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A scoping review of the use and application of virtual reality in pre-clinical dental education


Introduction Virtual reality (VR) is gaining recognition as a valuable tool for training dental students and its use by dental schools around the world is growing. It is timely to review the literature relating to the use of VR in dental education, in order to ensure that educators are well-informed of current areas of inquiry, and those requiring further investigation, to enable appropriate decisions about whether to employ VR as a teaching tool. Method A scoping review using the method outlined by Arksey and O'Malley was conducted. Both Web of Science and ERIC databases were searched. Inclusion and exclusion criteria were established to filter results. The data were collected and categorised using a custom data collection spreadsheet. Results The review identified 68 relevant articles. Following review, four educational thematic areas relating to the 'simulation hardware', the 'realism of the simulation', 'scoring systems' and 'validation' of the systems emerged. Conclusion This paper summarises and draws out themes from the current areas of inquiry in the literature, uncovering a number of weaknesses and assumptions. It recommends areas where additional investigation is required in order to form a better evidence base for the utility of VR in dental education, as well as to inform its future development.

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  1. 1.

    University of Glasgow. The University of Glasgow Story: Edward Oswald Fergus. 2010. Available at (accessed February 2019).

  2. 2.

    Owen H. Simulation in Dentistry and Dental Hygiene. In Owen H (ed) Simulation in Healthcare Education: An Extensive History. pp 431-450. Berlin: Springer, 2016.

  3. 3.

    Xia P, Mendes Lopes A, Restivo M T. Virtual reality and haptics for dental surgery: A personal review. Vis Comput 2013; 29: 433-447.

  4. 4.

    Arksey H, O'Malley L. Scoping studies: Towards a methodological framework. Int J Soc Res Methodol 2005; 8: 19-32.

  5. 5.

    Plessas A. Computerized Virtual Reality Simulation in Preclinical Dentistry: Can a Computerized Simulator Replace the Conventional Phantom Heads and Human Instruction? Simul Healthc 2017; 12: 332-338.

  6. 6.

    de Boer I R, Lagerweij M D, de Vries M W, Wesselink P R, Vervoorn J M. The Effect of Force Feedback in a Virtual Learning Environment on the Performance and Satisfaction of Dental Students. Simul Healthc 2017; 12: 83-90.

  7. 7.

    Kolesnikov M, Žefran M, Steinberg A D, Bashook P G. PerioSim: Haptic virtual reality simulator for sensorimotor skill acquisition in dentistry. 2009 IEEE International Conference on Robotics and Automation 2009; 689-694.

  8. 8.

    Wang D, Zhang Y, Sun Z. Multi-Modal Virtual Reality Dental Training System with Integrated HapticVisualAudio Display. In Tarn T J, Chen S B, Zhou C (eds) Robotic Welding, Intelligence and Automation. pp 453-462. Berlin: Springer, 2007.

  9. 9.

    Rhienmora P, Haddawy P, Suebnukarn S, Dailey M N. A VR Environment for Assessing Dental Surgical Expertise. Proceedings of the 2009 conference on Artificial Intelligence in Education: Building Learning Systems that Care: From Knowledge Representation to Affective Modelling. 2009; 746-748.

  10. 10.

    Tse B, Harwin W, Barrow A, Quinn B, San Diego J, Cox M. Design and Development of a Haptic Dental Training System - hapTEL. In Kappers A M L, van Erp J B F, Bergmann Tiest W M, van der Helm F C T (eds) Haptics: Generating and Perceiving Tangible Sensations. pp 101-108. Berlin: Springer, 2010.

  11. 11.

    Somrang N, Chotikakamthorn N. Interactive haptic simulation of dental plaque removal. 2006 International Symposium on Communications and Information Technologies. 2006; 319-322.

  12. 12.

    Rhienmora P, Gajananan K, Haddawy P et al. Haptic augmented reality dental trainer with automatic performance assessment. Proceedings of the 15th international conference on Intelligent user interfaces. 2010. 425-426.

  13. 13.

    Zheng F, Lu W F, Wong Y S, Foong K W C. Graphic Processing Units (GPUs)-Based Haptic Simulator for Dental Implant Surgery. J Comput Inf Sci Eng 2013; 13: 041005.

  14. 14.

    Chen L Y, Fujimoto A, Miwa A, Abe T, Sumi A, Ito Y. A dental training system using virtual reality. Proceedings 2003 IEEE International Symposium on Computational Intelligence in Robotics and Automation. Computational Intelligence in Robotics and Automation for the New Millennium. 2003; 430-434.

  15. 15.

    Jamieson E S, Chandler J H, Culmer P R, Manogue M, Mon-Williams M, Wilkie R M. Can virtual reality trainers improve the compliance discrimination abilities of trainee surgeons? 2015 37th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. 2015; 466-469.

  16. 16.

    Wang D, Zhang Y, Hou J et al. iDental: A haptic-based dental simulator and its preliminary user evaluation. IEEE Trans Haptics 2012; 5: 332-343.

  17. 17.

    Li Y, Zhang S, Ye X. Penalty-based haptic rendering technique on medicinal healthy dental detection. Multimed Tools Appl 2017; 76: 10825-10835.

  18. 18.

    Rhienmora P, Haddawy P, Khanal P, Suebnukarn S, Dailey M N. A virtual reality simulator for teaching and evaluating dental procedures. Methods Inf Med 2010; 49: 396-405.

  19. 19.

    Germans D M, Spoelder H J W, Renambot L, Bal H E, van Daatselaar S, van der Stelt P. Measuring in Virtual Reality: A case study in dentistry. IEEE Trans Instrum Meas 2008; 57: 1177-1184.

  20. 20.

    Medellín-Castillo H I, Govea-Valladares E H, Pérez-Guerrero C N, Gil-Valladares J, Lim T, Ritchie J M. The evaluation of a novel haptic-enabled virtual reality approach for computer-aided cephalometry. Comput Methods Programs Biomed 2016; 130: 46-53.

  21. 21.

    Ioannou I, Kazmierczak E, Stern L. Comparison of oral surgery task performance in a virtual reality surgical simulator and an animal model using objective measures. Conf Proc IEEE Eng Med Biol Soc 2015; 5114-5117. DOI: 10.1109/EMBC.2015.7319542.

  22. 22.

    Syllebranque C, Duriez C. Six degree-of freedom haptic rendering for dental implantology simulation. In Syllebranque C, Duriez C (eds) Biomedical Simulation. pp 139-149. Berlin: Springer, 2010.

  23. 23.

    Deshpande S, Nahavandi S, Mullins J, Khan M B, Creighton D. Enhancing audio-haptic enabled novel dental training platform performance. ASME 2012 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference. 2012; 1371-1376. DOI: 10.1115/DETC2012-70666.

  24. 24.

    Mohamed N F F, Luke D A. Virtual reality on the WWW: Simulating class I procedures in restorative dentistry. Student Conference on Research and Development. 2002; 360-363. DOI: 10.1109/SCORED.2002.1033132.

  25. 25.

    Wang D, Zhao X, Shi Y, Zhang Y, Hou J, Xiao J. Six DegreeofFreedom Haptic Simulation of Probing Dental Caries Within a Narrow Oral Cavity. IEEE Trans Haptics 2016; 9: 279-291.

  26. 26.

    Wang D, Tong H, Shi Y, Zhang Y. Interactive haptic simulation of tooth extraction by a constraint-based haptic rendering approach. IEEE International Conference on Robotics and Automation (ICRA). 2015; 278-284. DOI: 10.1109/ICRA.2015.7139012.

  27. 27.

    Escobar-Castillejos D, Noguez J, Neri L, Magana A, Benes B. A Review of Simulators with Haptic Devices for Medical Training. J Med Syst 2016; 40: 104.

  28. 28.

    Osnes C, Keeling A J. Developing haptic caries simulation for dental education. J Surg Simul 2017; 4: 29-34.

  29. 29.

    Wu J, Wang D, Wang C C L, Zhang Y. Toward Stable and Realistic Haptic Interaction for Tooth Preparation Simulation. J Comput Inf Sci Eng 2010; 10: 021007.

  30. 30.

    Luciano C, Banerjee P, DeFanti T. Haptics-based virtual reality periodontal training simulator. Virtual Real. 2009; 13: 69-85.

  31. 31.

    Kim L, Park S H. Haptic interaction and volume modeling techniques for realistic dental simulation. Vis Comput 2006; 22: 90-98.

  32. 32.

    Wang D X, Zhang Y, Wang Y, Lu P. Development of dental training system with haptic display. 12th IEEE International Workshop on Robot and Human Interactive Communication. 2003; 159-164. DOI: 10.1109/ROMAN.2003.1251836.

  33. 33.

    Luciano C, Banerjee P, DeFanti T, Mehrotra S. Realistic cross-platform haptic applications using freely-available libraries. Proceedings. 12th International Symposium on Haptic Interfaces for Virtual Environment and Teleoperator Systems. 2004; 282-289. DOI: 10.1109/HAPTIC.2004.1287207.

  34. 34.

    Wang D, Zhang Y, Wang Y, Lü P, Zhou R, Zhou W. Haptic rendering for dental training system. Sci China, Ser F Inf Sci. 2009; 52: 529-546.

  35. 35.

    Konukseven E I, Onder M E, Mumcuoglu E, Kisnisci R S. Development of a visio-haptic integrated dental training simulation system. J Dent Educ 2010; 74: 880-891.

  36. 36.

    De Boer I R, Wesselink P R, Vervoorn J M. The creation of virtual teeth with and without tooth pathology for a virtual learning environment in dental education. Eur J Dent Educ 2013; 17: 191-197.

  37. 37.

    Ben-Gal G, Weiss E I, Gafni N, Ziv A. Testing manual dexterity using a virtual reality simulator: Reliability and validity. Eur J Dent Educ 2013; 17: 138-142.

  38. 38.

    Eve E, Koo S, Alshihri A A et al. Performance of Dental Students Versus Prosthodontics Residents on a 3D Immersive Haptic Simulator. J Dent Educ 2014; 78: 630-637.

  39. 39.

    Suebnukarn S, Chaisombat M, Kongpunwijit T, Rhienmora P. Construct validity and expert benchmarking of the haptic virtual reality dental simulator. J Dent Educ 2014; 78: 1442-1450.

  40. 40.

    de Boer I R, Wesselink P R, Vervoorn J M. Student performance and appreciation using 3D vs. 2D vision in a virtual learning environment. Eur J Dent Educ 2016; 20: 142-147.

  41. 41.

    Wang D, Li T, Zhang Y, Hou J. Survey on multisensory feedback virtual reality dental training systems. Eur J Dent Educ 2016; 20: 248-260.

  42. 42.

    Suebnukarn S, Haddawy P, Rhienmora P, Jittimanee P, Viratket P. Augmented kinematic feedback from haptic virtual reality for dental skill acquisition. J Dent Educ 2010; 74: 1357-1366.

  43. 43.

    Kikuchi H, Ikeda M, Araki K. Evaluation of a virtual reality simulation system for porcelain fused to metal crown preparation at Tokyo Medical and Dental University. J Dent Educ 2013; 77: 782-792.

  44. 44.

    Gottlieb R, Lanning S K, Gunsolley J C, Buchanan J A. Faculty impressions of dental students' performance with and without virtual reality simulation. J Dent Educ 2011; 75: 1443-1451.

  45. 45.

    Gal G B, Weiss E I, Gafni N, Ziv A. Preliminary assessment of faculty and student perception of a haptic virtual reality simulator for training dental manual dexterity. J Dent Educ 2011; 75: 496-504.

  46. 46.

    Urbankova A, Engebretson S P. The use of haptics to predict preclinic operative dentistry performance and perceptual ability. J Dent Educ 2011; 75: 1548-1557.

  47. 47.

    Urbankova A, Eber M, Engebretson SP. A complex haptic exercise to predict preclinical operative dentistry performance: a retrospective study. J Dent Educ 2013; 77: 1443-1450.

  48. 48.

    Steinberg A D, Bashook P G, Drummond J, Ashrafi S, Zefran M. Assessment of faculty perception of content validity of PerioSim, a haptic-3D virtual reality dental training simulator. J Dent Educ 2007; 71: 1574-1582.

  49. 49.

    Wierinck E R, Puttemans V, Swinnen S P, van Steenberghe D. Expert performance on a virtual reality simulation system. J Dent Educ 2007; 71: 759-766.

  50. 50.

    Roy E, Bakr M M, George R. The need for virtual reality simulators in dental education: A review. Saudi Dent J 2017; 29: 41-47.

  51. 51.

    Corrêa C G, Machado M A M, Ranzini E, Tori R, Nunes F L S. Virtual Reality simulator for dental anaesthesia training in the inferior alveolar nerve block. J Appl Oral Sci 2017; 25: 357-366.

  52. 52.

    Suebnukarn S, Haddawy P, Rhienmora P, Gajananan K. Haptic virtual reality for skill acquisition in endodontics. J Endod 2010; 36: 53-55.

  53. 53.

    Joseph D, Jehl J P, Maureira P et al. Relative contribution of haptic technology to assessment and training in implantology. Biomed Res Int 2014; 413951. DOI: 10.1155/2014/413951.

  54. 54.

    Kusumoto N, Sohmura T, Yamada S, Wakabayashi K, Nakamura T, Yatani H. Application of virtual reality force feedback haptic device for oral implant surgery. Clin Oral Implants Res 2006; 17: 708-713.

  55. 55.

    Suebnukarn S, Hataidechadusadee R, Suwannasri N, Suprasert N, Rhienmora P, Haddawy P. Access cavity preparation training using haptic virtual reality and microcomputed tomography tooth models. Int Endod J 2011; 44: 983-989.

  56. 56.

    Heiland M, Petersik a, Pflesser B et al. Realistic haptic interaction for computer simulation of dental surgery. Int Congr Ser 2004; 1268: 1226-1229.

  57. 57.

    Suebnukarn S, Phatthanasathiankul N, Sombatweroje S, Rhienmora P, Haddawy P. Process and outcome measures of expert/novice performance on a haptic virtual reality system. J Dent 2009; 37: 658-665.

  58. 58.

    Sabalic M, Schoener J D. Virtual Reality-Based Technologies in Dental Medicine: Knowledge, Attitudes and Practice Among Students and Practitioners. Tech Know Learn 2017; 22: 199-207.

  59. 59.

    Shahriari-Rad A, Cox M, Woolford M. Clinical Skills Acquisition: Rethinking Assessment Using a Virtual Haptic Simulator. Tech Know Learn 2017; 22: 185-197.

  60. 60.

    San Diego J P, Cox M J, Quinn B F A, Newton J T, Banerjee A, Woolford M. Researching haptics in higher education: The complexity of developing haptics virtual learning systems and evaluating its impact on students' learning. Comput Educ 2012; 59: 156-166.

  61. 61.

    Cormier J, Pasco D, Syllebranque C, Querrec R. VirTeaSy a haptic simulator for dental education. The 6th International Conference on Virtual Learning. 2011; 61-68.

  62. 62.

    Păvăloiu IB, Ioaniţescu R, Drăgoi G, Grigorescu S, Sandu S A. Virtual Reality for Education and Training in Dentistry. The 12th International Scientific Conference eLearning and Software for Education Bucharest. 2016; 115-120. DOI: 10.12753/2066-026X-16-052.

  63. 63.

    Fernández C, Esteban G, Conde-Gonzalez M, Garcia- Peñalvo F J. Improving motivation in a haptic teaching/learning framework. Int J Eng Educ 2016; 32: 553-562.

  64. 64.

    Bogdan C M, Dinca A, Popovici DM. A Brief Survey of Visuo-Haptic Simulators for Dental Procedures Training. The 6th International Conference on Virtual Learning. 2011; 55-61.

  65. 65.

    Păvăloiu I B, Sandu S A, Grigorescu S, Dragoi G. Inexpensive Dentistry Training Using Virtual Reality Tools Proceedings of INTED2016 Conference. 2016; 279-285.

  66. 66.

    Yoshida Y, Yamaguchi S, Kawamoto Y, Noborio H, Murakami S, Sohmura T. Development of a multi-layered virtual tooth model for the haptic dental training system. Dent Mater J 2011; 30: 1-6.

  67. 67.

    Sofronia R E, Davidescu A, Savii G G. Development of an Efficient Haptic System for Tooth Processing. Adv Mater Res 2012; 463-464: 651-654.

  68. 68.

    Toosi A, Arbabtafti M, Richardson B L. Virtual Reality Haptic Simulation of Root Canal Therapy. Appl Mech Mater 2014; 666: 388-392.

  69. 69.

    Yamaguchi S, Yoshida Y, Noborio H, Murakami S, Imazato S. The usefulness of a haptic virtual reality simulator with repetitive training to teach caries removal and periodontal pocket probing skills. Dent Mater J 2013; 32: 847-852.

  70. 70.

    Wang D, Zhao S, Li T, Zhang Y, Wang X. Preliminary evaluation of a virtual reality dental simulation system on drilling operation. Biomed Mater Eng 2015; 26 (Spec Iss): S747-756.

  71. 71.

    Kozhevnikov M, Schloerb D W, Blazhenkova O et al. Egocentric versus Allocentric Spatial Ability in Dentistry and Haptic Virtual Reality Training. Appl Cogn Psychol 2013; 27: 373-383.

  72. 72.

    Umemura H. Effects of haptic information on the perception of dynamic 3D movement. PLoS One 2014; 9: e106633.

  73. 73.

    Cicciù M, Bramanti E, Signorino F, Cicciù A, Sortino F. Experimental study on strength evaluation applied for teeth extraction: an in vivo study. Open Dent J 2013; 7: 20-26.

  74. 74.

    Martin N, Mylon P, Lewis R, Carr M J. Evaluation of the effect of medical gloves on dexterity and tactile sensibility using simulated clinical practice tests. Int J Ind Erg 2016; 53: 115-123.

  75. 75.

    Field J C, Cowpe J G, Walmsley A D. The Graduating European Dentist: A New Undergraduate Curriculum Framework. Eur J Dent Educ 2017; 21 (Spec Iss): 2-10.

  76. 76.

    Field J, Stone S, Orsini C et al. Curriculum content and assessment of pre-clinical dental skills: A survey of undergraduate dental education in Europe. Eur J Dent Educ 2018; 22: 122-127.

  77. 77.

    Field J. Pre-Clinical Dental Skills at a Glance. New Jersey, USA: Wiley Blackwell, 2016.

  78. 78.

    Banerjee A, Watson T F. Pickard's Guide to Minimally Invasive Operative Dentistry. 10th ed. Oxford: OUP, 2015.

  79. 79.

    Norman G, Dore K, Grierson L. The minimal relationship between simulation fidelity and transfer of learning. Med Educ 2012; 46: 636-647.

  80. 80.

    Wages R, Grünvogel S M, Grützmacher B. How realistic is realism? Considerations on the aesthetics of computer games. In Rauterberg M (ed) Entertainment Computing - ICEC 2004. pp 216-225. Berlin: Springer, 2004

  81. 81.

    European Aviation Safety Agency. Certification Specifications for Aeroplane Flight Simulation Training Devices. 2012. Available at (accessed February 2019).

  82. 82.

    Civil Aviation Authority. PPL (A) requirements. Available at (accessed February 2019).

  83. 83.

    McCloud S. Understanding Comics: The Invisible Art. New York, USA: HarperCollins, 2001.

  84. 84.

    Mori M. The Uncanny Valley. Energy. Robot Autom Mag 2012; 19: 98-100.

  85. 85.

    Salas E, Bowers C A, Rhodenizer L. It Is Not How Much You Have but How You Use It: Toward a Rational Use of Simulation to Support Aviation Training. Int J Aviat Psychol 1998; 8: 197-208.

  86. 86.

    Beilock S L, Bertenthal B I, McCoy A M, Carr T H. Haste does not always make waste: Expertise, direction of attention, and speed versus accuracy in performing sensorimotor skills. Psychon Bull Rev 2004; 11: 373-379.

  87. 87.

    Hindmarsh J, Hyland L, Banerjee A. Work to make simulation work: "Realism", instructional correction and the body in training. Discourse Stud 2014; 16: 247-269.

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Declaration of interests

The research team hold an active R&D collaboration with Haptique & Réalité Virtuelle, Laval, France that is part-funding a PhD studentship for the lead author, Ashley Towers.

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Correspondence to Ashley Towers.

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Towers, A., Field, J., Stokes, C. et al. A scoping review of the use and application of virtual reality in pre-clinical dental education. Br Dent J 226, 358–366 (2019).

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