Technology-enhanced simulation-based learning in orthodontic education: A scoping review

ABSTRACT Introduction: Technology-enhanced simulations seem to be effective in dentistry, as they can support dental students to improve competencies in simulated environments. However, implementation of this technology in orthodontic education has not been reviewed. Objective: This scoping review aimed to comprehensively summarize the use of technology-enhanced simulations in orthodontic practice. Methods: A systematic search was conducted to identify literature on technology-enhanced simulation-based learning in orthodontic education published from 2000 to 2021. The search was conducted up to September 2021 to identify articles from Scopus, Embase, PubMed, ProQuest Dissertations & Theses Global, Google Scholar and the reference lists of identified articles. Results: The search identified 177 articles. Following the inclusion and exclusion criteria, 16 articles of 14 digital simulators were included in this review. The findings demonstrated an increasing use of technology-enhanced simulations in orthodontic education. They were designed in several formats, including three-dimensional virtual format, augmented reality, virtual reality, automaton, haptic, and scenario-based simulations. These simulations were implemented in varied areas of orthodontics including diagnosis and treatment planning, bracket positioning, orthodontic procedures, facial landmark, removable appliance and cephalometric tracing. Most included articles demonstrated the development process without outcome evaluation. Six studies provided outcome evaluations at reaction or learning levels. None of them provide the evaluation at behaviour and results levels. Conclusion: Insufficient evidence has been generated to demonstrate the effectiveness of technology-enhanced simulations in orthodontic education. However, high-fidelity computer-based simulations together with robust design research should be required to confirm educational impact in orthodontic education

A rapid review of serious games: from healthcare education to dental education

Introduction: Games involving technology have the potential to enhance hand-eye coordination and decision-making skills. As a result, game characteristics have been applied to education and training, where they are known as serious games. There is an increase in the volume of literature on serious games in healthcare education; however, evidence on their impact is still ambiguous. Aims: The aims of this study were (1), to identify high-quality evidence (systematic reviews or meta-analyses) regarding impacts of serious games on healthcare education; and (2), to explore evidence regarding impacts of serious games in dental education. Methods: A rapid review of the literature was undertaken to synthesise available evidence and examine serious games in healthcare education (Stage 1) and dental education (Stage 2). Results: Nine systematic reviews were included in Stage 1, four of which were of high, three of moderate, and two of low quality. For Stage 2, two randomised control trials with moderate quality were included. The findings demonstrated that serious games are potentially effective learning tools in terms of knowledge and skills improvement, although outcomes of serious games over traditional learning approaches were not consistent. In addition, serious games appeared to be more engaging and satisfying for students, which could be considered as the most important positive impact. Conclusion: Serious games provide an option for healthcare and dental education but remain under-utilised and researched. At best, they offer a similar experience to other methods in relation to educational outcome; however, they can provide a supplementary strategy to engage students and improve learner satisfaction

The Effect of Dentin Contamination by Topical Anesthetics on Micro-Shear Bond Strength: An In Vitro Experiment

Topical anesthetics are commonly used to minimize pain and anxiety during dental procedures. Research is scarce on the influence of topical anesthetics on bond strength. Thus, this research evaluated the effect of dentin contamination by topical anesthetic solution and gel on the micro-shear bond strengths of etch-and-rinse and self-etch bonding systems. Ninety transversally hemi-sectioned dentin discs were prepared and randomly assigned to three groups: no contamination (control group), contamination with topical anesthetic solution (Xylonor spray, Septodont), and contamination with topical anesthetic gel (Xylonor gel, Septodont). Each contamination group was subdivided into two subgroups (n = 15) based on whether the adhesive system was etch-and-rinse (Optibond Solo Plus, Kerr) or self-etch (Optibond XTR, Kerr). Tygon tubes with resin composite (Filtek Z350 XT, 3M ESPE) were placed on each surface and light cured. After 24 h, a universal testing machine was used to measure micro-shear bond strength (MPa). Furthermore, nine additional specimens of non-contaminated and contaminated dentin were prepared and scanned by a scanning electron microscope. The data of micro-shear bond strength were analyzed using two-way ANOVA, and narrative analysis was used to qualitatively interpret visual data of the micro-morphology of dentin from the scanning electron microscope. No significant differences in micro-shear bond strength among different contamination groups and adhesive systems were found (p > 0.05). The results are supported by micro-morphology of the treated dentin surfaces and modes of failure, as the micro-morphology was similar among contamination and control groups. There was no significant impact of topical anesthetic forms and dentin bonding systems on the micro-shear bond strength, which was supported by the micro-morphology from a scanning electron microscope

Significance of Non-Statistically Significant Results in the Prediction of Oral Health-Related Quality of Life in Orthodontic Patients: A Survey Using Two Linking Questionnaires

Patients with a fixed orthodontic appliance may have difficulties in maintaining good oral health-related quality of life (OHRQoL), and evaluating self-perceived OHRQoL in orthodontic patients could be challenging for their orthodontists. Therefore, this research was conducted to investigate whether orthodontic postgraduates would accurately evaluate the OHRQoL of their patients. Two self-administered questionnaires were designed for patients to rate their OHRQoL and for their orthodontic postgraduates to evaluate them on OHRQoL. All pairs of patients and their orthodontic postgraduates were requested to independently complete the questionnaires. Pearson’s correlation and multiple linear regression were performed to determine the relationships of the variables and to identify significant predictors on OHRQoL, respectively. There were 132 pairs of orthodontic patients and their residents who completed the questionnaires. There were no significant correlations between OHRQoL perceived by patients and evaluated by their orthodontic postgraduates in all aspects of treatment needs and dietary difficulties (p > 0.05). In addition, the regression model demonstrated no significant predictors for the self-perceived treatment needs and dietary difficulties of orthodontic patients. There seemed to be challenges for orthodontic postgraduates to evaluate their patients’ oral health-related quality of life. Therefore, the OHRQoL measures should be increasingly implemented in orthodontic education and practice in order to enhance the concept of patient-centered care

The development of an online serious game for oral diagnosis and treatment planning: evaluation of knowledge acquisition and retention

Abstract Background While serious games seem to be supportive in healthcare education, none of them had been designed to develop competence in diagnosis and treatment planning of oral lesions. Therefore, this research aimed to develop an online simulation-based serious game for training diagnosis and treatment planning of oral lesions (SimOL) and to evaluate its educational impact in terms of knowledge improvement and retention. Methods As a mandatory task in an oral lesion course, all 28 students were required to participate in SimOL activities. Participants were instructed to complete a pre-knowledge assessment following a one-week washout period prior to the game activity. Subsequent to the game completion, they were tasked to complete a post-knowledge assessment I (Full score = 15) and satisfaction questionnaire. A post-knowledge assessment II was administered a week later to evaluate knowledge retention. Results The findings demonstrated a significant increase in the assessment scores after interacting with the game (P  0.05). Additionally, students perceived the game as positively in all aspects, although the entertainment aspect achieved a slightly lower score of 3.70 (SD = 0.21), in comparison to the usefulness and ease of use with a score of 4.02 (SD = 0.11) and 4.02 (SD = 0.16), respectively. Conclusion SimOL demonstrated its potential as an effective learning tool for improving and retaining knowledge for diagnosis and treatment planning of oral lesions. The game was perceived positively by dental students in all aspects, however further improvements should prioritize the enhancement of entertaining components

The Effects of Temperature and Time of Heat Treatment on Thermo-Mechanical Properties of Custom-Made NiTi Orthodontic Closed Coil Springs

Nickel-Titanium (NiTi) springs have been increasingly used in orthodontics; however, no optimum condition of heat treatment has been reported. Therefore, this research was conducted to determine the optimum heat-treatment temperature and duration for the fabrication of NiTi-closed coil springs by investigating their effects on thermo-mechanical properties. As-drawn straight NiTi wires of 0.2 mm diameter were used to fabricate closed coil springs of 0.9 mm lumen diameter. The springs were heat-treated at three different temperatures (400, 450, and 500 °C) with three different durations (20, 40, and 60 min). Electron Probe Micro-Analysis (EPMA) and Differential Scanning Calorimetry (DSC) were used to investigate element composition and thermo-mechanical properties, respectively. Custom-made NiTi closed coil springs composed of 49.41%-Ti and 50.57%-Ni by atomic weight, where their DSC curves of 500 °C presented the obvious endothermic and exothermic peaks, and the austenite finish temperature (Af) were approximately 25 °C. With increasing temperature, deactivation curves presented decreased plateau slopes generating higher superelastic ratios (SE ratios). At 500 °C, closed coil springs showed superelastic tendency with lower stress hysteresis. The thermo-mechanical properties were significantly influenced by heat-treatment temperature rather than duration. The optimum parameter appeared to be 500 °C for 40 min to produce appropriate force delivery levels, relatively low plateau slope, and lower hysteresis for orthodontic use

Evaluating a Dental Public-Health Game across Two Learning Contexts

Serious games have been shown to be effective learning tools in various disciplines, including dental education. Serious-game learning environments allow learners to improve knowledge and skills. GRAPHIC (Games Research Applied to Public Health with Innovative Collaboration), a serious game for dental public health, was designed to simulate a town, enabling students to apply theoretical knowledge to a specific population by selecting health promotion initiatives to improve the oral health of the town population. This study employed a literature-based evaluation framework and a sequential explanatory mixed-methods research design to evaluate the use of GRAPHIC among final-year dental undergraduates across two learning contexts: King’s College London in the United Kingdom and Mahidol University in Thailand. Two hundred and sixty-one students completed all designated tasks, and twelve participated in semi-structured interviews. The findings demonstrated knowledge improvement after game completion based on pre- and post-knowledge assessments, and the students’ perceptions of the game as an interactive and motivational learning experience. The evaluation identified five serious-game dimensions and clear alignment between these dimensions, demonstrating the impact of serious games in dental public health and, more widely, in healthcare education

The accuracy of virtual setup in simulating treatment outcomes in orthodontic practice: a systematic review

Abstract Objectives To evaluate the accuracy of virtual orthodontic setup in simulating treatment outcomes and to determine whether virtual setup should be used in orthodontic practice and education. Materials and Methods A systematic search was performed in five electronic databases: PubMed, Scopus, Embase, ProQuest Dissertations & Theses Global, and Google Scholar from January 2000 to November 2022 to identify all potentially relevant evidence. The reference lists of identified articles were also screened for relevant literature. The last search was conducted on 30 November 2022. Results This systematic review included twenty-one articles, where all of them were assessed as moderate risk of bias. The extracted data were categorized into three groups, which were: (1) Virtual setup and manual setup; (2) Virtual setup and actual outcomes in clear aligner treatment; (3) Virtual setup and actual outcomes in fixed appliance treatment. There appeared to be statistically significant differences between virtual setups and actual treatment outcomes, however the discrepancies were clinically acceptable. Conclusion This systematic review supports the use of orthodontic virtual setups, and therefore they should be implemented in orthodontic practice and education with clinically acceptable accuracy. However, high-quality research should be required to confirm the accuracy of virtual setups in simulating treatment outcomes