Virtual Dentistry: The Forces Behind the Pain

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Virtual Dentistry: The Forces Behind the Pain Steven Dow Honors Project Presentation December 999 Background Experiment One: Formative Evaluation Design Results Experiment Two: Signal Detection Test Design Results Now What? Challenge of Dental Education Background Teach biomedical sciences Teach irreversible surgical procedures Integrate science with application Produce safe practitioner within four years

Further Complications Challenge Diminishing patient pool Increasing costs for patient care Must decrease the number of procedures performed on human subjects strictly for educational purposes Project Goal Teach and test dental students the subtle tactile and surgical skills required of the dental profession. Solution -- IDSS Use force feedback (haptics) to teach and assess the tactile skills of dentistry Begin with the detection of dentin caries Collaboration between Colleges of Dentistry and Engineering

Initial Research Original Conception Nigel Gomez -- College of Engineering Great variability in the forces expert dentists exerted during probing visual feedback (monitor) Impulse 2000 computer (PC) Haptic Device (IE 2000) Behind the Scenes (30 Hz)

The Force Models Experiment One: Formative Evaluation Evaluation Questions Probing Tasks Are the forces realistic? What design improvements are required? Hand position natural and comfortable? Able to concentrate on probing versus on operating the simulator? Are the graphics of sufficient quality? Preparation Carious Lesion

Prototype System Probing Instruments Joystick Explorer Evaluation Design Common Questions Group / Probing Group A (N = 3) Group A2 (N = 3) Group B (N = 3) Group B2 (N = 3) Practice First Experience; Questions Joystick - Carious lesion Joystick - Preparation Explorer - Preparation Explorer - Carious lesion Second Experience; Questions Explorer - Preparation Explorer - Carious lesion Joystick - Carious lesion Joystick - Preparation Feel" of the healthy tooth tissues? User s comfort with the simulator? Graphics quality? Hand position? Improvements needed for teaching tactile sensitivity? Improvements to the realism?

Task Specific Questions Carious Lesion Feel" of the enamel Feel" of the "pop" of the carious lesion Preparation Feel" of carious dentin Experiment One: Results -- Questionnaire General Response Naturalness of Hand Position Effectiveness Ratings

Relative Importance of Components Overall Findings Training Realism Vibration bothered the dentists Work on hand device - add more degrees of freedom Understand tradeoff between graphics and vibration Led to second experiment Introduction Experiment Two: Signal Detection Test Previous work with Dental Simulator indicates vibration as a potential problem Amount of vibration is a function of update rate and output force Previous work indicates a servo rate of 000HZ is needed for stable environments

Objective To measure whether the vibration limited the dentist s ability to perceive small features To determine which enhancements would remove the vibration Methodology Signal Detection Test Signal + Noise => Vibration and step present Noise => Vibration only Task: slide the cursor across a virtual surface perceive a small step amidst vibration = definitely yes, 6 = definitely no What the subject viewed... Methodology 4 conditions on the surface 2 Update rates (630 HZ and 468 HZ) 2 Output forces (4.88 N and.63 N) Randomly presented signal, levels of vibration Six participants 20 repetitions, fully crossed, 2 3 full factorial (60 total trials)

Results Experiment Two: Results -- ROC Curves Response Operator Characteristic (ROC) curves across conditions and confidence level Separation in performance levels for one condition (Strong force, slow servo rate) 69% accuracy versus 86% accuracy t(2.73)p<0.05 Results - ROC curves Results 0.9 0.8 0.7 0.6 0.5 0.4 0.3 0.2 0. ROC Curves Big force and slow update Big force, fast update Small force, slow update Small force, fast update Also recorded force and position in 30 ms increments During trials with weak force the vibrations ceased when the user entered the step May have two discriminating factors kinesthetic movement due to step momentary lapse of vibration 0 0 0. 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 Averaged across subjects

Results - Position and output force Force (N) pixels 60 50 40 30 20 0 0-0 -20 6 5 4 3 2 time (30 ms increments) Force - Trial type Force (N) pixels 60 50 40 30 20 0 0-0 6 5 4 3 2 Position - Trial type 4 (.63N/630Hz) 26 5 76 0 26 5 76 20 226 25 276 30 326 tim e (30 m s increm ents) Force - Trial type 4 35 0 27 53 79 05 3 57 83 209 235 26 287 33 339 365 Position - Trial type (4.88N/468Hz) 0 26 5 76 0 26 5 76 20 226 25 276 30 326 35 Conclusions 27 53 79 05 3 57 83 209 235 26 287 33 339 365 Slow update rate and strong force results in poor performance Momentary lapse of vibration may have added a cue for detecting the step signal Replicated experiment, but eliminated the effect of the lapse of vibration -> > Results similar Increase update rate for better performance time (30 ms increments) time (30 ms increments) Future Work Must consider specifications in haptic interfaces: level of touch detail needed importance of touch importance of graphics Currently working on the second generation of the Dental Simulator with new device Now What?

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