The application of virtual reality has become increasingly extensive as this technology has developed. In dental education, virtual reality is mainly used to assist or replace traditional methods of teaching clinical skills in preclinical training for several subjects, such as endodontics, prosthodontics, periodontics, implantology, and dental surgery. The application of dental simulators in teaching can make up for the deficiency of traditional teaching methods and reduce the teaching burden, improving convenience for both teachers and students. However, because of the technology limitations of virtual reality and force feedback, dental simulators still have many hardware and software disadvantages that have prevented them from being an alternative to traditional dental simulators as a primary skill training method. In the future, when combined with big data, cloud computing, 5G, and deep learning technology, dental simulators will be able to give students individualized learning assistance, and their functions will be more diverse and suitable for preclinical training. The purpose of this review is to provide an overview of current dental simulators on related technologies, advantages and disadvantages, methods of evaluating effectiveness, and future directions for development.

Background: Virtual reality (VR) dental simulators are currently used in preclinical skills training. However, with the development of extended reality technologies, the use of mixed reality (MR) has shown significant advantages over VR. Objective: This study aimed to describe the research and development of a newly developed MR and haptic–based dental simulator for tooth preparation and to conduct a preliminary evaluation of its face validity. Methods: A prototype of the MR dental simulator for tooth preparation was developed by integrating a head-mounted display (HMD), special force feedback handles, a foot pedal, computer hardware, and software program. We recruited 34 participants and divided them into the Novice group (n=17) and Skilled group (n=17) based on their clinical experience. All participants prepared a maxillary right central incisor for an all-ceramic crown in the dental simulator, completed a questionnaire afterward about their simulation experience, and evaluated hardware and software aspects of the dental simulator. Results: Of the participants, 74% (25/34) were satisfied with the overall experience of using the Unidental MR Simulator. Approximately 90% (31/34, 91%) agreed that it could stimulate their interest in learning, and 82% (28/34) were willing to use it for skills training in the future. Differences between the 2 study groups in their experience with the HMD (resolution: P=.95; wearing comfort: P=.10), dental instruments (P=.95), force feedback of the tooth (P=.08), simulation of the tooth preparation process (P=.79), overall experience with the simulation (P=.47), and attitude toward the simulator (improves skills: P=.47; suitable for learning: P=.36; willing to use: P=.89; inspiring for learning: P=.63) were not significant. The Novice group was more satisfied with the simulator’s ease of use (P=.04). There were significant positive correlations between the overall experience with the simulation and the HMD’s resolution (P=.03) and simulation of the preparation process (P=.001). Conclusions: The newly developed Unidental MR Simulator for tooth preparation has good face validity. It can achieve a higher degree of resemblance to the real clinical treatment environment by improving the positional adjustment of the simulated patients, for a better training experience in dental skills.

Background: Virtual reality (VR) simulators are increasingly used in dental education, offering advantages such as repeatable practice and immediate feedback. However, evidence comparing their efficacy to traditional phantom heads for veneer preparation training remains limited. Objective: This study aimed to compare the effectiveness of 2 widely used VR simulators (Unidental and Simodont) against traditional phantom heads for veneer tooth preparation training and evaluate the impact of training sequence (simulator-first vs phantom-head-first) on skill acquisition. Methods: A randomized controlled trial was conducted with 80 fourth-year dental students from Peking University School of Stomatology. Participants were stratified by gender and academic performance, then equally allocated to 8 groups. Groups 1‐3 trained exclusively using Unidental, Simodont, or phantom heads, respectively, while groups 4‐8 followed hybrid sequences combining simulator and phantom-head training. Each participant performed veneer preparations on a maxillary central incisor. Preparations were evaluated by a blinded instructor using a validated 100-point rubric assessing marginal integrity (30%), preparation depth (25%), proximal contour (25%), and surface smoothness (20%). Posttraining questionnaires (100-point scale) compared user perceptions of simulator realism, haptic feedback, and educational value. Results: There were no statistically significant differences in the preparation quality among groups using different training methods (Unidental: 88.9, SD 3.6; Simodont: 88.6, SD 1.6; phantom heads: 89.4, SD 2.8; P=.81) or different training methodologies (simulator-first vs phantom-head-first) (simulator first: P=.18; phantom head first: P=.09, different sequences of Unidental: P=.16; different sequences of Simodont: P=.11). However, significant differences were observed between the evaluations of the 2 simulators in terms of realism of the odontoscope’s reflection (Simodont: 55.6, SD 33.7; Unidental: 87.5, SD 13.9; P<.001), force feedback (Simodont: 66.2, SD 22.4; Unidental: 50.8, SD 18.9; P=.007), and simulation of the tooth preparation process (Simodont: 64.4, SD 16.0; Unidental: 50.6, SD 16.6; P=.003). Evaluation results showed no statistical differences between the 2 simulators in display effect (Simodont: 77.43, SD 21.58; Unidental: 71.68, SD 20.70; P=.24), synchronism of virtual and actual dental instruments (Simodont: 67.86, SD 19.31; Unidental: 59.29, SD 20.10; P=.11), and dental bur operation simulation (Simodont: 63.32, SD 19.99; Unidental: 55.79, SD 19.62; P=.16). The Unidental simulator was rated better than the Simodont simulator in terms of the realism of odontoscope’s reflection. In all other aspects, Simodont was superior to Unidental. There was no significant difference in the students’ attitudes towards the 2 simulators (improve skills: P=.19; inspire to learn: P=.29; will to use: P=.40; suitable for training: P=.39). Conclusions: The study found no significant differences in training outcomes between VR simulators and traditional phantom heads for veneer preparation, suggesting that VR technology may serve as a viable alternative or supplementary tool in dental education. However, the absence of significant differences does not imply equivalence, as formal equivalence testing was not performed. Future studies should incorporate equivalence testing and explore cost-effectiveness, long-term skill retention, and adaptability to complex clinical scenarios.