A Real-Time Inertial Sensor-Based Diagnostic Support System for Improving Angular Accuracy in Dental Implant Placement: Preclinical Experimental Validation in a 3D Haptic Simulation Model Raul Cuesta Román, Pere Riutord-Sbert, Daniela Vallejos Rojas, Irene Coll Campayo, Joan Obrador de Hevia, Sebastiana Arroyo Bote Dentistry Journal, 2026 Background: Accurate three-dimensional positioning of dental implants is critical for ensuring biomechanical stability, prosthetic passivity, and long-term clinical success. While computer-assisted navigation systems achieve high precision, their complexity and cost often limit accessibility. This study presents the development and preclinical experimental validation of a low-cost prototype designed to enhance angular accuracy in dental implant placement within a controlled 3D haptic simulation environment. Methods: A preclinical experimental design was implemented using a 3D haptic simulator (Virteasy, Montpellier, France). The prototype incorporated high-precision inertial measurement units (IMUs) and an Extended Kalman Filter (EKF) for real-time angular feedback. Ninety-seven simulated implant placements were performed—both freehand and with prototype assistance—under identical virtual conditions by a single experienced operator. Angular deviations in mesiodistal and buccolingual planes were recorded, combined into a composite 3D index, and analyzed using paired t-tests and linear mixed-effects models. The study was conducted in a controlled simulation environment, which does not fully replicate clinical conditions. Results: The prototype significantly reduced angular deviation from 13.49° to 2.99° in the mesiodistal plane (−77.8%) and from 13.56° to 5.59° in the buccolingual plane (−58.8%), achieving an overall 67% improvement in three-dimensional orientation (p < 0.001; Cohen’s d = 1.47). Agreement with an optical reference system (OptiTrack) was excellent (bias = +0.36°, RMSE = 0.39°). Intra-operator reliability exceeded 0.95 (ICC), confirming strong reproducibility and measurement stability. Conclusions: The proposed inertial sensor-based prototype achieved angular accuracy within the range reported for computer-guided systems while maintaining advantages of portability, low cost, and usability. Its integration into haptic simulators provides a valid tool for both educational and preclinical applications, offering real-time feedback that enhances spatial perception and psychomotor learning. Future clinical studies should validate its performance in cadaveric and patient-based contexts to determine its practical impact on surgical precision and implant success.
Comparative Performance of Haptic Virtual Simulation vs. Conventional Training in Class V Cavity Preparation: A Paired In Vitro Study Aitor Basterra López, Sebastiana Arroyo Bote, Ángel Arturo López-González, Raúl Cuesta Román, Joan Obrador de Hevia, Pere Riutord-Sbert Dentistry Journal, 2026 Background: Haptic virtual simulation (HVS) has emerged as a promising tool in dental education, yet evidence comparing its performance to conventional preclinical training remains limited. Establishing its effectiveness is essential to support its integration into competency-based curricula. Objective: The aim of this study was to compare Class V cavity preparations performed using conventional training on extracted teeth with those performed using a haptic virtual simulator, evaluating preparation time and cavity volume. Methods: Sixty-one extracted human molars were digitized using cone-beam computed tomography (CBCT) to generate corresponding virtual replicas. A calibrated operator prepared 122 standardized Class V cavities (61 real and 61 virtual). The simulator automatically recorded preparation time and cavity volume. For natural teeth, cavity volume was calculated by digital superimposition of pre- and post-operative STL models using Blender. Paired means were compared using Student’s t-test (α = 0.05). Results: Preparation time was significantly shorter when using HVS compared with the conventional method (p < 0.001). Virtual preparations resulted in slightly larger cavity volumes than real preparations, with a statistically significant yet clinically small difference (p = 0.047). Conclusions: Haptic virtual simulation enables more time-efficient Class V cavity preparation while producing cavity volumes comparable to those obtained through conventional training. These findings support the implementation of haptic simulators as a valid and effective complement for preclinical skill acquisition in operative dentistry.
Skills acquisition in cavity preparation in conservative dentistry through virtual haptic simulation Sebastiana Arroyo-Bote, Catalina Bennasar-Verger, Daniela Paz-Vallejos, Jorge Dominguez-Perez, Pere Riutord-Sbert, Thais Cristina Pereira Frontiers in Dental Medicine, 2026 Introduction Virtual reality-based training tools have become increasingly incorporated into health education in recent years. In dentistry, three-dimensional (3D) haptic simulators are used in several undergraduate programs to support preclinical training in procedures such as caries removal, cavity preparation, coronal access, prosthodontic preparation, periodontal therapy, and surgical techniques. The aim of this study was to explore student performance in cavity preparation tasks using a virtual haptic simulation system across different academic years of the dentistry degree. Methods Second-, third-, and fourth-year dentistry students underwent prior training using 3D haptic simulators in the Virtual Haptic Simulation classroom at ADEMA University School (Universal Simulation, London, UK). Training consisted of completing five cavity preparation activities using preforms, followed by repetition of the same activities with and without the preform. Performance outcomes recorded by the simulator were analyzed and compared between academic years, including precision, surgery time, drilling time, activity progress, target volume, and external volume. Results Statistical analysis using ANOVA revealed no statistically significant differences in accuracy among the different academic years ( p = 0.09915). In contrast, significant differences were observed between groups for surgery time ( p = 9.059 × 10 − ⁷), drilling time ( p = 0.0001236), activity progress ( p = 4.26 × 10 − ⁸), target volume ( p = 1.244 × 10 − ⁹), and external volume ( p = 0.005844). No statistically significant differences were identified between cavities prepared with and without the preform in terms of surgery time, drilling time, or activity progress. Discussion Within the methodological limitations of this study, including the absence of clinical-transfer assessment, the use of non-equivalent tasks across academic levels, and reliance on simulator-derived metrics with limited sensitivity, the findings should be interpreted with caution. The observed performance patterns reflect students' interaction with the virtual haptic environment rather than definitive evidence of skill acquisition or progressive competence development. Non-significant differences in accuracy between academic years should not be interpreted as equivalence of operative competence. Overall, this study provides descriptive insight into the use of VR-haptic simulation as a supplementary preclinical training resource, highlighting areas for further methodological refinement and future controlled investigations.
Digitally Guided Modified Intentional Replantation for a Tooth with Hopeless Periodontal Prognosis: A Case Report Raul Cuesta Román, Ángel Arturo López-González, Joan Obrador de Hevia, Sebastiana Arroyo Bote, Hernán Paublini Oliveira, Pere Riutord-Sbert Diagnostics, 2025 Background and Clinical Significance: Advanced periodontitis with severe vertical bone loss and grade III mobility is usually managed by extraction and implant placement. Digital workflows and modern regenerative techniques have opened the possibility of preserving teeth that would traditionally be considered for extraction. This report describes a digitally guided modified intentional replantation (MIR) protocol applied to a maxillary tooth with severe periodontal involvement and unfavourable prognosis. Case Presentation: A 68-year-old male, non-smoker, with a history of heart transplantation under stable medical control, presented with generalized Stage IV, Grade C periodontitis. Tooth 21 showed >75% vertical bone loss, probing depths ≥ 9 mm, bleeding on probing, and grade III mobility. After non-surgical therapy and periodontal stabilization, a CAD/CAM-assisted MIR procedure was planned. Cone-beam computed tomography (CBCT) and a 3D-printed tooth replica were used to design a surgical guide for a new recipient socket. The tooth was atraumatically extracted, stored in chilled sterile saline, and managed extraorally for approximately 10 min. Apicoectomy and retrograde sealing with Biodentine® were performed, followed by immediate replantation into the digitally prepared socket, semi-rigid splinting, and guided tissue regeneration using autologous bone chips, xenograft (Bio-Oss®), enamel matrix derivative (Emdogain®), and a collagen membrane (Bio-Gide®). A conventional orthograde root canal treatment was completed within the first month. At 12 months, tooth 21 exhibited grade 0 mobility, probing depths of 3–4 mm without bleeding on probing, and stable soft tissues. Standardized periapical radiographs and CBCT showed radiographic bone fill within the previous defect and a continuous periodontal ligament-like space, with no signs of ankylosis or root resorption. The tooth was fully functional and asymptomatic. Conclusions: In this medically complex patient, digitally guided MIR allowed preservation of a tooth with severe periodontal involvement and poor prognosis, achieving favourable short-term clinical and radiographic outcomes. While long-term data and larger series are needed, MIR may be considered a tooth-preserving option in carefully selected cases as an alternative to immediate extraction and implant placement.
Influence of Academic Training and Professional Experience on the Management of Deep Caries Lesions Sebastiana Arroyo-Bote, David Ribas-Perez, Catalina Bennasar Verges, Diego Rodriguez Menacho, Paloma Villalva Hernandez-Franch, Ignacio Barbero Navarro, Antonio Castaño Séiquer Healthcare Switzerland, 2024 Background/Objectives: Managing caries lesions that affect the inner third of the dentin is crucial to ensuring pulp vitality; the clinician must make decisions that will affect the vitality of the tooth. Our purpose is to understand the behavior of Spanish dentists in treating deep cavities and to examine whether variations exist based on their academic training and/or years of professional experience. Methods: This study was approved by the ethics committee of the Balearic Islands CEI-IB. A survey was conducted using the SurveyMonkey platform with 11 questions, the first 4 of which focused on defining the characteristics of the respondents. The following six concerned a clinical case of deep caries in tooth number 4.7, and the last regarded the opinion of the actual treatment of the case. The survey was sent by email in April 2022. The results were analyzed with the SPSS 29.0 program using the chi-square test. Results: A total of 347 responses were obtained (93.95%), and those surveyed stated that they apply minimal intervention concepts in their treatments, with 90.49% performing conservative dentistry treatments daily. A total of 56.48% of the respondents had bachelor’s degrees, 12.39% had graduated, 33.14% had a postgraduate degree, 38.90% had a master’s degree, and 17% had a doctorate. Most (40.63%) had been in professional practice for 16–30 years. Conclusions: Significant differences were identified regarding years of professional experience in terms of decision-making in methods of treatment and the choice of materials used for pulp protection. Likewise, significant differences were found regarding the academic training of the respondents, the cavity cleaning method selected, and the use of chemical substances for removing carious dentin. We can conclude that academic training and years of professional practice influence decision-making at some points in treating deep caries lesions.
Development of a three-dimensional printed model from a digital impression of a real patient for aesthetic dentistry undergraduate teaching Sebastiana Arroyo‐Bote, Catalina Bennasar‐Verger, Andrés Martínez‐Jover, Pablo Ferragut‐Pina, Pere Riutot‐Sbert, Ángel Arturo López‐González, Pål Barkvol Journal of Dental Education, 2024 IntroductionThe acquisition of skills and manual dexterity in aesthetic dentistry in undergraduate teaching requires preclinical practices with simulation that should approximate real clinical situations.ObjectiveWe will present a digital procedure for the creation of three‐dimensional (3D) resin models adapted to the practices of the Aesthetic Dentistry course.Material and methodStereolithography or Standard Tesellation Language (STL) files of a real patient were previously obtained with a 3‐shape intraoral scanner. Using the Exocad computer programme for dental prosthesis design, various modifications were made, such as incisor rotation, surface alterations imitating dysplasias or erosions, the creation of diastemas, or even changes in tooth size. The virtual model was printed in resin for use by students. Once the practices were finished, the students and the teachers evaluated the use of the 3D printed models.ResultsThe result is the typodont model, in which seven laboratory sessions took place: 1‐Restoration of conoid tooth morphology, 2‐Cervical abrasion/ erosion restoration, 3‐Direct Composite Veneer, 4‐Aesthetic correction in a tooth with rotation, 5‐Diastem closure, 6‐Occlusal abrasions/ erosion, and 7‐Maryland bridge. 90.48% of the students evaluated the designed 3D model as the best method for laboratory practice compared to other methods, obtaining a general assessment of 8.3 out of 10.ConclusionThe method used has provided a reproducible standard analog model for direct aesthetic dental restoration practice, with a good assessment by students and teachers.
Management of a clinical case of caries lesions by undergraduate dentistry students S. Arroyo-Bote, A. Antonelli-Sastre Journal of Clinical and Experimental Dentistry, 2024 Background: Dental caries remains the most prevalent chronic disease worldwide. Hence the importance of detecting and evaluating caries and combining this with additional diagnostic methods to ensure the best treatment. The main objective was to study what is the sensitivity and specificity for detecting initial and cavitated caries lesions by students in third, fourth and fifth year of the Degree in Dentistry at the University of Barcelona, analysing if there is any difference between the diagnoses and treatments among the different years and each student's clinical experience. It was also determined if they apply the techniques based on the concepts of minimal intervention. Material and Methods: An observational cross-sectional study using an online survey was performed, based on a real clinical case, aimed at the students in third, fourth and fifth year of the Degree in Dentistry at the University of Barcelona. Results: Most of the respondents (72.13%) observed demineralization or cavities caused by caries in the clinical image and all in the radiographic image (100%). Meanwhile, they showed a more conservative attitude in the treatment of occlusal face, where 23.08% in 4.6 and 46.25% in 4.7 indicate filling of pits and fissures. On the other hand, on the proximal faces, they directly opted for a class II filling (95% in 4.5 distal, 94% in 4.6 mesial and 84% in 4.6 distal). Eighty-five percent of the students considered applying techniques based on the concepts of minimal intervention. Conclusions: Dental caries, caries diagnosis, caries management, questionnaire.
Dental care for patients with down syndrome: A survey for dentists of the college of the balearic islands S. Arroyo-Bote, C. Bennasar-Verger, Á. López-González Journal of Clinical and Experimental Dentistry, 2024 Background: Down Syndrome (DS) presents with systemic, craniofacial and oral alterations accompanied by different levels of intellectual disability and because of this, they frequently require professional dental care. Objective: This work aims to know the dental care patients with DS receive from dentists in the Balearic Islands. Material and Methods: An 11-question survey was carried out via email from the College of Dentists of the Balearic Islands. The researchers conducted the survey based on previous researchs. The first three questions refered the professional´s profile (age, sex and years since graduation) and the restant 8 were focused on the academic training and dental care provided to patients with DS. Results: 129 surveys were collected. 40.45% were between 34-43 years old, 67.84% were women, and 32.16% were men. 33.30% had been in professional practice for between 15-24 years, followed by those with 4-14 years with 27.33% and those with 25-34 years with 24.04%. 81.64% received undergraduate academic training, and 60.72% completed training after graduating. 57.17% believe that patients with DS should be treated by a dentist specialised in special patients, 20.67% by a pediatric dentist, and 18.87% by a general dentist. 63.40% perform sealing, fillings or dental extractions, 60.6% perform oral examination, oral cleaning and give prophylaxis instructions, and 26.72% state that they perform endodontic treatments. Significant differences were found between some of the variables analysed and the age, sex, academic training or professional scenario of the professionals. Conclusions: Down Syndrome, Trisomy 21, Surveys and Questionnaires, Dental Care for Children, Oral Health.
Complications Arising from Dental Trauma Incurred from Falls Involving Geriatric Patients: A Case Report Sebastiana Arroyo Bote, Catalina Bennasar Verges, David Ribas-Perez, Diego Rodriguez Menacho, Paloma Villalva Hernandez-Franch, Ignacio Barbero Navarro, Antonio Castaño Séiquer Diagnostics, 2023 Elderly patients have a high incidence of falls that result in facial injuries. Many cases present with dental crown fractures and soft-tissue lacerations. The initial diagnosis is especially important in this type of dental trauma, since an initial error can result in the failure to establish the correct treatment from the very beginning, worsening the prognosis, which, in the worst case, can compromise the teeth affected by the trauma. Case report: We present the case of a patient, a 79-year-old woman, who suffered an accidental fall. The patient was examined by a dentist in the emergency room. She was diagnosed with a simple crown fracture of the right upper central incisor and right upper lateral incisor without any pulpal involvement and with laceration of the lower lip. Months later, she had an episode of inflammation in the lower lip, and she developed edema and pain. An X-ray of the lower lip revealed a radiopaque mass compatible with a fragment of dental tissue due to the inclusion of remnants of the dental tissue resulting from the previous accident fall. Conclusions: The population of geriatric patients is steadily increasing in our society, and a higher frequency of falls has been observed in this age group, affecting the maxillofacial region, with consequent dental trauma on many occasions. Therefore, as professionals, we must pay special attention to the prevention and treatment of this problem, insisting on the importance of routine investigation in the emergency visit for dental trauma, which includes a meticulous examination of the soft tissues accompanied by a radiographic examination, when the inclusion of foreign bodies is suspected.
Interpersonal violence education: An analysis of the Spanish oral health school's curricula and future requirements Sebastiana Arroyo‐Bote, Carolina Martínez‐Arroyo, Mª. Ángeles Gallego‐Álvarez, Chelo Arroyo‐Bote, Mª. Cristina Manzanares‐Céspedes European Journal of Dental Education, 2023 IntroductionInterpersonal violence results in injuries that frequently affect oral, head and neck structures, the treatment of which must be carried out by Oral health practitioners with sufficient training to detect the problem and manage the victim's lesions and need for referral. The objective of this study is to know the academic preparation that Spanish dentistry students receive in learning outcomes related to interpersonal violence during undergraduate academic training.Materials and methodsA survey was conducted through an online form with 9 questions (Survey Monkey platform). The link was sent by email to the deans of the 23 Spanish universities (public and private) offering dentistry degrees. The analysis of the results was carried out using Fisher's test and a chi‐squared test.Results95.63% of the deans (n = 22) responded. 85.7% of the universities report to carry on training in violence, according with Spanish legislation. Currently 33.3% dedicate less than 5 h to this training, whereas in the future study plans only 19% would dedicate less than 5 h to these learning outcomes. 85.7% of the respondents agree in consider this training as mandatory. The subjects in which learning outcomes on interpersonal violence were reported to be included were: legal and forensic dentistry (78%), psychology (55%), medical ethics (33.3%), paediatric dentistry (39%), surgery (5.5%) and 22% respondents cited other specialties. In future curricula, the competence areas in which such training is proposed to be imparted are: legal and forensic dentistry (80.9%), psychology and medical ethics (57.1%), paediatric dentistry (38.1%), surgery (14.2%) and in 23.8% also in other specialties. Significant differences were found between public and private universities only in the number of hours that would be dedicated to interpersonal violence learning outcomes in the future.ConclusionsInterpersonal violence encompasses situations of abuse and neglect inflicted to different patients (women, children, elderly) that are perceived both by Oral Health students and practitioners to require a comprehensive training. Most of the respondent deans consider that in the future curricula both the hours and areas that teach interpersonal violence learning outcomes must be increased. To respond to victim's need for help and care, the future requirements for the Oral health workforce education must encompass interprofessional undergraduate as well as postgraduate training in interpersonal violence.
MICRO-COMPUTED TOMOGRAPHIC ANALYSIS OF THE EFFECTS OF INSTRUMENTATION ON MICROCRACK FORMATION USING A CADAVER MODEL International Journal of Clinical Dentistry, 2022
Backscattered electron imaging for the interface analysis of dental biomaterials Biodental Engineering II Proceedings of the 2nd International Conference on Biodental Engineering Biodental 2012, 2014
Composite-reinforced glass fiber morphology Biodental Engineering II Proceedings of the 2nd International Conference on Biodental Engineering Biodental 2012, 2014