Prof Ana Arias (Faculty of Dentistry, Complutense University of Madrid, Spain)

Development and Evaluation of an Immersive 3D Multicamera Virtual Reality Simulation for Teaching Endodontic Microsurgery.

 

Abstract

Background and Rationale

The European Society of Endodontology Undergraduate Curriculum Guidelines for Endodontology state that the undergraduate should be familiar with a range of surgical endodontic procedures and suggests observation or direct assistance as educational methods to achieve this goal. Modern endodontic microsurgery (EMS) is a technically demanding procedure that requires an in-depth understanding of periapical anatomy and microsurgical instrumentation, as well as effective coordination with an assisting team under magnification. Conventional didactic approaches are limited in conveying essential aspects of EMS, including spatial orientation, ergonomic principles, and team coordination within the magnified surgical field. Immersive virtual reality (VR) technologies may help overcome these limitations by providing realistic and context-rich learning environments facilitating a smoother transition from didactic and pre-clinical training to clinical practice.

Objectives

The main objective of the present project is to develop an educational tool in the form of a VR-based, multicamera 360-degree immersive simulation that captures real endodontic microsurgical procedures under authentic clinical conditions. A secondary objective is to evaluate whether this tool can effectively complement traditional teaching methods in EMS training and to assess student satisfaction with the developed simulation.

Methodology

This educational study will include postgraduate endodontic students in their second and third years (n = 12). A real EMS procedure will be recorded using a multicamera setup combining 360-degree stereoscopic cameras and a 180-degree camera strategically positioned around the operating room to document the full clinical workflow. In parallel, the procedure will also be recorded through the integrated Zeiss EXTARO 300 surgical microscope camera (Carl Zeiss Meditec AG, Jena, Germany). The recorded footage will be edited and integrated into an interactive VR module. Prior to implementation, the completed VR module will undergo expert validation by a panel of endodontists and faculty members.

The educational intervention will follow two differentiated protocols adapted to each cohort of students. Second-year students will use the immersive simulation as a preparatory tool prior to preclinical EMS training, whereas third-year students will use it as a reflective learning tool to reinforce prior preclinical and clinical experience.  Knowledge acquisition will be assessed using a written examination and compared with retrospective data from a previous cohort trained without the immersive component. Student satisfaction will be evaluated through a structured survey, and qualitative insights will be gathered through a focus group interview with third-year students to explore the perceived value of the immersive module in supporting reflective learning.

CV
Prof Ana Arias is a full-time professor in the Department of Conservative and Prosthetic Dentistry and Director of the Postgraduate program of Endodontology at Complutense University of Madrid (Spain) where she received her degree in Dentistry, her Certificate in Endodontics and earnt her PhD in Dentistry. Along her career, she has also earned a Postgraduate Certificate in Statistics and Study Design for Health Sciences at Autonoma University (Barcelona, Spain); worked as an assistant Professor at the Department of Endodontics at University of the Pacific Arthur A. Dugoni School of Dentistry (San Francisco) and completed a Master of Science in Medical Education Leadership at University of New England (Biddeford-Maine, USA). She has extensively published in journals with high impact factor in the field of Endodontics.

 

 

Prof Sıla Nur Usta (Gülhane Faculty of Dentistry, University of Health Sciences, Ankara, Turkey)

Microbiological and inflammatory analysis of carious lesions of teeth with symptomatic irreversible pulpitis associated with deep and extremely deep caries

Abstract

Background and Rationale

Symptomatic irreversible pulpitis (SIP) is primarily driven by microbial invasion from deep carious lesions, triggering complex inflammatory responses within the dental pulp. Although clinical symptoms guide diagnosis and treatment decisions, they do not reliably reflect the underlying biological status of the pulp. In particular, the role of caries depth in shaping both the microbial profile and pulpal inflammatory response remains poorly understood.

Current Clinical Practice

Conventional management of SIP typically involves root canal treatment; however, increasing evidence supports the potential of vital pulp therapies even in symptomatic cases. The lack of objective biological markers limits accurate case selection, often leading to overtreatment. A better understanding of the microbiological and inflammatory characteristics associated with different caries depths could improve biologically driven clinical decision-making.

Material and Methods

Ninety patients will be allocated into three groups: deep caries with SIP, extremely deep caries with SIP, and shallow caries with normal pulp. Carious dentin and pulp tissue samples will be collected under strict aseptic conditions. Microbial profiling will be performed using 16S rRNA sequencing and qPCR, while pulpal inflammatory mediators will be quantified using multiplex immunoassay analysis.

Importance and Implications

This study addresses a critical gap in endodontic diagnostics by linking caries depth with both microbial composition and pulpal inflammatory status in teeth with SIP. Identifying distinct microbiological and inflammatory patterns could support more accurate case classification and improve the selection of conservative, pulp-preserving treatment strategies.

CV

Sıla Nur Usta earned her DDS degree from Gazi University in 2017 and completed her specialization in Endodontics at Hacettepe University in 2021. She served as an Assistant Professor between 2022 and 2025 and is currently an Associate Professor in the Department of Endodontics at Gülhane Faculty of Dentistry, University of Health Sciences, Turkey. She is concurrently pursuing her PhD in the Department of Microbiology at the University of Granada, Spain. Her research interests include endodontic microbiology, inflammatory mechanisms in pulpal and periapical tissues, minimally invasive and regenerative endodontic approaches, and the integration of advanced technologies in endodontic education. Professor Usta has authored several scientific publications in national and international peer-reviewed journals and currently serves as an Assistant Editor of the Turkish Endodontic Journal.