[version 1; peer review: 1 approved, 1 approved with reservations]
No competing interests were disclosed.
Prosthodontics significantly impacts oral health-related quality of life, especially oral comfort, functions, aesthetics, and overall well-being. This discipline is grounded in a solid academic and evidence-based understanding of fundamental principles for managing dental diseases and aims to restore the health of teeth and supporting tissues and compensate missing ones. Dental education is evolving quickly with the rise of digital dentistry, especially in prosthodontics. Integrating augmented reality simulations and haptic feedback has significantly advanced this transformation. This systematic review protocol intends to determine the effectiveness of haptic simulators in prosthodontics training during preclinical dental education.
An exhaustive search strategy will be employed, exploring PubMed, Scopus, EBSCO, Web of Science and Cochrane Central to select relevant studies, thereby enhancing the robustness of the review findings. Boolean operators (AND,OR) were utilized to assemble MeSH terms and relevant keywords. Titles and abstracts screening to identify studies that satisfy the eligibility criteria was followed by the quality and risk of bias assessment for the selected studies, via the Cochrane Collaboration’s tool and the Newcastle-Ottawa Scale (NOS). Data will be collected via standard form. Reviewers disagreement will be solved throughout debate, or by referring to a third opinion. This protocol will adhere the recommendations appointed by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
The outcomes of this systematic review are highly significant for dental education exploring the importance of enhancing haptic simulation during preclinic prosthetic training.
Recognizing the strengths and weaknesses of virtual reality (VR) in relation to traditional preclinical training methods is crucial for developing effective educational strategies. This understanding can lead to enhanced training outcomes and increased student satisfaction, which in turn contributes to improved quality of clinical prosthetic services.
PROSPERO: CRD42024603681 (Registered on 30/10/2024).
Improvements in digital prosthodontics have profoundly transformed the field of dentistry.
Dental educators can leverage digital advancements to enrich the educational experience, particularly by incorporating haptic technology into dental school curricula. This integration allows for hands-on, simulated practice that closely mirrors real clinical scenarios, helping students develop essential skills in a controlled environment. By embracing these technologies, educators can foster a deeper understanding of complex procedures, improve student engagement, and ultimately prepare future dental professionals to meet the challenges of contemporary practice.
Traditionally, first-year dental students initiate honing their manual ability with typodonts. They move from desktop typodonts to mannequin heads that imitate a clinical context.
With the advent of technologies like mixed reality (MR) haptic-based dental simulators, students can enhance their motor skills while receiving immediate feedback, all without the need for an instructor’s physical presence.
This technology can be applied across all specialties in dentistry such as implant placement, crown and bridge preparation, a wide range of procedures with varying levels of difficulty.
This systematic review protocol targets to investigate the aptitude of haptic simulators in enhancing prosthetic training of pre-graduated dental students. An initial search of MEDLINE, the Cochrane Database of Systematic Reviews, and the JBI Database of Systematic Reviews was carried out, and as far as we are aware, there are no available systematic reviews addressing the raised issue.
This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations to ensure a complete and clear approach.
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.
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.
The inclusion criteria are outlined by specifying the crucial parts of the research question according to the PICO plan
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.
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,
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.
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.
After performing a comprehensive search through chosen databases, identified articles will be classified via
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.
Two separated reviewers will conduct the evaluation and mark the studies to reduce bias and improve credibility.
To ensure the accuracy of the results, the methodological quality and risk of bias of the included studies will be assessed through normalized tools.
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.
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.
This approach of the evaluation of methodological rigor and bias will garantee that the study’s outcomes are grounded in high-quality evidence.
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.
This systematic review will comprehensively assess the current literature on the utilization of haptic simulators during prosthetic education. The findings will be particularly beneficial for students and teachers, especially in preclinical training.
By evaluating the efficacy of haptic technology in hand skills improvement, this review intends to find evidence-based guidance on novice’s sensorimotor acquisition concerning prosthetic procedures and dental preparation assessment. Moreover, this review will identify activities most concerned by this tool and the prosthetic procedures most likely to be simulated by haptic technology, and propose a strategy for introducing this tool into the curriculum of dental students in order to improve the sense of touch, particularly for immersion and force feedback. By that, students can learn the appropriate amount of pressure to apply when using dental instruments.
As a result, this review will be a considerable source for justifying pedagogical approach and improving the quality of academic training and dental care subsequently provided.
No ethical approval is required for this systematic review protocol.
This systematic review is in the selection phase. This protocol has been registered with PROSPERO (CRD42024603681) since 30/10/2024.
Figshare, PRISMA-P-checklist for impact of haptic simulator in prosthodontics training during preclinic dental education: a systematic review protocol, DOI:
The project contains the following dataset:
PRISMA-P-checklist.docx
Data are available under the terms of the
No data are associated with this article.
Grammar and Syntax:
There are minor grammatical errors (e.g., “garantee” instead of “guarantee”). A final proofread is recommended.
Figures and Flowcharts:
A PRISMA flowchart showing the selection process could enhance clarity and align with guidelines.
Incorporate Mixed Reality (MR):
While VR and AR are discussed, MR is not adequately included. Clarify why MR is excluded or consider adding it to broaden the scope.
Search Strategy:
Explicitly list all databases and search terms used. Including MR and other emerging technologies could strengthen the protocol.
Clarify if hand-searching reference lists or reaching out to authors for unpublished data will be part of the strategy.
Data Extraction:
Expand details to include the length of intervention application, fidelity levels of simulators, and participant feedback for a holistic analysis.
Ensure consistency by using validated data extraction forms.
Data Analysis:
Specify if meta-analysis is planned. If so, detail methods for:
Heterogeneity assessment (e.g., I² statistic).
Sensitivity analysis and publication bias testing.
Criteria for fixed vs. random effects model selection.
Include a framework for synthesizing qualitative findings.
Quality of Evidence:
Adopt GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) or similar methodology for assessing the quality of evidence.
Discuss plans for addressing biases and limitations in included studies.
Discussion Section:
Highlight potential implications for integrating haptic simulators into curricula, addressing cost, and training challenges.
Address potential scalability for different educational institutions.
Compare the Study with Previously Published article , Some research you can read to compare - [Ref 1] and [Ref 2].
Is the study design appropriate for the research question?
Yes
Is the rationale for, and objectives of, the study clearly described?
Yes
Are sufficient details of the methods provided to allow replication by others?
Yes
Are the datasets clearly presented in a useable and accessible format?
Yes
Reviewer Expertise:
Metaverse Applications in DentistryBlockchain and Cryptocurrencies in HealthcareArtificial Intelligence (AI) in DentistryCone Beam Computed Tomography (CBCT) Platelet-Rich Fibrin (PRF)
We confirm that we have read this submission and believe that we have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however we have significant reservations, as outlined above.
As technology advances, the use of digital teaching methods, such as haptic simulators, in preclinical oral skills training is growing rapidly. This systematic review aims to provide robust evidence on the effectiveness of haptic simulators in prosthodontic training during preclinical dental education, thereby assisting dental educators in refining their teaching strategies.
The systematic review protocol is well-defined and largely aligns with PRISMA.
Here are several suggestions for the authors' consideration:
In the introduction, the authors have mentioned virtual reality (VR), augmented reality (AR), and mixed reality (MR), yet the search terms did not encompass MR. I wonder the interplay between the three technologies and the rationale for excluding MR from your search. Search Strategy section: Please list all the databases you intend to consult. Data Extraction section: It's recommended to extract additional details, such as the length of intervention application. Data Analysis and Synthesis section: Does the quantitative analysis refer to meta-analysis? If so, please describe the methods for assessing heterogeneity, principles for model selection, sensitivity analysis, and other relevant analyses. It's suggested to include the method for evaluating the quality of evidence found in the systematic review.
Is the study design appropriate for the research question?
Yes
Is the rationale for, and objectives of, the study clearly described?
Yes
Are sufficient details of the methods provided to allow replication by others?
Partly
Are the datasets clearly presented in a useable and accessible format?
Not applicable
Reviewer Expertise:
Stomatology Education
I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.