Effectiveness of the Multilayered Caries Model and Visuo-tactile Virtual Reality Simulator for Minimally Invasive Caries Removal: A Randomized Controlled Trial

Oper Dent. 2018 May/Jun;43(3):E110-E118. doi: 10.2341/17-083-C. Epub 2018 Mar 7.

Abstract

This work presents the multilayered caries model with a visuo-tactile virtual reality simulator and a randomized controlled trial protocol to determine the effectiveness of the simulator in training for minimally invasive caries removal. A three-dimensional, multilayered caries model was reconstructed from 10 micro-computed tomography (CT) images of deeply carious extracted human teeth before and after caries removal. The full grey scale 0-255 yielded a median grey scale value of 0-9, 10-18, 19-25, 26-52, and 53-80 regarding dental pulp, infected carious dentin, affected carious dentin, normal dentin, and normal enamel, respectively. The simulator was connected to two haptic devices for a handpiece and mouth mirror. The visuo-tactile feedback during the operation varied depending on the grey scale. Sixth-year dental students underwent a pretraining assessment of caries removal on extracted teeth. The students were then randomly assigned to train on either the simulator (n=16) or conventional extracted teeth (n=16) for 3 days, after which the assessment was repeated. The posttraining performance of caries removal improved compared with pretraining in both groups (Wilcoxon, p<0.05). The equivalence test for proportional differences (two 1-sided t-tests) with a 0.2 margin confirmed that the participants in both groups had identical posttraining performance scores (95% CI=0.92, 1; p=0.00). In conclusion, training on the micro-CT multilayered caries model with the visuo-tactile virtual reality simulator and conventional extracted tooth had equivalent effects on improving performance of minimally invasive caries removal.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Dental Caries / diagnostic imaging
  • Dental Caries / surgery*
  • Dental Cavity Preparation / methods
  • Education, Dental / methods*
  • Humans
  • Minimally Invasive Surgical Procedures / education
  • Minimally Invasive Surgical Procedures / methods
  • Models, Dental*
  • Students, Dental
  • User-Computer Interface*
  • X-Ray Microtomography