Surgical Training 2.0: A systematic approach reviewing the literature focusing on oral maxillofacial surgery - Part II

3D-printed model for gingival flap surgery simulation: Development and pilot test

INTRODUCTION

To assess the feasibility of a realistic model for learning oral flaps using 3D printing technology.

MATERIALS AND METHODS

A mould was designed to reproduce the mandibular gingival mucosa, and a mandibular model was created using a three-dimensional printer for training undergraduate students to perform gingival flaps. After a short interview about its use, the participants were asked to use the simulator and provide feedback using a 5-point Likert questionnaire.

RESULTS

The 3D-printed oral surgery flap training model was practical and inexpensive. The model was very realistic, educational and useful for hands-on training.

CONCLUSIONS

3D printing technology offers new possibilities for training in dental treatments that are currently difficult to replicate. The use of this simulator for oral flap surgery was well-received and considered promising by the participants.

Contribution of 3D printing for the surgical management of jaws cysts and benign tumors: A systematic review of the literature

BACKGROUND

Three-dimensional (3D) printing is now a widely recognized surgical tool in oral and maxillofacial surgery. However, little is known about its benefits for the surgical management of benign maxillary and mandibular tumors and cysts.

PURPOSE

The objective of this systematic review was to assess the contribution of 3D printing in the management of benign jaw lesions.

METHODS

A systematic review, registered in PROSPERO, was conducted using PubMed and Scopus databases, up to December 2022, by following PRISMA guidelines. Studies reporting 3D printing applications for the surgical management of benign jaw lesions were considered.

RESULTS

This review included thirteen studies involving 74 patients. The principal use of 3D printing was to produce anatomical models, intraoperative surgical guides, or both, allowing for the successful removal of maxillary and mandibular lesions. The greatest reported benefits of printed models were the visualization of the lesion and its anatomical relationships to anticipate intraoperative risks. Surgical guides were designed as drilling locating guides or osteotomy cutting guides and contributed to decreasing operating time and improving the accuracy of the surgery.

CONCLUSION

Using 3D printing technologies to manage benign jaw lesions results in less invasive procedures by facilitating precise osteotomies, reducing operating times, and complications. More studies with higher levels of evidence are needed to confirm our results.

Visual Novels in Maxillofacial Surgery Education: A Hidden Gem

Visual novels are vital learning tools that promote student satisfaction and help them acquire the skills and knowledge needed to solve problems. They use interactive narrative designs to create a list of effective teaching strategies to enhance user experience. The practical use of these resources would require orienting learners to online training to improve their understanding of content. Educators must recognize the uniqueness of online learning designs and tools to develop effective strategies to enhance user understanding and improve student-teacher interactions. Visual novels' effectiveness in maxillofacial surgery education should involve assessing the play and diverting attention from lesson content to how effectively students learn. Deduction activities and features in the game should be informative and entertaining and make considerations for short- and long-term objectives like delivering feedback on immediate and appropriate tool use and communication. Visual novels are interactive, allowing users to control story development through specific actions. These interactive narratives are primarily used in academic and industrial contexts covering diverse subjects. These models have become increasingly crucial in maxillofacial surgery, providing technical help and improving surgery's quality and speed. Instructors could develop the games as a course component or integrate them with other course materials because they are easy to access and download. However, some visual novels have failed to incorporate educational content delivery with interactive experiences. This indicates a research gap in interactive narrative designs and the primary content delivery mechanisms. Incorporating these resources into education and practice would reduce reliance on experience alone, reducing surgical errors and mistakes. This review highlights the importance of visual novels in maxillofacial surgery education and emphasizes their educational role.

Validity of an immersive virtual reality training system for orthognathic surgical education

Virtual reality (VR) has been proven an important supplement for surgical education in medical students. However, studies on immersive VR (iVR) simulation in orthognathic surgical education are limited. This study aimed to assess the validity of the iVR surgical training system for orthognathic surgery. Participants completed questionnaires at the end of the course to assess the validity of the training system. The questionnaires included questions on the experience of using the iVR system and surgical authenticity. Seven experienced surgeons and seven inexperienced students were recruited in this study to use our self-developed iVR training system for orthognathic surgery. The participants showed strong agreement to the fidelity of our training system (4.35 out of 5), including the virtual environment, instruments, anatomy structures, and surgical procedures. The participants also strongly agreed that the iVR technique was essential in imparting surgical education. However, most of the participants experienced some degree of dizziness or fatigue after 1 h of using the system. The iVR training system is a new method for imparting education about orthognathic surgery. The iVR training system can act as a supplement and potential substitute of the traditional surgical training method.

Three-dimensional printing models improves long-term retention in medical education of pathoanatomy: A randomized controlled study

INTRODUCTION

Craniosynostosis is a rare and complex pathology, and visuospatial skills are necessary for a good understanding of the condition. While the use of three-dimensional (3D) models has improved the understanding of complex craniofacial anatomy, no study has evaluated the impact of this teaching support on long-term retention.

MATERIALS AND METHODS

Our randomized controlled trial was designed to compare the long-term retention of information with 3D-printed models of four types of craniosynostosis versus classic 3D reconstructions displayed in two-dimensional (2D) among undergraduate students. All students benefited from the same standardized course followed by the manipulation of the learning tool associated with the group for 15 minutes. Long-term retention was assessed by the capability to properly recognize different types of craniosynostosis 3 weeks after the course.

RESULTS

Eighty-five students were enrolled. Previous educational achievements and baseline visuospatial skills were similar between the groups. The bivariate analysis showed the mean score in the 3D and 2D groups were 11.32 (2.89) and 8.08 (2.81), respectively (p < 0.0001).

CONCLUSIONS

3D-printed models of structures with spatial complexity such as various craniosynostosis patterns improve significantly medical students' long-term retention, indicating their educational efficacy.