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.
 Stereo
Projection

Haptic
feedback

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.
 Simodont
Preclinic/lab Clinic
Preclinic Simodont
Clinic Patients
lab
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
 Courseware

11/27/2019 20
Courseware
Courseware
Courseware
 Criteria
Preparation border within 1st and 2nd circle

Wall perpendicular to the bottom and outer surface.

Bottom within certain level and flat

 Circle

4.5
4.0
3.5
Assessment

3.0
Control
2.5
Phantom
2.0
1.5 Simodont
1.0
0.5
0.0
1 2 3
Timepoint

Kruskall Wallis Control vs Ph and Simodont p< .05

Time point 1 vs 3 Ph, Simod p<.05

 Total

12.0

10.0
Assessment

8.0
Control
6.0 Phantom

4.0 Simodont

2.0

0.0
1 2 3
Timepoint

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
 Simodont
Preclinic/lab Clinic
Preclinic Simodont
Clinic Patients
lab
Patients
 Decision strategy in new
development

Innovation or evidence, what first?

Thanks

p.wesselink@acta.nl