Abstract
BACKGROUND: Root canal irrigation is a crucial component of endodontic treatment, yet it is often insufficiently addressed in dental education. Although its clinical significance is well recognized, dedicated simulation platforms for irrigation training remain scarce. This study aimed to develop a virtual simulation system for root canal irrigation and to evaluate its effectiveness in improving dental students' knowledge and procedural competence. METHODS: Thirty-four dental students (26 undergraduates and 8 postgraduates) participated in this prospective study. After receiving standardized theoretical instruction, all students completed baseline and post-training assessments using three-dimensional printed tooth models. Training sessions were conducted with the newly developed virtual simulation system. Outcome measures included theoretical knowledge scores, pre- and post-training practical scores, and simulation-based performance scores. Data were analyzed using paired t-tests, Pearson correlation analyses, subgroup comparisons, and a post-hoc power analysis conducted with G*Power 3.1. In addition, a 26-item Likert-scale questionnaire was administered to assess usability and learner perceptions. RESULTS: Significant improvements were observed in both theoretical knowledge (mean increase: 0.59 points, p < 0.001) and practical performance (mean increase: 3.15 points, p < 0.001). Simulation-derived performance scores demonstrated a strong positive correlation with post-training practical outcomes (r = 0.73, p < 0.001). Questionnaire analysis indicated consistently high ratings for learning effectiveness, usability, instructional value, and overall satisfaction, with Cronbach's alpha values above 0.80 across all domains. CONCLUSION: This virtual simulation system shows preliminary value in improving theoretical and procedural learning in root canal irrigation, with strong acceptability among students. Further validation through larger, multi-center and long-term studies is needed to establish its broader educational impact.