# Skills acquisition in cavity preparation in conservative dentistry through virtual haptic simulation

## TL;DR

This study examines how dental students perform cavity preparation tasks using virtual haptic simulation, finding differences in performance metrics across academic years.

## Contribution

The study provides descriptive insights into the use of virtual haptic simulation for dental training and identifies areas for further methodological refinement.

## Key findings

- No significant differences in accuracy were found between academic years.
- Significant differences were observed in surgery time, drilling time, activity progress, target volume, and external volume across academic years.
- Performance patterns reflect interaction with the virtual haptic environment rather than definitive skill acquisition.

## Abstract

Virtual reality-based training tools have become increasingly incorporated into health education in recent years. In dentistry, three-dimensional (3D) haptic simulators are used in several undergraduate programs to support preclinical training in procedures such as caries removal, cavity preparation, coronal access, prosthodontic preparation, periodontal therapy, and surgical techniques. The aim of this study was to explore student performance in cavity preparation tasks using a virtual haptic simulation system across different academic years of the dentistry degree.

Second-, third-, and fourth-year dentistry students underwent prior training using 3D haptic simulators in the Virtual Haptic Simulation classroom at ADEMA University School (Universal Simulation, London, UK). Training consisted of completing five cavity preparation activities using preforms, followed by repetition of the same activities with and without the preform. Performance outcomes recorded by the simulator were analyzed and compared between academic years, including precision, surgery time, drilling time, activity progress, target volume, and external volume.

Statistical analysis using ANOVA revealed no statistically significant differences in accuracy among the different academic years (p = 0.09915). In contrast, significant differences were observed between groups for surgery time (p = 9.059 × 10−⁷), drilling time (p = 0.0001236), activity progress (p = 4.26 × 10−⁸), target volume (p = 1.244 × 10−⁹), and external volume (p = 0.005844). No statistically significant differences were identified between cavities prepared with and without the preform in terms of surgery time, drilling time, or activity progress.

Within the methodological limitations of this study, including the absence of clinical-transfer assessment, the use of non-equivalent tasks across academic levels, and reliance on simulator-derived metrics with limited sensitivity, the findings should be interpreted with caution. The observed performance patterns reflect students' interaction with the virtual haptic environment rather than definitive evidence of skill acquisition or progressive competence development. Non-significant differences in accuracy between academic years should not be interpreted as equivalence of operative competence. Overall, this study provides descriptive insight into the use of VR-haptic simulation as a supplementary preclinical training resource, highlighting areas for further methodological refinement and future controlled investigations.