Mobile educational tool based on augmented reality technology for tooth carving: results of a prospective cohort study.

BACKGROUND: Augmented reality (AR) technology has been shown to be effective in displaying information and presenting three-dimensional objects. Although AR applications are commonly used by learners via mobile devices, plastic models or two-dimensional images are still commonly used in tooth carving practice. Learners practicing tooth carving face a challenge due to the three-dimensional features of teeth as there is a lack of tools available that provide sequential guidance. In this study, we developed an AR-based tooth carving practice tool (AR-TCPT) and compared it to a plastic model to evaluate its potential as a practice tool as well as its user experience. METHODS: To model tooth carving, we created a three-dimensional object from sequential steps that included the maxillary canines and maxillary first premolars (16 steps), mandibular first premolars (13 steps), and mandibular first molars (14 steps). Image markers, created using Photoshop software, were assigned to each tooth. An AR-based mobile application was developed using the Unity engine. For tooth carving, 52 participants were randomly assigned to a control group (n = 26; using a plastic tooth model) or an experimental group (n = 26; using the AR-TCPT). User experience was evaluated using a 22-item questionnaire. Data were comparatively analyzed using the nonparametric Mann-Whitney U test via the SPSS program. RESULTS: The AR-TCPT detects image markers with the mobile device camera and displays three-dimensional objects for tooth fragmentation. Users can manipulate the device to view each step or examine the shape of a tooth. The results of the user experience survey revealed that the AR-TCPT experimental group scored significantly higher in tooth carving experience compared with the control group that used the plastic model. CONCLUSION: Compared with the conventional plastic model, the AR-TCPT provided a better user experience for tooth carving. The tool is highly accessible as it is designed to be used on mobile devices by users. Further studies are required to determine the educational impact of the AR-TCTP on quantitative scoring of carved teeth as well as individual user's carving abilities.

Effect of Dental Course Cycle on Anatomical Knowledge and Dental Carving Ability of Dental Students.

This study assessed the effect of the course cycle on theoretical knowledge of dental morphology and the dental carving ability of dental students. Thirty-two dental students from the third semester (initial cycle) and 30 students from the eighth and tenth semesters of the dental course (end cycle) had their theoretical knowledge on dental morphology assessed using a questionnaire with ten closed questions. Their dental carving ability was also assessed using wax carvings in macro models of plaster (for the third [S3] and eight [S8] semesters) and natural-sized artificial teeth (for the tenth [S10] semester). The teeth chosen for the dental carving activity were #16 and #47. The scores were statistically analyzed using the t-test, Kruskal-Wallis test, and Mann-Whitney test (α = 0.05). Students from the initial cycle presented better theoretical knowledge than the other groups did (P < 0.007). No significant differences in carving score were found between the initial and end cycles (P > 0.05), although S10 students obtained a higher score for teeth #16 and #47 (P < 0.05). Natural-sized artificial teeth received a higher evaluation score in dental carvings than the macro models (P < 0.001). Within the limits of this study, it was possible to conclude that students from the initial cycle (S3) presented higher theoretical knowledge, whereas no difference in carving ability was observed between the initial and end cycles. The tenth semester (S10) students performed dental carvings with better quality. Furthermore, carvings in natural-sized artificial teeth presented better quality compared with the macro models.

Educational Interventions to Improve Dental Anatomy Carving Ability of Dental Students: A Systematic Review.

This systematic review aimed to identify the level of impact of educational strategies for teaching tooth carving on the carving ability of undergraduate dental students. The PubMed-NCBI, Cochrane-CENTRAL, LILACS, Ibecs, BBO, Web of Science, and Scopus databases were searched in May 2019, for randomized controlled trials (RCTs) and two-arm non-randomized studies of interventions (NRSI) addressing educational interventions toward the dental carving of undergraduate students. Studies from the year 2000 until the search date, written in English, Portuguese, and Spanish were included. Study screening and data extraction were performed in duplicate and blinded. The data were presented narratively, considering the dental carving ability of students the primary outcome. The risk of bias was assessed using the RoB tool 2.0 and ROBINS-I, and the level of evidence was determined with GRADE. Of 3,574 studies, 6 were included, with 3 RCTs and 3 NRSIs. Very low level of evidence was provided from the NRSIs that flipped classroom (1 study; n = 140) and a student-driven revised module (1 study; n = 264) improved the carving ability of students. Additionally, there was moderate evidence of online complementary material (1 RCT; n = 30) and reinforcement class improving the carving ability of students (1 RCT; n = 29). The replacement of traditional classes by an instructional DVD (1 RCT; n = 73) and assessment of carving projects through digital systems (1 NRSI; n = 79) did not enhance the carving ability of students. Study design, risk of bias, and imprecision downgraded the level of evidence. There was a very low to moderate evidence on the effectiveness of student-driven educational approaches and complementary classes of dental anatomy in improving the dental carving ability of students.

Optimizing quality of dental carving by preclinical dental students through anatomy theory reinforcement.

Knowledge of dental anatomy is of great importance in the practice of dentistry, especially in oral rehabilitation, because without this knowledge, professional practice is not possible. Dental carving plays a major role in training dental students as it develops their manual dexterity. This randomized controlled trial aimed to evaluate the influence of didactic-theoretical reinforcement on the theoretical and practical knowledge of dental anatomy of preclinical students by examining the quality of the anatomical restorations performed by these students before and after a didactic-theoretical reinforcement. For the evaluation of theoretical knowledge, a questionnaire with closed questions about dental anatomy was used. To evaluate the effect of didactic reinforcement on dental carvings, two groups of 15 preclinical students were assessed. Experimental group (G1) received a three-hour theoretical tutoring on dental anatomy, while the control group (G2) did not. The dental carving scores obtained by the two different groups were compared using Student's t-test. Cohen's d was used to estimate the effect sizes between groups. The frequency of correct answers given for each theoretical knowledge question was compared in each group using Fisher's exact test. T-test was also used to compare the means of the two groups' final scores of theoretical evaluations. To compare these final scores obtained in both carving and theoretical tests, a principal component analysis was performed with different items assessed in each test to obtain factor loading scores and a final weighted score, where factor loadings were considered for each item. Weighted scores were compared using t-test. Also, scores obtained during the head and neck course were assessed and compared using t-test. Spearman's correlation test was used to assess the correlation between scores obtained prior to the anatomy course and scores obtained in the dental carving exercise. The theoretical evaluation revealed no significant difference between the grades (mean ± SD) of G1 (85.1 ± 6.6%) and G2 (86.2 ± 9.1%) with the grades of a baseline test that was previously obtained when students submitted to the study (P = 0.725). Regarding the tooth carving assessment, the dental carving quality by students of G1 has significantly improved, except for tooth #23 (P = 0.096). Theoretical reinforcement of dental anatomy seems to improve the students' carving performance but does not enhance their knowledge about dental anatomy. Anat Sci Educ 11: 377-384. © 2017 American Association of Anatomists.