Sunday, March 23, 2008

Practice Makes Perfect with 3-D Dental Simulator



A group of dental and dental hygiene students at the University of Illinois at Chicago pick up instruments and prepare to begin a procedure.

In their hands, their tools gently rub against the teeth and underneath the gums, feeling for calculi on the tooth root, measuring pocket depth, and searching for periodontal abnormalities.

These students, however, are not practicing on patients. They're using a computer equipped with a 3-D training system to improve their skills.

Researchers at UIC's colleges of dentistry and engineering are collaborating to develop a life-like training simulator called PerioSim, which uses haptic virtual reality technology.

Haptics is the science of applying touch sensation and control to computer applications. It allows the user to "feel" what is pictured on a computer screen.

Over the past several years, dentistry has begun using simulators to train students, but the programs traditionally use tracker technology, not haptics, said Dr. Arnold Steinberg, professor of periodontics at UIC and project leader.

With the PerioSim, students guide a stylus on-screen that resembles an explorer -- a sharp, pointed instrument used by dentists during an examination. They can feel life-like tactile sensations as they navigate through various procedures.

"We can enhance the learning and training of a wide variety of tasks or procedures using this system," Steinberg said. "The need to practice on mannequins, animals and patients can be significantly reduced, and in some cases, eliminated entirely."

The device also provides a way for professionals and students to further refine their skills even after having experience with patients, he said.

Students can access PerioSim via the Internet. A realistic 3-D human mouth is shown in real-time, and the user can adjust the model position, viewpoint and transparency level.

The haptic device allows the student to feel the sensations in the virtual mouth, and a control panel lets the user choose different procedures to practice and instruments to use, Steinberg said.

The system allows instructors to create short scenarios of periodontal procedures, which can be saved and replayed at any time. The 3-D component permits students to replay from any angle, so the user can observe different views of the placement of the instrument and gingival relationships during a procedure, Steinberg said.

The recorded file can be viewed on any personal computer, and while not in 3-D, it is an actual representation of the original scenario, which offers great training potential, Steinberg said.

The program also allows for a second playback mode, where an instructor leads the trainee through the program. By simply holding onto the haptic stylus, the trainee receives the same sensations felt by the instructor. Trainees can also be tested and evaluated on their ability to mimic the instructor's periodontal procedures, Steinberg said.

A validation study was recently undertaken, finding the simulator to be "very useful," Steinberg said. Results were published in the Journal of Dental Education in December.

Today's dental schools are faced with rising costs, faculty shortages and an overloaded curriculum, Steinberg said. Haptic-based simulators such as the PerioSim require less initial investment, maintenance, and replacement of parts than earlier generation mannequin-based simulators and are more versatile, he said.

During his research methodology course, Gary Couser, a first-year orthodontics resident, used the PerioSim and said he has "never seen anything like it."

"I was able to perform periodontal probing and feel how rough enamels are when an explorer is drawn across the area," he said.

"The simulator is very eye-catching, and I think it has the potential to be an excellent tool to educate dental students in the future."

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