Currently submitted to: JMIR Medical Education
Date Submitted: Dec 3, 2025
Open Peer Review Period: Dec 6, 2025 - Jan 31, 2026
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Evaluating the Effectiveness of Haptic Virtual Reality Simulators in Preclinical Prosthodontic Crown Preparation: A Mixed-Methods Analysis
ABSTRACT
Background:
Crown preparation is a technically demanding psychomotor skill in undergraduate dental education. While traditional typodont training is the gold standard, it is resource-intensive and is difficult to individualize. Haptic Virtual Reality Simulation (HVRS) offers a sustainable pedagogical alternative, but its efficacy in transferring skills to the physical environment remains a subject of critical investigation.
Objective:
This study aimed to evaluate whether short-term training on the HVRS improves crown preparation performance on typodont teeth, and to examine manual dexterity and self-confidence outcomes.
Methods:
The study was conducted with 44 fifth-semester dental students at Karolinska Institutet, allocated to a simulator group (SIM; n = 22) or a control group (n = 22). The SIM group completed three hours of haptic virtual reality simulator (HVRS) training over one week, while the control group received no simulator exposure. Both groups prepared a maxillary first molar for a monolithic zirconia crown on a phantom head. Crown preparation quality was assessed using PrepCheck® and a blinded examiner. Manual dexterity was measured using the Grooved Pegboard Test (GPT), and self-confidence and simulator perceptions were evaluated through surveys.
Results:
The SIM group achieved a higher mean total preparation score than the control group (11.91 vs. 10.91), though the difference was not statistically significant (p = 0.235). Significantly better scores were observed in Total Occlusal Convergence (TOC) angle for the SIM group (p = 0.04). Manual dexterity improved in both groups, but the control group remained significantly faster at baseline and post-intervention (p = 0.044 and p = 0.001). While overall self-confidence levels were comparable, the SIM group reported fewer instances of "very low" confidence (5%) compared to the Control group (18%). Participants perceived the simulator’s tactile realism as low, though they valued its ability to demonstrate procedural workflows.
Conclusions:
Three hours of self-directed HVRS training do not significantly improve overall crown preparation quality or general self-confidence, but improve performance in TOC angle for crown preparations. HVRS may serve as an effective "Partial Task Trainer" within a blended curriculum.
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