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用于下牙槽神经阻滞牙科麻醉培训的虚拟现实模拟器

Virtual Reality simulator for dental anesthesia training in the inferior alveolar nerve block.

作者信息

Corrêa Cléber Gimenez, Machado Maria Aparecida de Andrade Moreira, Ranzini Edith, Tori Romero, Nunes Fátima de Lourdes Santos

机构信息

Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Laboratório de Aplicações de Informática em Saúde (LApIS), São Paulo, Brasil.

Universidade de São Paulo, Escola Politécnica, Laboratório de Tecnologias Interativas (Interlab), São Paulo, Brasil.

出版信息

J Appl Oral Sci. 2017 Jul-Aug;25(4):357-366. doi: 10.1590/1678-7757-2016-0386.

Abstract

OBJECTIVES

This study shows the development and validation of a dental anesthesia-training simulator, specifically for the inferior alveolar nerve block (IANB). The system developed provides the tactile sensation of inserting a real needle in a human patient, using Virtual Reality (VR) techniques and a haptic device that can provide a perceived force feedback in the needle insertion task during the anesthesia procedure.

MATERIAL AND METHODS

To simulate a realistic anesthesia procedure, a Carpule syringe was coupled to a haptic device. The Volere method was used to elicit requirements from users in the Dentistry area; Repeated Measures Two-Way ANOVA (Analysis of Variance), Tukey post-hoc test and averages for the results' analysis. A questionnaire-based subjective evaluation method was applied to collect information about the simulator, and 26 people participated in the experiments (12 beginners, 12 at intermediate level, and 2 experts). The questionnaire included profile, preferences (number of viewpoints, texture of the objects, and haptic device handler), as well as visual (appearance, scale, and position of objects) and haptic aspects (motion space, tactile sensation, and motion reproduction).

RESULTS

The visual aspect was considered appropriate and the haptic feedback must be improved, which the users can do by calibrating the virtual tissues' resistance. The evaluation of visual aspects was influenced by the participants' experience, according to ANOVA test (F=15.6, p=0.0002, with p<0.01). The user preferences were the simulator with two viewpoints, objects with texture based on images and the device with a syringe coupled to it.

CONCLUSION

The simulation was considered thoroughly satisfactory for the anesthesia training, considering the needle insertion task, which includes the correct insertion point and depth, as well as the perception of tissues resistances during the insertion.

摘要

目的

本研究展示了一种牙科麻醉训练模拟器的开发与验证,该模拟器专门用于下牙槽神经阻滞(IANB)。所开发的系统利用虚拟现实(VR)技术和一种触觉设备,在麻醉过程中的针刺任务中提供可感知的力反馈,从而模拟在真实患者身上插入真实针头的触觉感受。

材料与方法

为模拟逼真的麻醉过程,将一个卡普乐注射器与一个触觉设备相连。采用Volere方法从牙科领域的用户那里获取需求;使用重复测量双向方差分析(ANOVA)、Tukey事后检验以及平均值进行结果分析。应用基于问卷的主观评价方法来收集有关模拟器的信息,26人参与了实验(12名初学者、12名中级水平者和2名专家)。问卷包括个人资料、偏好(视角数量、物体质地和触觉设备操控方式),以及视觉方面(物体外观、比例和位置)和触觉方面(运动空间、触觉感受和运动再现)。

结果

视觉方面被认为是合适的,而触觉反馈必须改进,用户可以通过校准虚拟组织的阻力来实现。根据方差分析测试(F = 15.6,p = 0.0002,p < 0.01),视觉方面的评价受参与者经验的影响。用户偏好具有两个视角的模拟器、基于图像有纹理的物体以及连接有注射器的设备。

结论

考虑到针刺任务,包括正确的进针点和深度以及进针过程中对组织阻力的感知,该模拟对于麻醉训练被认为是完全令人满意的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e14/5595107/8e9b7dd7a895/1678-7757-jaos-25-4-0357-gf01.jpg

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