Virtual Nursing Simulator With Haptic

Force-Feedback For Oral Hygiene

Students: Diana SerafimovskaThuy Pham

Advisor: Dr. ElhajjNurse: Dr. Harrison

FactsFacts

80% of adults have periodontal disease, 99% of those people have no sign to indicate the problem [1].

40% of Americans do not receive proper oral hygiene care [3].

1.5 out of 1.6 million people residing in nursing homes have poor oral health care [5] [6].

Only 16% of the nursing home residents had their teeth cleaned with substandard oral hygiene care [8].

Bad Oral-Hygiene Leads toBad Oral-Hygiene Leads to......

Plaque accumulation leads to Gingivitis Periodontitis

Aspiration Pneumonia

Cardiovascular diseases

Decreased quality of life

Increased cost of care

Oral-Hygiene In Nursing HomeOral-Hygiene In Nursing Home

[4]

If you can't touch it, but you can see it,

it's .

If you can touch it, and you can see it,

it's .

Our Research is about…Our Research is about…

REALREAL

VIRTUALVIRTUAL

“Virtual Interactive Real-Time Simulation withHaptic Force-Feedback”

The Set-upThe Set-up

Diagram

“Virtual Interactive Real-Time Simulation withHaptic Force-Feedback”

Virtual Environment

Simulator

Haptic ToolPHANTOM OMNI

Real-TimeUser interactive

The systemThe system

User

Graphical User Interface

PhysicalForce

- Input- Output

Proxy (x,y,z)

Force

SystemForce

To Physical

ForceVisualization

Haptic Device

Haptic Interface

activateHaptic();findProxyPosition();DrawShape();If contact Force = kxElse no contact Force = 0outputForce();outputContactPoint();

Data

Control

HapticDisplay- Collision detection/Response

Haptic Device Position 1Haptic Device Position 1Proxy 1Proxy 1

Object Surface

SpringSpringF = kxF = kx

Haptic Device Position 2Haptic Device Position 2

Proxy 2Proxy 2

Our PurposesOur Purposes

Worthwhile Educational ValuesWorthwhile Educational Values

Users: nurses & nursing studentsImpacts:

Smoother transition into the clinical environment [5]Support and reinforce ergonomics [5]Reduction in the need of instructorsImprovement in skills

Provide:Convenient work environmentUser-friendly interfaceRepetitionSufficient supporting materialsPerformance Assessment

Other Simulation StudiesOther Simulation Studies

The Johnson Center at Lucile The Johnson Center at Lucile Packard Children’s HospitalPackard Children’s Hospital

The first dedicated pediatric and obstetric medical simulation center in the world

Allows health-care professionals to use their skills in a simulated medical environment [10].

Biological Simulators, IncBiological Simulators, Inc A program that contains mathematical descriptions of physiological functions in the human body.

Interaction with equations through an interface that allows you to create a disturbance and then track the subsequent physiological response [17].

Other Simulation Studies Other Simulation Studies (cont)(cont)

Optimizing the design, manufacturingcost, and functionality of new toothbrushes.

CAD toothbrush model, 3D - CT scans of person’s jaw.

PHANTOM 1.5A, GHOST library.

Finite Elements Method, Voxel-Based Algorithm.

Limitations: multi-point collision, oral surface contact detection.

Goals: pre-operative planning system for cranio-facial surgery, surgeons.

Interactive Simulation of Teeth Interactive Simulation of Teeth CleaningCleaning

[7]

Other Dental Simulation StudiesOther Dental Simulation Studies

The Iowa Virtual Reality Dental The Iowa Virtual Reality Dental Simulator Simulator

Teach and test dentist students surgical skills

Remove vibration to enhance realistic tactile feeling by increasing update rate (1kHz)

VRML 3D models

PHANTOM desktop

C and C++, World Toolkit

Goals: levels of touch detail, graphical display.

[6]

Other Dental Simulation Studies Other Dental Simulation Studies (cont)(cont)

DentSimDentSimDenX America

Physical models: head and teeth

Equipment: computer, camera, simulators

No time-delay between simulators and software

Outcome-based assessment of the procedures

Being used in many schools in the U.S

Limitations: too expensive

[13]

Other Dental Simulation Studies Other Dental Simulation Studies (cont)(cont)

University of Pittsburgh School of Dental Medicine

Use simulators for their first year dental students. The simulator is made up of standard dental equipment where each station is equipped with a dummy patient simulator that has a removable jaw with lifelike movement that can be approached from any angle. Provides the clinical experience without setting foot in an actual clinic [11].

University of Washington Offers a teaching camp that gives students the opportunity to work with teeth simulators while learning to make impressions, models, and reconstructions of portions of teeth [12].

Our Oral-Hygiene Simulation StudiesOur Oral-Hygiene Simulation Studies

How can we prove that our research will be How can we prove that our research will be effective?effective?

If doctors can, why can’t nurses?

Faster way of learning Columbia University’s School of Dental and Oral Surgery has shown that students learn much faster using simulation machines [9].

Well prepared for real clinical practices [5]

Capability of our application

Oral health care training gives:Significant improvement specifically for oral hygiene (Nicol, Sweeney, McHugh, Bagg, 2005). 369 caregivers were improved in attitudes and knowledge of oral health care (Frenkel. Harvey, Needs, 2002)

ChallengesChallenges

Graphic User InterfaceVisual Basic interfaces with Visual C++

Realistic 3D modelingPhysical properties: colors, size, etc. Facial features: tongue, face, etc.

Force-feel realismSynchronization:

Haptic (1kHz) & graphic (30Hz) update rate [14]Multi-threading structure [14]

Reduction in vibration: haptic device force & update rateMulti-point tactile sensory Tactile feelings at different regions Deformation of soft tissues

Accuracy in calculationThe specific surfaces of contactTiming

Procedural Assessment Detailed evaluation

The process…The process…

Graphical User Interface (GUI) - Visual Basic

The process… The process… (cont)(cont)

Programming language: C++

Rendering techniquesHLAPI / HDAPI - haptic library

OpenGL – graphic rendering library

GLUT – auxiliary library handles window creations: mouse movement, button and keyboard functions, callbacks, etc.

GLUI – GUI for GLUT

The process… The process… (cont)(cont)

3D modelOBJ format

OBJLOADER

VERTICESFACES

OPENGL MESH

The process… The process… (cont)(cont)

Load 3D Toothbrush

Problem: Missing vertices & facesLoader does not work

well with a larger numberof polygons

Solution: SplodgeLimitation: no texture

The process… The process… (cont)(cont)

Enable haptic device

Load models

Draw models GraphicallyHaptically

Determine proxy point

Force calculation

Collision Detection done by HLAPI

GLUI builds on top of GLUT

Start/Stop timeEvaluation form

The process… The process… (cont)(cont)

Problems Collision DetectionPenetration

Third-party physics/dynamics and collision detection engine

Sphere Trees

Axis Aligned Bounding Box (AABB)

Oriented Bounding Box (OBB) – RAPID

SWIFT++ - convex-decomposition & bounding volume hierarchy

I-COLLIDE – only convexQ-COLLIDE – enhancement of I-COLLIDE

QuickCD & CD – dynamic/dynamic, static/dynamic objects; k-dop bounding volume

[14] [15] [16]

Movie TimeMovie Time

Future Implementation & Directions Future Implementation & Directions

Graphical visualizationLoader

Textures

Facial features

Bleeding of gum

AlgorithmsVisual collision detection

Surface contact calculation

Optimization of the

force-feedback systemMulti-point collision

Reduce vibration

Quote From This ResearchQuote From This Research

• If you can touch it and you can see it, it's REALREAL

• If you can't touch it but you can see it, it's VIRTUALVIRTUAL

• If you can touch it but you can't see it, it's TT

• If you can't touch it and you can't see it, it's

RANSPARENTRANSPARENT

GONEGONE

ReferencesReferences

[1] “Oral Hygiene.” Wikipedia Online Encyclopedia. 6 June 2006.[2] Anton, Pam. Advanced Dental Hygiene Practitioner Fact

Sheet 2006. 6 June 2006.[3] “An Overview of Nursing Home Facilities: Data from 1997

National Nursing Home Survey.” National Center for Health Statistics. No 311. 1 March 2000.

[4] Fundamentals of Nursing: The Art and Science of Nursing Care. Lippincott William and Wilkins © 2005.

[5] Judith Ann Buchanan. Use of Simulation Technology in Dental Education. Journal of Dental Education. November 2001.

[6] Steven Dow, Geb Thomas, Lynn Johnson, Clark Standford. Iowa Dental Surgical Simulator. University of Iowa College of Dentistry and the GROK Lab. 2004.

[7] Gockel T, Salb T, Weyrich T, Burgert O, Dillmann R. Interactive Interactive Simulation of Teeth Cleaning. Institute for Process Control and Robotics. University Karlsruhe, Germany, 2000.

[8] “Oral Care Provided by Certified Nursing Assistants in Nursing Homes.” Oral Care in Nursing Homes. January 2006. Vol. 54. No. 1.

[9] Dougherty, Matthew. Dental Students Cut Teeth on New Simulators. Columbia University Health Sciences. © 2002.

[10] Conger, Krista. “New center innovates teaching through simulation.” Stanford Report. 13 November 2002

References References (cont)(cont)

[11] Uhl, Jocelyn. “Dental Education of the Future at Pitt now: First-year Students Learn Clinical Skills Now, $2.8 million Simulation Clinic.” Pitt Chronicle: Newspaper of the University of Pittsburgh. 23 September 2002.

[12] Neary, Walter. “Dental camp will give youth a rare close-up view of profession.” UWnews.org. 19 July 2002.

[13] DentSim. DenX Advanced Medical System. DenX America, Inc. 2006.

[14] Cagatay Basdogan, Chih-Hao Ho. Principles of Haptic Rendering for Virtual Environments. Laboratory for Human and Machine Haptics. MIT.

[15] Stephen A. Ehmann and Ming C. Lin. Accurate and Fast Proximity Queries between Polyhedra Using Surface Decomposition. Computer Graphics Forum (Proc. of Eurographics), 2001.

[16] Ales Daneu. Collision Detection Algorithms. Computer and Information Science. University of Ljubljana. 2002. pp: 7-10.

[17] Biological Simulators, Inc. Simulation for Education and Research. Tom Coleman. 14 July 2006.

THANK YOU…THANK YOU…