Editor's Note: This story was first published in the Spring 2026 Edition of the Dental Link magazine.

At the University of Iowa College of Dentistry and Dental Clinics, students learn over realistic models of human teeth, focusing on one in particular. A 3-D printed educational caries tooth that resembles a real cavity – and it was designed and produced at Iowa.  

The catalyst of the project was straight forward. Operative Dentistry faculty noticed a problem: the plastic teeth students were using often broke during practical exercises.

“This made grading a challenge,” says Dr. Natalia Restrepo-Kennedy, Clinical Associate Professor of Operative Dentistry, "We didn’t know if it was due to the student’s technique, or failure of the material.”

That challenge sparked an idea: if the existing materials weren’t good enough, why not make better ones themselves? Faculty began exploring ways to design educational teeth that behaved like real teeth, with layers of enamel, dentin, and pulp, giving students more realistic feedback and a deeper understanding of decay.  

What started as a question in the clinic quickly became a collaborative project with IowaMADE and Protostudios, turning a teaching challenge into an innovation that enhances student learning and patient care.

Prototyping the Perfect Cavity 

What sets Iowa apart is not just having ideas but having a system available to nurture them.  IowaMADE and Protostudios provide the engineering, design, and fabrication expertise needed to turn concepts into working models.

“Dr. Erica Teixeira came to us and asked, ‘Can you design teeth for students to practice drilling cavities?’” recalls Charles Romans, lead designer at Protostudios. “We hadn’t done that before, but we decided to see what was possible.”

Using CAD software and multi-material 3D printers, the team created teeth with realistic layers—enamel, dentin, and pulp.

“It’s not just about making a tooth that looks real,” Romans says. “It has to behave like a tooth, with different hardness and colors. That’s what gives students meaningful feedback.”

Restrepo-Kennedy took a hands-on approach with the design, helping provide insight and feedback into the teeth as they were developed.

"We went back and forth on the anatomy, the hardness of the enamel, the softer dentin, even the color,” says Restrepo-Kennedy, “Every detail mattered so students could get realistic feedback.”

Today, Protostudios prints thousands of these educational caries teeth annually, and the designs have expanded to programs beyond Iowa, including Texas A&M.

“Every project teaches us something new,” Romans adds, “Each iteration helps us work faster and smarter on the next design.”  

The educational caries teeth allow students to experience decay progression and treatment decisions in a controlled setting. Each model includes distinct layers so learners can practice selective caries removal and see the results of their technique in a standardized environment.

“They’re super detailed,” says Michael Sneller, prototype engineer at Protostudios, “You can feel the difference as you work through each layer.”

“The idea with these teeth was that students understood the philosophy of selective caries removal,” Restrepo-Kennedy explains, “Even though they go into clinic and it feels different, they already have the concept in mind. They learn where to remove decay and where to be conservative, depending on the depth and location of the lesion.”

Surveys conducted with D1 and D2 students confirmed positive results: learners felt more capable working with the teeth and appreciated the realistic simulation of clinical scenarios.

For Restrepo-Kennedy, the project shows how clinical observation sparks innovation.

“Watching students struggle points to gaps in our materials or approach,” she says “Innovation comes from seeing the problem firsthand and asking, ‘How can we do this better?’”

So, after five years, it was an incredibly fulfilling experience for Restrepo-Kennedy to finally have a quality product for student learners.

“Having something tangible that improves student learning and applies directly to patient care—there’s nothing like that,” she adds.

Turning Ideas into Impact 

To help bring innovations like this to a broader audience, UI Ventures, the University of Iowa’s program supporting faculty innovation, helps translate ideas from campus into broader practice. Christopher Parker, the program’s director and Chief Technology Officer for medical innovation, guides faculty through commercialization, scalability, and market readiness.

“You have to wear two hats,” Parker says. “One for the clinic, and one for the business side of things.”

In exploring how far the product can reach, ECTs have made their way around the world. And the initiative is just getting started.

“We’re looking at ways to sell the teeth for different procedures and courses,” Restrepo-Kennedy adds. “Some have even been shipped to schools in Europe. The goal is to expand access while maintaining the educational philosophy behind them.”

“Ideas are developed here, shaped here, and often produced in partnership with local teams and businesses,” Sneller says, “What emerges is distinctly Iowa.”