Virtual reality and haptics in dental education: Implementation progress and lessons learned after a decade

A comparison of traditional and virtual reality haptic simulator approaches in preclinical endodontic training: Impacts on skill acquisition, confidence and stress

AIM

This study aimed to evaluate the influence of virtual reality (VR) haptic simulators on manual dexterity, self-confidence and stress levels of 3rd-semester dental students during preclinical endodontic training, as well as to determine the optimal timing for their introduction into the curriculum-before or after training with artificial teeth.

METHODOLOGY

Forty volunteered dental students enrolled in preclinical endodontic training were randomly divided into two groups. Group 1 (VR Haptic Simulator group, n = 20) completed four sessions with VR haptic simulators, including three training sessions followed by an evaluation session, before practicing on artificial teeth, whilst Group 2 (Control group, n = 20) performed a single attempt on artificial teeth first followed by the identical VR haptic simulator training period as Group 1. Prior to the training sessions, both groups received standardized lectures and demonstrations on access cavity preparation. Pre- and post-training evaluations included stress levels measured via a visual analog scale (VAS) at different phases, assessment of manual dexterity through preclinical training with artificial teeth performance scores, and self-confidence surveys. Statistical analyses were conducted with significance set at p < .05.

RESULTS

Group 1 demonstrated significantly higher manual dexterity scores and self-assessed proficiency compared to Group 2 (p < .05). Stress levels, measured via VAS, were notably reduced following simulator practice in both groups, with Group 1 reporting lower anxiety levels during preclinical training with artificial teeth sessions (p < .05). Simulator-based performance metrics were comparable between the groups (p > .05). Self-confidence surveys indicated that Group 1 felt better prepared and more confident in performing access cavity preparations and managing procedural challenges.

CONCLUSION

The integration of VR haptic simulators before preclinical training with artificial teeth has a positive effect on students' manual dexterity along with reduced stress and increased self-confidence in clinical skills. Further research is needed to explore long-term effects and optimal integration strategies for VR simulators in dental curricula.

Development and user experience of a three-dimensional object-based virtual reality-simulation tool for dental radiography training: a randomized controlled trial

BACKGROUND

In dental radiography education, students typically observe instructor demonstrations and practice on mannequins or peers. However, owing to the large student-to-instructor ratio, providing individualized feedback is challenging. Repeated practice is also hindered by radiation exposure from dental radiography machines. Implementing three-dimensional (3D) object-based virtual reality (VR) simulations can address these concerns. We developed a 3D object-based VR-simulation tool for dental radiography learning (namely, 3DOVR-DR) and evaluated user experiences.

METHODS

For the development of 3DOVR-DR, a virtual dental radiography room was constructed using 3D objects. The intraoral radiography process was divided into 12 steps, and the Unity 3D engine was used to create an interactive VR environment for step-by-step learning. This study was a randomized controlled trial. To evaluate user experience, 79 participants were randomly assigned to a control group (n = 39), which used Google Cardboard for VR, or an experimental group (n = 40), which used 3DOVR-DR, to evaluate the user experience. A survey questionnaire of 22 items was administered to all participants. Statistical analyses included descriptive statistics and Mann-Whitney U test.

RESULTS

The 3DOVR-DR tool provided an immersive experience for simulating and learning the dental radiography process within a VR setting. Users performed step-by-step tasks related to dental radiography in the virtual space, adjusting and repeating the entire process or specific steps as needed for their learning. Users received guidance and practiced dental radiography using 3DOVR-DR. User-experience ratings were significantly higher in the experimental group (4.35±0.47) compared to the control group (3.63±0.66; P < 0.001).

CONCLUSIONS

The 3DOVR-DR tool shows potential as a learning medium for intraoral radiography education. Further analysis is needed to examine the impact and mediating effects of the 3D object-based VR experience on dental radiographic practice. Future research should include pedagogical analysis to evaluate the educational effectiveness of this learning tool.

From Virtual Reality to Reality: Fine-Tuning the Taxonomy for Extended Reality Simulation in Dental Education

INTRODUCTION

Digital simulation in dental education has substantially evolved, addressing several educational challenges in dentistry. Following global lockdowns and sustainability concerns, dental educators are increasingly adopting digital simulation to enhance or replace traditional training methods. This review aimed to contribute to a uniform taxonomy for extended reality (XR) simulation within dental education.

METHODS

This scoping review followed the PRISMA and PRISMA-ScR guidelines. PubMed/MEDLINE, EMBASE, Web of Science and Google Scholar were searched. Eligible studies included English-written publications in indexed journals related to digital simulation in dental/maxillofacial education, providing theoretical descriptions of extended reality (XR) and/or immersive training tools (ITT). The outcomes of the scoping review were used as building blocks for a uniform of XR-simulation taxonomy.

RESULTS

A total of 141 articles from 2004 to 2024 were selected and categorised into Virtual Reality (VR), Mixed Reality (MR), Augmented Reality (AR), Augmented Virtuality (AV) and Computer Simulation (CS). Stereoscopic vision, immersion, interaction, modification and haptic feedback were identified as recurring features across XR-simulation in dentistry. These features formed the basis for a general XR-simulation taxonomy.

DISCUSSION

While XR-simulation features were consistent in the literature, the variety of definitions and classifications complicated the development of a taxonomy framework. VR was frequently used as an umbrella term. To address this, operational definitions were proposed for each category within the virtuality continuum, clarifying distinctions and commonalities.

CONCLUSION

This scoping review highlights the need for a uniform taxonomy in XR simulation within dental education. Establishing a consensus on XR-related terminology and definitions facilitates future research, allowing clear evidence reporting and analysis. The proposed taxonomy may also be of use for medical education, promoting alignment and the creation of a comprehensive body of evidence in XR technologies.

Benefits and challenges of the integration of haptics-enhanced virtual reality training within dental curricula

BACKGROUND

Haptics-enhanced virtual reality (VR-haptic) simulation in dental education has evolved considerably during the past decade, representing a promising resource of simulation-based training opportunities to support conventional practice. We aim to summarize current literature on the applications of VR-haptics in learning, practicing, and teaching dental education.

METHODS

A literature search was performed using PubMed, focusing on research articles published between January 2010 and January 2024. Out of the 667 articles that matched the search terms (dentistry, education, haptic, teaching, training, virtual reality), 105 were screened, and 42 were eligible for full-text reading and utilization. Findings from an ongoing educator survey on the use of VR-haptics in dental education have also been provided.

RESULTS

VR-haptic simulation has been shown to have a supportive role in dental simulation practice. Despite training within a digital world, hand skill transfer to the real world has been demonstrated, which affords educators more flexibility in how to train their students before and during traditional preclinical and clinical practical education. The individualized VR-haptic training and feedback help students in mastering essential working techniques, while also increasing engagement and motivation.

CONCLUSIONS

VR-haptics-supported dental education can help students effectively address challenges during their preclinical and clinical training, as well as in their subsequent careers, and it may help mitigate some weaknesses of the current educational system. Validation is a key factor for the acceptance of VR-haptic simulators; thus, further research and verification are needed before VR-haptics could be considered a primary hand skill development method of learning in dental education. VR-haptic simulation may in the future be used as an assessment tool for the students' and clinicians' credentialing process.

The use of augmented reality (AR) and virtual reality (VR) in dental surgery education and practice: A narrative review

Integrating augmented reality (AR) and virtual reality (VR) into dental surgery education and practice has significantly advanced the precision and interactivity of dental training and patient care. This narrative review summarizes findings from extensive literature searches conducted in PubMed, Cochrane Library, and Embase, highlighting AR and VR technologies transformative impact and current applications. Research shows that AR improves surgical precision by offering real-time data overlays during procedures, leading to better outcomes in operations like dental implant placements. On the other hand, VR has revolutionized training environments by offering detailed, immersive simulations that significantly improve the retention of surgical skills. This was demonstrated through VR applications in orthognathic surgery in 2023. Despite their advantages, these technologies encounter adoption challenges, such as high implementation costs and the complexity of integrating advanced simulations into standard training curricula. The prospects for AR and VR in dental surgery are promising. Ongoing developments aim to enhance realism through improved haptic feedback and integrate artificial intelligence to tailor learning experiences. Continued innovation and research are crucial to overcome current limitations, expand applications, and fully realize the potential of AR and VR in improving dental education and clinical practice.

Haptic devices as an educational approach for oral and maxillofacial surgical procedures

OBJECTIVE

Developing the skills of a proficient surgeon with a deep understanding of force requires extensive training and repetitive practice. Traditionally, dental students and surgical trainees observed and participated in procedures using models, animals, or cadavers under expert supervision before performing the procedures independently. To address these challenges, interactive simulators with visuo-haptic features have been introduced in surgical training, providing visual and tactile feedback that replicates the sense of touch through applied forces, vibrations, or motions.

STUDY DESIGN

Two independent reviewers employed a specific search strategy to explore online databases such as PubMed, Scopus, and Web of Science (WoS). This strategy included keywords such as "haptic device," "education," "oral surgery," "surgery," and "maxillofacial surgery." All types of studies related to maxillofacial surgery, except for case reports, reviews, and eBooks, were considered for inclusion.

RESULTS

A total of 22 articles meeting the screening criteria were identified. The use of haptic devices for training dental students in oral surgery, anesthesia, as well as oral and maxillofacial trainees and surgeons in various surgical procedures, was evaluated.

CONCLUSION

Incorporating tactile devices into the training of residents and maxillofacial surgeons offers numerous advantages, including improved technical skills and enhanced patient safety.

Haptics in fixed prosthodontics and their role in dental education: A literature review

Technological progress leads to new advances in dental education. One of the applications involves the use of virtual and augmented reality as educational aids. The emerging question is to establish if and how these enhancements may prove beneficial to the overall student learning process. A review of recent literature was conducted with the aim of providing evidence for the development of relevant clinical guidelines. The proposed topic attempted to provide answers to the questions of (a) how participants perform when using haptic devices compared to traditional tooth preparation methods on typodonts, (b) how the use of simulators is perceived by both students and educators, and (c) what added value simulators may have in prosthetic dentistry training. The main findings of this study showed that participants expressed satisfaction with the educational experience, finding it both stimulating and very similar to the actual clinical environment. However, differences between haptic and conventional methods were also apparent. Haptics was a significant predictor of clinical crown performance. Significantly better results and shorter preparation times tended to increase with experience. In conclusion, self-directed learning appears to be beneficial in the clinical education that follows data-driven approach. At the pre-laboratory level, simulators may act as an initial familiarization instrument. At the preclinical level, they may aid in detecting students who require extra assistance, or to provide extra training hours for students lacking adequate competency to enter the clinical training phase.

The application of a virtual rubber dam isolation training system in dental preclinical education

Objective

To assess the efficacy of a virtual rubber dam isolation training system in enhancing preclinical dental education.

Methods

A total of 28 Grade 4 undergraduate dental students were randomly divided into two groups: a virtual simulation priority group and a conventional phantom-head priority group. The virtual simulation priority group underwent virtual simulation training initially, followed by conventional phantom-head training. Conversely, the conventional phantom-head priority group received traditional training first, subsequently followed by virtual simulation training. Pre- and post-training theoretical knowledge examination were administered, and a practical ability assessment was conducted after the second theoretical examination. A questionnaire survey was also conducted to gauge students' attitudes and satisfaction towards the training process.

Results

After training, both groups exhibited significantly higher mean scores of theoretical knowledge examination compared to their baseline scores (P < 0.001). Notably, the virtual simulation priority group achieved significantly higher average scores than the conventional phantom-head priority group (P < 0.001,Cohen's d = 1.778). However, there was no significant difference in the mean time taken to complete the practical ability assessment between the two groups (P>0.05,Cohen's d = 0.19). Furthermore, the majority of students (96.4 %) strongly agreed that the virtual rubber dam isolation training enhanced their comprehension of the knowledge. 92.9 % of the students strongly agreed that the virtual training system improved their abilities of mastering the rubber dam isolation technique. Only two students (7.1 %) expressed neutrality regarding the virtual simulation effectiveness.

Conclusions

This study showed that the virtual rubber dam isolation training was useful in the preclinical skills training. The integration of virtual simulation into the curriculum, particularly when prioritized over conventional methods, has shown promising results in enhancing students' theoretical knowledge and technical skills related to rubber dam isolation.

Assessment and evaluation of online education and virtual simulation technology in dental education: a cross-sectional survey

BACKGROUND

The global outbreak of coronavirus disease (COVID-19) has led medical universities in China to conduct online teaching. This study aimed to assess the effectiveness of a blended learning approach that combines online teaching and virtual reality technology in dental education and to evaluate the acceptance of the blended learning approach among dental teachers and students.

METHODS

The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) checklist was followed in this study. A total of 157 students' perspectives on online and virtual reality technology education and 54 teachers' opinions on online teaching were collected via questionnaires. Additionally, 101 students in the 2015-year group received the traditional teaching method (TT group), while 97 students in the 2017-year group received blended learning combining online teaching and virtual reality technology (BL group). The graduation examination results of students in the two groups were compared.

RESULTS

The questionnaire results showed that most students were satisfied with the online course and the virtual simulation platform teaching, while teachers held conservative and neutral attitudes toward online teaching. Although the theoretical score of the BL group on the final exam was greater than that of the TT group, there was no significant difference between the two groups (P = 0.805). The skill operation score of the BL group on the final exam was significantly lower than that of the TT group (P = 0.004). The overall score of the BL group was lower than that of the TT group (P = 0.018), but the difference was not statistically significant (P = 0.112).

CONCLUSIONS

The blended learning approach combining online teaching and virtual reality technology plays a positive role in students' learning and is useful and effective in dental education.

Application of virtual reality and haptics system Simodont in Chinese dental education: A scoping review

INTRODUCTION

Virtual reality (VR) and haptic simulation technology have been increasingly implemented in dental training. Since the first haptic VR dental simulator (Simodont) was introduced 10 years ago, it has been applied in more than 40 universities in mainland China. This scoping review aimed to review literature, showcasing the teaching reform of dental virtual simulation in mainland China to global dental education peers.

METHODS

This scoping review was conducted using the PRISMA extension for scoping review guidelines. Seven electronic databases were searched, and two reviewers independently performed the selection and characterization of the studies.

RESULTS

The final scoping review included 12 studies. Four studies focused on the G. V. Black class II cavity, three on manual dexterity skills training, two on full metal crown preparation, one on pulpal access and coronal cavity preparation, one on flipped classroom teaching, and one on 'doctor-patient communication' skills.

DISCUSSION

The most critical scenarios, self-assessment, working posture, curriculum setting, training and cost are analysed and discussed.

CONCLUSION

Haptic simulation technology is a valuable complementary tool to the phantom head in dental education. The combined utilization of these two training devices has been superior to either in isolation. However, there is a lack of research on the sequencing of the two systems, as well as the appropriate distribution of curriculum between them. It is necessary for educators to organize or engage in experience sharing, collaboration and knowledge dissemination. These actions are essential for promoting effective teaching within dental educational institutions.

Enhancing learning experiences in pre-clinical restorative dentistry: the impact of virtual reality haptic simulators

BACKGROUND

Utilization of Virtual Reality haptic simulation (VRHS) to aid in the training of various pre-clinical skills is of recent interest. The aim of this study was to evaluate the impact of VRHS in restorative dentistry on the learning experiences and perceptions of dental students.

METHODS

An interventional study design was utilized to recruit third year students. All participants provided informed consents and were randomly divided into two groups. Group 1: Initially performed a Class I cavity preparation with the VRHS, followed by the same exercise using the phantom head/ acrylic typodont teeth in a conventional simulation environment (CSE). Group 2: Initially performed Class I preparations in a CSE, followed by the same exercise using VRHS. Both groups performed the exercises on a lower right first molar. To understand students' perception, an online questionnaire was circulated. Data analysis involved Chi-square tests, independent t-tests and Mann-Whitney U-tests using the R statistical environment package.

RESULTS

A total of 23 dental students participated in this study. Although student's perceptions were similar in both groups, a strong agreement that VRHS training might be used to supplement standard pre-clinical training was noted. Advancements to the VRHS hardware and software are required to bridge the gap and provide a smooth transition to clinics.

CONCLUSION

Novice dental students generally perceived VRHS as a useful tool for enhancing their manual dexterity. Dental institutions should endorse virtual reality technology with caution, ensuring a planned integration into the curriculum to optimize benefit. Feedback is pivotal to effective learning in simulation-based education, and the triangulation of feedback could serve as a powerful aid to maximize the learning experience.

Reshaping dental faculty development using collective healthcare experiences

Dental academics provide a fulfilling career path to educate the next generation of oral health professionals. The number of dentists choosing a career in dental academics is declining and existing faculty are opting for other career options. As the number of dental schools increase across the US, a critical shortage of educators may be evidenced. In dentistry, innovative approaches to develop academic faculty are not keeping pace with the growing needs of dental faculty, who are challenged to establish a fulfilling work-life balance. This work reviews existing methods that other health professions implement to develop faculty for successful career growth. This review highlights factors and related cofactors that influence career development among dental faculty. Recommendations are presented as potential solutions based on the assessment of similar experiences published by related academic healthcare professions. Dental academia must increase attention to faculty needs and awareness by conducting institutional-specific studies to address these issues with customizable solutions.

Perceptions of Online Learning Implementation in Dental Education during the COVID-19 Pandemic: A Cross-Sectional Study of Dental School Faculty Members in Southeast Asia

OBJECTIVE

To assess the perceptions of faculty members from dental schools in Southeast Asian countries regarding the implementation of online learning during the COVID-19 pandemic.

METHODS

A previously implemented questionnaire comprising 43 questions was utilized in this study. Lecturers from four universities in Southeast Asia were invited to participate in the study.

STATISTICAL ANALYSIS

The data were analyzed using SPSS version 25.0 through several types of comparative and correlation analyses.

RESULTS

There were 183 lecturers who participated in the study. The overall responses suggest that the perceived effectiveness of online learning in dentistry was centered on a neutral value. The participants faced challenges when implementing online learning during the COVID-19 pandemic, with the lack of interaction being the most challenging factor. They agreed that online learning had many advantages, specifically in time flexibility and communication. The participants had stronger perceptions relating the advantages and opportunities of online teaching, and recognized that the effectiveness of offline teaching alone was limited.

CONCLUSION

The perceptions of Southeast Asian dental school faculty members were inclined toward a positive outlook on blended learning for implementation in dentistry, as a means of providing opportunities to use online learning beyond COVID-19 in the future.