The Impact of Virtual Reality Haptic Simulators and Mobile Apps in Endodontic Clinical Practice

NCT07097233 | Not Yet Recruiting

• 1 other identifier: SBU-GFOD-ENDO-SILANURUSTA-002
• Study Type: interventional
• Target: 30
• Locations: 0 countries
• Sites: N/A

Brief Summary

Endodontics presents unique challenges due to the complexity and precision required in procedures such as access cavity preparation, canal instrumentation, and obturation. In this context, access cavity preparation is widely regarded as a critical step in endodontic treatment, as it facilitates the identification of the main root canal anatomy and enables effective chemomechanical debridement of the root canal system. However, the clinical application of this procedure can be particularly challenging for undergraduate students, as patients requiring endodontic care often present with varying degrees of anatomical complexity and clinical difficulty. These variations increase the of procedural complications. This is evident during the fourth year of dental education, when clinical endodontic training typically begins and students are required to perform their first treatments on patients. Initial attempts are often prone to failure due to limited theoretical knowledge, inadequate operative skills, and elevated stress levels. Therefore, ensuring comprehensive and well-structured preclinical training through the use of innovative educational strategies plays a critical role in both facilitating an effective transition to clinical practice and minimizing the risk of potential mishaps.The integration of virtual reality haptic simulators (VRHS) has shown considerable promise in enhancing the quality of endodontic preclinical education. VRHS provides students with an immersive, interactive environment that closely replicates real clinical scenarios, allowing for the development of tactile perception, fine motor control, and procedural accuracy in a risk-free setting. These simulators also encompass the potential drawbacks, such as a lack of standardized feedback and restricted opportunities for repetitive learning of traditional preclinical educational methods. In addition, through the advancements on the internet and mobile technology, mobile applications have become a game-changing tool for dental education. Mobile apps offer a flexible and self-paced learning environment that can be tailored to individual needs, thereby promoting greater engagement and a more interactive, immersive educational experience. As well as the VRHSs, mobile apps also simulate the clinical scenarios and procedures, providing students with the opportunity to develop and refine their skills within a structured and risk-free educational environment. Although the effectiveness of simulators has been investigated in endodontic preclinical settings using artificial teeth, their potential impact on real clinical performance and outcomes remains largely unexplored. Similarly, the role of mobile apps in endodontic education-particularly their effectiveness at the clinical level-has not been adequately studied.

Conditions

Manual Dexterity; Self-Confidence; Stress Level

Keywords

dental education; dental students; educational virtual reality; endodontics; mobile app

Outcome Measures

Primary Outcomes (2)

• Manual dexterity

  Measurements of clinical score and drilling time.

  through study completion, an average of 1 day

• Stress

  Measurements of stress levels using VAS scale. This scale consists of a 10cm line, with two end points representing 0 ('no stress') and 10 ('stress as bad as it could possibly be').

  Baseline and through study completion, an average of 1 day

Secondary Outcomes (1)

• Self-confidence

  through study completion, an average of 1 day

Study Arms (3)

Virtual Reality Haptic Simulator

EXPERIMENTAL

VRHS simulator will be used by dental students before treating a real patients in the endodontic clinical practice.

Procedure: Virtual Reality Haptic Simulator

Mobile app

EXPERIMENTAL

Mobile app simulator will be used by dental students before treating a real patients in the endodontic clinical practice.

Procedure: Mobile app

Control

OTHER

Control group will directly treat patients in the endodontic clinical practice withot prior exposure to any additional educational models

Procedure: Control

Interventions

Virtual Reality Haptic Simulator PROCEDURE

Students will use a virtual reality haptic simulator as an adjunct educational tool before treating real patients in the clinical setting.

Virtual Reality Haptic Simulator

Mobile app PROCEDURE

Students will use a mobile app as an adjunct educational tool before treating real patients in the clinical setting.

Mobile app

Control PROCEDURE

Students will directly treat real patients without using virtual reality haptic simulator or mobile app.

Control

Eligibility Criteria

• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• having undergone similar training in access cavity preparation on extracted human teeth, with equivalent duration and methodology during their 2nd and 3th- years of preclinical education from the same educator
• not having previous experience regarding the use of VRHS and/or mobile app;
• having received the same theoretical lecture in endodontics
• not currently using any medication for anxiety, depression, or systemic illness
• demonstrating at least a moderate level of computer literacy, as assessed by a standardized questionnaire
• possessing a baseline knowledge regarding access cavity preparation, determined by a brief theoretical quiz.
• maxillary central or lateral incisors with apical periodontitis and only occlusal cavity
• teeth with absence of any dental malformations
• teeth suitable for rubber dam isolation.

You may not qualify if:

• Prior experience using virtual reality haptic simulators (VRHS) or the Dental EndoMaster mobile application
• Inconsistent or insufficient preclinical training in access cavity preparation (e.g., trained by a different educator, different duration or methodology).
• Did not attend or receive the same theoretical endodontics lecture as peers.
• Currently taking medications for anxiety, depression, or systemic illnesses that may affect cognitive or motor function.
• Demonstrating low computer literacy, as determined by a standardized self-assessment tool.
• Failing to achieve the minimum required score (e.g., \<60 points) on the theoretical quiz about access cavity preparation.
• Refusal to provide informed consent or incomplete demographic/evaluation forms.
• Previous clinical experience in endodontics (e.g., performing real access cavity preparations on patients prior to the study).
• Teeth other than maxillary central or lateral incisors (e.g., molars, premolars, mandibular teeth)
• Presence of extensive caries beyond occlusal cavity, restorations, or prosthetic crowns.
• History of previous endodontic treatment in the selected tooth.
• Dental malformations, such as dens invaginatus, dens evaginatus, or root anomalies.
• Calcified canals or limited canal visibility on radiographs
• Teeth not suitable for rubber dam isolation
• Patients with systemic diseases (e.g., immunocompromised, uncontrolled diabetes)

Sponsors & Collaborators

• Saglik Bilimleri Universitesi: lead

Related Publications (5)

• Li Y, Ye H, Wu W, Li J, Zhao X, Liu Y, Zhou Y. Effectiveness and Methodologies of Virtual Reality Dental Simulators for Veneer Tooth Preparation Training: Randomized Controlled Trial. J Med Internet Res. 2025 May 22;27:e63961. doi: 10.2196/63961.

  PMID: 40402564 BACKGROUND

• Patil S, Bhandi S, Awan KH, Licari FW, Di Blasio M, Ronsivalle V, Cicciu M, Minervini G. Effectiveness of haptic feedback devices in preclinical training of dental students-a systematic review. BMC Oral Health. 2023 Oct 10;23(1):739. doi: 10.1186/s12903-023-03410-3.

  PMID: 37817151 BACKGROUND

• Suebnukarn S, Hataidechadusadee R, Suwannasri N, Suprasert N, Rhienmora P, Haddawy P. Access cavity preparation training using haptic virtual reality and microcomputed tomography tooth models. Int Endod J. 2011 Nov;44(11):983-9. doi: 10.1111/j.1365-2591.2011.01899.x. Epub 2011 May 28.

  PMID: 21623838 BACKGROUND

• Bandiaky ON, Loison V, Volteau C, Cretin-Pirolli R, George S, Soueidan A, Le Guehennec L. Benefits of using immersive virtual reality in haptic dental simulation for endodontic access cavity training: A comparative crossover study. Int Endod J. 2025 May 12. doi: 10.1111/iej.14252. Online ahead of print.

  PMID: 40353716 BACKGROUND

• Usta SN, Silva EJNL, Keskin C, Tekkanat H, Liukkonen M, Felszeghy S. A comparison of traditional and virtual reality haptic simulator approaches in preclinical endodontic training: Impacts on skill acquisition, confidence and stress. Int Endod J. 2025 Apr 10. doi: 10.1111/iej.14236. Online ahead of print.

  PMID: 40207994 BACKGROUND

Central Study Contacts

Sıla Nur Usta, Associate Professor

CONTACT

0090 507 279 5558; silandeniz29@gmail.com

Cangül Keskin, Professor

CONTACT

0090 541 420 39 09

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: Patients who will be treated and the assessor who will assess the clinical scores of the students will be blinded regarding which educational method was used for the students.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor (Associate)

Model Details: Students will divided into 3 groups based on the received educational model before conducting endodontic treatment on real patients.

Study Record Dates

• First Submitted: July 8, 2025
• First Posted: July 31, 2025
• Study Start: August 15, 2025
• Primary Completion: September 15, 2025
• Study Completion: September 20, 2025
• Last Updated: July 31, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share