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NUS Advances Dental Education with AR Radiography Simulator

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In a significant development, Dr Lim Li Zhen, Senior Lecturer at NUS Dentistry, has introduced the iRadiate3D radiography simulator, leveraging augmented reality (AR) to enhance the training of dentistry students in acquiring X-ray images of teeth. This innovation is part of the university’s broader strategy to integrate advanced technology into its teaching methods, making lessons more engaging and effective.

Image credits: National University of Singapore

Dr Lim frequently encounters a common question from students learning intraoral radiography: “Dr Lim, does this look correct?” Unlike extraoral X-rays, where the film is placed outside the mouth, intraoral radiography requires precise positioning of X-ray holders inside the patient’s mouth. Errors in positioning can lead to inaccurate images, complicating the diagnosis of dental issues such as tooth decay and bone loss.

To address this challenge, Dr Lim developed two innovative tools: iRadiate2D and iRadiate3D. These tools simulate the X-ray-taking process, allowing students to practice and refine their skills.

“Students tend to get overwhelmed when a task has too many steps or components,” explained Dr Lim. “I break it down into smaller, simpler tasks.”

Initially, students learned intraoral radiography through lectures and a 45-minute practical session but struggled with positioning X-ray holders correctly. To address this, Dr Lim collaborated with the Keio-NUS CUTE Center to create iRadiate2D, an interactive web-based tool integrated into the curriculum in 2019, which guides students in setting up and positioning X-ray holders accurately.

The success of iRadiate2D led to the development of iRadiate3D in 2020, providing a more immersive experience. This tool uses a 3D-printed model of a jaw, tongue, and cheek, along with a phone that uses its camera and AR to display corresponding X-ray images. This setup allows students to practice without needing an actual X-ray room, specialised equipment, or staff supervision.

The introduction of iRadiate3D faced challenges. Initially, its dynamic mode made students over-reliant on real-time X-ray images, unlike real-world conditions where images appear only after exposure. Dr Lim adjusted by using the dynamic mode for demonstrations and the static mode, which shows images after clicking a capture button, for student practice.

With iRadiate2D and iRadiate3D, students find it easier to grasp intraoral radiography, arriving better prepared for practical sessions, which are now more efficient and productive. These adjustments significantly improved students’ learning experiences, making the procedure less intimidating. The tools were found to be convenient and effective in reinforcing lecture content through step-by-step guidance and corrections.

For their innovative use of technology in teaching, Dr Lim and her team received the NUS Annual Digital Education Award (Team category) in 2022 and the Faculty of Dentistry’s Excellence in Teaching Award in AY2020/21.

While plans to scale iRadiate3D are in the early stages, its predecessor, the iRadiate2D website, is already being adopted by dental schools overseas, including in the United States. This global interest underscores the value and effectiveness of these innovative teaching tools.

Dr Lim’s vision extends beyond just teaching students how to take X-rays. She is now exploring new ways to help students read X-ray images and make accurate diagnoses. These advancements are not just beneficial for the students but also keep the teaching process dynamic and engaging for educators.

The integration of AR and advanced technologies in dental education at NUS showcases technology’s transformative impact on traditional teaching methods. Tools such as iRadiate2D and iRadiate3D provide immersive, hands-on training that raises the bar in dental education, thoroughly preparing students for the complexities of clinical practice.

As technology continues to evolve, the potential for further educational advancements is vast, promising an exciting future for both educators and dental students. This evolution not only enhances learning outcomes but also fosters a more engaging and effective educational environment.


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