Three-Dimensional Tooth Models with Pulp Cavity Enhance Dental Anatomy Education

The level of confidence of dentists in identifying intact and sectioned teeth

OBJECTIVE

This study aimed to assess the confidence levels of dentists in identifying intact and sectioned human teeth and to identify the factors contributing to variations in confidence levels.

DESIGN

An anonymous Jisc e-survey showing 14 questions was sent to dentists worldwide. Apart from acquiring demographic details of the participants, ten three-dimensional (3D) tooth models were presented for tooth identification including the opinion on the level of confidence in identifying. They included seven permanent and three deciduous teeth in intact or sectioned state. The tooth models were created and manipulated using ZBrush software (Maxon Industries, Inc.) and uploaded to the Sketchfab model hosting platform. The accuracy of results was quantitatively analysed in five categories, namely: (I) tooth type, (II) region, (III) tooth classification, (IV) tooth within the same class, and (V) FDI World Dental Federation notation.

RESULTS

Most participants received education in dental anatomy at the undergraduate level. No significant differences in accuracy were seen between intact and fractured tooth models. The highest accuracy was seen in Category I (Permanent or Deciduous, 0.74) and the lowest in Category V (FDI Notation, 0.26). The perceived confidence of each participant (total of 56) was seen to have the highest accuracy when the participant opined limited confidence, although with no significant differences for each category (P>0.05). Moreover, the most common error was found in the category II region, where participants could not correctly locate the tooth on the right or left side of the mouth in six 3D tooth models.

CONCLUSION

The assessment of intact and sectioned teeth has not presented differences in accuracy. High accuracy was seen when dentists categorised permanent and deciduous teeth. The highest accuracy in results was linked to the limited confidence of dentists but factors contributing to this level of confidence are not clear in this study. More attention should be paid to the dental features that distinguish location on the right or left side of the mouth.

Dental damage: Creating 3D anatomical models to illustrate destructive effects on human teeth

Forensic odontologists often must identify human remains with damaged teeth. This damage is due to high-impact accidents, violence, or disasters. This 2-part study aimed to create two 3D digital models. They should show the destructive effects of physical and chemical agents on human teeth and popular dental materials. Researchers created an e-survey to investigate how digital models are perceived as an educational tool for Forensic Odontology. Also, a systematic review assessed experimental studies on the effects of high temperature on various prosthodontic materials. According to the results of the survey, most participants (n=69; 79%) agreed that they would find a 3D model useful for training. Participants misidentify images of burned and broken teeth under Ellis and Davey system (1970). The systematic review identified dental implant and dental crown as the most studied prosthodontic materials exposed to heat. The researchers designed dental damage model 1 to represent restored and unrestored burnt teeth, postmortem pink teeth, and traumatic injuries. The dental damage model 2 was created to demonstrate the effects of various types of damage to different prosthetic and restorative dental materials, as well as the impact of acid, water, and burial on restorative materials as additional information. Both models were edited, sculpted and painted using 3D modelling software ZBrush (2020. 1.4) and Blender (version 3.6.2). The dental damage models were uploaded and labelled on Sketchfab (Cédric Pinson, Paris, France). The study's materials could transform the teaching of complex tooth changes.

Identifying teeth and tooth fragments from digital 3D models

Dental anatomy is an essential skill for human identification in forensic odontology. With the advent of technology enabling virtual autopsies, there is scope for virtual consultation by forensic odontologists especially when the expertise is unavailable but needed in zones of conflict or disasters. This study aimed to investigate potential benefits and challenges of identifying intact and damaged teeth from 3D scanned digital models. Ten 3D tooth models - nine permanent and deciduous human teeth and one animal tooth were uploaded on a hosting platform. A 3-part survey was circulated among 60 forensic odontologists with questions about demography (P1), tooth identification of the scanned 3D models (P2) and the perceived usefulness of 3D models for tooth identification (P3). This was the first time that a survey required the identification of individual human teeth (intact or not) and animal tooth combined. The response rate for study participation was 58%. Substantial agreement among participants was seen in the determination of tooth classification (i.e., molars, premolars) or non-human and tooth within the same tooth class (i.e., lateral incisors, second molar) (both k=0.61). The least agreement (k=0.21) was seen in identification of tooth according to the FDI notation with a mean accuracy of 0.34. While most responders correctly identified the animal tooth, most incorrect responses were seen in the identification of the intact third molar. While 3D-scanned teeth have the potential to be identified virtually, forensic odontologists should continuously test their skills in tooth morphology and dental anatomy of humans (damaged or not) and animals.

Assessment of the students' performance and support needs in a novel digital carving exercise

OBJECTIVES

In recent years, digital technology has been rapidly expanding in dental practice, which entails an early integration of digital dentistry into the preclinical dental curriculum. This study introduces first-year dental students to a digital carving exercise and investigates its role in enhancing their understanding and performance in traditional wax carving activities. Another objective was to explore the students' challenges and needs for support in the digital carving activity.

METHODS

Digital carving exercise was introduced into the first-year dental morphology curriculum in 2020. Students' performance in anterior wax carving was quantitively compared prior to and following the implementation of the exercise. The students' grades in the digital carving exercise were also compared across three academic years: 2020, 2021, and 2022. Qualitatively, an interpretive description approach using focus group with 31 first-year dental students was utilized to explore their perspectives regarding the digital exercise.

RESULTS

A statistically significant improvement was found in the students wax carving performance following the incorporation of the digital carving activity (p-value = 0.0001). Students' performance in the digital carving exercise also statistically improved over the years. Students' challenges included the technology's unfamiliarity, and a perceived irrelevance of the exercise. Additional guidance, resources, and timely feedback were reported among the students' support needs during the exercise.

CONCLUSION

Digital carving is a promising tool in anatomical education that can improve the students' spatial understanding and manual dexterity. However, educators need to carefully integrate it into the curriculum to address the students' challenges and optimize their learning experience.

Mirror training device improves dental students' performance on virtual simulation dental training system

INTRODUCTION

Clinical practice of dentistry entails the use of indirect vision using a dental mirror. The Mirrosistant is a device that helps dental students become proficient with use of indirect vision mirror operation. This study aimed to explore the role of the Mirrosistant on students' performance with the virtual simulation dental training system.

MATERIALS AND METHODS

A total of 72 dental students were equally assigned to the Control group and the Experimental group. Subsequently, Mirrosistant was used to conduct a series of mirror training exercises in the Experimental group. The training consisted of tracing the edge and filling in the blank of the prescribed shape, as well as preparing the specified figure on raw eggs using indirect vision via Mirrosistant. Next, both groups were examined using the SIMODONT system, a virtual reality dental trainer, for mirror operation. In addition, a five-point Likert scale questionnaire was used to assess student feedback by using Mirrosistant.

RESULTS

The mirror operation examination conducted by the SIMODONT system revealed that mirror training using Mirrosistant had statistically improved students' performances (score: 80.42 ± 6.43 vs. 69.89 ± 15.98, P = 0.0005) and shorten their performance time of mirror operation (time of seconds: 243.28 ± 132.83 vs. 328.53 ± 111.89, P = 0.0013). Furthermore, the questionnaire survey indicated that the participants had positive attitudes toward the mirror training using Mirrosistant. Most students believed that the mirror training device could improve their perceptions of direction and distance, as well as their sensations of dental operation and dental fulcrum.

CONCLUSION

Mirror training using Mirrosistant can enhance dental students' mirror perceptual and operational skills on virtual simulation dental training system.

Application of 3D-printed pulmonary segment specimens in experimental teaching of sectional anatomy

BACKGROUND

Lung cross-section is one of the emphases and challenges in sectional anatomy. Identification of the complex arrangement of intrapulmonary tubes such as bronchi, arteries, and veins in the lungs requires the spatial imagination of students. Three-dimensional (3D) printing has become increasingly used in anatomy education. This study aimed to analyze the effectiveness of 3D-printed specimens used for the experimental teaching of sectional anatomy.

METHODS

A digital thoracic dataset was obtained and input into a 3D printer to print multicolor specimens of the pulmonary segment after software processing. As research subjects, 119 undergraduate students majoring in medical imaging from classes 5-8 in the second-year were chosen. In the lung cross-section experiment course, 59 students utilized 3D printed specimens in conjunction with traditional instruction as the study group, while 60 students received traditional teaching as the control group. Preclass and postclass tests, course grading, and questionnaire surveys were used to assess instructional efficacy.

RESULTS

We obtained a set of pulmonary segment specimens for teaching. The students in the study group scored better in the postclass test than those in the control group (P < 0.05), and the students in the study group scored higher in satisfaction with the teaching content and spatial thinking for sectional anatomy than those in the control group (P < 0.05). The course grades and excellence rates in the study group exceeded those in the control group (P < 0.05).

CONCLUSION

The application of high-precision multicolor 3D-printed specimens of lung segments in experimental teaching of sectional anatomy can improve teaching effectiveness and is worth adopting and promoting in sectional anatomy courses.

The landscape of endodontic education research area: A bibliometric analysis

OBJECTIVES

Educational research is essential for rationalizing curriculum design, improving evaluation systems, and updating teaching content. This bibliometric study aimed at analyzing the characteristics of publications relevant to endodontic education, thus forming a comprehensive scope of this research area.

METHODS

The search was conducted in the Web of Science Core Collection database in May 2022. Knowledge units of the included publications, such as year of publication, journal, country/institution/author, keywords, and highly cited articles/references, were analyzed.

RESULTS

The United States ranked first in the number of articles with a total of 17 articles. The majority of included articles were published in Journal of Dental Education (n = 25), International Endodontic Journal (n = 21), and European Journal of Dental Education (n = 14). The top 3 most frequent keywords were Endodontics, Education, and Root canal treatment. The main topic in endodontic education were curriculum, preclinical education, educational technology, and continuing education.

CONCLUSION

Forming a full scope of the endodontic research area, this bibliomertic analysis can help mine the hot topic, predict the frontiers in the field and provide the data necessary to determine the direction of research, rationalize resource allocation, and formulate policy.

Application of HoloLens-based augmented reality and three-dimensional printed anatomical tooth reference models in dental education

Tooth anatomy is fundamental knowledge used in everyday dental practice to reconstruct the occlusal surface during cavity fillings. The main objective of this project was to evaluate the suitability of two types of anatomical tooth reference models used to support reconstruction of the occlusal anatomy of the teeth: (1) a three-dimensional (3D)-printed model and (2) a model displayed in augmented reality (AR) using Microsoft HoloLens. The secondary objective was to evaluate three aspects impacting the outcome: clinical experience, comfort of work, and other variables. The tertiary objective was to evaluate the usefulness of AR in dental education. Anatomical models of crowns of three different molars were made using cone beam computed tomography image segmentation, printed with a stereolithographic 3D-printer, and then displayed in the HoloLens. Each participant reconstructed the occlusal anatomy of three teeth. One without any reference materials and two with an anatomical reference model, either 3D-printed or holographic. The reconstruction work was followed by the completion of an evaluation questionnaire. The maximum Hausdorff distances (Hmax) between the superimposed images of the specimens after the procedures and the anatomical models were then calculated. The results showed that the most accurate but slowest reconstruction was achieved with the use of 3D-printed reference models and that the results were not affected by other aspects considered. For this method, the Hmax was observed to be 630 μm (p = 0.004). It was concluded that while AR models can be helpful in dental anatomy education, they are not suitable replacements for physical models.

Implementation of an interactive virtual microscope laboratory system in teaching oral histopathology

Laboratory course acts as a key component of histopathology education. Recent trends of incorporating visual and interactive technology in active and inquiry-based learning pedagogical methods have led to significant improvement of histopathology laboratory courses. The present work aimed to describe interactive virtual microscope laboratory system (IVMLS) as a virtual platform for teaching histopathology in order to improve the quality and efficiency of teaching. The system is based on interactive technology and consists of interactive software, slide-reading software, teaching resources and integrated auxiliary equipment. It allows real-time interaction between teachers and students and provides students with a wealth of learning and review materials. In order to evaluate the effectiveness of the system, we conducted a comparative study with the use of light microscope (LM) as a method. Specifically, we compared the results of six assignments and one laboratory final exam between IVMLS group and LM group to analyse the impact of IVMLS on students' academic performance. A questionnaire survey was also conducted to obtain students' attitudes and views on this system. There was no overall difference in assignment performance between IVMLS group and LM group. But laboratory final test grades increased from a mean of 62% (43.8–80.0, 95% CI) before to 83% (71.0–94.2, 95% CI) after implement IVMLS, suggesting highly significant (p < 0.001) improvement on students' histopathology laboratory performance. Feedback of the questionnaire was positive, indicating that students were satisfied with the system, which they believed improved student communication and teacher-student interaction, increased learning resources, increased their focus on learning, and facilitated their independent thinking process. This study proves that IVMLS is an efficient and feasible teaching technology and improves students' academic performance.