Objectives
Administering anesthesia to the inferior alveolar nerve is 1 of the most stressful processes in dental training. Most studies using virtual reality (VR) for dental training have used non‐immersive technologies. The purpose of this work is to assess the impact of immersive technologies on skills training.
Methods
On May 2019, an experimental study was conducted with 163 clinical dental students, divided into 4 groups across 2 phases (preceptorship and training) with haptic feedback either On or Off. The participants trained on the inferior alveolar dental anesthesia procedure in a haptic VR simulator. Their technical skills were evaluated in terms of needle insertion features which were computed from a haptic device providing kinematic data. Also, the participants reported their subjective experience with syringe handling and simulator sickness. A machine learning method was implemented to automatically evaluate the needle insertion point performance of the student.
Results
Groups receiving immersive preceptorship and/or immersive training showed more accuracy and confidence in administering the anesthesia. Participants perceived a high sense of realism with the haptic feedback when handling the syringe. The machine learning method was validated, with an accuracy of 84%, as a good classifier to assess a student's needle insertion point performance.
Conclusions
The immersive VR simulator allows the practice of the inferior alveolar nerve block under near real conditions and with immediate feedback to the dental student with respect to the needle insertion point. This machine learning based automatic evaluation provides a method to improve technical skills, contributing to dental training.
The successful clinical application of materials should involve detailed investigations on interaction between them and tissue with which they will contact. We examined herein the behavior of endothelial cells (ECs) on a collagen material, using histological and immunohistochemical methods. We used isolated human umbilical cord vein cells (HUVECs) identified by means of endothelial-specific antibodies. Cells were seeded in a standard density on a collagen membrane (Lycoll, Resorba, Nuernberg, Germany) and on gelatin-coated, control plastic surfaces, after two passages. These were then maintained for periods of 1, 7, or 14 days. The cells adhered, spread, and proliferated, and within 24 h started forming a subconfluent monolayer. We observed that the cultured cells expressed integrins (alpha5beta1 and alpha(v)beta3) and synthesized fibronectin. After 14 days, we could observe a confluent layer of ECs. We could conclude that the collagen material supported growth and attachment of endothelial cells. In addition, the attachment seemed to be most related to the fibronectin synthesized by the cells and to its highly expressed receptor (the alpha5beta1 integrin); even though this is not the only protein related to this adhesion, we observed that our cultured HUVECs did not synthesize vitronectin.
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