Virtual education: Dental morphologies in a virtual teaching environment

Tooth Anatomy Inspector: A comprehensive assessment of an extended reality (XR) application designed for teaching and learning of root canal anatomy by students

AIM

To develop and evaluate a suitable software application for mobile devices designed for teaching root canal anatomy to undergraduate students in an informative and engaging manner.

METHODOLOGY

Extracted human teeth were scanned by μCT and digitized by converting into STL files. An extended reality (XR) application illustrating the root canal anatomy of the scanned teeth was developed. Prior to deployment, undergraduate dental students were voluntarily asked about their expectations regarding an educational application on tooth anatomy. After a testing phase of the application on a mobile device and within a virtual reality environment, a subsequent evaluation was conducted to assess their overall experience in relation to their initial expectations. Data were analysed using Kolmogorov-Smirnov test and Mann-Whitney U test. The level of significance was set to .05 (p = .05).

RESULTS

The application was able to meet the expectations of the students in all categories (p < .466-.731). Furthermore, it was evaluated as user-friendly (98.2%) and highly motivating for the purpose of learning more on root canal anatomy (100%).

CONCLUSION

Given the overwhelmingly positive reception from undergraduate dental students, the application emerges to be a promising supplementary teaching method for the endodontic curriculum.

The effect of augmented reality book on the proficiency of local anesthesia administration of the inferior alveolar nerve

BACKGROUND/OBJECTIVE

Advancements in augmented reality (AR) technology enable developers to create augmented reality books (AR Books). AR Books can show interactive 3D objects and multimedia content to the user. The purpose of this study was to investigate the effect of a developed AR Book on the theoretical and practical abilities in the administration of local anesthesia of the inferior alveolar nerve block.

METHODS

An exclusive AR Book was developed based on Chapter 14, Handbook of Local Anesthesia, seventh edition, Stanley F. Malamed, which enabled students to use their book (printed or electronic) as an AR Book. Forty dental students were randomly divided into control and study groups. In the control group, students were asked to use regular books, while in the study group, students were instructed to use interactive AR Books. All students took the written exam, scoring 0 to 10. Also, the administration of mandibular local anesthesia was evaluated in students. The level of concentration during the study, the written exam score, the practical score, the success rate of local anesthesia, and the needed time for injection were compared between the two groups.

RESULTS

There was a significant difference in the level of concentration during the study (p < 0.001), practical skill score (p = 0.037), and needed time for injection (p = 0.040) between the two groups. Conversely, the success rate of local anesthesia was almost similar (p = 0.705). Although the written exam score was higher in the study group than in the control group, the difference was not significant (p = 0.414).

CONCLUSION

Using AR Books can engage students and help them to remain focused during the study. AR Books may be beneficial in enhancing the practical abilities of dental students.

Expectancy from, and acceptance of augmented reality in dental education programs: A structural equation model

OBJECTIVE

Dental schools need hands-on training and feedback. Augmented reality (AR) and virtual reality (VR) technologies enable remote work and training. Education programs only partially integrated these technologies. For better technology integration, infrastructure readiness, prior-knowledge readiness, expectations, and learner attitudes toward AR and VR technologies must be understood together. Thus, this study creates a structural equation model to understand how these factors affect dental students' technology use.

METHODS

A correlational survey was done. Four questionnaires were sent to 755 dental students from three schools. These participants were convenience-sampled. Surveys were developed using validity tests like explanatory and confirmatory factor analyses, Cronbach's ɑ, and composite reliability. Ten primary research hypotheses are tested with path analysis.

RESULTS

A total of 81.22% responded to the survey (755 out of 930). Positive AR attitude, expectancy, and acceptance were endogenous variables. Positive attitudes toward AR were significantly influenced by two exogenous variables: infrastructure readiness (B = 0.359, β = 0.386, L = 0.305, U = 0.457, p = 0.002) and prior-knowledge readiness (B = -0.056, β = 0.306, L = 0.305, U = 0.457, p = 0.002). Expectancy from AR was affected by infrastructure, prior knowledge, and positive and negative AR attitudes. Infrastructure, prior-knowledge readiness, and positive attitude toward AR had positive effects on expectancy from AR (B = 0.201, β = 0.204, L = 0.140, U = 0.267, p = 0.002). Negative attitude had a negative impact (B = -0.056, β = -0.054, L = 0.091, U = 0.182, p = 0.002). Another exogenous variable was AR acceptance, which was affected by infrastructure, prior-knowledge preparation, positive attitudes, and expectancy. Significant differences were found in infrastructure, prior-knowledge readiness, positive attitude toward AR, and expectancy from AR (B = 0.041, β = 0.046, L = 0.026, U = 0.086, p = 0.054).

CONCLUSION

Infrastructure and prior-knowledge readiness for AR significantly affect positive AR attitudes. Together, these three criteria boost AR's potential. Infrastructure readiness, prior-knowledge readiness, positive attitudes toward AR, and AR expectations all increase AR adoption. The study provides insights that can help instructional system designers, developers, dental education institutions, and program developers better integrate these technologies into dental education programs. Integration can improve dental students' hands-on experience and program performance by providing training options anywhere and anytime.

Different Methods of Teaching and Learning Dental Morphology

Dental anatomy education is traditionally structured into theoretical and practical modules to foster both cognitive and psychomotor development. The theoretical module typically involves didactic lectures where educators elucidate dental structures using visual aids. In contrast, practical modules utilize three-dimensional illustrations, extracted and plastic teeth, and tooth carving exercises on wax or soap blocks, chosen for their cost, ease of handling, and fidelity in replication. However, the efficacy of these traditional methods is increasingly questioned. The criticism in this concern is that oversized carving materials may distort students' understanding of anatomical proportions, potentially affecting the development of necessary skills for clinical practice. Lecture-driven instruction, on the other hand, is also criticized for its limitations in fostering interactive learning, resulting in a gap between pre-clinical instruction and practical patient care. In this study, we review the various educational strategies that have emerged to enhance traditional dental anatomy pedagogy by describing the effectiveness of conventional didactic lectures, wax carving exercises, the use of real and artificial teeth, the flipped classroom model, and e-learning tools. Our review aims to assess each method's contribution to improving clinical applicability and educational outcomes in dental anatomy, with a focus on developing pedagogical frameworks that align with contemporary educational needs and the evolving landscape of dental practice. We suggest that the optimal approach for teaching tooth morphology would be to integrate the digital benefits of the flipped classroom model with the practical, hands-on experience of using extracted human teeth. To address the challenges presented by this integration, the creation and standardization of three-dimensional tooth morphology educational tools, complemented with concise instructional videos for a flipped classroom setting, appears to be a highly effective strategy.

Assessment of a virtual prosthetic case planning environment for dental education - A multicentric analysis

OBJECTIVES

The aim of the present study was the multicentric assessment of the virtual prosthetic case planning environment (VCPE), which relocates patient planning into the virtual space in dental education.

MATERIALS AND METHODS

The VCPE is separated into two rooms: a virtual entry area where the user can choose between 10 different prosthetic case plans of ascending complexity, and a virtual patient case planning room. In spring term 2022, the use of virtual case planning was voluntarily assessed in four different German dental schools (DSs) from the perspective of both lecturers and students. The assessment was performed afterwards using a questionnaire. Data were analysed using Kolmogorov-Smirnov test, exploratory data analysis, Fisher-Freeman-Halton test, and exact Fisher test. Reliability was assessed with Cronbach Alpha test (α < 0.05).

RESULTS

A total of 59 lecturers and 63 students were included. There were 38.5% male, 60.7% female, and 0.8% diverse participants. The mean age of the lecturers was 36.2 ± 9.0 years and of the students 24.3 ± 3.0 years. The VCPE was assessed as good, yet the evaluations between either the DSs or between the lecturers and students were significantly different.

CONCLUSIONS

Even though for some assessment criteria significantly different results between the four DS were observed, the majority of participants evaluated the VCPE positively and recommended them for teaching. The virtual reality as a teaching method for teaching prosthetic case planning for the further preparation of the students for the later professional life can be considered as helpful.

Impact of a virtual prosthetic case planning environment on perceived immersion, cognitive load, authenticity and learning motivation in dental students

INTRODUCTION

The application of virtual reality (VR) presents a big trend in medical education. The aim of this investigation was the presentation and assessment of a multi-user virtual prosthetic case planning environment using criteria such as perceived immersion, cognitive load, authenticity and students´ learning motivation during a virtual seminar.

MATERIALS AND METHODS

The virtual case planning environment consisted of two different virtual environments - the entrance area and the case planning environment. Students and lecturers visited it with the used VR glasses Oculus Quest 2 (Meta Quest). All participants appeared as tooth avatars (molars) during the prosthetic case planning seminar and were able to communicate. These voluntary virtual case planning seminars took place in the clinical prosthetic courses (4th and 5th year). Students were asked to fill in the questionnaire comprising 15 questions separated into four categories, each assessed by a 11-point Likert scale: perceived presence/immersion, cognitive load, motivation and authenticity. A negative and a positive focus group were built, each consisting of three students answering three guiding questions. An exploratory data analysis was performed with the significance level set at p = .05.

RESULTS

A total of 64 students out of 98 participated in the virtual seminars. The results demonstrated that the students felt very comfortable in the virtual seminar environment and were able to focus well on the content, demonstrated in predominantly positive results for presence/immersion. Cognitive load and authenticity presented positive results. In particular, the motivation of the students showed a high score (median: 2.1-2.6; IQR: 3.9). The cognitive load should be reduced if necessary to increase focus. The cyber sickness is a challenge for some students as well as the technical requirements of the internet connection, which needs to be addressed. Nevertheless, virtual case planning seminars are an essential tool for motivating the new generation of students.

CONCLUSIONS

The results of the investigation demonstrate that the students felt very comfortable in the virtual seminar environment and were able to focus well on the content. The prosthetic case plannings were well understood and the students quickly become familiar with the environment. The cognitive load could be reduced to increase focus. In particular, the motivation of the students showed a high score. The cyber sickness is a challenge for some students as well as the technical requirements of the internet connection, which needs to be addressed.

Evaluating the Effectiveness of a Virtual Simulation Platform for Apexification Learning

The traditional teaching methods for apexification face difficulties in meeting dental students' practical training needs. Herein, we aimed to find optimal techniques of learning apexification and to evaluate whether a virtual simulation platform for apexification learning was effective. A virtual simulation learning platform for apexification was developed. Ninety-nine 4th-year dentistry students were classified randomly into the control group (Con, receiving conventional teaching) and the experimental group (Exp, receiving virtual simulation teaching). Theoretical tests before (test 1) and after the virtual simulation training (test 2) assessed the effect of learning. In the Exp group, a questionnaire was used to assess student understanding of the virtual simulation platform. In the Exp group, the test-2 scores were significantly better compared those in the Con group (p < 0.001). Furthermore, in the Exp group, the test-2 scores exceeded those of test 1 (p < 0.001). Feedback using the questionnaire covered the evaluation of the Exp group for the virtual reality platform and offered useful suggestions. Applying the virtual simulation learning platform had positive effects on improving learning quality related to apexification.

Comparison of the effectiveness of virtual reality-based education and conventional teaching methods in dental education: a systematic review

BACKGROUND AND OBJECTIVES

Virtual reality dental simulators as an educational tool may create specific training conditions for dental students, allowing them to practice dental skills in a safe and controlled condition. This study aimed to investigate the effectiveness of virtual reality-based education in dental education compared to traditional education approaches.

METHODS

In this systematic review, four databases (PubMed, Scopus, Web of Science, and Science Direct) were searched until 2023 following PRISMA guidelines. The Quality assessment and risk of bias were assessed by the Cochrane Collaboration Tool for RCTs and GRADE, respectively. Inclusion criteria were restricted to randomized or quasi-randomized trials about virtual reality efficacy in dental education. Two authors independently evaluated the data and reviewed the overall risk of bias for all selected studies. Study design, sample size, hardware, onset time of intervention, duration, and number of procedures performed were among the data extracted.

RESULTS

From the 703 titles, 48 full texts were chosen for review, yielding 14 articles for final inclusion. The review of these articles indicated the effective role of virtual reality dental simulators in improving students' knowledge and practical skills.

CONCLUSIONS

Based on our findings, adding haptic technology to virtual reality can improve students' practical skills, hand skills, theoretical knowledge, self-confidence, and learning environment. Although a fair amount of research needs to be done, notably on cost-effectiveness, student satisfaction, and other potentially adverse effects, virtual reality is a growing phenomenon with immense potential.

Endodontic microsurgery virtual reality simulation and digital workflow process in a teaching environment

INTRODUCTION

Computer simulations are stimulating increased attention in dentistry. Augmented reality superimposes a virtual scenario over an existing reality and allows interaction with it. Virtual reality (VR) simulates a fully immersive situation permitting the user to experience the full environment in real time. Haptic technology provides tactile and realistic force feedback for the user to experience the immersive situation as if they were really there. Preclinical training is important to gain familiarity with difficult surgical techniques and to implement interpersonal skills. Developing a valid assessment of surgical simulation is challenging. This paper wants to present a newly realized VR simulation in endodontic microsurgery through the developmental digital workflow, the demonstration of a haptic VR scenario and student self-assessment and self-reflection feedback.

METHODS

The volumes were exported in a stereolithography format to prepare and optimize in terms of shape and shade for the VR simulation. The graphics and touchable haptic solid were created using Virteasy Editor, which allows the transformation of 3D surfaces into graphical and volumetric haptic solids depending on their material (enamel, dentine, pulp and bone). Users were asked to execute the osteotomy and root-resection preparation. The assessment criteria were determined, and the feedback statements were created by a questionnaire with fixed answers. Objective and qualitative criteria for assessing the preparation were obtained from the literature.

RESULTS

This study provides proof that it is possible to provide reliable and clinically relevant qualitative feedback with a VR simulator.

CONCLUSION

VR simulation offers an innovative approach with all the benefits of clinical experience. It permits you to save your own progress and review the assessment at any time.

Which digital learning strategies do undergraduate dentistry students favor? A questionnaire survey at a German university

Background

The development in teaching dental education toward ever greater digitization has gained enormous momentum in the last 2 years due to the pandemic. However, acceleration is not synonymous with improvement, especially from the learners' point of view. Therefore, the aim of this survey among students of dentistry was to determine which digital learning strategies and which media are preferred.

Method

Undergraduate students of clinical semesters (6th to 9th) in dental medicine during at the University of Freiburg participated in an online-survey. Questions were asked about personal learning strategies for and experience with using digital media for private and educational reasons. Furthermore, students were asked which digital learning formats they preferred for different learning phases.

Results

Students (N=148) are experienced in using digital media for learning. They prefer classical media (such as textbooks and lectures) for acquiring basic theoretical knowledge and mention digital teaching formats more in relation to practical training and complex treatment procedures. 67% prefer learning alone and 90% rate visualizations as helpful for learning. 78% report, that they feel well supported in the learning process by digital media and 83% agree that e-learning offerings are a quality factor for university teaching. 82% state e.g. that the growing range of online content allows a more flexible approach to face to face-teaching, enriches classroom teaching (78%) and helps organize one's own study (79%).

Conclusion

Students have a positive attitude towards the use of digital media, especially when it comes to having more time available for practical exercises. They also see an advantage in the fact that through the use of digital media, lectures can be organized more flexibly and also the organization of their studies can be optimized. New digital teaching media should be created based on these results. It is important to consider which digital formats seem suitable for which content during different semesters.

Virtual reality simulation of panoramic radiographic anatomy for dental students

PURPOSE

This work aimed to utilize virtual reality (VR) in dental radiographic anatomical interpretation in junior dental students and test if it can enhance student learning, engagement, and performance.

METHODS

VR software for panoramic anatomy was developed. Sixty-nine first-year dental students were divided into a control group (lecture-based) and an experimental group (VR) to learn panoramic radiographic anatomy. Both groups were then tested on knowledge via a 20-question quiz. Student feedback on VR experience was collected via an online survey.

RESULTS

There was a statistically significant difference between lecture-based and VR students in the correct identification of anatomical landmarks. Lecture-based students scored higher in identifying the ear lobe, hyoid bone, condylar neck, and external oblique ridge, whereas VR students scored higher in identifying zygoma (Chi-squared test, p < 0.005). The VR group reported high evaluation on all perception items of the online feedback survey on their experience (Student t-test, p < 0.005).

CONCLUSIONS

Lecture-based students generally showed better performance in panoramic radiographic anatomy. Several structures were not correctly identified in both groups of novice students. The positive feedback of VR experience encourages future implementation in education to augment conventional methods of radiographic anatomy in dentistry with considerations to repeated exposures throughout undergraduate dental education.

Comparison of digital and conventional assessment methods for a single tooth preparation and educational satisfaction

INTRODUCTION

Digital feedback for tooth preparation can provide dental practitioners with more objective and accurate evaluations compared to conventional methods. This study aimed to evaluate the educational effect and satisfaction of digital feedback compared with those of the conventional putty index method for tooth preparation.

MATERIAL AND METHODS

Forty-eight third-grade dental students were selected. All students performed a full-coverage preparation on a right mandibular first molar resin tooth. They were randomly divided into four groups (n = 12)-no guide (control), putty index, digital feedback, and digital and putty index assessment. Three-dimensional analysis was performed using an analysis software (GomInspect 2018, Gom) to evaluate the amount of tooth structure removed. At the end of the practice, the students completed a questionnaire to evaluate the educational satisfaction of the respective methods.

RESULTS

There was no statistical significance of the amount of preparation amongst groups in most of the measured areas only except for several specific points. Overall occlusal surface showed 0.99 ± 0.27 mm in the N group (no guide) and 1.15 ± 0.31 mm in the D group (digital feedback), and overall axial surface showed no statistical differences (p > .05). The groups that used digital assessment showed a high level of satisfaction compared with conventional assessment.

CONCLUSIONS

It was difficult to confirm that the digital-based feedback promotes accurate tooth preparation compared to conventional feedback within the limitation of this study. However, it improved educational satisfaction and permitted objective evaluation.

Enabling Virtual Learning for Biomechanics of Tooth Movement: A Modified Nominal Group Technique

Virtual learning is a medium that can enhance students' understanding of a specific topic. The emergence of the COVID-19 pandemic provided an opportunity for dental education to shift from traditional learning to blended learning as it began to utilize technology to help students study effectively. In this study, we collaborated with experts in the field of dentistry to reach a consensus about which topics are appropriate to include in the virtual learning module about the biomechanics of tooth movement. We convened a panel of five experts who had a minimum of two years of experience in teaching orthodontics and introduced them to the Nominal Group Technique (NGT), which is a well-established, organized, multistep, assisted group meeting technique for generating consensus. The following ten key topics were identified for inclusion in the module: physiology of tooth movement; tooth movement-definition, type, theory, indications; force systems; anchorage; fixed appliances; biomaterials related to tooth movement; removable appliances; factors affecting tooth movement; iatrogenic effect of tooth movement; and current advances and evidence regarding tooth movement. The modified NGT approach led to the development of a ranked thematic list of the topics related to the biomechanics of tooth movement that can be delivered to students via virtual learning.

Pre-clinical undergraduate students' perspectives on the adoption of virtual and augmented reality to their dental learning experience: A one-group pre- and post-test design protocol

Background: We live in a time where traditional education has rapidly incorporated online modalities due to the recent SARS-CoV-2 (COVID-19) safety measures such as social distancing. Regardless of these challenges, health education constantly strives to implement the best technologies available for an effective student deep learning outcome. Virtual (VR) and augmented reality (AR) in the dental pre-clinical stage may help stimulate students to better understand the foundation material prescribed in the curriculum. Most visual material available for students is still mainly based on 2D graphics. Thus, this study will attempt to evaluate the students' perceptions about implementing VR/AR technologies in the learning setting. Methods: A single-group pretest-posttest design will be implemented where students will be exposed to VR/AR and fill out two questionnaires, one before and one after the exposure. Conclusions: This project is intended to start once the institutional ethical approval is obtained. It is expected that the analysis from the current project will provide recommendations to improve the students' academic curriculum pre-clinical experience. The recommendations will be provided in the form of at least three scientific publications, with one publication for each subject area intended to be evaluated (i.e., head and neck anatomy, dental anatomy, and removable prosthodontics).

Visualizing Anatomy in Dental Morphology Education

Tooth morphology is a foundation course for all dental healthcare students including dentists, dental hygiene, dental therapy, and dental nursing students. This chapter explores the conventional and innovative teaching methods to deliver tooth morphology educational modules. The teaching tools are explored with a 2D and 3D lens, with a particular focus on visualization, student understanding, and engagement. Traditional methods of teaching tooth morphology must be complemented with innovative pedagogical approaches in order to maintain student's attention and accommodate their diverse learning methods. Teaching 3D anatomy enables students to visualize and spatially comprehend the link between various anatomical components. Online tests and quizzes motivate students and are also beneficial in preparing students for exams. Online self-examinations offering visualization with 3D teeth enable students to evaluate their knowledge and offers immediate feedback, which aids in the long-term retention of information. These tools can be as efficient as other teaching methods, allowing the students to study at their own pace and with repetition. The authors conclude that blended and innovative teaching methods should supplement student learning and not replace, traditional face-to-face educational methods.

Mobile virtual tooth morphology teaching environment for preclinical dental students

OBJECTIVES

Extended reality as an additional digital learning concept comprises virtual reality (VR), augmented reality, and mixed reality. In particular, VR allows an interaction in the virtual world. The aim of this study was to evaluate the students' attitude toward a mobile VR application for teaching tooth morphologies.

METHODS

Eighty-two first year dental students were enrolled. After using the VR learning environment with mobile VR glasses at home for 1 week, the students were asked to fill in a questionnaire with 21 questions regarding intuitive handling, and supplemental learning information in comparison to the use of conventional textbooks. Nine questions provided predefined answer options, another nine had the form of a visual analog scale (VAS, range 0%-highly negative to 100%-highly positive), and three allowed free text answers. The data were checked for normal distribution (Kolmogorov-Smirnov test) and was analyzed descriptively.

RESULTS

Forty-four percent of the students rated their perception of understanding of dental morphologies much better with VR than with conventional learning. The potential of the VR learning environment for further dental topics was assessed with a median VAS score of 75.8%. Its intuitive handling was evaluated with a median VAS score of 67.1%. The haptic, visual, and auditory supplemental learning information was consistently rated positively with VAS scores of 73.9%, 80.0%, and 71.6%, respectively. Overall, a majority of the students (85.5%) recommended the VR learning environment for dental morphology.

CONCLUSIONS

The VR dental learning environment allows dental students an additional learning opportunity of dental morphologies, recommended by more than 85% of students.

Virtual and augmented reality in dental education: The good, the bad and the better

INTRODUCTION

Virtual reality and augmented reality (VR/AR) are becoming established technologies with a wide range of possibilities in various academic fields, including dentistry. The practice of dentistry encompasses a spectrum of skills and knowledge of anatomy, complex technical and clinical skills and sound academic understanding. This review aims to scope the current use of these technologies in dental education, explore their impact on teaching and learning and envisage their potential in this field.

MATERIALS AND METHODS

The Cochrane Library, PubMed and EMBASE were searched. Cochrane Handbook was used to conduct this systematic review. Inclusion and exclusion criteria were applied; randomised control trials published in English in the last 10 years (2010-2020) were considered and screened independently by two authors.

RESULTS

Fourteen of 524 studies were included and assessed. The majority of articles describing the use of VR/AR focused on an Undergraduate/General Dental Practitioner audience. Its use in Oral and Maxillofacial Surgery, Endodontics and Restorative dentistry was also described. There is evidence of motor skill acquisition using these systems which is comparative to that of traditional methods.

CONCLUSION

The use of VR/AR is well established in dental education; most applications relate to undergraduate education as a useful adjunct to dental training. In this article, the breadth of learning in dental education using VR/AR was exploited providing an overview to aid dental education. VR/AR is a useful adjunct to conventional learning in dentistry. However, there are limitations preventing VR/AR widespread use and applications, such as lack of trials, standardisation and accreditation of systems/content.

Three-Dimensional Tooth Models with Pulp Cavity Enhance Dental Anatomy Education

Dental anatomy is an integrated, core fundamental dental course, which prepares students for all future clinical dental courses. This study aimed to build up an online dental learning platform of micro-computed tomography-based three-dimensional (3D) tooth models with pulp cavity, and to further evaluate its effectiveness for dental anatomy education using a cohort study. First, ninety-six extracted permanent teeth were scanned by micro-computed tomography and the enamel, dentine, and pulp cavity of each was distinguished by different grey-scale intensities using Mimics software. Three-dimensional images allowed further discrimination and insights into permanent three-rooted premolars, central tip, and dental diseases including deep caries and wedge-shaped defects. Furthermore, a second mesiobuccal canal (MB2) in maxillary permanent molar teeth and Vertucci type III root canal configuration in mandibular anterior teeth could be detected using the 3D analytical tool. A digitized 3D tooth model learning platform was implemented. Last, two groups of dental students were assessed to evaluate the effect of 3D models on dental anatomy education. Participants in the Digital group were allowed to use the online dental learning platform freely after class, while the participants in the Traditional group were not. Assessment quizzes showed that participants' scores improved in the Digital group with the use of the learning platform compared with scores in the Traditional group. A questionnaire survey indicated that the participants had a positive attitude toward the 3D models. Thus, adding digital 3D resources to a traditional curriculum may have a positive effect on academic achievements.

Application of holography and augmented reality based technology to visualize the internal structure of the dental root - a proof of concept

BACKGROUND

The Augmented Reality (AR) blends digital information with the real world. Thanks to cameras, sensors, and displays it can supplement the physical world with holographic images. Nowadays, the applications of AR range from navigated surgery to vehicle navigation.

DEVELOPMENT

The purpose of this feasibility study was to develop an AR holographic system implementing Vertucci's classification of dental root morphology to facilitate the study of tooth anatomy. It was tailored to run on the AR HoloLens 2 (Microsoft) glasses. The 3D tooth models were created in Autodesk Maya and exported to Unity software. The holograms of dental roots can be projected in a natural setting of the dental office. The application allowed to display 3D objects in such a way that they could be rotated, zoomed in/out, and penetrated. The advantage of the proposed approach was that students could learn a 3D internal anatomy of the teeth without environmental visual restrictions.

CONCLUSIONS

It is feasible to visualize internal dental root anatomy with AR holographic system. AR holograms seem to be attractive adjunct for learning of root anatomy.

Digital technologies, healthcare and Covid-19: insights from developing and emerging nations

COVID-19 pandemic created a global health crisis affecting every nation. The essential smart medical devices/accessories, quarantine facilities, surveillance systems, and related digital technologies are in huge demand. Healthcare, manufacturing industries, and educational institutions need technologies that allow working from a safe location. Digital technologies and Industry 4.0 tools have the potential to fulfil these customized requirements during and post COVID-19 crisis. The purpose of this research is to provide understanding to healthcare professionals, government policymakers, researchers, industry professionals, academics, and students/learners of the paradigm of different Digital technologies, Industry 4.0 tools, and their applications during the COVID-19 pandemic. Digital technologies, Industry 4.0 tools and their current and potential applications have been reviewed. The use of different Digital technologies and Industry 4.0 tools is identified. Digital technologies and Industry 4.0 tools (3D Printing, Artificial Intelligence, Cloud Computing, Autonomous Robot, Biosensor, Telemedicine service, Internet of Things (IoT), Virtual reality, and holography) offer opportunities for effective delivery of healthcare service(s), online education, and Work from Home (WFH) environment. The article emphasises the usefulness, most recent development, and implementation of Digital technologies, Industry 4.0 techniques, and tools in fighting the COVID-19 pandemic worldwide.

Scoping review of artificial intelligence and immersive digital tools in dental education

PURPOSE

The aim of this scoping review is to examine artificial intelligence (AI) and virtual teaching models within the context of dental education, establish methods to address the resources being investigated, and ultimately augment this approach for future scientific research.

METHODS

To evaluate the applications of AI and immersive technology, a scoping literature review was conducted using the Embase, PubMed, Web of Science, and Cochrane Library database from the years 2018 to May 19, 2021. Additionally, a manual search was completed. The search strategy was formulated according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR) guidelines. Studies that addressed the current uses of virtual devices and their revolutionary potential in dental education were categorized separately for further evaluation.

RESULTS

 Of the 2500 articles found in our initial search results, 31 articles met the inclusion criteria set for this review. The selected studies were directly related to AI and immersive tools in dental education.

CONCLUSION

To our knowledge, there are very few comprehensive literature reviews identifying the applications and efficacy of virtual and AI-driven tools in dental education. With limited verifiable evidence, an improved understanding of virtual and AI domains is needed to enable dental students to adapt to changes within and beyond their dental training education. To increase the scientific value of digital-related research, the scientific community must quickly define guidelines to enhance methodological approaches in order to effectively digitalize dentistry.

Virtual dental teaching and its effect on test success - A cross-over study

OBJECTIVES

The aim of this cross-over investigation was to analyze the effect of virtual teaching using virtual reality (VR) within a dental learning environment by preclinical students with or without dental professional experience on test performance.

METHODS

Preclinical students (N = 82) were randomly divided into two groups for cross-over testing of tooth morphology knowledge: (a) anterior VR-group (group 1) using the VR-glasses as an additional learning tool for the anterior tooth morphologies and (b) posterior VR-group (group 2) using it for the posterior tooth morphologies also in addition to conventional learning. All students used the VR-glasses for 1 week independent of time and location depending on group. The students had to recognize teeth (anterior or posterior within two separate tests after three [anterior test] and 6 weeks [posterior test] of practical course) and note the tooth number and characteristics in written form. Former dental experience (dental technician/assistance) was noted. Test results were analyzed to quantify the effect of virtual teaching on test scores. Data were analyzed with the Kolmogorov-Smirnov and Mann-Whitney U test (p = 0.05).

RESULTS

By differentiating the two student groups (use of VR glasses for anterior/posterior teeth) within the dental experience group, significantly better test results (p = 0.040) were shown for group 1 in the total posterior teeth test score. Furthermore, no other significant differences, but a possible tendency, in the test results and thus no effect of the use of the VR glasses on both VR groups could be analyzed (p ≥ 0.051).

CONCLUSIONS

Using the VR tooth learning environment predominantly did not lead to a significant improvement of test results. Anterior teeth test scores predominantly showed significantly better results than posterior teeth test scores.

Effectiveness of Virtual Reality and Interactive Simulators on Dental Education Outcomes: Systematic Review

In recent years, virtual reality and interactive digital simulations have been used in dental education to train dental students before interacting with real patients. Scientific evidence presented the application of virtual technology in dental education and some recent publications suggested that virtual and haptic technologies may have positive effects on dental education outcomes. The aim of this systematic review was to determine whether virtual technologies have positive effects on dental education outcomes and to explore the attitudes of dental students and educators toward these technologies. A thorough search was conducted in PubMed, Scopus, MEDLINE (via EBSCO), The Cochrane Library (via Wiley), Web of Science Core Collection (via Thomson Reuters), and Dentistry and Oral Science source (via EBSCO) using the keywords (student, dental) AND (education, dental) AND (virtual reality) OR (augmented reality) OR (haptics) OR (simulation) AND (dentistry) OR (dental medicine). The quality of the reported information was assessed following the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement for systematic reviews. A total of 73 publications were considered for this review. Fifty-two of the selected studies showed significant improvement in educational outcomes and virtual technologies were positively perceived by all the participants. Within the limitations of this review, virtual technology appears to improve education outcomes in dental students. Further studies with larger samples and longer term clinical trials are needed to substantiate this potential positive impact of various virtual technologies on dental education outcomes.

A multicentric survey to evaluate preclinical education in Endodontology in German-speaking countries

AIM

To evaluate preclinical education in Endodontology at Austrian, German and Swiss dental schools using an online survey.

METHODOLOGY

An online survey divided into nine categories was sent using SurveyMonkey software to 37 dental schools, before the spread of the COVID-19 pandemic. The questionnaire included 50 questions to evaluate preclinical endodontic education, such as faculty-to-student ratios, topics taught and materials used, in preclinical phantom head courses. Seven and 14 days after the first e-mail contact, dental schools received a reminder e-mail. After four and six weeks, the dental schools were contacted by telephone and asked to participate in the online survey. The processing time was eight weeks in total.

RESULTS

The response rate was 89%. Preclinical endodontic education at the participating dental schools differs considerably. Theory classes ranged from 1 to 70 h (15 h mean), and practical classes ranged from 3 to 78 h (39 h mean). The faculty-to-student ratio varied between 1:4 and 1:38 (1:15 mean). Forty-five per cent of the dental schools had a specialist in endodontics teaching theory. Several dental microscopes were available for preclinical teaching purposes at 82% of the dental schools. The majority (82%) taught root canal preparation with rotary or reciprocating NiTi instruments. Overall, 85% of the dental schools taught lateral compaction, amongst other methods, for canal filling.

CONCLUSION

A substantial divergence amongst the dental schools regarding the time dedicated to theory and practical instruction in Endodontology was reported. However, convergence in the use of root canal treatment techniques and materials was reported.

RoboEthics in COVID-19: A Case Study in Dentistry

The COVID-19 pandemic has caused dramatic effects on the healthcare system, businesses, and education. In many countries, businesses were shut down, universities and schools had to cancel in-person classes, and many workers had to work remotely and socially distance in order to prevent the spread of the virus. These measures opened the door for technologies such as robotics and artificial intelligence to play an important role in minimizing the negative effects of such closures. There have been many efforts in the design and development of robotic systems for applications such as disinfection and eldercare. Healthcare education has seen a lot of potential in simulation robots, which offer valuable opportunities for remote learning during the pandemic. However, there are ethical considerations that need to be deliberated in the design and development of such systems. In this paper, we discuss the principles of roboethics and how these can be applied in the new era of COVID-19. We focus on identifying the most relevant ethical principles and apply them to a case study in dentistry education. DenTeach was developed as a portable device that uses sensors and computer simulation to make dental education more efficient. DenTeach makes remote instruction possible by allowing students to learn and practice dental procedures from home. We evaluate DenTeach on the principles of data, common good, and safety, and highlight the importance of roboethics in Canada. The principles identified in this paper can inform researchers and educational institutions considering implementing robots in their curriculum.

Development and Student Perception of Virtual Reality for Implant Surgery

(1) Introduction: New and innovative approaches to dental education have continued to improve with time. The coronavirus disease 2019 (COVID-19) pandemic forced dental education to change as social distancing implementations were enforced. Virtual reality was used as a resource before the COVID-19 pandemic, and it has become more essential due to social restrictions. Virtual reality can allow students to be fully immersed in a clinical environment without leaving their homes. (2) Methods: The development of virtual reality (VR) for implant surgery was described. Selected students filled out a survey before and after using the program. Then, a focus group discussion for the students was held to analyze the program further. (3) Results: Seven dental students enrolled in the Advanced Predoctoral Implant Program (APIP) participated in the study. Qualitative analysis of this study suggests that virtual reality can be used as a supplemental resource to enhance student learning of specific topics. Additionally, the students had positive outlooks for using virtual reality as a resource in dental education and were hopeful to use it in the future for particular topics and subjects. (4) Discussion: The advantages and disadvantages of VR application in education were described. This application allows the students to be immersed fully with virtual dental operatory. The application provides the student with an enhanced learning experience in implant dentistry. Students displayed supportive attitudes towards the applicability of VR in dental education but considered this application as an adjunctive tool for learning. (5) Conclusion: The application of this technology in dental education is promising. The use of virtual reality in teaching and learning implant dentistry offers positive enhancement, especially during these challenging times.