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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