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Virtual Dental Simulator: Enhancing Dental Education with Haptic Technology

The hapTEL project at King's College London has developed a haptically enabled virtual reality dental simulator. This simulator aims to improve dental education by providing students with a realistic virtual environment to practice their skills. The project is funded by the UK Technology Enhanced Learning Research Programme and the UK Economic and Social Research Council, among others.

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Virtual Dental Simulator: Enhancing Dental Education with Haptic Technology

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  1. King’s College London a The hapTEL Project A haptically enabled Virtual Reality Dental Simulator by Dr Barry F.A. Quinn

  2. Funders • UK Technology Enhanced Learning (TEL) Research Programme (within ESRC) • UK Economic and Social Research Council (ESRC) • UK Engineering and Physical Sciences Research Council (EPSRC) • UK Joint Information Systems Committee (JISC) Award Number: RES-139-25-0387 2

  3. hapTEL Interdisciplinary team Prof. Margaret Cox (Director, KCL) Prof. Nairn Wilson (User-Group Coordinator, KCL) Dr. Jonathan P. San Diego (Project Manager, KCL) Dr. Barry Quinn ((Lead Clinician, KCL) King’s College Staff and Post-graduate students Prof. Stephen Dunne, Prof. Tim Newton, Dr. Jon Hindmarsh, Dr. Mark Woolford, Prof. Brian Millar, Dr. Brett Robinson, Dr. Barry Quinn, Dr. Avijit Banerjee, Mr. Joe Harper, Mr. Lewis Hyland, Ms Tracy-ann Green, Mr. Arash Shahriari Rad and Mrs. Clarabella Gray University of Reading - Cybernetics team Prof. William Harwin, Dr. Alistair Barrow and Mr. Brian Tse. Consultants Mr. Bruce Elson - Engineering Prof. Patricia Reynolds – Flexible learning in Dentistry

  4. Previous research into learning with haptic virtual dental systems Effects on transfer (Alexander et al., 2005 and Muchinsky, 1991) • Fidelity • Physical (Baum, Riedel, Hays, & Mirabella, 1982) • Functional (Allen et al., 1986) • Psychological (Kaiser & Schroeder, 2003). • Levels of Immersion (Taylor, 2002) • Diegetic and situated • Levels of Presence (Heeter, 1992) • Three types: Environmental, Social and Personal • Buy-in e.g. Levels of Attitudinal beliefs ( c.f. Webb and Cox, 2004)

  5. Why simulated practice? • Smoother transition for students into the clinic • Support and reinforces ergonomics, infection control etc • Broaden the students’ preclinical experience by including additional models mimicking real patient • Encourages autonomous and competent skills learning • Improves the delivery of supporting material such as demonstrations, diagrams, manuals etc.

  6. Goals and issues for Dental Education Undergraduate Dental Education hand-eye Co-ordination Developing the learner to become a practising professional Using tactile devices Manipulative skills Spatial reasoning skills Changing the way Professionals work: e.g. in teams with DCPs Increasing size of student cohorts Need to provide satisfactory and sufficient feedback to students

  7. Research into developing virtual dental systems • Physical Layout (Ergonomics, collocation, workspace) • Physical interface (inclusion of rubber cheeks, synthetic tissues) • Touch (Collision detection, DoF, workspace, etc.) • Vision (3D or 2D, tissue models, colour changes, magnification, graphic scene changes) • Audio (mono/stereo/3D, variants of feedback) • Others (data logs and visualisation, motion representation, smell)

  8. Requirements analysis: meeting users’ needs • Physical setup of the device • Ergonomics • Finger-rest • Foot control • Oral workspace • Oral cavity model • First lower molar with the adjacent and opposing teeth • Other tissues (but not haptic at present) • Multi-sensory feedback (colour, sound, vibration etc.) • Teaching aids (orientation, magnification, playback, 3D measurement, scores)

  9. Clinical concepts and skills for undergraduate dental students • Caries removal • Depth of the cavity • Angle of entry into the tooth • Speed of the bur • Different tactile sensations in cutting between different tissues( Enamel, Dentine and Pulp) • Cavity design • Time available for the task and the actual time taken

  10. Phases of developing the 3D models 3D VR Tooth and Jaw models

  11. Teeth and mouth model

  12. Beta Version

  13. hapTEL Workstation (Curriculum Ver.) 3D Display Monitor Shutter glasses Camera Audio speakers Haptic handpiece Pod Haptic Device Foot Controls

  14. Traditional hapTEL • Removal of artificial decayed material on a plastic tooth • Three sessions: Two attempts per session • Removal of virtual decayed material on a virtual tooth located in a jaw • Three sessions: as many attempts as they wish within a given time per session

  15. Graphic models

  16. Research design and methods to measure students‘ learning • Pre and post tests • Spatial reasoning; fine motor skills; 3-D perceptions • Attitudes towards ICT and haptics • Video observations of students’ practices in the laboratories • Task performance in traditional and hapTEL laboratories • Final Cavity preparation task • Post-lab self assessment task

  17. Gross, Fine Motor and 3-D Skills Assessment

  18. Study Design (Large scale trials)

  19. Clinical skills assessment methods • Traditional methods • Observation by tutors during manikin-head work • Reviewing finished work at end of treatment/course • Practical examination of specific clinical skills tasks • TEL methods Based on logs, screen capture and live feedback • Reviewing in-progress virtual clinical treatment on screen • Post-evaluation of each recorded student’s task procedure • Examining series of completed of tasks and peer review

  20. Educational impact results • hapTEL ‘dental chair’ provided individual feedback to each student who didn’t have to wait for the tutor to provide feedback • TEL activity enabled the students to have multiple attempts to improve their practice • Frasco plastic analogy teeth cost about £16 per tooth • hapTEL tooth could be enlarged 6-times by the students so they could see the result of their cavity preparation, and learn about accurate self assessment • hapTEL ‘dental chair’ enables the students to replay their procedure to observe their strengths and weaknesses • Year 1 students who were only taught using the hapTEL virtual system and had never treated a real or plastic tooth, performed as well as the traditionally taught students when preparing a plastic tooth cavity at the end of the term

  21. Other Systems on the market

  22. VOXEL-MAN TempoSurg

  23. VirtEasy by HRV Simulation

  24. Forsslund Dental Simulator for third molar surgical extractions

  25. Further Dental procedures • Dental Injections • Periodontal probing • Scaling of teeth • Root canal procedures • Filling Dental Cavities • Crown preparations • Orthodontic bracket placement • Implant surgery

  26. Conclusions • hapTEL trained students did equally as well as traditionally trained students • University teachers need to be involved in the innovation from the beginning. • TEL needs to complement the traditional teaching practices • TEL needs to be seen to enhance the evolving curriculum. • Extensive ongoing support for teachers is needed to maximise its potential.

  27. Thank you for listening Barry Quinn

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