A Reproducible Digital Workflow for Patient-Specific 3D-Printed Teeth with Anatomically Stratified Enamel and Multi-Material Caries for Preclinical Operative Dentistry.

Conventional typodonts for preclinical operative dentistry are idealised and lack the variability and tactile feedback of natural teeth; virtual-reality and haptic simulators remain costly for large cohorts. This study developed a reproducible, low-cost digital workflow for patient-specific, multi-material 3D-printed dental simulators and evaluated the models from a learner's perspective. Intraoral and CBCT data from a single de-identified case were co-registered to a Virtual Patient. A modular tooth-socket architecture with trans-apical screw retention allowed repeatable individual tooth replacement; each tooth combined a variable-thickness enamel shell over a dentin core with multi-material carious lesions. Two fabrication routes (MSLA and PolyJet) and an adopted hybrid route (MSLA base, PolyJet teeth) were compared for cost, time and fidelity. The hybrid produced complete bimaxillary models at low consumable cost while preserving the source occlusion and contacts. Fifty dental students evaluated a PolyJet specimen hands-on: didactic utility scored highest (4.32 ± 0.65 on 1-5) and visual realism exceeded tactile realism (p < 0.001); 94% rated it at least comparable to a natural extracted tooth and 62% preferred it, while perceived hardness remained the main limitation. The workflow enables scalable in-house production of patient-specific simulators, with tactile realism the priority for material development.