Faculty of Dentistry of Piracicaba is the only institution in the country that uses equipment
The dexterity required of dentists during procedures, including restoration, crown preparation and root canal treatment, is tested, trained and developed during the undergraduate course on plastic teeth or those extracted from humans on clinical indications and donated teeth, which are increasingly difficult to obtain for ethical reasons, and then to be perfected with the assistance of professors in clinics maintained by the colleges. And the broader and more diverse these practices are, the greater the possibilities of training properly qualified professionals.
The operations mentioned require perfect control over the dental pen, which at the tip uses a surgical drill that rotates on a high-speed micromotor, a set always feared by patients who call it a “little motor”. It is with this that the dentist performs the necessary removals and wear on the tooth. In these procedures, he must be sensitive to dimension the force that must be applied so that these operations are carried out conservatively within the appropriate limit, not compromising the tooth beyond what is necessary.
To improve students' dexterity in these techniques, the Virtual Reality Laboratory of the Faculty of Dentistry of Piracicaba (FOP) at Unicamp has five simulators (Simodont Dental Trainer – Moog) that reproduce, in a virtual environment, the movements and forces required to perform them. Professor Pablo Agustin Vargas, responsible for the laboratory and for introducing this technology in Brazil, notes that this type of training proves to be much more efficient than that commonly carried out on plastic teeth, mounted on human mannequins, with limited potential to reproduce the resilience of real teeth. Furthermore, on the simulators' screen, viewed through 3D glasses, the student is alerted about mistakes they make and the teacher can monitor their work on an auxiliary system. As the operations are virtual, there are no material expenses, just the consumption of electricity.
Unicamp is the only Brazilian university equipped with these simulators and was a pioneer in their use in Latin America. There are currently two dental simulators in Chile, one at the public University of Chile and the other at the private University of Los Andes. They exist also two pieces of equipment at the Universidad Peruana de Ciencias Aplicadas, in Lima, Peru, and another two at the Universidad de Las Americas, in Quito, Ecuador, both private. By the end of this year, these universities should be supplanted by the Universidad Cayetano Heredia, in Lima, Peru, which is acquiring ten of these same simulators. Teachers from this institution are at FOP for a period of training in the use of equipment.
How it works
This new technology has been used in the FOP dentistry graduation, in the pre-clinical area, using Simodont Moog equipment, from the Netherlands. The equipment allows virtual reality to be simulated so reliably that, when operating the system, the student can feel the nuances of the forces needed to wear down the different tissues of the teeth, realizing the need to properly grade them when it comes to removing enamel. or dentin, for example.
As in a virtual reality simulator, used in the training of airline pilots and large means of transport, the student handles a dental pen with the same weight as that used by dentists, connected to the device, and follows the screen virtually, with 3D glasses, the work carried out in the demarcated region of the tooth, feeling the need to apply more or less force, depending on the hardness of the material, being alerted when it reaches the wrong point.
“When the student moves and presses the 'virtual tool' on the 'virtual tooth', viewing the operation in 3D, the sensation enjoyed is much closer to reality [natural teeth] than that felt when manipulating plastic teeth. He removes the 'decayed' part of the tooth, as indicated on the screen and follows the work in the mirror. The idea is not to completely replace plastic teeth training in the pre-clinical laboratory, but to complement it”, explains Vargas.
The software used in Simodont allows the student to develop manual dexterity and psychometric skills based on indirect vision exercises with the aid of a virtual intra-oral mirror, cavity preparations and selective surface wear guided by very dynamic methods.
There is also a touch screen on which the teacher can monitor the student's performance and discuss clinical cases. The software currently used in FOP is the most advanced and allows training in the preparation of dental cavities in permanent and deciduous teeth, single crowns for anterior and posterior teeth and coronal opening for root canal treatment.
Home, today and future
It all started in 2011 when the professor was coordinator of the FOP undergraduate course, during the management of director Jacks Jorge Junior, and was invited by the company Moog, a manufacturer of flight simulators, to visit its headquarters in Amsterdam, to learn about Simodont, that was being released. After visiting the Moog factory, he and professor Alan Roger Santos Silva received training to use this equipment at the Faculty of Dentistry in Amsterdam, which has 50 simulators used in undergraduate dentistry teaching. At the same time, he responded to a notice related to the valorization of undergraduate teaching environments, published by the Dean of Undergraduate Studies, occupied at the time by professor Marcelo Knobel, current dean. Once classified, he received the funds to buy a device, the first in Latin America.
In 2013, when competing for the Best Universities Award, promoted by Editora Abril's Student Guide, in the Use of Technological Resources category, with the project “Use of new technologies in dental education”, it presents, among other innovations, the use of Simodont Moog in the dental pre-clinic area. The classification among the three finalists caused great repercussion. Given the importance of the project, the rector at the time, Tadeu Jorge, provided funds to purchase four more pieces of equipment and a server, which allows training to be monitored.
This equipment has been used for four years in the undergraduate course. “Firstly, we used them for fifth year students, now we move on to third year students, where employment is more suitable, through rotations that allow the use of 16 hours per student”, explains the teacher.
According to Vargas, to serve its 80 annual entrants, the ideal for the FOP would be to have 22 devices, which is not immediately viable due to costs and lack of physical space. “What we are going to pursue is its continuous increase, which will progressively facilitate the service of students, the expansion of their training hours and the reduction in the number of rotations, guarantees for broader and more efficient work”, he concludes.
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