Effect of a four-month indirect vision training program on ergonomic posture and class I cavity preparation performance in dental students

OBJECTIVE: This study aimed to evaluate the effects of an indirect vision training (IVT) program on dental students' working postures and cavity preparation performance, using a modified CADEP (Compliance Assessment of Dental Ergonomic Posture) scoring system. MATERIALS AND METHODS: In this single-group pre-post quasi-experimental study, The IVT group consisted of 35 third-year dental students, while the control group comprised 67 third-year students from the subsequent academic year who completed the same preclinical restorative dentistry curriculum without receiving IVT. They performed Class I cavity preparations on teeth #16 and #46 using phantom heads. Ergonomic posture was assessed using a modified CADEP scale before and after training. Cavity preparation scores were evaluated for tooth #16 and #46. Data were analyzed using Chi-square, Mann-Whitney U, and Wilcoxon signed-rank tests. Repeated measurements were additionally evaluated using generalized linear mixed models (GLMMs). Statistical significance was set at p < 0.05. RESULTS: Following indirect vision training, significant improvements were observed in both ergonomic posture and cavity preparation performance. For Tooth 16, total CADEP scores increased from 47.86 to 62.29 (p < 0.001), while cavity preparation performance scores improved from 64.43 to 72.43 (p < 0.001). For Tooth 46, total CADEP scores increased from 42.29 to 53.86 (p = 0.006), and performance scores improved from 64.14 to 69.91 (p < 0.001). Significant improvements were detected in CADEP-2, CADEP-3, CADEP-6, and CADEP-7 for Tooth 16, and in CADEP-6 and CADEP-7 for Tooth 46. No significant differences were observed according to academic year or gender for most parameters (p > 0.05). CONCLUSION: This study showed that a 16-week indirect vision training program was associated with improvements in ergonomic posture and Class I cavity preparation performance, particularly in lumbar support, stool use, feet positioning, and dental light positioning.