving exercises can be helpful to some extent in crown carving.However, the logic behind root carving remains unclear.Although the knowledge of the shape, the number of roots, and several canals within the root are significant in endodontic and exodontic applications, this is not needed in laboratory applications, and it makes root carving exercises in dental techniques unnecessary.

A systematic review of PRISMA guidelines suggested that practical demonstration of dental wax carving with an instructor is one of the most effective ways to le A systematic review of PRISMA guidelines suggested that practical demonstration of dental wax carving with an instructor is one of the most effective ways to learn about dental anatomy (de Azevedo et al., 2018).The limitations of this study are that it was based on a single institution.It is necessary to include more central studies to generalize and confirm the findings of this study.Based on the recommendations from the results of this study, dental carving should be an integral component of the dental technician curriculum in Turkey.
rn about dental anatomy (de Azevedo et al., 2018).The limitations of this study are that it was based on a single institution.It is necessary to include more central studies to generalize and confirm the findings of this study.Based on the recommendations from the results of this study, dental carving should be an integral component of the dental technician curriculum in Turkey.

Based on the results of this study, dental wax carving was found to be an effective strategy for improving lab psychomotor skills of dental prosthesis technician students by recreating dental morphological features in wax and soap.Students' progress will be traced to their laboratory skills and then their laboratory work.Therefore, it is imperative that dental carving be included in the national prosthesis technician curriculum for longitudinal or spiral integration to be possible.

( 1 )
1
Figure 1: a: plaster model; b: soap tooth; c: wax tooth







Table 1 :
1
Scoring criteria A survey created by Based on the results of this study, dental wax carving was found to be an effective strategy for improving lab psychomotor skills of dental prosthesis technician students by recreating dental morphological features in wax and soap.Students' progress will be traced to their laboratory skills and then their laboratory work.Therefore, it is imperative that dental carving be included in the national prosthesis technician curriculum for longitudinal or spiral integration to be possible.

Table 1 :
Scoring criteria A survey created by Abu Eid et al. was modified to collect students' feedback on tooth carving (Table Abu Eid et al. was modified to collect students' feedback on tooth carving (Table


Table 2 :
2
Surveys questions and evaluation results
Tooth CharacteristicsScore: 0= No feature, 1 = feature exists but weak not asdesired, 2= feature is evident as requestedThe geometric form of surfacesLabialPalatalApproximalOcclusalRootsTooth dimensionsCervico-occlusalMesio-distal ve Labio-palatalRootsAnatomical featuresDevelopmental groovesTuberclesFossas (central, mesial, distal)Edge ridges (Mesial-Distal)Cusp ridges (triangular, oblique, transversal)Roo

10-Should carving be taught in Grade 1? (88,96%)
Exam grade = (Total score obtained according to Table1x 100) / 28 (maximum score according to Table1) The teaching of dental morphology begins with two-dimensional (2D) drawing and proceeds toward making the wax and tooth model in 3D.Carving wax teeth different from actual tooth size and morphology is a controversial teaching practice, as it significantly impairs the development of visual ability as does not give the student an idea of the deviations that actually exist.Newer technologies such as videos, computerized 3D models, and mobile *