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| Four classes of the alveolar bone and read gray values from CT slices (A) geometric models of different bone types (B) CTCT slices and corresponding volume slice.
Source publication
Motor skill learning of dental implantation surgery is difficult for novices because it involves fine manipulation of different dental tools to fulfill a strictly pre-defined procedure. Haptics-enabled virtual reality training systems provide a promising tool for surgical skill learning. In this paper, we introduce a haptic rendering algorithm for...
Context in source publication
Context 1
... is performed mainly on the alveolar bone, which is composed of multi-layer materials with different properties. As shown in Figure 2, the outer layer of alveolar bone is compact bone with high hardness, and the inner layer is cancellous bone with relative low hardness. And according to the agenda and age of different people, the alveolar bone can be divided into four different types as class I, II, III, and IV. ...
Citations
... The results of the identified haptic training studies are presented in Table 13. Yamaguchi et al. (2013) used a haptic VR simulator for caries removal and periodontal pocket probing, demonstrating improved skill retention through repeated training, while X. Zhao et al. (2020) introduced an innovative haptic rendering algorithm that skilfully simulated various tool-tissue interactions in dental implantation. More recently, Huang et al. (2023) showed that a multisensory teaching strategy for the training of periodontal instrumentation resulted in shorter treatment times and fewer post-operative complications (Table 13). ...
Aim
The 1st European Workshop on Periodontal Education in 2009 made recommendations regarding the scope of periodontal education at undergraduate (UG), postgraduate (PG) and continuing professional development (CPD) levels, defining competencies and learning outcomes that were instrumental at the time in helping to define periodontal teaching curricula. The 19th European Workshop on Periodontology and 2nd European Consensus Workshop on Education in Periodontology ( Education in Periodontology in Europe ) was held in 2023 to identify changes and future developments in periodontal education (including those informed by the COVID‐19 pandemic) and embracing methods and formats of periodontal teaching and training. The aim of this review was to assess current knowledge regarding education methods in periodontology, including traditional face‐to‐face (F2F) teaching and the move to student‐centred methods, virtual learning methods and use of digital technology, as well as blended teaching and learning (including teaching delivery and assessment) at UG, PG and CPD levels.
Materials and Methods
Systematic searches were conducted to identify relevant studies from the literature. Data were extracted and descriptive summaries collated.
Results
The pandemic was a major disruptor of traditional F2F teaching but provided opportunities for rapid implementation of alternative and supplementary teaching methods. Although online learning has become an integral part of periodontal education, teachers and learners alike favour some form of F2F teaching. Blended teaching and learning are feasible in many areas of periodontal education, both for knowledge and skills acquisition as well as in assessment. Student‐centred methods and blended approaches such as the flipped classroom seem highly effective, and online/virtual classrooms with both synchronous and asynchronous lectures are highly valued. Learning with haptic methods and virtual reality (VR) enhances the educational experience, especially when VR is integrated with traditional methods. The quality of the teacher continues to be decisive for the best knowledge transfer in all its forms.
Conclusions
Live F2F teaching continues to be highly trusted; however, all types of student‐centred and interactive forms of knowledge transfer are embraced as enhancements. While digital methods offer innovation in education, blended approaches integrating both virtual and traditional methods appear optimal to maximize the achievement of learning outcomes. All areas of periodontal education (UG, PG and CPD) can benefit from such approaches; however, more research is needed to evaluate their benefits, both for knowledge transfer and skills development, as well as in assessment.
... 13 Yomi is a semi-active robot assistance system that confines the movement of the implant drill to the planned location by restricting implant placement if the surgeon deviates from the planned position. Another robot, described by Zhao et al, 14 is a task autonomy robot, which can reach the entry point of the planned implant location and prepare the osteotomy automatically according to a prerecorded implant position. The use of robotics in dental implant surgery can allow for improved accuracy and help eliminate errors in positioning associated with fatigue, tremors, or visual hindrance of the surgical site. ...
Statement of problem. The development of robotic computer assisted implant surgery (r-CAIS)
offers advantages, but how the positional accuracy of r-CAIS compares with other forms of guided
implant surgery remains unclear.
Purpose. The purpose of this systematic review and meta-analysis was to evaluate the positional
accuracy of r-CAIS and to compare the positional accuracy of r-CAIS with s-CAIS and d-CAIS.
Material and methods. Five databases were systematically searched by 2 independent reviewers
for articles published before May 2023. A manual search was also performed. Articles evaluating
the positional accuracy of r-CAIS were included. The Cochrane risk of bias tool was used for the
clinical studies, whereas the QUIN tool was used for the in vitro studies. A meta-analysis was
performed to compare the positional accuracy of r-CAIS with d-CAIS.
Results. Thirteen studies were included, with 9 in vitro studies, 4 clinical studies, and a total of 920
dental implants. A high risk of bias was noted in 6 studies and low to moderate in 7 studies. R-CAIS
showed greater accuracy for the coronal, apical, and angular deviations compared with d-CAIS. (−0.17
[–0.24, 0.09], (P<.001); −0.21 [−0.36, −0.06] (P=.006), and −1.41 [−1.56, −1.26] (P<.001))
Conclusions. R-CAIS can provide improved positional accuracy compared with d-CAIS when
considering coronal, apical, and angular deviations. However, evidence to compare the positional
accuracy of r-CAIS with s-CAIS was insufficient. These results should be interpreted with caution because
of the limited data and the bias noted in several studies. (J Prosthet Dent xxxx;xxx:xxx-xxx)
... In the medical field haptic volumetric feedback was proposed for surgical simulation [8][10] [20], interaction with volumetric image data [9] [11], and application with cooperative surgical robotics [12]. Our study reviewed the impact of volumetric haptic assistance for 3D navigation tasks with 2D visual displays. ...
Manual control of surgical instruments represents a sensorimotor control task with at least 3-6 degrees of freedom (DoF). The impact of haptic guidance on volumetric navigation tasks, such as milling of planned volumes for prosthesis fits or preserving sensitive tissues, is investigated. Interaction centered studies are performed to evaluate the usability of the assistance modes for navigation within a volume, along the surface of a volume and around forbidden regions. Results show that haptic assistance can reduce the number of constraint violations, if the virtual stiffness is high enough. However, haptic assistance also can increase error rates when counterforces are close to the absolute perception threshold, as a false sense of security can arise. For navigation along complex surfaces bilateral haptic constraints should be preferred, while unilateral constraints are sufficient for simple geometries. This study complements previous publications as a basis for a flexible rule-based selection or adaptation of modular haptic assistance systems.
... With the development of the virtual reality technology, the construction of dental simulation systems capable of providing force feedback, as shown in Figure 2, has gradually become a research focus [15,16] . The dental simulation system developed by Dangxiao Wang of Beihang University can simulate various surgeries, including periodontal [17] , tooth extraction [18] , restoration [19] , and implantation [20] . This highlights the importance of supporting multi-point and multi-region interactions between the tools and teeth during training. ...
Background
A virtual system that simulates the complete process of orthodontic bracket placement can be used for pre-clinical skill training to help students gain confidence by performing the required tasks on a virtual patient.
Methods
The hardware for the virtual simulation system is built using two force feedback devices to support bi-manual force feedback operation. A 3D mouse is used to adjust the position of the virtual patient. A multi-threaded computational methodology is adopted to satisfy the requirements of the frame rate. The computation threads mainly consist of the haptic thread running at a frequency of >1000Hz and the graphic thread at >30Hz. The graphic thread allows the graphics engine to effectively display the visual effects of biofilm removal and acid erosion through texture mapping. Using the haptic thread, the physics engine adopts the hierarchy octree collision-detection algorithm to simulate the multi-point and multi-region interaction between the tools and the virtual environment. Its high efficiency guarantees that the time cost can be controlled within 1 ms. The physics engine also performs collision detection between the tools and particles, making it possible to simulate paint and removal of colloids. The surface-contact constraints are defined in the system; this ensures that the bracket will not divorce from or embed into the tooth during the adjustment of the bracket. Therefore, the simulated adjustment is more realistic and natural.
Results
A virtual system to simulate the complete process of orthodontic bracket bonding was developed. In addition to bracket bonding and adjustment, the system simulates the necessary auxiliary steps such as smearing, acid etching, and washing. Furthermore, the system supports personalized case training.
Conclusions
The system provides a new method for students to practice orthodontic skills.
... Rhienmora et al. [25] used the proportional dependence of the reaction force and penetration depth of dental drill and proposed force filtering method with possibility of large magnitude control of the force. Zhao et al. [27] proposed to evaluate the penetration force by integrating the unit force acting on the outer voxels of the tool. ...
The technologies of the augmented and virtual reality have a special role in medical education as an additional tool for training professional skills in pre-clinical practice. In the paper, we describe the development of a virtual reality simulator with immersion in VR scene for dentist office and simulation of tooth drilling. Such kinds of simulators would contribute to evolving capacities of motor skills and hand-eye coordination. The VR simulator for dental students training is developed for Oculus Quest 2 VR headset with six degrees of freedom. The Marching Cubes algorithm is chosen as an optimal decision for autonomous VR headsets, the computational power of which is much lower than PCs. The main stages of the development of tooth drilling simulation are considered. They include voxelization, marching cubes algorithm, collision detection, and detection of penetration depth of the dental drill. The experience of VR scene using for dental students training has been piloted at the Faculty of Dentistry at the V. I. Vernadsky Crimean Federal University. To evaluate the pilot study we used a satisfaction questionnaire, which evaluated the realism of tooth 3D model drilling and the realism of VR scene for the creation of a dentist's office atmosphere.
... Due to the characteristics of human touch receptors, real-time haptic rendering requires a refresh frequency of at least 1 kHz [31]. For force feedback interaction in dental skills training, several kinds of interaction algorithms have been proposed for various scenarios, including teeth preparation, scaling, and bone drilling [32,33]. ...
BACKGROUND
Dental simulator is used in preclinical skills training and virtual reality is the main technology of it. With the development of XR technology, mixed reality appeared and it has significant advantage over virtual reality.
OBJECTIVE
This study intended to research and develop a mixed reality (MR) and haptic-based dental simulator for tooth preparation and preliminarily evaluate its face validity.
METHODS
A prototype of MR dental simulator for tooth preparation was innovatively developed by integrating the head-mounted display (HMD), special force feedback handles, foot pedal, computer hardware, and software program. Thirty-four participants were recruited and were divided into Novice group (N=17) and Skilled group (N=17) based on their clinical experience. All participants prepared a maxillary right central incisor for all ceramic crown in the dental simulator, and completed a questionnaire after the preparation to investigate their experience and evaluation toward the dental simulator in aspects of the hardware and software.
RESULTS
A prototype of MR dental simulator for tooth preparation (Unidental MR Simulator) was newly developed. 73.53% of the participants were satisfied with the overall experience in using Unidental MR Simulator. Over 90% of the participants agreed with that Unidental MR Simulator can stimulate their interest in learning and over 80 % of them were willing to use dental simulator Unidental MR Simulator for skills training in the future. The differences in the experience of the HMD, simulation of the dental instruments, realism of the force feedback of teeth, simulation of the tooth preparation process, overall experience of the simulator and attitudes toward the simulator between Novice group and Skilled group were not statistically significant (P>0.05). Novice group were more satisfied with the ease of use of the simulator. (P<0.05). The resolution of the HMD and the simulation of the preparation process had significant positive correlations with the overall using experience of the simulator (P<0.05).
CONCLUSIONS
The newly developed dental simulator for tooth preparation, Unidental MR simulator, has a good face validity. It can achieve a higher degree of similarity to the real clinical treatment environment by achieving position adjustment of patients, allowing users to have a better dental skill training experience.
... On the other side, according to the surgical specialty considered, these systems can make trainees deal with various complex hazards, rarely occurring in practice in OR, but potentially very dangerous if not carefully faced. This is especially the case of specialties involving drilling or burring, like mastoidectomy (27), orthognathic (28) and dental implantation (29), and orthopedic surgery (30). ...
Background: While performing surgeries in the OR, surgeons and assistants often need to access several information regarding surgical planning and/or procedures related to the surgery itself, or the accessory equipment to perform certain operations. The accessibility of this information often relies on the physical presence of technical and medical specialists in the OR, which is increasingly difficult due to the number of limitations imposed by the COVID emergency to avoid overcrowded environments or external personnel. Here, we analyze several scenarios where we equipped OR personnel with augmented reality (AR) glasses, allowing a remote specialist to guide OR operations through voice and ad-hoc visuals, superimposed to the field of view of the operator wearing them.
Methods: This study is a preliminary case series of prospective collected data about the use of AR-assistance in spine surgery from January to July 2020. The technology has been used on a cohort of 12 patients affected by degenerative lumbar spine disease with lumbar sciatica co-morbidities. Surgeons and OR specialists were equipped with AR devices, customized with P2P videoconference commercial apps, or customized holographic apps. The devices were tested during surgeries for lumbar arthrodesis in a multicenter experience involving author's Institutions.
Findings: A total number of 12 lumbar arthrodesis have been performed while using the described AR technology, with application spanning from telementoring (3), teaching (2), surgical planning superimposition and interaction with the hologram using a custom application for Microsoft hololens (1). Surgeons wearing the AR goggles reported a positive feedback as for the ergonomy, wearability and comfort during the procedure; being able to visualize a 3D reconstruction during surgery was perceived as a straightforward benefit, allowing to speed-up procedures, thus limiting post-operational complications. The possibility of remotely interacting with a specialist on the glasses was a potent added value during COVID emergency, due to limited access of non-resident personnel in the OR.
Interpretation: By allowing surgeons to overlay digital medical content on actual surroundings, augmented reality surgery can be exploited easily in multiple scenarios by adapting commercially available or custom-made apps to several use cases. The possibility to observe directly the operatory theater through the eyes of the surgeon might be a game-changer, giving the chance to unexperienced surgeons to be virtually at the site of the operation, or allowing a remote experienced operator to guide wisely the unexperienced surgeon during a procedure.
... Due to the characteristics of human touch receptors, real-time haptic rendering requires a refresh frequency of at least 1 kHz [31]. For force feedback interaction in dental skills training, several kinds of interaction algorithms have been proposed for various scenarios, including teeth preparation, scaling, and bone drilling [32,33]. ...
UNSTRUCTURED
The application of virtual reality has become increasingly extensive as this technology develops. In dental education, virtual reality is mainly used to assist or replace traditional methods of teaching clinical skills in preclinical training for several subjects, such as endodontics, prosthodontics, periodontics, implantology and dental surgery. Dental simulators allow repeatable and reversible preclinical training of clinical skills, and they also allow digital evaluation and feedback since they can record the training processes. Preclinical training assisted by dental simulators is economical and environmentally-friendly, as it requires less material for dental skills training. The application of dental simulators in teaching can make up for the deficiency of traditional teaching methods and reduce the teaching burden, improving convenience for both teachers and students. When combined with big data, cloud computing, 5G and deep learning technology, the dental simulator can give students individualized learning assistance and other functions depending on their diverse learning aptitudes in the future, to improve their learning effects.
... Due to the characteristics of human touch receptors, real-time haptic rendering requires a refresh frequency of at least 1 kHz [31]. For force feedback interaction in dental skills training, several kinds of interaction algorithms have been proposed for various scenarios, including teeth preparation, scaling, and bone drilling [32,33]. ...
The application of virtual reality has become increasingly extensive as this technology has developed. In dental education, virtual reality is mainly used to assist or replace traditional methods of teaching clinical skills in preclinical training for several subjects, such as endodontics, prosthodontics, periodontics, implantology, and dental surgery. The application of dental simulators in teaching can make up for the deficiency of traditional teaching methods and reduce the teaching burden, improving convenience for both teachers and students. However, because of the technology limitations of virtual reality and force feedback, dental simulators still have many hardware and software disadvantages that have prevented them from being an alternative to traditional dental simulators as a primary skill training method. In the future, when combined with big data, cloud computing, 5G, and deep learning technology, dental simulators will be able to give students individualized learning assistance, and their functions will be more diverse and suitable for preclinical training. The purpose of this review is to provide an overview of current dental simulators on related technologies, advantages and disadvantages, methods of evaluating effectiveness, and future directions for development.
Tactile hands-only training is particularly important for medical palpation. Generally, equipment for palpation training is expensive, static, or provides too few study cases to practice on. We have therefore developed a novel haptic surface concept for palpation training, using ferrogranular jamming. The concept's design consists of a tactile field spanning 260 x 160 mm, and uses ferromagnetic granules to alter shape, position, and hardness of palpable irregularities. Granules are enclosed in a compliant vacuum-sealed chamber connected to a pneumatic system. A variety of geometric shapes (output) can be obtained by manipulating and arranging granules with permanent magnets. The tactile hardness of the palpable output can be controlled by adjusting the chamber's vacuum level. A psychophysical experiment (N 28) investigated how people interact with the palpable surface and evaluated the proposed concept. Untrained participants characterized irregularities with different position, form, and hardness through palpation, and their performance was evaluated. A baseline (no irregularity) was compared to three irregularity conditions: two circular shapes with different hardness (Hard Lump and Soft Lump), and an Annulus shape. 100% of participants correctly identified an irregularity in the three irregularity conditions, whereas 78.6% correctly identified baseline. Overall agreement between participants was high (κ 0.723). The Intersection over Union (IoU) for participants sketched outline over the actual shape was IoU Mdn 79.3% for Soft Lump, IoU Mdn 68.8% for Annulus, and IoU Mdn 76.7% for Hard Lump. The distance from actual to drawn center was Mdn 6.4 mm (Soft Lump), Mdn 5.3 mm (Annulus), and Mdn 7.4 mm (Hard Lump), which are small distances compared to the size of the field. The participants subjectively evaluated Soft Lump to be significantly softer than Hard Lump and Annulus. Moreover, 71% of participants thought they improved their palpation skills throughout the experiment. Together, these results show that the concept can render irregularities with different position, form, and hardness, and that users are able to locate and characterize these through palpation. Participants experienced an improvement in palpation skills throughout the experiment, which indicates the concepts feasibility as a palpation training device.
