Virtual dental training simulators need some improvement

Anisha Hall Hoppe, Dental Tribune International

Fri. 20. September 2024

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BONN, Germany: As digital dentistry gains traction, dental education is increasingly adopting virtual systems, which also includes simulators that mimic real-life procedures. However, a recent study evaluating the efficacy of virtual instructional models indicates that the new systems may not yet be up to par in replicating the skill practice required by dental students and thus may need further improvement before being employed widely in dental schools.

Compared with physical phantom heads, simulators offer the possibility of reducing the need for physical resources in the training of dental students while also offering real-time feedback and greater accessibility to practice time. Despite the potential advantages of virtual simulators, the conventional methods have long been considered the gold standard. Phantom heads allow students to work in a tangible environment, simulating real-world scenarios more accurately, including factors such as tooth hardness and handpiece ergonomics.

The newer virtual systems also allow students to perform a variety of procedures, both simple and complex ones involving anaesthesia or even implant placement. Individual patient cases can be digitalised and practised with no waste materials in a virtual environment as well. The study authors also cited research indicating that students trained on virtual platforms require significantly less time with an instructor than those using physical materials.

For the study, 60 dental students were recruited, half of whom were trained using traditional phantom heads and the other half using the SIMtoCARE Dente haptic virtual reality simulator. All the students underwent training to prepare tooth #36 for a complete crown. Both groups had equal amounts of free practice time, and participants could seek feedback from faculty members. At the end of the study, the students’ performance was evaluated by three experienced dental examiners.

The traditional phantom head group consistently outperformed the virtual simulator group in the final examination. The students who trained using the phantom heads scored significantly better across all three examiners. Specifically, the phantom head group received grades that indicated good or satisfactory preparation, whereas the simulator group’s performance was mostly rated as sufficient or poor. Moreover, the authors noted that students who practised on phantom heads were better able to handle the real-life conditions of dental work, such as controlling the handpiece and managing patient anatomy. These findings suggest that virtual simulators might not yet be fully adequate for training dental students, especially when it comes to preparing for examinations or performing complex procedures on patients.

Participants in the phantom head group overwhelmingly preferred the conventional means of training, for both practice and examination preparation. Many students in the virtual simulator group expressed dissatisfaction with the virtual simulator, indicating that they did not feel well prepared for the final examination. A common criticism of the virtual system was its lack of realism. The ability to rotate the virtual model 360°, for example, was seen as unrealistic, as it provided perspectives not available in real-life scenarios. Additionally, the virtual system had technical issues, such as freezing and problems with rendering the teeth correctly, which undermined students’ confidence in its use.

Interestingly, students also noted that the lack of tactile feedback, such as the feel of the handpiece and the resistance of the tooth, made the virtual system less intuitive to use. While virtual simulators offer certain advantages, such as reduced waste and the ability to practise anytime, these benefits were not enough to outweigh the drawbacks perceived by the students.

However, the study also acknowledged that virtual simulators have potential as supplementary tools, especially for introducing students to dental procedures in a more relaxed environment. For instance, the virtual environment allows for greater experimentation, where students can try different techniques without the pressure of damaging a physical model. The authors expressed the view that, over time, virtual simulators may improve, particularly as haptic technology becomes more advanced.

They concluded that virtual simulators are not yet sufficient to replace traditional phantom head training in dental education. However, they can serve as useful tools for early-stage learning, particularly when used alongside traditional methods. For more advanced training, particularly in preparation for examinations and clinical practice, conventional methods still provide a more reliable and realistic experience for students, the authors said.

The study, titled “Efficacy of virtual preparation simulators compared to traditional preparations on phantom heads”, was published online on 14 August 2024 in Dentistry Journal.