Impact of haptic simulator in prosthodontics training during preclinic dental education: a systematic review protocol

Methods

This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations to ensure a complete and clear approach.⁶

The approach complies with the norms established by the F1000 journal. Additionally, this protocol has been reported with PROSPERO, the international prospective register for systematic reviews (CRD42024603681) since 30/10/2024.

Objectives

The main objective of the review is to evaluate the efficiency of haptic simulators in comparison to standard educational methods on skill acquisition, retention, and overall learning outcomes for dental students for prosthetic preclinic training. The secondary objectives are to measure knowledge retention and to compare error rates.

Inclusion criteria

The inclusion criteria are outlined by specifying the crucial parts of the research question according to the PICO plan⁷:

Type of population: Dental students in preclinical prosthodontic training.

Intervention type: The use of Virtual reality haptic simulator in preclinical prosthodontic training. The training covers a variety of tasks performed in the course of treatment with one of the different types of dental prostheses.

Comparison group: Conventional typodont training.

Types of outcomes: Improvements in student learning and skill development.

Measures of effect: This study will evaluate results based on quantitative and qualitative measurements.

Study Types: randomized controlled trials (RCTs) that randomly assign participants to either the haptic simulator group or the standard training group to evaluate differences in outcomes, non-randomized controlled trials (non-RCTs), observational studies, including cohort and case-control studies that follow groups of students trained with haptic simulators and those using traditional methods over time to compare their performance and skill retention, will be included if they meet a minimum of 15 criteria from the STROBE quality exigences.^8–10

Exclusion criteria

Case reports and letters to the editor will be excluded because of their restricted reproducibility. Furthermore, non-English papers will be eliminated to minimize language bias and address source limitations. Studies with insufficient data or low methodological quality will be dismissed to ensure the accuracy and validity of the review.

Search strategy

A thorough search strategy includes relevant controlled vocabulary terms and Medical Subject Headings (MeSH) terms related to the research issue: haptic technology, dental education, dental student, prosthodontics, High Fidelity Simulation Training, virtual reality (VR), augmented reality (AR).

To reduce the risk of overlooking pertinent studies, various databases, such as MEDLINE, Web of Science, EBSCO, Scopus and Cochrane Central will be carefully consulted.

To promote inclusiveness, unprinted papers and current clinical trials through sources such as conference proceedings, dissertations, and clinical trial registries will be located.

To ensure a comprehensive review, qualified reviewer will assist in determining sources of grey literature and judging their relevance to the study.¹¹

Additionally, bibliographies of included studies will be manually reviewed to discover further papers that may not have been captured via automatic searches.

This strategy seeks to eliminate publication bias and guarantee a comprehensive review of the available evidence.

Study selection

After performing a comprehensive search through chosen databases, identified articles will be classified via Zotero software, with duplicate papers elimination. Two reviewers (OT, CS) will separetly evaluate the titles and abstracts of identified studies. Those that meet the eligibility criteria will have a full-text review by the same reviewers. Furthermore, reviewers will meticulously check the references of selected articles to uncover further pertinent papers. Studies that satisfy the selection criteria will then advance to the data extraction phase. Justifications for excluding papers that do not meet the criteria will be mentioned in the finished assessment.

Reviewers’ discrepancies will be dealt by means of debate. If necessary, an experienced reviewer (JJ) will be involved to ensure accuracy, reach an agreement and uphold the validity of the selection approach.

The results from the initial identification to final selection procedure will be carefully described and presented in the eventual systematic review, respecting adherence to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) recommendations.^12,13

Evaluation of methodological quality and risk of bias

Two separated reviewers will conduct the evaluation and mark the studies to reduce bias and improve credibility.¹⁴ Disagreements in the evaluations will be solved through discussion or by referring to a supplementary opinion to reach an accord.

To ensure the accuracy of the results, the methodological quality and risk of bias of the included studies will be assessed through normalized tools.¹⁵

For randomized controlled trials, the Cochrane Risk of Bias (ROB II) scale will be employed to evaluate methodological rigor according to crucial elements: randomization process, conformity to planned interventions, integrity of outcome data, outcome measure, and precision in reporting results. Each element will be classified as having low, high, or unclear risk of bias.¹⁶

The Newcastle-Ottawa Scale (NOS) will serve to assess non-randomized studies basing on scoring the selection of study participants, group comparability, and outcome ascertainment. Higher scores reflect better methodological quality.¹⁷

This approach of the evaluation of methodological rigor and bias will garantee that the study’s outcomes are grounded in high-quality evidence.

Data extraction

Data items: Data pointed from the selected studies will encompass participant demographics and study characteristics. Further information about haptic simulator features, means of outcome measurement, level of education and type of prosthetic activity are to be determined.

Extraction method: The same reviewers will individually gather information from all selected studies into detailed extraction template specifically developed for this task. This template has been rigorously evaluated during a pilot phase to ensure consistency and accuracy in data handling. Any discrepancies will be resolved through discussion, with another reviewer involved if necessary. Final decisions will be reached by majority agreement. This organized method ensures precise and reliable conclusions for future analysis.

Data analysis and synthesis

The extracted information will be thoroughly examined to be utilized to justify the efficacy of haptic simulator in preclinical prosthetic training. An primary descriptive synthesis will identify the study determinants, participant characteristics, simulator features, prosthetic field (fixed, removable, supra implant) and outcome measures. Quantitative analysis will evaluate outcomes with 95% confidence intervals and control non-homogeneity crosswise studies via statistical tests.

Ethics and dissemination

No ethical approval is required for this systematic review protocol.

Study status

This systematic review is in the selection phase. This protocol has been registered with PROSPERO (CRD42024603681) since 30/10/2024.

Reporting guidelines

Figshare, PRISMA-P-checklist for impact of haptic simulator in prosthodontics training during preclinic dental education: a systematic review protocol, DOI: https://doi.org/10.6084/m9.figshare.27761997.v1, CC BY 4.0.¹⁸

The project contains the following dataset:

Data are available under the terms of the Creative Commons Attribution 4.0 International license (CC-BY 4.0)