Simodont
Training in virtual reality to prepare for the reality
Current educational
circumstances
•
Golden standard from the “best” preparation.
•
Criteria
–
inter and intra observer reliability low.
•
Mental model developed on preparation model on
plastic teeth.
•
Internal model not based on pathology.
•
Problem solving is taught as a separate skill.
•
Only in the clinic problem solving, pathology and
preparation design are integrated.
Why change?
•
Educational reasons
-
improve integration theory and practice
-
process and outcome evaluation
-
incorporation of problem solving in
preclinical training
-
practice in realistic context closing the
gap to the clinic
Why change?
•
Practical reasons
-
reduction of maintenance costs
-
no waste of materials
-
no water problems ( legionella)
-
unlimited availability of practice
material
Practical skill development
and caries treatment
•
Accurate realistic 3D simulation of both manual
dexterity and pathologic concepts.
Proper haptics and realistic images. Realistic
mental modeling, muscle memory, proprioceptive
training.
•
Integration of existing and present knowledge.
This is the case, why are you going to do what and
how are you going to do it?
•
Realistic interaction with the virtual patient
Simulation of space limitations (tongue, cheek) and
patients perceptions.
Advantage of complete
virtual imitation
•
Integration of techniques and theory.
•
Unlimited practicing in a safe and almost real
-
life
situation.
•
Time and partially space independent ( lap top work
station).
•
Level of skill can be easily adapted.
•
Development from skills to competencies
•
Saving of materials, equipment and staff.
Borders of the virtual
dimensions
•
Complete patient.
•
Complete oral cavity.
•
Dental arch(es) with soft tissue.
•
Dental arch(es) only.
•
Single tooth.
Haptic
feedback
Stereo
Projection
Course
ware
3D models of real teeth
System borders selected
for
Simodont
version I
•
Realistic force feedback.
•
Realistic imaging.
-
resolution of 3D models.
-
hardness and color of tissue structures.
-
stereo imaging
-
collocation of image and haptics .
•
Dental arch(es) only.
Clinic
Patients
Preclinic
lab
Simodont
Simodont
Preclinic/lab
Clinic
Patients
Purpose of the study
•
To investigate if students without
any dental experience practicing at
the Simodont will develop skills
transferable to reality at a similar
level as students practicing in the
traditional preclinical setting
Experiment
S (n=10)
P (n=10)
C (n=8)
Day 1
test + practice (2x30)
test + practice (2x30)
test
Day 2
practice (3x30)
practice (3x30)
Day 3
test + practice (2x30)
test + practice (2x30)
test
Day 4
practice (2x30) + test
practice (2x30) + test
test
Design
•
Students practice after an initial
test their manual dexterity for
handling a dental bur either on the
Simodont or with a real bur on resin
plates.
•
Thereafter they perform a similar
test on plastic blocks
20
11/14/2013
Courseware
Courseware
Courseware
Courseware
Criteria
Preparation border within 1
st
and 2
nd
circle
Wall perpendicular to the bottom and outer surface.
Bottom within certain level and flat
Circle
0.0
0.5
1.0
1.5
2.0
2.5
3.0
3.5
4.0
4.5
1
2
3
Timepoint
Assessment
Control
Phantom
Simodont
Kruskall Wallis Control vs Ph and Simodont p< .05
Time point 1 vs 3 Ph, Simod p<.05
Total
0.0
2.0
4.0
6.0
8.0
10.0
12.0
1
2
3
Timepoint
Assessment
Control
Phantom
Simodont
Kruskall Wallis Control vs Ph and Simodont p<.05
Time point 1 vs 3 Ph
–
Simo p< .05
Conclusions
•
Practicing resulted in a better
performance than without practicing.
•
Skills transfer from the Simodont to
reality was equal as from reality to reality.
•
Practicing after the second test did not
show any improvement probably due to
reduced concentration and fatigue
Clinic
Patients
Preclinic
lab
Simodont
Simodont
Preclinic/lab
Clinic
Patients
Decision strategy in new
development
Innovation or evidence, what first?
Thanks
p.wesselink@acta.nl
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