Publications

 We have developed a haptic virtual reality system for dental skill training. In this study we examined several kinds of kinematic information about the movement provided by the system supplement knowledge of results (KR) in dental skill acquisition. The kinematic variables examined involved force utilization (F) and mirror view (M). This created three experimental conditions that received augmented kinematic feedback (F, M, FM) and one control condition that did not (KR-only). Thirty-two dental students were randomly assigned to four groups. Their task was to perform access opening on the upper first molar with the haptic virtual reality system. An acquisition session consisted of two days of ten trials of practice in which augmented kinematic feedback was provided for the appropriate experimental conditions after each trial. One week after, a retention test consisting of two trials without augmented feedback was completed. The results showed that the augmented kinematic feedback groups had larger mean performance scores than the KR-only group in Day 1 of the acquisition and retention sessions (ANOVA, p<0.05). The apparent differences among feedback groups were not significant in Day 2 of the acquisition session (ANOVA, p>0.05). The trends in acquisition and retention sessions suggest that the augmented kinematic feedback can enhance the performance earlier in the skill acquisition and retention sessions.

We have developed a virtual reality (VR) and an augmented reality (AR) dental training simulator utilizing a haptic device. The simulators utilize volumetric force feedback computation and real time modification of the volumetric data. They include a virtual mirror to facilitate indirect vision during a simulated operation. The AR environment allows students to practice surgery in correct postures by combining the 3D tooth and tool models with the real-world view and displaying the result through a video see-through head-mounted display (HMD). Preliminary results from an initial evaluation show that the system is a promising tool to supplement dental training and that there are advantages of the AR over the VR approach.

Objective
We present a dental training simulator that provides a virtual reality (VR) environment with haptic feedback for dental students to practice dental surgical skills in the context of a crown preparation procedure. The simulator addresses challenges in traditional training such as the subjective nature of surgical skill assessment and the limited availability of expert supervision.Methods and materials
We identified important features for characterizing the quality of a procedure based on interviews with experienced dentists. The features are patterns combining tool position, tool orientation, and applied force. The simulator monitors these features during the procedure, objectively assesses the quality of the performed procedure using hidden Markov models (HMMs), and provides objective feedback on the user's performance in each stage of the procedure. We recruited five dental students and five experienced dentists to evaluate the accuracy of our skill assessment method and the quality of the system's generated feedback.

Results
The experimental results show that HMMs with selected features can correctly classify all test sequences into novice and expert categories. The evaluation also indicates a high acceptance rate from experts for the system's generated feedback.

Conclusion
In this work, we introduce our VR dental training simulator and describe a mechanism for providing objective skill assessment and feedback. The HMM is demonstrated as an effective tool for classifying a particular operator as novice-level or expert-level. The simulator can generate tutoring feedback with quality comparable to the feedback provided by human tutors.

 Objectives

The goal of dental education is to guide students’ development through different stages from novice to competent, eventually resulting in an expert clinician. In this study we sought to identify process and outcome measures of clinical skill performance by comparing novices and experts using a virtual reality (VR) simulation system developed by our group.

We have developed a haptic virtual reality system for dental skill training. In this study we examined several kinds of kinematic information about the movement provided by the system supplement knowledge of results (KR) in dental skill acquisition. The kinematic variables examined involved force utilization (F) and mirror view (M). This created three experimental conditions that received augmented kinematic feedback (F, M, FM) and one control condition that did not (KR-only). Thirty-two dental students were randomly assigned to four groups. Their task was to perform access opening on the upper first molar with the haptic virtual reality system. An acquisition session consisted of two days of ten trials of practice in which augmented kinematic feedback was provided for the appropriate experimental conditions after each trial. One week after, a retention test consisting of two trials without augmented feedback was completed. The results showed that the augmented kinematic feedback groups had larger mean performance scores than the KR-only group in Day 1 of the acquisition and retention sessions (ANOVA, p<0.05). The apparent differences among feedback groups were not significant in Day 2 of the acquisition session (ANOVA, p>0.05). The trends in acquisition and retention sessions suggest that the augmented kinematic feedback can enhance the performance earlier in the skill acquisition and retention sessions.

The goal of dental education is to guide students' development through different stages from novice to competent, eventually resulting in an expert clinician. In this study we sought to identify process and outcome measures of clinical skill performance by comparing novices and experts using a virtual reality (VR) simulation system developed by our group.