digital prosthodontics C D A J O U R N A L , V O L 4 9 , Nº 6
Problem-Based, Patient-Specific Learning
FIGURE 6 . Implantology module. Slices of a CBCT
scan are visible while preparing osteotomy site to emulate bone density feedback.
step is to analyze how the root canal can be best reached while preserving as much tooth structure as possible. FIGURE 5 . Example of prosthodontic module
exercise. The amount of enamel and dentin is recorded. Numerous handpiece and bur options are available to select.
plan. Subsequently, the treatment plan is executed and caries can be drilled out where applicable.
Fixed Prosthodontics
Within the prosthodontics module (FIGURE 5 ), students can perform exercises related to both fixed and removable prosthodontics. In regard to crown preparations, these haptic simulators allow the user to see the original shape of the tooth as they prep to visualize the amount of reduction they have completed. Students can also prepare fixed partial denture preparations to assess the path of draw as well as other indirect restorations such as inlays or onlays. Removable prosthodontics can also be part of the module, allowing trainees to practice rest seat and guide plane preparations.
Endodontics
The endodontics module allows the trainee to perform access cavities with visualization of the root canals. The cases contain various teeth that require different approaches for creating the access cavity. The first 404 JUNE
2021
Implantology
This module contains exercises with cases to train for implant placement (FIGURE 6), with various jaw models that require implants in different locations. The first step is to analyze the specific aspects of the location and plan the correct implant size and type. Next, the location and angle of the planned implant is determined then executed by preparing the osteotomy sites. One of the major areas where patient-specific learning is lacking is surgically at the postgraduate level. The simulators allow residents to import patient CBCT files and practice implant placement. Surgical training in an augmented reality environment allows the user to drill into bone with differing quality and feel the difference in haptic force feedback when switching from one drill to the next.11 Importing DICOM files into the software also allows the student to see their progress in different views of the imported CBCT. As real-time navigation is becoming more popular,12 the steep learning curve associated with dynamic implant placement can be flattened with practice using dental simulator technology that provides immediate feedback during augmented reality implant placement.
This module contains exercises based on patient-specific scans. The haptic training simulator has the ability to import intraoral scans or scans of a dental cast of real patients. A digital dental cast is a life-size likeness of some desired form, formed from a scan of a material poured into a matrix or of an impression. Perhaps the most promising application of this technology is the ability to perform an anticipated treatment in a simulation and evaluate performance all prior to direct patient care. For example, prior to any student performing a procedure on an actual patient, they could import the case in the simulator and rehearse the preparation and steps virtually. In aviation, this is often referred to as briefings, an opportunity to rehearse the steps of a procedure you anticipate performing. This application may allow providers to practice treatment, reduce and anticipate errors and improve overall treatment outcome. With the technology available using the simulators, educators may create custom “model” patients with the desired pathology that then allows students to treat the exercise as they would a real patient. Some programs may have questions associated with the patient for the student to answer, reinforcing theoretical knowledge and applying it in a clinical scenario. This allows students to practice and reinforce the critical thinking that is required during dental procedures on real patients. These exercises may get more complex as the students’ experience improves and may be applied to procedures in operative dentistry and fixed and removable prosthodontics. These preoperative patient exercises may be evaluated by an expert to allow
