ECU dental school, health sciences library team up on virtual reality project

The East Carolina University School of Dental Medicine is integrating virtual reality into its curriculum across all four years to build confidence in future dentists — and ease dental anxiety in their patients.

The dental school partnered with ECU’s Laupus Health Sciences Library for the project, which provides the school with the library’s virtual reality equipment, software programs and expertise. Faculty members work with students across the curriculum to build knowledge of head and neck anatomy and how it applies in providing high-quality oral health care.

“Most dental schools are implementing this kind of augmented reality just in D1 (first year of dental school) or just in the early stages of curriculum. But what we are doing here, which is unique, is that we will use it in every year of dental school,” said Hanan Elgendy, clinical assistant professor and VR project lead in the dental school.

“It will be implemented in all the curriculum, including in the operative. Students will be able to visualize the (cavities) from inside the tooth, and they will be able to visualize the tooth — the enamel, the dentin and the structure itself.”

Elgendy said using VR to learn will help students use the creative side of their brains and develop better eye-hand coordination, in addition to grasping the concepts within the curriculum.

The program uses Laupus Library’s Oculus headsets with Medicalholodeck, a platform for medical collaboration in virtual reality. The software allows users to visualize, edit, discuss and teach medical imaging, human dissections and 3D human anatomy models in a fully immersive digital environment. Jamie Bloss, liaison librarian to allied health sciences and dental medicine, and Courtney Horns, business officer for Laupus Library, were instrumental in getting the partnership up and running.

“Laupus is a really innovative library; we have done some really exceptional work in our space over the last several years,” said Beth Ketterman, director of Laupus Library. “When we found out that Dr. Elgendy was interested in applying that for the benefit of her students, it just seemed like a great partnership, allowing Laupus to leverage our expertise, our skills, our equipment to benefit the student learners in dental medicine.”

Virtual reality is becoming a standard part of modern, contemporary education in many disciplines because it encourages active learning and leads to a more experiential learning environment by allowing students to immerse themselves in the subject matter.

So far, VR in dentistry has mostly been used with simulations that require external equipment besides the headset and may feature unrealistic looking teeth and procedures. Using the Medicalholodeck apps, any item, including teeth, can be scanned and viewed, including cross-sectionally, in the VR headset. The application is an immersive 3D VR anatomy surgical planning and operating guide that allows CT, MRI and digital imaging and communications in medicine scans to be imported into the app for virtual simulation, instruction and visualization.

Enthusiastic students

Dental students are enthusiastic about the dual possibilities of VR through all the years of dental education.

“There are two huge benefits about using VR in dental medicine. One, it will greatly enhance the students’ perspective, but also it will greatly help patients as well,” said first-year dental student Luke Fogarty of Greenville. “When it comes to students, we’re able to see anatomy from a different viewpoint where we can situate ourselves, for instance, within the oral cavity, and see the lingual sides of teeth which are very difficult to see from the external perspective that we would normally have. We’re also able to use it for gross anatomy, do full body dissections that we could do in virtual reality without additional resources that would otherwise be needed to be able to do that in the cadaver lab.”

Moamen Sheba, clinical assistant professor of prosthodontics, said VR is beneficial in part because technology has been intertwined in their life experiences so far.

Nowadays, the dental students are more audiovisual; the average age is 23-24, so technology has been implemented in their life for a very long time,” Sheba said. “Dental education is trying to match their expectations by providing more technological tools and more audiovisual tools … so students can get more exposure to these concepts before they do it on actual patients.”

Virtual reality also has potential to further address dental phobia, which causes many patients to delay or avoid oral health care. Several studies have reported that VR reduced some patients’ awareness of dental pain because they were so absorbed in the VR experience.

Hanan Elgendy, clinical assistant professor in the ECU School of Dental Medicine, helps first-year student Garren Freeze learn to use the new VR program during class.

Hanan Elgendy, clinical assistant professor in the ECU School of Dental Medicine, helps first-year student Garren Freeze learn to use the new VR program during class.

“When it comes to patients,” Fogarty said, “an interesting area of research is that using VR can actually increase patient compliance and also decrease patient anxiety because it allows the patient to become a more interactive part of the experience and enhance the experience overall while decreasing nerves.”

In preclinical settings, VR can be used to learn dental anatomy, view teeth and their structures from different angles, and target specific specialties such as root canal anatomy, implant placement and surgical guides. In clinical settings, it can be used during procedures and surgeries. During implant placement, VR can act as automatic information filters that selectively display only the most relevant information to surgeons, helping them concentrate fully on the implant placement and reducing time and additional costs.

Aziz Aileru, professor of neuroscience, division director of basic sciences and interim chair of foundational sciences for the dental school, said VR exposure will make students more confident in their knowledge of the complex structure of the head and neck, including nerves in the brain and blood vessels and muscles around the neck, which are crucial to their understanding of anatomy and providing dental care to patients.

“They will have an in-depth understanding and be more comfortable in treating patients,” he said. “Using this technology is very beneficial to them as they go out in the world to treat patients and provide these services to the community.”

Zach Schnoor, clinical assistant professor of endodontics, said the VR project shows the progressive nature of the dental school in finding new and innovative ways of teaching — which in turn attracts potential students, builds the school’s reputation and “creates buzz around the dental community that will be promotional for the school and the university,” he said.

Fogarty said the project cements students’ view of the dental school as innovative — because of the faculty who use their specialized expertise to enhance their students’ educational experiences.

“ECU is, of course, huge on innovation and especially diversity through innovation,” Fogarty said. “I’ve mostly been impressed with our faculty at this school, the different aspects that they’re so excited about. It seems every realm of dentistry, there’s a faculty member that’s all in on that. Everyone has their own niche, and I think it’s a great combination of faculty that I didn’t see at any other dental school I interviewed at.”