Introduction
Materials and methods
Search strategy
Inclusion criteria
Exclusion criteria
Search strategy and study selection
Database | Search query | Results |
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PubMed | ("haptic interfaces"[MeSH Terms] OR ("haptic"[All Fields] AND "interfaces"[All Fields]) OR "haptic interfaces"[All Fields] OR "haptic"[All Fields] OR "haptic technology"[MeSH Terms] OR ("haptic"[All Fields] AND "technology"[All Fields]) OR "haptic technology"[All Fields] OR "haptics"[All Fields] OR "haptical"[All Fields] OR "haptically"[All Fields]) AND ("students, dental"[MeSH Terms] OR ("students"[All Fields] AND "dental"[All Fields]) OR "dental students"[All Fields] OR ("dental"[All Fields] AND "student"[All Fields]) OR "dental student"[All Fields]) | 64 |
"simodont"[All Fields] AND ("students, dental"[MeSH Terms] OR ("students"[All Fields] AND "dental"[All Fields]) OR "dental students"[All Fields] OR ("dental"[All Fields] AND "student"[All Fields]) OR "dental student"[All Fields]) | 19 | |
Scopus | TITLE-ABS-KEY ( Haptic AND dental AND training) | 3 |
Web of Science | Haptic (All Fields) and dental students (All Fields) | 17 |
Author | Sample Size | Level | Study design | Pretraining | Version of Devices | Intervention | Evaluation items | Assessment | Results | Inference |
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de Boer et al. (2017) [23] | 62 dental students | 1st year | Grp 1: students who practiced without effect of force feedback Grp 2: students who practiced with effect of force feedback | Practice sessions—the cross preparation with a dental teacher available for questions | Moog Simodont dental trainer (Nieuw-Vennep, the Netherlands) | Students practiced with or without force feedback depending on the group they were assigned to, and then completed an assessment task involving cross preparation. All students were tested under both conditions, with half of the group starting with force feedback and half without, assigned randomly | To pass test 1 or test 2, three of five (ie, cross) preparations had to be successfully completed within 45 min. The maximum number of permitted manual dexterity preparations during the tests was 5 | Data collected during both tests were statistically analyzed | Students failed test without Force Feedback, confirming its necessity for high precision manual dexterity tasks in dentistry. Only FFB users passed the tests | The results suggest that effect of force feedback is important for performance in a virtual learning environment and essential for satisfaction. FFB is required to perform on the high precision level that manual dexterity tasks in dentistry require |
Mirghani et al. (2018) [24] | 289 Dental Students | Year 1 (n = 92), Year 3 (n = 79) Year 4 (n = 57) Year 5 (n = 61) | All participants engaged in 6 manual dexterity exercises | Students received an instruction sheet and verbal guidance from a tutor on system operation, including how to turn it on, log in, and select tasks. They adjusted the chair and unit to their comfort and wore stereoscopic spectacles. Questions were encouraged throughout the training | Simodont ‘courseware’ software (developed by the Academic Centre for Dentistry Amsterdam (ACTA), Amsterdam, Netherlands) | Geometric Shapes- The task involved the use of a dental hand piece to remove a target ‘red zone’, presented as a cross-shape in the middle of a block, whilst attempting to minimise removal of leeway zones (the ‘safe’ outer areas of the block) as much as possible | Real-time feedback on performance was recorded- a percentage score for each of the following: Target (task completion percentage) Error scores (Leeway Bottom, Leeway Sides, container bottom and container sides) Drill Time (in seconds) | Measured performance on four outcome variables: Time (in seconds), Leeway Bottom, Leeway Sides (quantified as percentages) and finally, a Composite Score that captured speed-accuracy trade-offs in performance | Simodont has shown sensitivity to performance differences between novice and experienced students Statistically significant differences were found between novice (Year 1) and experienced dental trainees (operationalised as 3 or more years of training), but no differences between performance of experienced trainees with varying levels of experience | The study provides evidence that the Simodont is a valid tool for assessing motor skills in dental students and can differentiate between different levels of real-world dental experience. The results showed that the performance of dental students improved as their level of experience increased, and the time taken to complete the task decreased as their level of experience increased |
Al- Saud et al. (2020) [25] | 72 dental students (46F,26 M) | Year 4 | The study was conducted with second-year undergraduate dental students, and their performance on a VR haptic simulator was compared to their subsequent clinical performance involving patients two years later | Simodont | crown preparation using Simodont and typodont | simulator to measure the performance of second-year undergraduate dental students on a variety of simulated abstract manual dexterity tasks. The simulator was used as part of a formative assessment, and the students were left to their own devices and could practice as much or as little as they liked | The study compared the performance of the students on the VR haptic simulator to their subsequent clinical performance involving patients two years later | Mean performance on simulated manual dexterity tasks 2 years earlier could explain 14% of the variance in clinical performance scores in year 4 of dental study. This measure was more effective than a traditional typodont test, despite the typodont test being conducted preclinically 1 year prior to the clinical measure | Simodont shows promise in predicting clinical performance and identifying individuals who may need early training support | |
de Boer et al. (2019) [26] | 126 dental students | Year 1 | Grp 1: Low levels of force feedback and Standard levels of force feedback Grp 2: Standard levels of force feedback and Low levels of force feedback Grp 3: High elevels of force feedback and Standard levels of force feedback Grp4: Standard levels of force feedback and High levels of force feedback | Participants trained for 3 months during their scheduled educational time with standard levels of force feedback on 3 geometric figures to improve fine motor skills | Simodont dental trainer (Moog, Inc, Nieuw-Vennep, the Netherlands) | Students prepared the "block cross-figure" using standard and low or high levels of force feedback, depending on their assigned group | Effect of practicing with standard force feedback on student performance was examined, along with the ability to transfer skills from one force feedback level to another | five attempts—the student had to pass three of them for each level of effect of force feedback | Even inexperienced students can transfer their manual dexterity skills from one level of force feedback to another. This suggests that once the skill is mastered in virtual reality, it can be transferred to the real world. Therefore, it is important to incorporate virtual reality education into dental curricula | The study highlights the importance of accuracy in haptics (sense of touch/feeling) in a simulation environment and the need for further research to investigate the transfer of skills from reality to VR |
Murbay et al.(2020) [27] | 32 students | Year 2 | Grp 1: Received feedback from machine only Grp 2: Instructor verbal feedback only Grp 3: Instructor and device feedback | Moog Simodont dental trainer (VR) | Class I cavity preparation on plastic mandibular molar tooth | •underprepared/overprepared, •centeredness •contour smoothness •depth of preparation •convergence and divergence of walls •line angles •treatment execution | Three assessors visually assessed the preparations under 2.5 × magnification, while also saving the preparations as STL files for digital assessment | In both manual and digital assessment, students who had practiced with the virtual dental trainer showed better scores compared to the control group | The virtual reality simulator may be a valuable adjunct in the UG direct restorations course and for student remedials | |
Cecilie Osnes et al. (2021) [28] | 112 dental students. 17 Clinicians | Year 1 students and clinical teaching staff | Group 1: Dental Students Group 2: Clinicians | Users were introduced to the exercise with a prewritten verbal introduction displaying their progress live on screen. The exercise could be restarted or repeated within a 15-min time frame, and the color and live score helped users understand the task | Simodont | Generated caries lesions using unique shapes as "seed images". Two blocks were used—one for introduction containing green caries and one for testing without any discolouration | Participant precision score was calculated using the number of voxels drilled in each of the segments: enamel, dentine, ADJ caries (including any unsupported enamel), (deep) caries and pulp | Perfect score for the precision of tooth preparation was achieved by removing unsupported enamel and ADJ caries, which represented approximately 7% of the complete block. Any additional material removed, except for deep caries, would result in a penalty to the score. The precision score was calculated as the percentage of ADJ caries removed minus the percentage of enamel, dentine, and pulp removed | The exercise may be a useful tool for assessing conceptual understanding of caries removal. Clinicians were significantly more precise than students in removing caries without excessively removing the non-carious parts of the block p = 0.009. Clinicians removed significantly more caries at the ADJ (ADJ caries) than students Fourteen (82%) clinicians and 69 (62%) student participants removed more than half of the deep caries available | Haptic simulation exercises may be a useful tool for assessing understanding of the concept of caries removal |
Ignacio Aliaga et al. (2020) [29] | 82 students | 1st year dental students reevaluated in third year | A total of 82 students who completed the first year of dentistry were followed for 2 years. Their performance on the same task (i.e., cavity preparation of three figures in the Simodont and methacrylate blocks) was then reevaluated in the third year | Enrolled students had performed preclinical practice first in MBs and then in the SDT. Students received a brief explanation | Simodont (Moog Inc., Nieuw-Vennep, Netherlands) with software 3.18.4 | Students sequentially prepared three cavities with geometric shapes (bar, circle, and cross) in 15 min, removing simulated caries (red) from each figure through the software | 1. Percentage drilled segment target 2. Percentage drilled leeway bottom (PDSLB) 3. Percentage drilled leeway sides (PDSLS) 4. Percentage drilled container bottom (PDSCB) 5. percentage drilled container sides (PDSCS), where variables 2 to 5 reflect students’ errors 6. session time, which is real time (seconds) | The same professor evaluated the students performance first in first year and then in third year | The Simodont practice can be reliably evaluated. Preclinical methodologies of Simodont detected improvements in the manual skills of first- and third-year dental students | Both methodologies can detect manual skill improvement in dental students. Additionally, the Simodont practice can be reliably evaluated |
Hattori et al. (2022) [30] | 30 dental students (12 M, 18F) | 6th year | Grp1:dental students using the haptic simulator Grp 2: dental students using a conventional mannequin simulator | Students were instructed on how to operate the haptics simulator prior to tooth preparation. Following a 10-min period of explanation, subjects were given free practice time to become familiar with the device | Simodont" (Nissin Dental Products Europe BV, Nieuw- Vennep, Netherlands) | full cast crown of the right first molar in the mandible | Each item was scored on a 5-point rating scale •the occlusal surface •margin design •Surface smoothness •Taper angle •Total cut volume •Overall impression of the products | Three evaluators with more than 10 years of university teaching experience evaluated the products of both haptic and conventional simulators | The scores of the haptics simulator were lower than those of the conventional type for several evaluation items. The conventional simulator showed higher values for Margin design, Surface smoothness, and Total cut volume, and the difference between the simulators was significant (P < 0.05) Margin design and Total cut volume showed a significant difference in the score between haptics and conventional simulators (P < 0.05) | This study suggests that the unique characteristics of virtual reality, such as the simulated cutting sensation and the simulated three-dimensional images created by stereo viewers, affect operators’ performance and evaluators’ perception. Therefore, it is important to develop an educational program that is conscious of the features of each simulator |
Farag and Hashem (2021) [31] | 21 female dental students | 3rd year | Prepared cavities before and after Haptic virtual reality simulation training for each student were used as an assessment tool for the students’ psychomotor skills | Lecture and hands-on demonstration | Simodont | Training on geometric Shapes Testing Class I cavity preparation on plastic mandibular molar tooth | •Occlusal outline •Pulpal floor •Buccal and lingual walls •Internal line and point angles | Two evaluators independently assessed based on design features | statistically significant increase in the overall marks after haptic virtual reality simulation training there was an improvement in all evaluation criteria scores after Haptic virtual reality simulation training | Improved overall performance in psychomotor skills was found after haptic virtual reality simulation training |
Data extraction
Assessment of study quality
Quality of evidence for outcomes in Summary of Findings table
Results
Quality assessment
Quality of evidence for outcomes in Summary of Findings table
Quality assessment | Summary of findings | |||||||
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Outcome | Risk of bias | Inconsistency | Indirectness | Imprecision | Publication bias | Impact | No. of participants (Studies) | Certainty of evidence (GRADE) |
Improved Student performance and skill development | Seriousa | Not Serious | Serious | Not serious | Not serious | Our confidence in the effect estimate is limited: the true effect may be substantially different from the estimate of the effect | 826 (9) | Low ⊕⊕ |