Support: UIC College of Dentistry and NSF grant CMS-0600658
In a world where technology is continually growing at a rapid pace, instructors must compete to keep students attention. Educators must find new innovative ways of educating students; why not mesh the worlds together by creating a simulator system that embellishes new technology such as 3D visualization and haptics?
PerioSim, a computerized virtual reality (VR) system that shows a 3-dimensional model of a quadrant of a lower arch, along with the controls to create a transparent version in which teeth, gingiva, bone and all underlying supportive structure are visible, is valuable in dental training. The system offers 3D, VR graphics and tactile sensation (haptics) allowing the user to feel a variety of dental instruments, such as a Shepherd's hook explorer for training in visualizing and detecting the feel of an caries active white spot lesion or use a VR periodontal probe to probe and evaluate the disease status of a periodontal pocket. The instrument pressure (in grams of force being applied to the gingival area) can also be viewed on a gauge and recorded. A control panel is available for fine control of a variety of parameters such as instrument and model selection, degree of model transparency, navigation, haptic fidelity of tissues and tremor modulation. Furthermore, the system allows instructors to create short scenarios of periodontal procedures, such as periodontal probing, which can be stored and played back by the student at any future time. During playback the trainee can cradle the stylus, observe a "ghost" of the original instrument and view the on-screen instrument movement. A recorded procedure can be paused and the 3D component of the program permits playback from any angle, so that the user can observe various views of an instrument as well as the tooth and gingival relationships during a procedure. The recorded procedure file can be transferred to any computer and, by using our proprietary viewer, the procedure can be observed as recorded in the simulator. This offers great training and testing potential for a variety of procedures.
In a second (playback) mode, the trainee holds the haptic stylus and actually physically feels it guiding his/her hands through exactly the same movements, and encountering the same tactile feedback, felt by the instructor who recorded the procedure. A testing component is available to both test and evaluate the student's ability to emulate the instructor's periodontal procedures scenario. Upon initiating the testing mode, the trainee can perform the same procedure recorded by the instructor and receive instant grading of how well he/she performed the procedure in all aspects of the procedure.
This system could reduce or eliminate altogether the need to practice on patients or mannequins. PerioSim has been developed at the University of Illinois at Chicago through the collaboration between the Colleges of Dentistry and Engineering. The dental simulator (PerioSim) allows students to fully experience what the instructor is demonstrating. It combines a graphical animation of a 4-tooth segment of a human lower jaw, projected and zoomed in on a screen or computer monitor, along with a haptic device linked to a stylus providing the sensations of touch that are so important in dentistry. Users wear special glasses to make the objects on the screen look 3-dimensional. They can place a VR instrument into contact with a projected image suspended in space to feel the teeth and gingiva, as if the model were real.
The haptic device allows one to touch what is displayed on a computer screen so that the student can feel exactly what the instructor is feeling, whether soft tissue alterations or a hard calculus deposit beneath the gingiva. As a first step in the development of this system, we have focused on clinical periodontal procedures, such as periodontal probing, the use of the periodontal explorer in the detection of subgingival calculus and a variety of other subgingival topographies. Normally, such procedures as detection of subgingival calculus are done in the blind since in many cases calculus is under the gingiva. Additionally, we have also developed this system to train student skills in detecting initial caries active white spot lesions.
Students' hands-on use of this device has been already implemented in one course and is being implemented in 2 additional courses in the Fall of 2008.
In the future, this system will also be developed for head-neck lymphadenopathy detection and in other areas of clinical dentistry and medicine. A parallel system has been developed for use in training in non-medical areas where 3D visualization is important.
The intent of the Learning Periodontal Probing Skills CD is to provide a supplemental training along with a cutting edge educational tool to help students to learn at home. Students are provided with a state-of-the-art, take-home, highly interactive CD with the ability to view 2D and 3D instrumentation and structural models. They are able to learn and practice procedures and be self-tested. The 3D videos are instructor-created scenarios through the use of PerioSim's 3D recording ability. The CD provides basic information about the procedure and prepares the student for clinical application. It also allows for unlimited practice time, testing of students' ability to learn the procedure and helps standardize the millimeter (mm) reading of pocket depth in a 3D VR environment. In the summer of 2007, the CD was implemented within the College of Dentistry computer lab. Students are now able to take home the CD, as well as practice during school hours.
Arnold D. Steinberg DDS MS
Professor of Periodontics
Department of Periodontics\Rm461A\Rm351A
UIC College of Dentistry
801 S. Paulina St., MC 859
Chicago, IL 60612
312-996-4599 (O)
847-287-0020 (M)
stein@uic.edu
View Video of PerioSim Application