Abstract: PURPOSE: To explore the application and evaluation of aesthetic design based on actual clinical cases and virtual simulation training of tooth preparation for anterior crown restoration in fixed prosthodontics internships. METHODS: A total of 58 full-time dental undergraduates from the 2020 and 2021 grades of School of Stomatology, Fudan University were selected as research objects. A combined teaching mode of "actual clinical cases + virtual simulation tooth preparation training" was adopted. With the help of intraoral scanning system, digital smile design (DSD) and virtual simulation technology, "digital patients" were constructed using real clinical patient data to guide students in completing aesthetic design and tooth preparation training in the virtual simulation system. The students' operation effects before and after training were evaluated with reference to the scoring standards for full crown preparation in the practical skills examination for dental practitioners. RESULTS: After the virtual simulation training of tooth preparation based on clinical cases, the students' DSD aesthetic design skills were significantly improved, and their operation process of tooth preparation became more proficient. The assessment indicators of the smoothness of the preparation body, the shoulder margin, the occlusal surface morphology, and the pass rate were all significantly improved compared with those before the training, and the differences were statistically significant(P<0.05). CONCLUSIONS: Virtual simulation dental preparation training based on actual clinical cases can effectively improve the DSD design skills and dental preparation level of interns, laying a solid foundation for clinical practice.

Key words: Clinical cases, Digital smile design, Virtual simulation training, Aesthetic restoration of anterior teeth, All-porcelain crown