Rina NOWKA, Mohamad EID, Elizabeth MCALPIN, Pi KO, Marci LEVINE, Dianne SEFO
Journal of Dental Sciences and Education - 2026;4(1):1-10
Aims: The inferior alveolar nerve block (IANB) is a common injection in dentistry and requires precise motor and anatomical skills. Traditional local anesthesia training methods, plastic manikins (PMLA), often fall short, particularly in visualizing hidden anatomy, which can hinder student confidence and performance during live procedures. Virtual reality local anesthesia (VRLA) simulations offer visual advantages but typically lack realistic tactile feedback. This study evaluated a custom haptic-enhanced VR system (H-VRLA) designed to address this gap. Methods: A mixed-method, two-group, pre and post simulation design assessed the usability and effectiveness of the H-VRLA (n=31) versus PMLA (n=30) in preparing students (n=61) for peer-to-peer IANB injections. Participants completed a pre and post simulation survey and knowledge assessment, rotated simulation methods, delivered peer-to-peer injections and took a survey. Data was analyzed using descriptive and inferential statistics. Results: Prior to simulation training, students exhibited low baseline knowledge with no significant differences between groups. Post-intervention, both groups showed a statistically significant increase in knowledge test scores and confidence ratings, but only H-VRLA achieved a statistically reliable gain in Final Scores. In a comparison of training realism, PMLA method was rated significantly higher for procedural features (e.g., holding the syringe, retracting the cheek), while the H-VRLA method was rated higher for visually locating anatomy. H-VRLA rated "Anatomy Helped" significantly higher. This high perceived helpfulness was a strong predictor of their final performance (R2=0.26). In contrast, for PMLA, the final score was not predicted by the helpfulness rating; instead, initial confidence was the sole strong predictor of final confidence. Conclusion: Both simulation methods effectively supported learning. H-VRLA excelled in anatomical visualization, while PMLA was superior for realistic tactile experience. A hybrid approach is recommended, and future H-VRLA development should focus on enhancing bimanual haptics and tactile realism to better support skill transfer to live practice.
