Scientometric Analysis of the World Scientific Production on Augmented and Virtual Reality in Dental Education

INTRODUCTION

The growing elderly population and economic development have underscored the importance of oral health. The high incidence and prevalence of dental issues have spurred the expansion of the global dental medical equipment market, which is projected to continue its growth trajectory.¹ In dentistry, augmented reality (AR) and virtual reality (VR) have emerged as promising technologies for enhancing dental care and treatment.²However, the low treatment rate among the elderly population remains a concern. In this scenario, AR and VR, as computer-based technologies, offer potential solutions to these challenges. These innovative technologies are poised to revolutionize dental care and improve outcomes.^2–4

Augmented reality integrates 3D virtual objects into real-world environments, allowing users to experience this utility. Virtual reality enables digital interaction by simulating patient participation in the dental office. These technological advances have the potential to transform the way treatments are delivered to address these needs.^5,6 The VR and AR are cutting-edge technologies that allow users to immerse themselves in three-dimensional, real-world environments displayed on the screens of electronic devices.⁷

Technological advances have made dental VR systems more portable, efficient, more responsive in a shorter time. This allows users to interact with more integrated virtual environments.^8–10 Virtual reality offers a wide range of systems, configurations, and content, from highly immersive interactive experiences to less immersive static experiences. Nonetheless, studies on this topic tend to be few, and heterogeneous. Therefore, it is still difficult to determine with certainty the advantages of VR over traditional approaches in medical education.^11,12 The use of these technologies offers important advantages, for example, it reduces the need for continuous monitoring and reduces the cost of training and medical staff. The experience is engaging, easy to use, increases participation, and creates a more comfortable environment.^13,14

The VR and AR can help to solve dental procedures for your patients using interactive methods. Therefore, there is a need to implement the use of VR and AR as they have the potential to revolutionize the field of dentistry, improving both the patient experience and treatment outcomes. The objective of this study was to conduct a comprehensive bibliometric analysis of VR and AR applications in dental education, identifying trends and topics explored and evaluating the available research.

MATERIALS AND METHODS

RESULTS

The table shows 10 institutions from different countries, along with their academic output, citations received, number of authors, citations per publication, and citation impact weighted by field. Beihang University stands out with 16 academic papers, followed by Stanford University with 16 papers and 170 citations, representing a high impact with 10.6 citations per publication. In contrast, Deakin University and the University of Zurich have less academic output, with 8 papers each and fewer citations. The University of South Africa and the National University of Singapore excel in terms of citation impact weighted by field. This table provides an overview of the academic performance and research relevance of these institutions (Table 1).

Table 1: Top 10 institutions with the highest scientific production on augmented and VR in dentistry

Institution	Country	Scholarly output	Citations	Authors	Citations per publication	Field-weighted citation impact
Beihang University		16	59	35	3.7	0.49
Stanford University		16	170	40	10.6	1.38
CNRS		12	35	43	2.9	0.92
Oklahoma State University		11	131	10	11.9	0.98
University of Florida		11	86	23	7.8	3.87
Deakin University		8	36	19	4.5	0.54
University of South Australia		8	324	13	40.5	4.39
National University of Singapore		8	348	19	43.5	3.77
KU Leuven		8	52	20	6.5	1.38
University of Zurich		8	108	19	13.5	1.74

It was found that the Q1 quartile has experienced a steady increase, reaching 87 scientific articles. While the Q4 quartile shows moderate growth, increasing only from 12 in 2018 to 38 in 2022. On the other hand, the Q2 quartile shows a paused growth, between 39 and 60 articles. These data provide insight into the performance and relevance of research on this topic (Table 2).

Table 3 shows an analysis of the main blind journals in this field of augmented and VR. The quartiles indicate the impact level of the publications. The journal “Virtual Reality” was in the Q1 quartile, which means that its publications had a high number of citations. However, some sources such as “ACM International Conference Proceeding Series” and “Proceedings of SPIE” did not yet have a quartile assigned to them.

The results show the top 10 authors in the scientific production on augmented and VR in dentistry, along with important metrics of their academic contributions. Among them are researchers such as Joe Amal Cecil, Avinash Gupta, and Miguel A Pirela-Cruz, who have produced a significant number of publications with citations ranging from 133 to 28. Some authors, such as Zhang Shusheng and Mark Billinghurst, have a particularly high FWCI, indicating that their research has been widely recognized and cited in the field. These scientists have made valuable contributions to advancing the knowledge and applications of these technologies in dentistry, and their work has been crucial to the progress of this area of research (Table 4).

Table 4: Top 10 most prominent authors in scientific production on augmented and VR in dentistry

Name	Country	Scholarly output	Citations	Citations per publication	Field-weighted citation impact	h-index
Cecil, Joe Amal		12	133	11.1	1.23	19
Gupta, Avinash		11	133	12.1	1.34	9
Pirela-Cruz, Miguel A		7	129	18.4	1.97	15
Zhang, Shusheng		6	128	21.3	3.57	21
Billinghurst, Mark		6	323	53.8	5.81	61
Bai, Xiangliang		6	128	21.3	3.57	17
He, Weiping		6	128	21.3	3.57	16
Chang, Yuchao		5	25	5	7.71	45
Vander Poorten, Emmanuel		5	28	5.6	0.69	22
Crespo, Laura Marchal		5	39	7.8	1.05	18

By analyzing the explored trends and themes of keyword co-occurrence, four main clusters were identified. The yellow cluster contained the largest amount of research with the keyword “virtual reality.” In addition, the blue cluster was found to be best related to the green “simulation,” purple “virtual reality (VR)” and light blue “human-centered computing” clusters (Fig. 1).

Fig. 1: Co-occurrence by keyword

In terms of co-authorship by country, the United States, Germany, and China are the most predominant in the clusters represented. However, other clusters also have a significant presence. This figure shows the collaboration between countries. On the other hand, the blue cluster was found to be interrelated with the red “India,” blue “Italy,” and orange “Canada” clusters. These findings suggest that the impact and influence of academic output are directly related and that other nations are also contributing significantly to the advancement of knowledge in their specialized fields. Furthermore, this study can see how the whole world, especially North America, Europe, and Asia, are collaborating with each other (Fig. 2).

Fig. 2: Co-authorship by country

The inference of this study constitutes an important milestone in the ongoing exploration of augmented and VR applications in dentistry. Because the study underscores the pivotal role of institutions such as Beihang University and Stanford University. In addition, the steady increase in first quartile scientific articles signifies a growing interest and recognition of high-impact research in this field. This trend is corroborated by the high number of citations to publications in the journal VR, indicating its prominence as a major source of impact research.

DISCUSSION

The VR and AR are innovative technologies that have found applications in a variety of disciplines, including dentistry. Because they offer different experiences for users, providing more interactive environments. In dentistry, these tools can significantly improve the diagnosis and treatment of various oral pathologies. They also allow future professionals to better integrate knowledge with greater confidence and safety when performing dental procedures, etc.^1,15

In addition, bibliometrics allows the use of quantitative methods to analyze the development of scientific publications as an information process.¹⁶ In this context, a scientometric analysis in the field of virtual and AR will provide insight into the impact and characteristics of research. This can help to make strategic decisions to improve research policy and funding, and facilitate collaboration between researchers.^17,18

Advances in technology have made dental VR systems more portable and efficient, providing greater responsiveness in less time. This allows users to interact with a more integrated virtual environment.⁸ Virtual reality offers a wide range of systems, configurations, and content, from highly immersive interactive experiences to less immersive static experiences. However, there tends to be little research on this topic, and a wide variety of studies. Therefore, it remains difficult to determine with certainty the advantages of VR over traditional approaches in medical education.^11,12

The use of these technologies provides important benefits, such as a reduced need for continuous monitoring, reduced training, and reduced medical staffing requirements. The experience is engaging, easy to use, increases engagement, and creates a more welcoming environment.^13,14 Virtual reality has been shown to be an effective tool to improve skills in diagnostic and surgical procedures, including reducing errors and procedure times in novice hospital residents performing laparoscopy.¹⁹ In addition, it has been used to assess suturing skills in different groups of operators, which could improve the quality and accuracy of surgical procedures. These findings suggest that VR and simulation could play a key role in the training and education of dental professionals, as well as in surgical planning and image guidance, which could improve the accuracy and safety of dental procedures.²⁰

Another relevant aspect is the application of VR in the field of dentistry. The use of VR tasks to assess and train episodic memory in elderly people has been explored, which could contribute to improve their quality of life and autonomy.²¹ However, despite the promising results, it highlights the need for further research to optimize the implementation of VR in dentistry and to evaluate its beneficial effects in different population groups. The diversity of existing studies means that there are still questions to be answered and variables to be considered. Further studies will allow the establishment of solid recommendations on the use of VR in cognitive rehabilitation. Virtual reality is making an impact in the health sciences because it provides a platform to simulate procedures and techniques in a controlled environment. This situation not only improves accuracy but also minimizes the reproducibility of practices making them safer and more effective. For this reason, VR is being used for training and education in healthcare. In the dental field, for example, dentists can use this technology to plan complex surgical procedures and predict the results, so that the patient can have more information about the procedures to be performed.^7–12

One limitation of the study is that not all the world’s scientific production on augmented and VR in dentistry was evaluated. There are many databases in different languages that were not used. However, the literature on the subject for the last 20 years was evaluated in Scopus, one of the main, most prestigious, and complete databases in the world.

CONCLUSION

In conclusion, the analysis of academic output from various institutions reveals a significant contribution to the field of augmented and VR in dentistry. Beihang University and Stanford University lead in terms of academic papers. The steady increase in Q1 quartile scientific articles indicates a growing interest and relevance in this research area. Prominent researchers such as Joe Amal Cecil, Avinash Gupta, and Miguel A Pirela-Cruz have made significant contributions to this field. The co-occurrence of keywords and co-authorship trends by country further highlight the collaborative nature of this research field, with notable contributions from the United States, Germany, China, India, Italy, and Canada.

REFERENCES

1. Huang TK, Yang CH, Hsieh YH, et al. Augmented reality (AR) and virtual reality (VR) applied in dentistry. Kaohsiung J Med Sci 2018;34(4):243–248. DOI: 10.1016/j.kjms.2018.01.009.

2. Vávra P, Roman J, Zonča P, et al. Recent development of augmented reality in surgery: A review. J Healthc Eng 2017;2017:4574172. DOI: 10.1155/2017/4574172.

3. Tiu J, Cheng E, Hung TC, et al. Effectiveness of crown preparation assessment software as an educational tool in simulation clinic: A pilot study. J Dent Educ 2016;80(8):1004–10011. PMID: 27480712.

4. Yeung AWK, Tosevska A, Klager E, et al. Virtual and augmented reality applications in medicine: Analysis of the scientific literature. J Med Internet Res 2021;23(2):e25499. DOI: 10.2196/25499.

5. Cipresso P, Giglioli IAC, Raya MA, et al. The past, present, and future of virtual and augmented reality research: A network and cluster analysis of the literature. Front Psychol 2018;9:2086. DOI: 10.3389/fpsyg.2018.02086.

6. Laver KE, Lange B, George S, et al. Virtual reality for stroke rehabilitation. Cochrane Database Syst Rev 2017;11(11):CD008349. DOI: 10.1002/14651858.CD008349.pub4.

7. Samadbeik M, Yaaghobi D, Bastani P, et al. The applications of virtual reality technology in medical groups teaching. J Adv Med Educ Prof 2018;6(3):123–129. PMID: 30013996.

8. Fiani B, De Stefano F, Kondilis A, et al. Virtual reality in neurosurgery: “Can You See It?” – A review of the current applications and future potential. World Neurosurg 2020;141:291–298. DOI: 10.1016/j.wneu.2020.06.066.

9. Spiegel BM. Virtual medicine: How virtual reality is easing pain, calming nerves and improving health. Med J Aust 2018;209(6):245–247. DOI: 10.5694/mja17.00540.

10. Gupta A, Scott K, Dukewich M. Innovative technology using virtual reality in the treatment of pain: Does it reduce pain via distraction, or is there more to it? Pain Med 2018;19(1):151–159. DOI: 10.1093/pm/pnx109.

11. Pourmand A, Davis S, Marchak A, et al. Virtual reality as a clinical tool for pain management. Curr Pain Headache Rep 2018;22(8):53. DOI: 10.1007/s11916-018-0708-2.

12. Maggio MG, Latella D, Maresca G, et al. Virtual reality and cognitive rehabilitation in people with stroke: An overview. J Neurosci Nurs 2019;51(2):101–105. DOI: 10.1097/JNN.0000000000000423.

13. Tieri G, Morone G, Paolucci S, et al. Virtual reality in cognitive and motor rehabilitation: Facts, fiction and fallacies. Expert Rev Med Devices 2018;15(2):107–117. DOI: 10.1080/17434440.2018.1425613.

14. Yeung AWK, Tzvetkov NT, Jóźwik A, et al. Food toxicology: Quantitative analysis of the research field literature. Int J Food Sci Nutr 2020;71(1):13–21. DOI: 10.1080/09637486.2019.1620184.

15. Tran BX, Vu GT, Ha GH, et al. Global evolution of research in artificial intelligence in health and medicine: A bibliometric study. J Clin Med 2019;8(3):360–378. DOI: 10.3390/jcm8030360.

16. Falconer CJ, Rovira A, King JA, et al. Embodying self-compassion within virtual reality and its effects on patients with depression. BJPsych Open 2016;2(1):74–80. DOI: 10.1192/bjpo.bp.115.002147.

17. Freeman D, Haselton P, Freeman J, et al. Automated psychological therapy using immersive virtual reality for treatment of fear of heights: A single-blind, parallel-group, randomised controlled trial. Lancet Psychiatry 2018;5(8):625–632. DOI: 10.1016/S2215-0366(18)30226-8.

18. Cicerone KD, Goldin Y, Ganci K, et al. Evidence-based cognitive rehabilitation: Systematic review of the literature from 2009 through 2014. Arch Phys Med Rehabil 2019;100(8):1515–1533. DOI: 10.1016/j.apmr.2019.02.011.

19. Mirelman A, Rochester L, Maidan I, et al. Addition of a non-immersive virtual reality component to treadmill training to reduce fall risk in older adults (V-TIME): A randomised controlled trial. Lancet 2016;388(10050):1170–1182. DOI: 10.1016/S0140-6736(16)31325-3.

20. van der Kolk NM, de Vries NM, Kessels RPC, et al. Effectiveness of home-based and remotely supervised aerobic exercise in Parkinson’s disease: A double-blind, randomised controlled trial. Lancet Neurol 2019;18(11):998–1008. DOI: 10.1016/S1474-4422(19)30285-6.

21. Wang S, Xu J, Wang W, et al. Skin electronics from scalable fabrication of an intrinsically stretchable transistor array. Nature 2018;555(7694):83–88. DOI: 10.1038/nature25494.